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.
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