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Our People, Our Health: Envisioning Better Primary Healthcare in Manitoba First Nation Communities 我们的人民,我们的健康:设想马尼托巴省第一民族社区更好的初级保健
IF 1.3 Q1 Social Sciences Pub Date : 2021-02-04 DOI: 10.18584/IIPJ.2021.12.1.13561
Grace Kyoon-Achan, W. Phillips-Beck, K. Kinew, J. Lavoie, Stephanie Sinclair, A. Katz
Recognizing the right of self-determination of Indigenous Peoples is essential to improving the state of community-based primary healthcare of First Nations in Canada. Understanding communities’ priorities and local health agendas is critical for primary healthcare transformation. We used a community-based participatory research approach to engage our partners: Nanaandawewiwgamig, the First Nations Health and Social Secretariat of Manitoba, and eight First Nation communities. Community-based research assistants conducted 183 in-depth interviews in their respective First Nations. Key themes that emerged from these interviews include primary prevention focused on health and social determinants; an integrated healthcare system providing access to both Western and First Nations traditional health knowledge; infrastructure improvement; youth engagement; healthcare leadership; investing in community-based human resources; and promoting culturally respectful, responsive, geographically sensitive, and outcomes-oriented care. Policy approaches could implement some local priorities with direct impact on healthcare, while other social determinants will create indirect, albeit critical, conditions for health and healthcare changes over time.
承认土著人民的自决权对于改善加拿大原住民以社区为基础的初级保健状况至关重要。了解社区的优先事项和当地卫生议程对于初级保健转型至关重要。我们采用了基于社区的参与式研究方法来吸引我们的合作伙伴:曼尼托巴省第一民族卫生和社会秘书处的Nanandawewiwgamig和八个第一民族社区。社区研究助理在各自的第一民族中进行了183次深入访谈。这些访谈中出现的主要主题包括以健康和社会决定因素为重点的初级预防;提供西方和第一民族传统健康知识的综合医疗保健系统;基础设施改善;青年参与;医疗保健领导力;投资于社区人力资源;以及促进文化上尊重、反应迅速、地理上敏感和注重结果的护理。政策方法可以实施一些对医疗保健有直接影响的地方优先事项,而其他社会决定因素将随着时间的推移为健康和医疗保健的变化创造间接但关键的条件。
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引用次数: 1
Is Geographical Isolation Associated with Poorer Outcomes for Northern Manitoba First Nation Communities? 地理隔离与马尼托巴北部第一民族社区较差的结果有关吗?
IF 1.3 Q1 Social Sciences Pub Date : 2021-01-28 DOI: 10.18584/iipj.2021.12.1.10475
Josée G. Lavoie,Wanda Phillips-Beck,Kathi Avery Kinew,Stephanie Sinclair,Grace Kyoon-Achan,Alan Katz
This study tested the assumption that geographical isolation is associated with poorer population health outcomes among First Nations in Manitoba. Our results show higher premature mortality rates (PMR) in northern communities, declining slower than for any other Manitoba communities. Our results also show lower ambulatory care sensitive conditions (ACSC) hospitalization rate in the North, suggesting barriers to prevention and early diagnosis. There remains a large gap in ACSC hospitalization rates between First Nations and all Manitobans. Further research is warranted to understand the relationship between the changes in the rates of ACSC and the difference in the rates between northern and southern communities.
