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Rationale and Implementation of the SLICK Project

Screening for Limb, I-Eye, Cardiovascular and Kidney (SLICK) Complications in Individuals with Type 2 Diabetes in Alberta’s First Nations Communities

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Abstract

Objective: Identifying diabetes complications through screening using portable laboratory equipment in Aboriginal communities, and providing education and client empowerment for improved follow-up care and self-care.

Participants: First Nations people with known diabetes.

Setting: Screening was carried out in temporary clinics and laboratories set up at the local health centre in each of Alberta’s 44 First Nations.

Intervention: Two mobile units (“SLICK vans”), equipped with professionally trained staff, portable lab instruments and a retinal camera, travelled to all 44 Alberta First Nations communities to facilitate implementation of the Canadian Diabetes Association Clinical Practice Guidelines (CPGs). The project provided relevant education and counselling in conjunction with screening activities.

Outcomes: SLICK screened 1,151 clients between December 2001 and July 2003, and the project remains ongoing. A preliminary evaluation of the project’s 19-month implementation period showed screening activities and satisfaction with diabetes services were low prior to SLICK. There were modest improvements in some program outcomes at 6–12 months follow-up.

Conclusion: The SLICK project is designed to address the impact of diabetes by utilizing evidence-based CPGs with respect to screening for complications at the community level. It had a successful implementation period facilitated by community acceptance.

Résumé

Objectif: Cerner les complications du diabète dans les communautés autochtones en procédant à un dépistage dans des laboratoires mobiles, sensibiliser la clientèle, et renforcer son autonomie afin d’améliorer le suivi et les autosoins.

Participants: Les membres des Premières nations ayant reçu un diagnostique de diabète.

Lieu: Le dépistage s’est effectué dans des cliniques et des laboratoires temporaires mis sur pied dans le centre sanitaire local de chacune des 44 Premières nations de l’Alberta.

Intervention: Deux unités mobiles (les «minibus SLICK»), dotés d’un personnel qualifié, d’appareils de laboratoire portatifs et d’un rétinographe, se sont rendues dans les 44 communautés des Premières nations de l’Alberta pour faciliter la mise en oeuvre des lignes directrices de pratique clinique (LDPC) de l’Association canadienne du diabète. On a aussi offert des activités de sensibilisation et de counselling pour accompagner les activités de dépistage.

Résultats: Le projet SLICK a administré des tests de dépistage à 1 151 personnes entre décembre 2001 et juillet 2003, et ces activités se poursuivent. Une évaluation préliminaire des 19 premiers mois de mise en oeuvre a montré que les activités de dépistage et la satisfaction par rapport aux services offerts aux diabétiques étaient faibles avant le projet. Lors du suivi entre 6 et 12 mois, on a constaté de légères améliorations de certains résultats.

Conclusion: Le projet SLICK vise à atténuer l’impact du diabète en utilisant des LDPC fondées sur la recherche pour dépister les complications à l’échelle communautaire. La mise en oeuvre réussie du projet a été facilitée par son acceptation dans les communautés.

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Author information

Authors and Affiliations

  1. Alberta Health and Wellness, Edmonton, AB, Canada

    Shainoor Virani MD, FRCPC & David Strong MD, FRCPC

  2. Department of Ophthalmology, University of Alberta, Edmonton, AB, Canada

    Matthew Tennant MD, FRCPC & Mark Greve MD, FRCPC

  3. First Nations and Inuit Health Branch (FNIHB), Canada

    Heather Young BSc, MScN & Sandra Shade BN

  4. Concordia University, Montreal, QC, Canada

    Mebs Kanji PhD

  5. Department of Medicine, University of Alberta, Canada

    Ellen Toth MD, FRCPC (Professor)

Authors
  1. Shainoor Virani MD, FRCPC
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  2. David Strong MD, FRCPC
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  3. Matthew Tennant MD, FRCPC
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  4. Mark Greve MD, FRCPC
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  5. Heather Young BSc, MScN
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  6. Sandra Shade BN
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  8. Ellen Toth MD, FRCPC
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Implementation Committee of the Aboriginal Diabetes Initiative

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Correspondence to Ellen Toth MD, FRCPC.

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(Previously Department of Community Medicine, University of Calgary)

(Previously First Nations and Inuit Health Branch (FNIHB), Health Canada)

Sources of funding: Initial funding from Canadian Health Infostructure Partnership Program (CHIPP), Office of the Information Highway, Health Canada. Ongoing funding through Health Canada (FNIHB) and the University of Alberta.

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Virani, S., Strong, D., Tennant, M. et al. Rationale and Implementation of the SLICK Project. Can J Public Health 97, 241–247 (2006). https://doi.org/10.1007/BF03405595

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