To enhance prenatal education program interrupted by COVID-19 in remote and rural First Nations communities by expanding remote education through two-eyed seeing framework to improve maternal child health

Diabetes in pregnancy is an important risk factor for type 2 diabetes (T2D) in women and their offspring. First Nations (FN) people, especially those living in isolated communities, have a higher risk for diabetes in pregnancy and in youths compared to non-FN population. Our recent study demonstrated that a community-driven remote prenatal education improved participation in prenatal program and breastfeeding in FN women in rural or remote communities, but the outcome was affected by Wi-Fi service and postpartum supports in the communities. COVID-19 disrupted regular prenatal education and care in the communities. However, remote prenatal education remained active in participating communities. We propose to enhance the prenatal program by improving remote prenatal education using two-eyed seeing framework, and the incorporation of community-created educational format to revitalize community prenatal program interrupted by COVID-19 to increase program participation and improve pregnancy outcomes in rural and remote FN communities. Traditional education will be provided by FN Elders or Knowledge Keepers to pregnant women and their partners to promote spousal support and family-centered breastfeeding. The enhancement of prenatal program will help to improve prenatal education and the health and wellness of women and children in rural and remote FN communities. Our team is composed of Indigenous Principal Applicants, Knowledge Users, community partners, collaborators and multidisciplinary researchers with expertise in Indigenous or gender research. The project will be conducted following guidelines for Indigenous health research and the results will be owned, possessed accessed and controlled by community health authorities. The proposed studies will reduce inequity in prenatal education in women and children in remote or rural FN communities. The outcome can be scaled up to other communities to improve the health of Indigenous women and children in Canada.