这项研究验证了地理隔离与马尼托巴第一民族较差的人口健康结果有关的假设。我们的研究结果显示,北部社区的过早死亡率(PMR)较高,下降速度比马尼托巴省任何其他社区都要慢。我们的研究结果还显示,北方的门诊敏感病症(ACSC)住院率较低,表明预防和早期诊断存在障碍。第一民族和所有马尼托巴人在ACSC住院率方面仍然存在很大差距。有必要进一步研究,以了解ACSC率的变化与北部和南部社区之间的比率差异之间的关系。
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引用次数: 0
Tobacco Smoking Among First Nations Youth Living On-Reserve and in Northern Communities: A Mixed Methods Study 居住在保留区和北部社区的第一民族青年吸烟:一项混合方法研究
IF 1.3 Q1 Social Sciences Pub Date : 2020-12-22 DOI: 10.18584/iipj.2020.11.4.13369
L. Wright, C. Dell
The prevalence of tobacco smoking among First Nations youth living on reserve and in Northern communities is significantly higher than off-reserve Indigenous youth in Southern communities and non-Indigenous youth, although the majority do not smoke. Using a mixed-methods approach, we examine factors that support on-reserve First Nations youth’s resilience to smoking. Logistic regression analyses using data from the nationally representative First Nations Regional Early Childhood, Education, and Employment Survey suggest that not using other substances, having friends who do not smoke or use other substances, and having good mental health is associated with not smoking. A review of select community initiatives and in-depth interviews with First Nations anti-tobacco initiative managers and frontline workers about the initiatives also revealed the need for gender- and community-specific programming, recognition of Indigenous social determinants of health, and addressing the normalization of smoking in some community contexts.
居住在保留区和北部社区的第一民族青年的吸烟率明显高于南部社区的保留区外土著青年和非土著青年,尽管大多数人不吸烟。使用混合方法的方法,我们检查的因素,支持在保留地第一民族青年吸烟的弹性。使用具有全国代表性的第一民族区域幼儿、教育和就业调查数据进行的逻辑回归分析表明,不使用其他物质,有不吸烟或不使用其他物质的朋友,以及有良好的心理健康与不吸烟有关。对某些社区倡议的审查以及对土著反烟草倡议管理人员和第一线工作人员关于这些倡议的深入访谈也表明,需要制定针对性别和社区的方案,承认土著健康的社会决定因素,并解决在某些社区环境中吸烟正常化的问题。
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引用次数: 0
Does a Payment-for-Outcomes Model Improve Indigenous Wellbeing? Commissioning Agencies and Social Impact Bonds in New Zealand 按结果付费模式能改善土著居民的福祉吗?新西兰的委托机构和社会影响债券
IF 1.3 Q1 Social Sciences Pub Date : 2020-12-15 DOI: 10.18584/iipj.2020.11.4.8195
L. Humpage
Commissioning agencies and social impact bonds are two examples of New Zealand’s shift towards payment-for-outcomes funding mechanisms over the last decade, as the government attempted to improve both policy innovation and social outcomes. This article highlights that although the commissioning agencies have been more successful than social impact bonds, neither has completely achieved these goals of innovation and improved outcomes. This is particularly concerning given Indigenous Māori are disproportionately impacted by both policies. Discussion concludes by highlighting some of the problems associated with applying a payment-for-outcomes model to Indigenous Peoples, given these funding mechanisms are becoming increasingly popular in other settler nation states.
委托机构和社会影响债券是新西兰在过去十年中转向成果支付融资机制的两个例子,因为政府试图改善政策创新和社会成果。本文强调,尽管委托机构比社会影响债券更成功,但两者都没有完全实现创新和改善成果的目标。这尤其令人担忧,因为土著毛利人受到这两项政策的不成比例的影响。讨论最后强调了对土著人民应用成果付费模式的一些问题,因为这些资助机制在其他定居者民族国家越来越受欢迎。
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引用次数: 2
The Impact of Training Indigenous Facilitators for a Two-Eyed Seeing Research Treatment Intervention for Intergenerational Trauma and Addiction 训练本土辅导员对双眼视觉研究的影响:代际创伤与成瘾的治疗干预
IF 1.3 Q1 Social Sciences Pub Date : 2020-11-30 DOI: 10.18584/iipj.2020.11.4.8623
T. N. Marsh, D. Marsh, L. Najavits
Intergenerational trauma in Indigenous Peoples was not the result of a targeted event, but rather political and governmental policies inflicted upon entire generations. The resultant effects of these traumas and multiple losses include addiction, depression, anxiety, violence, self-destructive behaviors, and suicide, to name but a few. Traditional healers, Elders, and Indigenous facilitators agree that the reclamation of traditional healing practices combined with conventional interventions could be effective in addressing intergenerational trauma and substance use disorders. Recent research has shown that the blending of Indigenous traditional healing practices and the Western treatment model Seeking Safety resulted in a reduction of intergenerational trauma (IGT) symptoms and substance use disorders (SUD). This article focuses on the Indigenous facilitators who were recruited and trained to conduct the sharing circles as part of the research effort. We describe the six-day training, which focused on the implementation of the Indigenous Healing and Seeking Safety model, as well as the impact the training had on the facilitators. Through the viewpoints and voices of the facilitators, we explore the growth and changes the training brought about for them, as well as their perception of how their changes impacted their clients.
