PRACTICE Rationale and Implementation of the SLICK Project Screening for Limb, I-Eye, Cardiovascular and Kidney (SLICK) Complications in Individuals with Type 2 Diabetes in Alberta’s First Nations Communities

and the Implementation Committee of the Aboriginal Diabetes Initiative Objective: Identifying diabetes complications through screening using portable laboratory equipment in Aboriginal communities, and providing education and client empowerment for improved follow-up care and self-care. Participants: First Nations people with known diabetes. Setting: Screening was carried out in temporary clinics and laboratories set up at the local health centre in each of Alberta’s 44 First Nations. Intervention: Two mobile units (“SLICK vans”), equipped with professionally trained staff, portable lab instruments and a retinal camera, travelled to all 44 Alberta First Nations communities to facilitate implementation of the Canadian Diabetes Association Clinical Practice Guidelines (CPGs). The project provided relevant education and counselling in conjunction with screening activities. Outcomes: SLICK screened 1,151 clients between December 2001 and July 2003, and the project remains ongoing. A preliminary evaluation of the project’s 19-month implementation period showed screening activities and satisfaction with diabetes services were low prior to SLICK. There were modest improvements in some program outcomes at 6-12 months follow-up. Conclusion: The SLICK project is designed to address the impact of diabetes by utilizing evidence-based CPGs with respect to screening for complications at the community level. It had a successful implementation period facilitated by community acceptance. MeSH terms: Aboriginal, North American; type 2 diabetes mellitus; diabetes-related complications; screening; mobile health units; rural communities In 2003, over 1.2 million Canadiansreported having diabetes,1 and an esti-mated one third of all diabetes cases remained undiagnosed.2,3 Given current prevalence trends, it is projected that 2.4 million people in Canada’s general popula-tion will have diabetes by 2016.4 Rare in Aboriginal populations before the 1950s,5 national estimates from th