Grant: Operating Grant: Population Health Intervention Research

The disparity in TB rates in Aboriginal peoples as compared to Canadian-born "others" resulted in the release, in June 2010, of a highly publicized report of the Standing Committee on Health of the House of Commons; "The Way Forward: Addressing the elevated rates of tuberculosis infection in on-reserve First Nations and Inuit communities". It was followed in March 2012, by the release from Health Canada of a Strategy against Tuberculosis for First Nations on Reserve, hereafter referred to as "The 2012 Strategy". This strategy is meant to evolve to meet the heterogeneous and changing demands of vulnerable reserve communities across Canada. Research, the collection of surveillance data and the engagement of First Nations communities are promoted in The 2012 Strategy. However, the strategy itself has no research arm, no start-up data and no explicit recommendations about how to engage First Nations communities. Both the development and implementation of The 2012 Strategy have the potential to impact health and health equity at the population level. For the purpose of this initiative The 2012 Strategy and the remarkable demographic and geographic disparity of TB on the Prairies constitute a natural experiment. Successful implementation of the 2012 Strategy on the Prairies will require evidence in combination with stakeholder support. As such, we propose to use the databanks and organizational resources of The Determinants of TB Transmission in the Canadian-born Population of the Prairie Provinces (DTT) project, a mixed-method, prairie-wide CIHR and Health Canada funded project scheduled to end March 31st, 2013.