土著人民的代际创伤不是有针对性事件的结果,而是强加给整整几代人的政治和政府政策。这些创伤和多重损失的后果包括成瘾、抑郁、焦虑、暴力、自毁行为和自杀,仅举几例。传统治疗师、长老和土著促进者一致认为,将传统治疗方法与传统干预相结合,可以有效解决代际创伤和药物使用障碍。最近的研究表明,土著传统治疗实践和西方寻求安全的治疗模式相结合,减少了代际创伤(IGT)症状和物质使用障碍(SUD)。这篇文章的重点是作为研究工作的一部分,被招募和培训来进行分享圈的土著促进者。我们介绍了为期六天的培训,重点是实施土著康复和寻求安全模式,以及培训对辅导员的影响。通过主持人的观点和声音,我们探讨了培训给他们带来的成长和变化,以及他们对自己的变化如何影响客户的看法。
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引用次数: 5
A Journey of Doing Research “In a Good Way”: Partnership, Ceremony, and Reflections Contributing to the Care and Wellbeing of Indigenous Women Living with HIV in Canada “以一种好的方式”进行研究之旅:伙伴关系、仪式和对加拿大土著艾滋病毒感染妇女的关怀和福祉的反思
IF 1.3 Q1 Social Sciences Pub Date : 2020-11-25 DOI: 10.18584/iipj.2020.11.4.8215
Doris Peltier, Carrie Martin, R. Masching, Mike Standup, Claudette Cardinal, V. Nicholson, Mina Kazemi, A. Kaida, Laura Warren, Denise Jaworsky, L. Gervais, A. Pokomandy, S. Bruce, S. Greene, M. Becker, Jasmine Cotnam, Kecia Larkin, Kerrigan Beaver, C. Bourassa, M. Loutfy
The relationship between the First Peoples of Canada and researchers is changing as processes of self-determination and reconciliation are increasingly implemented. We used storytelling and ceremony to describe a historic event, the Indigenous Women’s Data Transfer Ceremony, where quantitative data of 318 Indigenous women living with HIV were transferred to Indigenous academic and community leaders. Relationship building, working together with a common vision, the Ceremony, and the subsequent activities were summarized as a journey of two boats. The Truth and Reconciliation Commission of Canada's Calls to Action and Indigenous ethical principles were central to the process. The article ends with team members’ reflections and the importance of shifting power to Indigenous Peoples in regard to data collection, their stories, and the resulting policies.
