Aboriginal Stroke Strategy hailed as success

The sudden onset of vision problems, numbness on one side of the body, difficulty speaking, dizziness and headache, as we all know, are signs of a stroke requiring urgent medical care in a fully-equipped emergency department within a four and a half hour window.

That's fine if you live within a short ambulance ride of Thunder Bay Regional Health Sciences Centre, but if you are a patient from a fly-in First Nation community like Sandy Lake, 600 kilometres northwest of Thunder Bay, your chances of arriving at an emergency department within the prescribed time period are pretty slim.

It helps, of course, if family members or friends recognize the symptoms and take immediate action, but it's even better if members of the community understand the risk factors that lead to stroke and take steps to mitigate them.

This is exactly the mission of the Northwestern Ontario Regional Stroke Network's Aboriginal Stroke Strategy.

The Regional Stroke Network began focusing on stroke education for First Nation communities in 2006 when "we looked at the risk factors for stroke and the population we serve," said Pauline Bodnar, community and long-term care specialist with the Northwestern Ontario Regional Stroke Network. "It was very obvious that we had a population with a prevalence of risk factors that we should be serving."

According to Bodnar, the prevalence of heart disease is 1.5 times higher in the Aboriginal population.


DVD

The regional stroke network applied for and received a grant from the Heart and Stroke Foundation for an education project targeting the northwest's Aboriginal population, held a focus group with representatives of 15 First Nation communities and produced a DVD called Heartbeat of the Anishnawbe Nation focusing on risk factors relating to stroke.
The DVD, produced in Ojibway and dubbed into English and Oji-Cree, follows a First Nation woman through the Anishnawbe Mushki Aboriginal Health Access Centre as she learns about the relationship between high blood pressure and stroke, and how tobacco, alcohol, diet and exercise impact on her health.

In the fall of 2008, the Regional Stroke Network followed up by establishing an Aboriginal Advisory Group. This, in turn, led to the production of a second DVD called As the Rivers Flow that focuses on the signs and symptoms of stroke and the importance of seeking immediate medical attention.

As the Rivers Flow was made possible by funding from the Ontario Stroke System and Lakehead University's Centre for Rural and Northern Health Research, and uses talking circles of elders and youth, story telling and animation to educate the members of First Nation communities. The DVDs were widely distributed to chiefs and councils, health directors, home and community care co-ordinators, schools and other Aboriginal health-care organizations throughout the region.


Tele-Rehab

St. Joseph's Care Group, KO Telemedicine and the Ontario Telemedicine Network have filled another gap by rolling out a Tele-Rehab pilot project that provides stroke survivors in remote communities with rehabilitation consultations using videoconferencing technology. Personal support workers in 31 communities received hands-on rehabilitation training and are able to work with physical and occupational therapists at St. Joseph's Care Group using hand-held cameras in the homes of stroke survivors.

The Regional Stroke Network's most recent initiative is a project targeting First Nation youth.

"The message we heard from the members of our advisory council was ‘Teach our children,' so that's what we're doing," said Diane Hiscox, Northwestern Ontario Regional Stroke Network co-ordinator. "We are developing a multi-media education tool targeting children between the ages of 10 and 13 because that's a good age group to influence. It's important because if a child knows about stroke symptoms and sees grandma in distress, the child knows what to do."

Measuring the effectiveness of all of these programs is difficult, said Hiscox, but they are definitely creating a greater awareness of stroke in First Nation communities.

The Regional Stroke Network's Aboriginal Stroke Strategy was one of several northwestern Ontario health care initiatives showcased at the Ministry of Health and Long-Term Care's Celebrating Innovations in Health Care Expo in Toronto in November.


www.tbrhsc.net/nwostroke