BACKGROUND: Aboriginal @entity1 globally, and First Nations @entity1 in Canada particularly, suffer from high rates of type 2 @entity6 and related complications compared with the general population. Research into the unique barriers faced by healthcare providers working in on-reserve First Nations communities is essential for developing effective quality improvement strategies. METHODS: In Phase I of this two-phased study, semi-structured interviews and focus groups were held with 24 healthcare providers in the Sioux Lookout Zone in north-western Ontario. A follow-up survey was conducted in Phase II as part of a larger project, the Canadian First Nations @entity6 Clinical Management and Epidemiologic (CIRCLE) study. The survey was completed with 244 healthcare providers in 19 First Nations communities in 7 Canadian provinces, representing three isolation levels (isolated, semi-isolated, non-isolated). Interviews, focus groups and survey questions all related to barriers to providing optimal @entity6 care in First Nations communities. RESULTS: the key factors emerging from interviews and focus group discussions were at the @entity1 , provider, and systemic level. Survey results indicated that, across three isolation levels, healthcare providers' perceived @entity1 factors as having the largest impact on @entity6 care. However, physicians and nurses were more likely to rank @entity1 factors as having a large impact on care than @entity497 ( @entity497 ) and physicians were significantly less likely to rank @entity1 -provider communication as having a large impact than @entity497 . CONCLUSIONS: Addressing @entity1 factors was considered the highest impact strategy for improving @entity6 care. While this may reflect " @entity1 blaming," it also suggests that self-management strategies may be well-suited for this context. Program planning should focus on training programs for @entity497 , who provide a unique link between @entity1 and clinical services. Research incorporating @entity1 perspectives is needed to complete this picture and inform quality improvement initiatives.

Challenges to the provision of XXXX care in first nations communities: results from a national survey of healthcare providers in Canada.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'peoples'] @entity497 :: ('MESH:D003147', 'Disease') :: ['CHRs', 'community health representatives'] @entity6 :: ('MESH:D003920', 'Disease') :: ['Diabetes', 'diabetes']
@entity6 :: (MESH:D003920,Disease) :: ['diabetes']