随着自决与和解进程的日益实施,加拿大第一民族与研究人员之间的关系正在发生变化。我们用讲故事和仪式来描述一个历史性事件,即土著妇女数据传递仪式,其中318名感染艾滋病毒的土著妇女的定量数据被传递给土著学术和社区领袖。建立关系,共同努力,仪式和随后的活动被总结为两艘船的旅程。加拿大行动呼吁真相与和解委员会和土著民族道德原则是这一进程的核心。文章的结尾是团队成员的反思,以及在数据收集、他们的故事和由此产生的政策方面,将权力转移给土著人民的重要性。
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引用次数: 4
Living in the South, Caring in the North: Exploring Inuit Women’s Care Responsibilities 生活在南方,关爱在北方:探索因纽特人妇女的关爱责任
IF 1.3 Q1 Social Sciences Pub Date : 2020-11-05 DOI: 10.18584/iipj.2020.11.4.8192
Magalie Quintal-Marineau
The increased Inuit population in Canadian Metropolitan Areas (CMA) has recently gained attention among the scientific community as well as within Inuit organizations. However, existing literature has overlooked the distinct experience of Inuit women and, more significantly, the importance of care responsibilities in understanding women’s mobility. This study examines the relocation experiences of 46 Inuit women across five CMAs, and the role care sites play in initiating women’s relocation to cities. Results show the key role caregiving responsibilities play in Inuit women’s decisions to move to southern urban areas, as dysfunctional care spaces in the North push them away from their communities, and the potential for safer care sites in the South act as a pulling factor.
加拿大大都会区因纽特人数量的增加最近引起了科学界和因纽特人组织的关注。然而,现有文献忽视了因纽特人妇女的独特经历,更重要的是,忽视了照顾责任在理解妇女流动性方面的重要性。本研究调查了五个CMA中46名因纽特人妇女的搬迁经历,以及护理场所在启动妇女搬迁到城市中所起的作用。研究结果表明,照顾责任在因纽特人妇女决定搬到南部城市地区的过程中发挥了关键作用,因为北方功能失调的护理空间将她们推离了社区,而南方更安全的护理场所的潜力是一个拉动因素。
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引用次数: 0
The Paths to Realizing Reconciliation: Indigenous Consultation in Jasper National Park 实现和解之路:碧玉国家公园的原住民协商
IF 1.3 Q1 Social Sciences Pub Date : 2020-10-22 DOI: 10.18584/iipj.2020.11.4.9348
J. Johnston, Courtney W. Mason
Diverse Indigenous nations have traditional territories inside Jasper National Park (JNP), but the park was established without consultation with local Indigenous communities. Parks were marketed as empty landscapes, which celebrated romantic ideas of European colonial expansion. The current representations of Indigenous Peoples in interpretive content still reflect this lack of consultation. This research was guided by Indigenous methodologies. Data was collected through interviews with Jasper Indigenous Forum (JIF) members and the JNP management team. Findings indicate that JIF members want increased representation and greater control over how their histories and cultures are presented. Park management needs to work in close consultation with the JIF if they want to improve Indigenous representations in the park and support processes of reconciliation.
不同的土著民族在贾斯珀国家公园(JNP)内拥有传统的领土,但公园的建立没有与当地土著社区协商。公园被宣传为空旷的风景,用来庆祝欧洲殖民扩张的浪漫思想。目前土著人民在解释性内容中的表述仍然反映出这种缺乏协商的情况。这项研究以土著方法为指导。数据是通过采访贾斯珀土著论坛(JIF)成员和JNP管理团队收集的。调查结果表明,JIF成员希望增加代表性,并对如何展示他们的历史和文化有更大的控制权。如果公园管理部门想要改善公园内的土著代表,并支持和解进程,就需要与JIF密切协商。
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引用次数: 2
Modeling the Impact of the COVID-19 Pandemic on First Nations, Metis, and Inuit Communities: Some Considerations 新冠肺炎大流行对原住民、梅蒂人和因纽特人社区影响的建模:一些考虑因素
IF 1.3 Q1 Social Sciences Pub Date : 2020-10-07 DOI: 10.18584/iipj.2020.11.3.10733
J. Lavoie, R. Romanescu, A. Katz, Nathan C. Nickel
