Community governance of the Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Mohawk Nation, Canada

Health Promot Int. 2003 Sep;18(3):177-87. doi: 10.1093/heapro/dag013.

Abstract

Health promotion emphasizes the importance of community ownership in the governance of community-based programmes, yet little research has been conducted in this area. This study examined perceptions of community ownership among project partners taking responsibility for decision-making related to the Kahnawake Schools Diabetes Prevention Project (KSDPP). Project partners were surveyed cross-sectionally at 18 months (T1) and 60 months (T2) into the project. The perceived influence of each project partner was assessed at T1 and T2 for three domains: (i) KSDPP activities; (ii) KSDPP operations; and (iii) Community Advisory Board (CAB) activities. Project staff were perceived to have the greatest influence on KSDPP activities, KSDPP operations and CAB activities at both T1 and T2. High mean scores of perceived influence for CAB members and community researchers, however, suggests that project decision-making was a shared responsibility among multiple community partners. Although academic researcher influence was consistently low, they were satisfied with their level of influence. This was unlike community affiliates, who were less satisfied with their lower level of influence. In keeping with Kanien'kehaka (Mohawk) culture, the findings suggest a participatory democracy or shared decision-making as the primary mode of governance of KSDPP.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advisory Committees
  • Canada
  • Community Health Planning / organization & administration
  • Community Health Services / organization & administration*
  • Community Participation
  • Cooperative Behavior
  • Decision Making
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diet
  • Exercise
  • Female
  • Health Promotion / organization & administration*
  • Health Services, Indigenous / organization & administration*
  • Humans
  • Indians, North American*
  • Male
  • Middle Aged
  • School Health Services / organization & administration
  • Surveys and Questionnaires