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 per year. Severe osteoarthritis in the hip and knee is often managed by joint replacement surgery for improve function, quality of life and pain control. In Saskatchewan, wait lists are very long - second and third longest in the country for hip and knee replacements. Getting rehabilitation such as physiotherapy is very important to improve surgical outcomes and function after surgery, but in rural and remote areas, this isn't always available. Nearly 36% of Saskatchewan residents live in rural and remote areas and they face barriers to accessing healthcare such as physiotherapy for rehabilitation due to geography, availability of practitioners, wait times and travel requirements. First Nation and Métis Peoples in Saskatchewan make up 17% of the total population and 85% of the Northern Saskatchewan population. They experience health inequities including higher rates of osteoarthritis when 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 communities and health governance structures. This project will use a community based participatory action approach, Ethical Space principles recommended by Cree scholar Willie Ermine, and the Cultural Responsiveness Framework developed by the Federation of Sovereign Indigenous Nations in Saskatchewan in 2013. Researchers, First Nation and Métis patients will work together to determine needs and preferences for hip and knee replacement rehabilitation, and co-develop and evaluate a hybrid (virtual and in-person) model of care to enhance access to physiotherapy services.