Pub Date : 2021-01-26DOI: 10.32799/IJIH.V16I2.33212
Soha Sabeti, C. Xavier, A. Slaunwhite, Louise Meilleur, L. MacDougall, S. Vaghela, Davis McKenzie, M. Kuo, P. Kendall, Ciaran Aiken, M. Gilbert, Shannon McDonald, B. Henry
First Nations Peoples in the province of British Columbia (BC), Canada, have been disproportionately affected by the overdose crisis. In 2016, a public health emergency was declared by BC’s Provincial Health Officer (PHO) in response to the significant rise in opioid-related overdose deaths reported in BC. New surveillance systems were required to identify trends in overdose events and related deaths in the province as a whole, and for First Nations Peoples. Data sharing and analysis processes that adhered to the principles of OCAP® (ownership, control, access, and possession), and to the Truth and Reconciliation Commission of Canada’s Calls to Action, needed to be developed. The First Nations Health Authority (FNHA), BC Centre for Disease Control, PHO, and the BC Ministry of Health have worked collaboratively to facilitate identification of First Nations persons in surveillance data for appropriate analysis by FNHA. This paper outlines the data stewardship and governance context, principles, and operational considerations for creating overdose surveillance systems to measure overdose events among First Nations Peoples in BC.
{"title":"Collaborative Data Governance to Support First Nations-Led Overdose Surveillance and Data Analysis in British Columbia, Canada","authors":"Soha Sabeti, C. Xavier, A. Slaunwhite, Louise Meilleur, L. MacDougall, S. Vaghela, Davis McKenzie, M. Kuo, P. Kendall, Ciaran Aiken, M. Gilbert, Shannon McDonald, B. Henry","doi":"10.32799/IJIH.V16I2.33212","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33212","url":null,"abstract":"\u0000 \u0000 \u0000First Nations Peoples in the province of British Columbia (BC), Canada, have been disproportionately affected by the overdose crisis. In 2016, a public health emergency was declared by BC’s Provincial Health Officer (PHO) in response to the significant rise in opioid-related overdose deaths reported in BC. New surveillance systems were required to identify trends in overdose events and related deaths in the province as a whole, and for First Nations Peoples. Data sharing and analysis processes that adhered to the principles of OCAP® (ownership, control, access, and possession), and to the Truth and Reconciliation Commission of Canada’s Calls to Action, needed to be developed. The First Nations Health Authority (FNHA), BC Centre for Disease Control, PHO, and the BC Ministry of Health have worked collaboratively to facilitate identification of First Nations persons in surveillance data for appropriate analysis by FNHA. This paper outlines the data stewardship and governance context, principles, and operational considerations for creating overdose surveillance systems to measure overdose events among First Nations Peoples in BC. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43016763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.32799/IJIH.V16I2.33230
G. Gaspard, C. Gadsby, J. Mallmes
Many Indigenous people who live on their traditional territory die in hospital when their preference is to enter the spirit world from their home. Indigenous people in Canada describe experiencing many barriers that prevent them from making this final choice in life. The First Nations Health Authority in British Columbia (BC), Canada, in collaboration with Douglas College, offered end-of- life doula training classes to Indigenous people in BC in 2019. The goal was to build on the strengths of community members already supporting people and their families during their final journey into the spirit world. There were 86 participants (72% identified as Indigenous) from the five health regions in BC, representing 47 Indigenous communities. Participants were overwhelmingly satisfied with the five-day course and planned to take their new learnings back to their community. It was noted, however, that this course would benefit from adaptations, including a greater emphasis on traditional Indigenous practices, facilitation tips, and strategies to support people through loss and bereavement. Furthermore, the term “end-of-life doula” is sometimes associated with a for-profit business, which is counterintuitive to traditional Indigenous practices, highlighting the necessity for a name change. Further evaluation over the next year is necessary to confirm that the course makes a positive difference in the final journey for Indigenous people.
