Module 1 Case Study

MODULE 1

CASE STUDY – THE BENEFITS OF EXERCISE TO PREVENT TYPE 2 DIABETES AMONG ABORIGINAL WOMEN

                This case study, described as a “means and an end” was to determine the effectiveness of an exercise program for  pregnant Aboriginal women in a Canadian city that were at risk for type two diabetes after having gestational diabetes (GDM).  I think that the best model to use for a program evaluation for this program would be a Goals Based Evaluation.

                The premise of the Goals Based Evaluation is that it can effectively determine if the program has met predetermined goals or objectives, in this case, whether an exercise program among this population would lower the instances of type two diabetes.  The program goals were established as a result of an increase of type two diabetes among the Aboriginal population in Saskatoon.  Program goals were established through a background and pre-natal history of the participants.  In the time period between 1995 and 1997, there were 114 inquiries about this exercise program with 69 participants.  It was determined through the use of a survey given to Aboriginal women in the city that were not only living with type two diabetes, but also those who were not experiencing the disease as a result of their pregnancy or lifestyle.  One of the strengths of this program was that the parameters around who could participate in this free program were broadened because there were already personnel in place for the originally determined population.

                The goals of this program were achieved according to the timeline suggested because after the year, including pre-natal and post natal care, there was follow up provided at the YMCA for mother and child.  The entire program was NHR funded after a feasibility study was conducted.  The study determined that the Aboriginal population was more susceptible to type two diabetes and gestational diabetes and that exercise was a key factor in reducing this risk.  Another strength of this program was that an Aboriginal Project Facilitator and an Elder were hired to manage the program.  The program itself was conducted by a trained fitness instructor as well as an RN and physiotherapist.  The program was provided free to the participants with child care, bus ticket, nutritious snack, weekly door prizes, and educational material provided.  That was another key strength.

                This program could be effectively evaluated with a Goals Based approach because it was designed to address the needs of a particular population (pregnant Aboriginal women) for a certain time period (second trimester of pregnancy through to post natal) and with an intended outcome (to reduce the number of Aboriginal women with type two diabetes) with a structured activity (exercise).  The program had start-up  and long term costs including salaries for the Program Facilitator, RN, fitness trainer and physiotherapist and probably a cost for the rental of the facility as well as the snacks, childcare, bus tickets, and educational material.  The fact that the program itself was free of charge is a benefit to the participants.

                Some of the questions I have after reading about the program:  was the program educational in nature or lifestyle and health cost based?  Was there adequate time and resources placed on informing younger Aboriginal populations (i.e. school age girls) about the potential health risks of diet, lifestyle, and glucose intolerance among the population?