Impact of a screen, triage and treat program for identifying chronic disease risk in Indigenous children.
Adolescent
Child
Child Health Services
/ organization & administration
Child Welfare
/ statistics & numerical data
Child, Preschool
Chronic Disease
/ epidemiology
Female
Health Services, Indigenous
/ organization & administration
Humans
Infant
Infant, Newborn
Male
Preventive Health Services
/ organization & administration
Primary Health Care
Prospective Studies
Journal
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
ISSN: 1488-2329
Titre abrégé: CMAJ
Pays: Canada
ID NLM: 9711805
Informations de publication
Date de publication:
13 09 2021
13 09 2021
Historique:
accepted:
15
06
2021
entrez:
14
9
2021
pubmed:
15
9
2021
medline:
6
1
2022
Statut:
ppublish
Résumé
The First Nations Community Based Screening to Improve Kidney Health and Prevent Dialysis project was a point-of-care screening program in rural and remote First Nations communities in Manitoba that aimed to identify and treat hypertension, diabetes and chronic kidney disease. The program identified chronic disease in 20% of children screened. We aimed to characterize clinical screening practices before and after intervention in children aged 10-17 years old and compare outcomes with those who did not receive the intervention. This observational, prospective cohort study started with community engagement and followed the principles of ownership, control, access and possession (OCAP). We linked participant data to administrative data at the Manitoba Centre for Health Policy to assess rates of primary care and nephrology visits, disease-modifying medication prescriptions and laboratory testing (i.e., glycosylated hemoglobin [HbA We included 324 of 353 children from the screening program (43.8% male; median age 12.3 yr) in this study. After the intervention, laboratory testing increased by 5.8% (95% confidence interval [CI] 1.1% to 10.1%) for HbA Chronic disease surveillance and care increased significantly in children after the implementation of a point-of-care screening program in rural and remote First Nation communities. Interventions such as active surveillance programs have the potential to improve the chronic disease care being provided to First Nations children.
Sections du résumé
BACKGROUND
The First Nations Community Based Screening to Improve Kidney Health and Prevent Dialysis project was a point-of-care screening program in rural and remote First Nations communities in Manitoba that aimed to identify and treat hypertension, diabetes and chronic kidney disease. The program identified chronic disease in 20% of children screened. We aimed to characterize clinical screening practices before and after intervention in children aged 10-17 years old and compare outcomes with those who did not receive the intervention.
METHODS
This observational, prospective cohort study started with community engagement and followed the principles of ownership, control, access and possession (OCAP). We linked participant data to administrative data at the Manitoba Centre for Health Policy to assess rates of primary care and nephrology visits, disease-modifying medication prescriptions and laboratory testing (i.e., glycosylated hemoglobin [HbA
RESULTS
We included 324 of 353 children from the screening program (43.8% male; median age 12.3 yr) in this study. After the intervention, laboratory testing increased by 5.8% (95% confidence interval [CI] 1.1% to 10.1%) for HbA
INTERPRETATION
Chronic disease surveillance and care increased significantly in children after the implementation of a point-of-care screening program in rural and remote First Nation communities. Interventions such as active surveillance programs have the potential to improve the chronic disease care being provided to First Nations children.
Identifiants
pubmed: 34518342
pii: 193/36/E1415
doi: 10.1503/cmaj.210507
pmc: PMC8443280
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
E1415-E1422Informations de copyright
© 2021 CMA Joule Inc. or its licensors.
Déclaration de conflit d'intérêts
Competing interests: Paul Komenda reports support from the Canadian Institutes of Health Research, outside the submitted work. Allison Dart reports funding from the Canadian Institutes of Health Research, the Children’s Hospital Research Institute of Manitoba and Research Manitoba, outside the submitted work. No other competing interests were declared.
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