{"title":"Indigenous End-of-Life Doula Course: Bringing the Culture Home","authors":"G. Gaspard, C. Gadsby, J. Mallmes","doi":"10.32799/IJIH.V16I2.33230","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33230","url":null,"abstract":"\u0000 \u0000 \u0000Many Indigenous people who live on their traditional territory die in hospital when their preference is to enter the spirit world from their home. Indigenous people in Canada describe experiencing many barriers that prevent them from making this final choice in life. The First Nations Health Authority in British Columbia (BC), Canada, in collaboration with Douglas College, offered end-of- life doula training classes to Indigenous people in BC in 2019. The goal was to build on the strengths of community members already supporting people and their families during their final journey into the spirit world. There were 86 participants (72% identified as Indigenous) from the five health regions in BC, representing 47 Indigenous communities. Participants were overwhelmingly satisfied with the five-day course and planned to take their new learnings back to their community. It was noted, however, that this course would benefit from adaptations, including a greater emphasis on traditional Indigenous practices, facilitation tips, and strategies to support people through loss and bereavement. Furthermore, the term “end-of-life doula” is sometimes associated with a for-profit business, which is counterintuitive to traditional Indigenous practices, highlighting the necessity for a name change. Further evaluation over the next year is necessary to confirm that the course makes a positive difference in the final journey for Indigenous people. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47628986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.32799/IJIH.V16I2.33236
P. Abernethy, Shannon N. Waters, Tim Kulchyski, D. Rolston, H. Swinkels, Gethsemane Luttrell, Linda Pillsworth
Climate change brings about novel types of public health emergencies. Unforeseen challenges put additional pressure on health systems and require innovative approaches to address emerging needs. The health of Indigenous Peoples is particularly impacted by the changing climate, because of their close connection to the land. For instance, the physical, emotional, mental, and spiritual well-being of coastal First Nations in British Columbia (BC), Canada, is interconnected with the abundance of healthy marine food sources that form the base of local traditional diets. The 2018 discovery of Vibrio cholerae illness in those who had eaten contaminated herring eggs not only had a clinical health impact but also created concerns for the safety of local food systems. The limited magnitude of the outbreak demonstrates the critical importance of collaborative partnerships between coastal First Nations communities in BC and health authorities working together in outbreak investigations. Yet, the lack of procedures that address cultural and institutional differences led to unnecessary discrepancies in the approach. This paper introduces the public health intervention used during the first ever Vibrio cholerae outbreak in coastal BC. The intervention has the potential to inform best practices when developing emergency response protocols potentially affecting Indigenous people and traditional foods. In this qualitative case study of the formal institutional documents and narratives of the key partners involved in the response, we assess the intervention, highlight the challenges and enablers, share lessons learned, and identify knowledge requirements to improve confidence in the traditional food system and support early warning systems.
{"title":"Climate Change and Vibrio cholerae in Herring Eggs: The Role of Indigenous Communities in Public Health Outbreak Responses","authors":"P. Abernethy, Shannon N. Waters, Tim Kulchyski, D. Rolston, H. Swinkels, Gethsemane Luttrell, Linda Pillsworth","doi":"10.32799/IJIH.V16I2.33236","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33236","url":null,"abstract":"\u0000 \u0000 \u0000Climate change brings about novel types of public health emergencies. Unforeseen challenges put additional pressure on health systems and require innovative approaches to address emerging needs. The health of Indigenous Peoples is particularly impacted by the changing climate, because of their close connection to the land. For instance, the physical, emotional, mental, and spiritual well-being of coastal First Nations in British Columbia (BC), Canada, is interconnected with the abundance of healthy marine food sources that form the base of local traditional diets. The 2018 discovery of Vibrio cholerae illness in those who had eaten contaminated herring eggs not only had a clinical health impact but also created concerns for the safety of local food systems. The limited magnitude of the outbreak demonstrates the critical importance of collaborative partnerships between coastal First Nations communities in BC and health authorities working together in outbreak investigations. Yet, the lack of procedures that address cultural and institutional differences led to unnecessary discrepancies in the approach. This paper introduces the public health intervention used during the first ever Vibrio cholerae outbreak in coastal BC. The intervention has the potential to inform best practices when developing emergency response protocols potentially affecting Indigenous people and traditional foods. In this qualitative case study of the formal institutional documents and narratives of the key partners involved in the response, we assess the intervention, highlight the challenges and enablers, share lessons learned, and identify knowledge requirements to improve confidence in the traditional food system and support early warning systems. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44632349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.32799/IJIH.V16I2.33098
R. Souza, Nicole M. Bilodeau, K. Gordon, A. D. Davis, J. Stearns, Mary Cranmer-Byng, K. Gasparelli, L. D. Hill, S. Anand
Haudenosaunee Peoples of eastern North America have a strong agricultural tradition and culture associated with maize horticulture. Traditional foodways and diet were disrupted after the people were dispossessed from traditional lands maintained prior to colonization. As a result, Haudenosaunee have been disconnected from their traditional diet and lifestyle, and chronic diseases such as diabetes and obesity are increasing. Healthy Roots was developed in Six Nations of the Grand River territory by Haudenosaunee community members. It started as a 90-day challenge, in which participants adhere to a diet of traditional foods found in Haudenosaunee territories pre-European contact. The community decided to formally evaluate the impact of the diet in a pilot pre–post intervention study of 22 participants in 2016/17. We investigated the effects of the 3-month dietary intervention on physical measurements, ectopic fat (including visceral and liver adipose tissue), serum lipids, and hemoglobin A1c among Haudenosaunee participants in Six Nations. We provided biweekly Haudenosaunee food boxes, and offered workshops, cooking classes, and individual support from a dietitian. The intervention reduced body weight, body circumferences including waist circumference, hemoglobin A1c, and MRI-detected hepatic fat fraction. There were no adverse events. Engagement in the program was high and trends favoured improved well-being. The intervention shows great potential as a mechanism for improving physical health and restoring cultural connectedness and identity. The implications for improving mental health and community cohesion are also important areas to consider in future research.
