Abstract
ObjectivesLaunched in 2011 by the Public Health Agency of Canada, the Canadian Diabetes Risk Questionnaire (CANRISK) is a self-assessment tool validated in a Canadian sample, but its uptake has never been assessed. We sought to determine the level of current use of the CANRISK tool, identify common facilitators and barriers to its use and recommend future improvements. MethodsTen professional allied health organizations across Canada were contacted for in-depth interviews. Contextual content and thematic analysis were used to analyze the qualitative data set. ResultsAccording to allied health professionals, the tool is widely used, appealing and needed, and is being used for risk screening and health promotion. Respondents also identified the need to provide support and next steps for users identified as high risk. Still, several barriers to implementation were found, including readability, offensive or confusing language and difficulty ascertaining body measurements. ConclusionsThe CANRISK is a valuable diabetes risk assessment tool in Canada, particularly for allied health organizations.
Highlights
In the last 40 years, the prevalence of prediabetes and type 2 diabetes has been increasing worldwide, with the greatest rise seen in high-income population subregions in North America [1]
Public health efforts include prevention and early detection so that proper management can be initiated before progression to diabetes or onset of associated comorbidities [14]
We used a convenience sample of 10 allied health organizations selected to cover a prespecified set of characteristics: 3 original pilot organizations; 1 organization that was exposed to the Canadian Diabetes Risk Questionnaire (CANRISK) but did not use the tool; 2 Francophone organizations, 1 from Québec and 1 from elsewhere in Canada; 1 organization that primarily reaches Indigenous peoples; 1 organization from the northern region of the country; 1 rural organization; and 1 organization from a large urban area
Summary
In the last 40 years, the prevalence of prediabetes and type 2 diabetes has been increasing worldwide, with the greatest rise seen in high-income population subregions in North America [1]. Within Canada, the most recent data estimate the prevalence of prediabetes at 15% in 2011 [2] and diabetes at 9% in 2016 [3] This represents a major increase beyond initial projections, yet rising trends are expected to continue [4] and have been increasing at a faster rate than expected among both adults and children (5e7). Risk factors for diabetes include lifestyle behaviours such as diet [11], weight status [5] and physical activity [12], as well as nonmodifiable factors such as age, family history of diabetes [5] and ethnicity [13] Given their increasing prevalence, diabetes prevention and prediabetes reversal through behaviour change have become high-priority issues. Invasive blood glucose tests are often costly and impractical for population-level screening [15]
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