Objectives: This article articulates the complexity of modeling in First Nations, Metis, and Inuit contexts by providing the results of a modeling exercise completed at the request of the First Nations Health and Social Secretariat of Manitoba Methods: We developed a model using the impact of a previous pandemic (the 2009 H1N1) to generate estimates Results: The lack of readily available data has resulted in a model that assumes homogeneity of communities in terms of health status, behaviour, and infrastructure limitations While homogeneity may be a reasonable assumption for province-wide planning, First Nation communities and Tribal Councils require more precise information in order to plan effectively Metis and urban Inuit communities, in contrast, have access to much less information, making the role of Indigenous organizations mandated to serve the needs of these populations that much more difficult Conclusion: For many years, Indigenous organizations have advocated for the need to have access to current and precise data to meet their needs The COVID-19 pandemic demonstrates the importance of timely and accurate community-based data to support pandemic responses
目的:本文阐述了第一民族、Metis、,根据曼尼托巴省第一民族卫生和社会秘书处的要求,通过提供建模工作的结果,了解因纽特人的情况。方法:我们开发了一个模型,利用前一次大流行(2009年H1N1流感)的影响来生成估计数。结果:由于缺乏现成的数据,行为和基础设施限制虽然同质性可能是全省规划的合理假设,但原住民社区和部落委员会需要更精确的信息才能有效规划Metis和城市因纽特人社区,相比之下,他们获得的信息要少得多,使被授权为满足这些人口需求的土著组织的作用变得更加困难结论:多年来,土著组织一直主张有必要获得最新和准确的数据来满足他们的需求新冠肺炎大流行表明及时和准确的社区数据对支持应对大流行的重要性
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引用次数: 4
"Healing on Both Sides": Strengthening the Effectiveness of Prison–Indigenous Community Partnerships Through Reciprocity and Investment “双方治愈”:通过互惠和投资加强监狱与土著社区伙伴关系的有效性
IF 1.3 Q1 Social Sciences Pub Date : 2020-10-05 DOI: 10.18584/iipj.2020.11.3.8064
C. Varcoe, H. Brown, Kelsey Timler, Melissa Taylor, Elizabeth J. Straus
This mixed methods study examined the impact of a prison–community partnership, entitled Work 2 Give. The partnership supports a program in which federally incarcerated men in Canada make items to donate to Indigenous communities. Qualitative interviews were conducted with participating men (n = 32), recipient community members (n = 29), and other prison and community stakeholders (n = 14). Selected outcomes (transfers to higher security, successful transfers to lower security, and serious institutional charges) were examined for 60 incarcerated men for whom data were available. Findings suggest that the program positively affected the men’s identities and provided opportunities for communities to help incarcerated men to heal; both sets of stakeholders see potential to strengthen the program. Whereas the emphasis has been on unidirectional donation, and the impetus for the program has been with correctional staff, findings suggest a bidirectional model with stronger feedback loops between the prison and community to support reciprocity, investment, and visibility would enhance impact. This model has broad implications for strengthening community–prison partnerships.
这项名为“工作-给予”的混合方法研究考察了监狱-社区伙伴关系的影响。该合作伙伴关系支持一项计划,即加拿大联邦监禁的男子制作物品捐赠给土著社区。对参与研究的男性(n = 32)、接受研究的社区成员(n = 29)以及其他监狱和社区利益相关者(n = 14)进行了定性访谈。选定的结果(转移到较高的安全级别,成功转移到较低的安全级别,以及严重的机构指控)对60名可获得数据的在押男子进行了检查。研究结果表明,该项目积极地影响了男性的身份认同,并为社区提供了帮助被监禁男性康复的机会;两组利益相关者都看到了加强该计划的潜力。虽然重点是单向捐赠,项目的推动力也来自惩教人员,但研究结果表明,在监狱和社区之间建立一个更强的反馈循环的双向模式,以支持互惠、投资和可见性,将增强影响。这一模式对加强社区监狱伙伴关系具有广泛的影响。
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引用次数: 2
期刊
International Indigenous Policy Journal
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