{"title":"Entsisewata’karí:teke (You Will Be Healthy Again): Clinical Outcomes of Returning to a Traditional Haudenosaunee Diet","authors":"R. Souza, Nicole M. Bilodeau, K. Gordon, A. D. Davis, J. Stearns, Mary Cranmer-Byng, K. Gasparelli, L. D. Hill, S. Anand","doi":"10.32799/IJIH.V16I2.33098","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33098","url":null,"abstract":"\u0000 \u0000 \u0000Haudenosaunee Peoples of eastern North America have a strong agricultural tradition and culture associated with maize horticulture. Traditional foodways and diet were disrupted after the people were dispossessed from traditional lands maintained prior to colonization. As a result, Haudenosaunee have been disconnected from their traditional diet and lifestyle, and chronic diseases such as diabetes and obesity are increasing. Healthy Roots was developed in Six Nations of the Grand River territory by Haudenosaunee community members. It started as a 90-day challenge, in which participants adhere to a diet of traditional foods found in Haudenosaunee territories pre-European contact. The community decided to formally evaluate the impact of the diet in a pilot pre–post intervention study of 22 participants in 2016/17. We investigated the effects of the 3-month dietary intervention on physical measurements, ectopic fat (including visceral and liver adipose tissue), serum lipids, and hemoglobin A1c among Haudenosaunee participants in Six Nations. We provided biweekly Haudenosaunee food boxes, and offered workshops, cooking classes, and individual support from a dietitian. The intervention reduced body weight, body circumferences including waist circumference, hemoglobin A1c, and MRI-detected hepatic fat fraction. There were no adverse events. Engagement in the program was high and trends favoured improved well-being. The intervention shows great potential as a mechanism for improving physical health and restoring cultural connectedness and identity. The implications for improving mental health and community cohesion are also important areas to consider in future research. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45160553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.32799/IJIH.V16I2.33224
G. Gaspard, C. Gadsby, Cindy Preston
Polypharmacy is the administration of more medications than clinically required or appropriate, and it can negatively impact wellness. Prescribers, pharmacists, nurses, and those receiving care services all have an important role to play in promoting healthy medication use and minimizing the risk related to polypharmacy. Medication management involves health care professionals regularly reviewing drug therapies with patients for any needed changes. This strategy is a key way to reduce the harms of polypharmacy. A review of the First Nations Health Authority Health Benefits Claims data in 2015 confirmed that polypharmacy is an issue for First Nations in British Columbia, Canada. This was further validated in a series of meetings held in four First Nations communities. The learnings from these meetings were that many people do not know the names of their medications, the reasons for taking them, or how to advocate for themselves during health care interactions. A unique strategy was needed to both encourage and empower First Nations and Indigenous people to discuss managing their medications, and to support health care professionals to better understand how to engage First Nations patients about their medications.
