Walking Together: Advancing Culturally Grounded Diabetes Care in Indigenous Communities.

Abstract

Diabetes disproportionately affects Indigenous populations in Canada, reflecting the enduring impacts of colonialism, structural inequities, and systemic barriers within healthcare. The "Walking Together in the Same Direction" project developed a community-driven, culturally rooted diabetes prevention framework with ten First Nations communities across South Vancouver Island, British Columbia. Through circle discussions, communities did not simply share experiences-they co-created a 13 Moons framework grounded in Indigenous ways of knowing. This cyclical model reflects a holistic understanding of health across physical, emotional, mental, and spiritual domains, aligned with seasonal teachings and community life. It represents a critical shift from adapting Western models toward centring Indigenous knowledge as the foundation of care, demonstrating community-led design, self-determination beyond consultation, and tangible Indigenous-led outcomes. This work highlights the importance of moving from linear, biomedical approaches toward relational, culturally grounded models that privilege trust, continuity, and holistic wellness.