Grant: Project Grant

In Canada more than 4.6 million people live with osteoarthritis, which is expected to grow to 10 million in 30 years. Direct costs for osteoarthritis in Canada are 1.4 billion/year. Severe osteoarthritis in the hip and knee is often managed by joint replacement surgery to improve function, quality of life and pain control. In Saskatchewan, wait lists for replacements are second and third longest in the country. Rehabilitation such as physiotherapy is very important to improve surgical outcomes and function, but in rural and remote areas this isn't always available. Nearly 36% of Saskatchewan residents live in rural and remote areas and face barriers to accessing healthcare such as physiotherapy due to geography, practitioner availability, wait times and travel requirements. First Nation and Métis Peoples make up 17% of the Saskatchewan population and 85% of the Northern Saskatchewan population. They experience health inequities including higher rates of osteoarthritis compared to non-Indigenous Canadians. They have unique historical, psychosocial, cultural, and environmental influences that impact health conditions. As a result of colonization and systemic racism, health services are often not culturally responsive or safe, and have not been developed in partnership with First Nation and Métis Peoples. This project will use a community-based participatory action approach. Ethical Space principles (envisioned by Cree scholar Willie Ermine), the Federation of Sovereign Indigenous Nations' Cultural Responsiveness Framework and teachings of wahkotohwin (Cree)/ wahkootowin (Michif) will guide the work. A First Nation and Métis Patient Advisory Committee who has worked with this team for the past year will work with researchers to co-develop and evaluate a virtual and hybrid process for pre and post surgical hip and knee replacement rehabilitation, and identify health policy, sovereignty and sustainability recommendations for this innovative model of care.