{"title":"Promoting Healthy Medication Use Through Indigenous Knowledge Sharing: A Coyote Story","authors":"G. Gaspard, C. Gadsby, Cindy Preston","doi":"10.32799/IJIH.V16I2.33224","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33224","url":null,"abstract":"\u0000 \u0000 \u0000Polypharmacy is the administration of more medications than clinically required or appropriate, and it can negatively impact wellness. Prescribers, pharmacists, nurses, and those receiving care services all have an important role to play in promoting healthy medication use and minimizing the risk related to polypharmacy. Medication management involves health care professionals regularly reviewing drug therapies with patients for any needed changes. This strategy is a key way to reduce the harms of polypharmacy. A review of the First Nations Health Authority Health Benefits Claims data in 2015 confirmed that polypharmacy is an issue for First Nations in British Columbia, Canada. This was further validated in a series of meetings held in four First Nations communities. The learnings from these meetings were that many people do not know the names of their medications, the reasons for taking them, or how to advocate for themselves during health care interactions. A unique strategy was needed to both encourage and empower First Nations and Indigenous people to discuss managing their medications, and to support health care professionals to better understand how to engage First Nations patients about their medications. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44458811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.32799/IJIH.V16I2.33119
Megan Barker, Anita Uuttuvak, Christine Lund, Rosa Dragonetti, P. Selby
Settler introduction of tobacco to Inuit Nunangat (homeland of Inuit in Canada) has led to high tobacco use prevalence among Inuit. Inuit are moving from traditional territories to the province of Ontario to access resources, including health services. Indigenous-specific tobacco cessation approaches in Ontario lack cultural relevance among Inuit, as they often reflect First Nations and Métis worldviews. To improve effectiveness of tobacco cessation services for Inuit living in Ontario, materials reflective of Inuit culture and worldviews were developed through a community-based participatory approach. The Centre for Addiction and Mental Health collaborated with Tungasuvvingat Inuit and members of an Engagement Circle who work with Inuit or identify as Inuk (n = 25) to initiate a knowledge translation project aimed at co-creating a toolkit of Inuit-specific cessation resources. Development was guided by Two-Eyed Seeing, whereby Inuit and Western worldviews come together to support a strengths-based approach. The toolkit was evaluated through a pilot session and focus group with Inuit living in Ottawa who use tobacco (n = 13) and an online survey administered with a group of helpers who work with Inuit (n = 11). Analysis of qualitative data from the focus group and online survey highlighted five themes: choice, cultural relevance and safety, capacity-building, access, and impact. Focus group participants reported they learned quitting was possible and identified new strategies to quit through the session. Our findings emphasize the importance of engagement and co-creation with Indigenous Peoples to ensure cultural relevance and appropriateness of healthcare interventions.
{"title":"Adapting Evidence-Based Tobacco Addiction Treatment for Inuit Living in Ontario: A Qualitative Study of Collaboration and Co-creation to Move From Pan-Indigenous to Inuit-Specific Programming","authors":"Megan Barker, Anita Uuttuvak, Christine Lund, Rosa Dragonetti, P. Selby","doi":"10.32799/IJIH.V16I2.33119","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33119","url":null,"abstract":"\u0000 \u0000 \u0000Settler introduction of tobacco to Inuit Nunangat (homeland of Inuit in Canada) has led to high tobacco use prevalence among Inuit. Inuit are moving from traditional territories to the province of Ontario to access resources, including health services. Indigenous-specific tobacco cessation approaches in Ontario lack cultural relevance among Inuit, as they often reflect First Nations and Métis worldviews. To improve effectiveness of tobacco cessation services for Inuit living in Ontario, materials reflective of Inuit culture and worldviews were developed through a community-based participatory approach. The Centre for Addiction and Mental Health collaborated with Tungasuvvingat Inuit and members of an Engagement Circle who work with Inuit or identify as Inuk (n = 25) to initiate a knowledge translation project aimed at co-creating a toolkit of Inuit-specific cessation resources. Development was guided by Two-Eyed Seeing, whereby Inuit and Western worldviews come together to support a strengths-based approach. The toolkit was evaluated through a pilot session and focus group with Inuit living in Ottawa who use tobacco (n = 13) and an online survey administered with a group of helpers who work with Inuit (n = 11). Analysis of qualitative data from the focus group and online survey highlighted five themes: choice, cultural relevance and safety, capacity-building, access, and impact. Focus group participants reported they learned quitting was possible and identified new strategies to quit through the session. Our findings emphasize the importance of engagement and co-creation with Indigenous Peoples to ensure cultural relevance and appropriateness of healthcare interventions. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44264448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.32799/IJIH.V16I2.33180
Jennifer Leason
This doctoral research highlights Indigenous women’s experiences of stress and postpartum depression (PPD) through secondary quantitative analysis of the Public Health Agency of Canada’s Canadian Maternity Experiences Survey (2009) and qualitative Indigenous maternity narratives. Indigenous women’s responses to the survey demonstrate that Indigenous women experience 1.9 times higher odds of PPD and are 1.5 times as likely to be diagnosed with depression prior to pregnancy, compared to Canadian women. Indigenous women are also 1.3 times as likely to experience higher levels of stress and 3.3 times as likely to experience three or more stressful life events. While the survey demonstrates higher rates of stress and PPD, it is not culturally or contextually relevant. Therefore, Indigenous maternity narratives from 10 Indigenous mothers in 2015 further contextualize experiences of stress and PPD to include narratives related to adverse social determinants of health and impacts of colonialism. The research includes a discussion on the limitations of previous maternity research and the limits of clinical-medical assessments and diagnosis of stress and PPD in Indigenous populations. The research concludes with recommendations for additional maternity experiences research and ways to support Indigenous women, infants and children, birth partners, families, and communities.
