The Transformation of Indigenous Primary Healthcare Delivery (FORGE AHEAD) program was launched in response to the growing awareness and understanding of how type 2 diabetes impacts Indigenous populations in Canada. The program created space for community-based participants from eleven First Nations communities to take leading roles in designing and implementing healthcare initiatives that reflected their unique needs, priorities, and concerns. It was a five-year program that supported the local QI teams during their assessment of available healthcare resources and the level of quality of care within their communities to generate testable ideas to create widespread improvements.


Tsuut'ina First Nation

Cree Nation of Waskaganish


Saugeen First Nation

Ebb and Flow First Nation

Cowichan Tribes

Seabird Island Band

Mishkeegogamang Ojibway Nation

Miawpukek First Nation

Kahnawake Mohawk Territory

Opaskwayak Cree Nation

Program Objectives
  1. Assess current healthcare delivery, funding models, and best practices used in First Nations communities in Canada.

  2. Assess community and clinical readiness to address and adopt chronic disease care.

  3. Enhance patient access to available community resources for chronic disease care.

  4. Implement, evaluate, and cost community and clinical QI initiatives to improve chronic disease management.

  5. Develop sustainment strategies and scale-up toolkits for improved chronic disease management.

Key Outcomes
  1. REDUCTION in blood pressure and LDL cholesterol

  2. REDUCTION in A1c

  3. INCREASED measuring for A1c, blood pressure, and LDL cholesterol

  4. INCREASED screening for diabetes nephropathy

  5. INCREASE in clients receiving Canadian guideline recommended care services


This sister program to FORGE AHEAD was designed to test out adaptations and improve care for people living with diabetes. The name and logo were developed by the community partners.


Sheshatshiu Innu First Nation

Oneida Nation of the Thames

Abegweit First Nation

Serpent River First Nation

Program Objectives
  1. Engage community partners and stakeholders to support meaningful participation and leadership.

  2. Review, improve, and adapt the diabetes quality improvement strategy with community partners.

  3. Evaluate the effectiveness of the adapted diabetes quality improvement strategy.

  4. Develop community-driven plans for sustainability and scale-up for the adapted diabetes quality improvement strategy.

The program is currently in the evaluation and knowledge exchange phase and will be wrapped up by March 2022. The main outcomes and publications will be posted here when they become available.
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REACH Program,
Centre for Studies in Family Medicine,
Western Centre for Public Health & Family Medicine,
Western University, 1151 Richmond St., LONDON, ONTARIO N6A 3K7

Business Hours

Monday — Friday 8am – 5pm EST
We acknowledge that Western University is located on the traditional lands of the Anishinaabek, Haudenosaunee, Lūnaapéewak and Chonnonton Nations, on lands connected with the London Township and Sombra Treaties of 1796 and the Dish with One Spoon Covenant Wampum. With this, we respect the longstanding relationships that Indigenous Nations have to this land, as they are the original caretakers. We acknowledge historical and ongoing injustices that Indigenous Peoples (First Nations, Métis and Inuit) endure in Canada, and we accept responsibility as a public institution to contribute toward revealing and correcting miseducation as well as renewing respectful relationships with Indigenous communities through our teaching, research and community service.