Case 1

Involving citizens in health care


Short case summary: The case describes a two year process of building strong partnerships between professional health researchers from the University of Minnesota (UMN) Medical School and lay people from a community of American Indians (AI) living in the Midwest, US. The collaboration was a reaction to the alarming increase of diabetes patients among the AI community, which was a shared concern between the AI community and health care professionals. Together they co-developed “The Family Education Diabetes Series” (FEDS), which was launched in 2003 as an alternative to traditional health care services. 36 AI community members with diabetes type 2 attended the programme and at the end of the intervention they evidenced significant improvement in the health status – across weight, blood pressure, and metabolic control. Read full length of case to know more about the pilot findings, its value and impact on key diabetes-relevant variables.

Relevance to CAR?

This case is relevant to the CAR-Network because it …

  • shares in detail core principles and action strategies for involving citizen in health-care interventions

  • describes the strengths and limitations of a successful community-based participatory research diabetes health care intervention in a Midwestern American Indian Community

  • describes the process of establishing a long-term partnership

  • reflects on the benefits of researchers being attentive and sensitivity to community members perspectives and worldviews in analysing, planning and carrying out health care interventions

Summary reflections

We want to briefly highlight the strengths we see in the case:

  • Building long-term partnership and investing time in weekly meetings to find gatekeepers and to create community-identified and owned issues

  • Integrating western biomedical knowledge with a sensitivity to the indigenous wisdom, culture and customs

  • Conducting interventions in urban-dwelling context by community members

  • Mobilising community resources and increasing the sense of ownership of community members.

We believe that the case gives methodological insight and inspiration on how to create high levels of community involvement in initiating, planning and carrying out health interventions.


Mendenhall, T. J. et al (2010). The Family Education Diabetes Series (FEDS): community-based participatory research with a midwestern American Indian community. Nursing Inquiry: 17 (4): 359-372.