(DCP049) IMPLEMENTATION OF THE ALBERTA KIDNEY HEALTH CHECK PROTOCOL THROUGH CO-DESIGN WITH INDIGENOUS COMMUNITIES

Background: Kidney Health Check (KHC) is a program targeted to prevention of kidney disease and related risk factors in underserved, rural and remote Indigenous communities of Canada. In Alberta, KHC partnered with the Alberta Health Services Diabetes, Obesity and Nutrition Strategic Clinical Network (DON SCN) to leverage the Creating Harmony in Care (CHiC) framework; an approach to integrate western care with culturally appropriate Indigenous practices. CHiC considers 4 key aspects, the person, the community, the care required and the system. Utilizing the CHiC framework, the DON SCN facilitated engagement sessions with KHC researchers and Indigenous community members to co-design an Alberta Indigenous community protocol for KHC to facilitate adoption and sustainability of the program.

METHODS AND RESULTS: Interactive sessions with community members, Elders, community health care professionals (HCP), a graphic recorder and research team led the development of a community driven wellness bundle(s) aimed at engaging the individual in their wellness and awareness on chronic disease prevention. An iterative process of sharing and combining cultural, medical and lifestyle wellness models was used to engage the person in their individual wellness plan.
A point-of-care testing process was leveraged for early identification of kidney disease or risk factors, and results used to stratify individuals based on risk (high risk, moderate risk, and no/low risk), and linkage provided to an appropriate care plan. A Registered Nurse (RN) facilitated capacity building in the participating communities by training the HCP on testing, results validation, quality assurance and risk stratification of screened individuals. Evaluation of the training day with 13 HCP working in two Indigenous communities indicated their knowledge, overall satisfaction, and confidence to implement the program increased for all participants throughout the one-day session.

Conclusion: Leveraging the CHiC framework to guide purposeful engagement with Elders and community members including HCP in Indigenous communities demonstrates the feasibility of early kidney disease identification and prevention program, owned, and led by the communities themselves. Further work is ongoing on the large-scale uptake across the province.