Travelling diabetes program popular in rural Alberta

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The Travelling Diabetes Resource Program, known as TDRP, is unique to Alberta and probably to all of Canada. Begun as a pilot project in 1997 by the Canadian Diabetes Association, Alberta and Northwest Territories Division, the aims of the program are to educate people on how to manage their diabetes and to link them up with local health professionals and diabetes support groups.

TDRP visits rural communities where people may not have access to much diabetes prevention and treatment information. CDA tries to take the program to all reserves and Metis settlements that request their services, since the incidence of diabetes is two to three times greater among Aboriginal people than in the general population. The resources of TDRP usually complement the work of nurses who are familiar with the needs of their communities, but who may have limited time to devote exclusively to diabetes.

Tracey Grey is a registered dietitian from Saskatchewan who took over as TDRP program co-ordinator in February. She works out of CDA's Edmonton office, but two and one-half weeks a month she's on the road in a 1998 van that was donated to her program by the Lions Club. April and May were typical, busy months.

For instance, April 12 to 15, Grey visited the Alberta Metis settlements of Gift Lake, Peavine and East Prairie, all in the Keeweetinok Lakes Regional Health Authority's jurisdiction. Representatives of the Aboriginal Diabetes Wellness Program, administered under the Aboriginal Health Services branch of Capital Health, accompanied Grey, who usually travels solo. Nurse Kathleen Cardinal, program co-ordinator at the Wellness Centre, dietitian Vanessa Nardelli and Elder Madge McCree all participated in the one-day workshops. A separate workshop was put on for the health professionals.

"It was the first time the two associations had worked together, and it was a great success," said Cheryl Brace-Beaudry, a registered nurse from High Prairie who helped co-ordinate the presentations.

"It was great being able to partner up with CDA," Nardelli agreed.

Among the reasons Brace-Beaudry cited for bringing the TDRP to their region was that distance and expense prevents many people from going to the cities for diabetes education. Sometimes it is too hard for elderly people to make the trip. She said their clients were enthusiastic that the presenters included Aboriginal people and they were happy to meet the Elder.

At least 60 people attended. Grey says one thing that made this trip so successful is that the three settlements identified a need for diabetes education and made the initial request for workshops themselves. Brace-Beaudry credits Thelma Gauchier of Peavine, Joan Haggerty of East Prairie and Corrine Goulet of Gift Lake with facilitating arrangements for their respective communities.

May 3 to May 6, Grey visited Peace River, Manning and the Metis settlement at Cadotte Lake. On the last day, she spent the morning at Dicksonville School near Peace River and later in the day held an adult clinic at the River Drive Mall. The TDRP is popular in their region, according to diabetes educator Lois Raymond, who sees 40 to 50 diabetic clients monthly at Peace River Hospital.

"Clients with diabetes are eager for that cure," Raymond said, adding that being 350 miles from the city, people appreciate getting the latest diabetes information brought to them first-hand. She was very enthusiastic about the services Grey could provide in the North.

Brace-Beaudry and Raymond said co-operation between CDA and the Aboriginal Diabetes Wellness Program makes sense, in terms of saving money, sharing expertise, and bringing a cultural component into the workshops.

"I thought that's the way we should be operating," Brace-Beaudry said. "We'll definitely access TDRP again."

Grey says most of the questions she gets are about diet, which presents more challenges in the North where choices may be fewer and costs are higher. She adds that visual aids to her presentaions, such as fake food in correct portion sizes, posters and videos are in high demand.

"Once you show people how much fat is in Kentucky Fried Chicken, it hits home," said Grey, who is optimistic that many people will adjust their dietary and exercise habits once they understand how this affects their diabetes control.

Grey also gets asked about current diabetes research developments and the latest diagnosis and management practices and guidelines.

"In a typical month," said Grey, "I might bring kids diabetes awareness, either to an elementary or high school, or I might attend a health fair or seniors' fair and go over complications, signs and symptoms, diet and exercise, management (and) the benefits of blood glucose monitoring." She added that prevention is an issue she is often asked to address, particularly with Type II diabetes. Most children have Type I, but recently, Aboriginal children are being seen with Type II, which is associated with obesity, lack of exercise and poor diet. So Grey is emphasizing diabetes prevention more when she meets with Aboriginal youth.

"I look at myself as more of a diabetes educator (than simply a dietitian)," Grey said. She also serves as a resource person to diabetes support groups, provides or directs people to written information that will help them, and puts up posters and displays.