{"title":"Indigenous Women’s Stress and Postpartum Depression: Discussions from the Canadian Maternity Experiences Survey and Indigenous Maternity Narratives","authors":"Jennifer Leason","doi":"10.32799/IJIH.V16I2.33180","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33180","url":null,"abstract":"\u0000 \u0000 \u0000This doctoral research highlights Indigenous women’s experiences of stress and postpartum depression (PPD) through secondary quantitative analysis of the Public Health Agency of Canada’s Canadian Maternity Experiences Survey (2009) and qualitative Indigenous maternity narratives. Indigenous women’s responses to the survey demonstrate that Indigenous women experience 1.9 times higher odds of PPD and are 1.5 times as likely to be diagnosed with depression prior to pregnancy, compared to Canadian women. Indigenous women are also 1.3 times as likely to experience higher levels of stress and 3.3 times as likely to experience three or more stressful life events. While the survey demonstrates higher rates of stress and PPD, it is not culturally or contextually relevant. Therefore, Indigenous maternity narratives from 10 Indigenous mothers in 2015 further contextualize experiences of stress and PPD to include narratives related to adverse social determinants of health and impacts of colonialism. The research includes a discussion on the limitations of previous maternity research and the limits of clinical-medical assessments and diagnosis of stress and PPD in Indigenous populations. The research concludes with recommendations for additional maternity experiences research and ways to support Indigenous women, infants and children, birth partners, families, and communities. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43733299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.32799/IJIH.V16I2.33106
Jacquie Kidd, Shemana Cassim, A. Rolleston, Rawiri Keenan, R. Lawrenson, N. Sheridan, I. Warbrick, Janette Ngaheu, B. Hokowhitu
Co-designed research is gaining prominence within the health care space. Community engagement is a key premise of co-design and is also particularly vital when carrying out kaupapa Maori research. Kaupapa Maori describes a “by Maori, for Maori” approach to research in Aotearoa/New Zealand. This article discusses the research process of Ha Ora: a co-design project underpinned by a kaupapa Maori approach. The objective was to explore the barriers to early presentation and diagnosis of lung cancer, barriers identified by Maori. The team worked with four rural Maori communities, with whom we aimed to co-design local interventions that would promote earlier diagnosis of lung cancer. This article highlights and unpacks the complexities of carrying out community- engaged co-design with Maori who live in rural communities. In particular, we draw attention to the importance of flexibility and adaptability in the research process. We highlight issues pertaining to timelines and budgets, and also the intricacies of involving co-governance and advisory groups. Overall, through this article, we argue that health researchers need to prioritise working with and for participants, rather than on them, especially when working with Maori communities.
{"title":"Hā Ora: Reflecting on a Kaupapa Māori Community-Engaged Co-design Approach to Lung Cancer Research","authors":"Jacquie Kidd, Shemana Cassim, A. Rolleston, Rawiri Keenan, R. Lawrenson, N. Sheridan, I. Warbrick, Janette Ngaheu, B. Hokowhitu","doi":"10.32799/IJIH.V16I2.33106","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33106","url":null,"abstract":"Co-designed research is gaining prominence within the health care space. Community engagement is a key premise of co-design and is also particularly vital when carrying out kaupapa Maori research. Kaupapa Maori describes a “by Maori, for Maori” approach to research in Aotearoa/New Zealand. This article discusses the research process of Ha Ora: a co-design project underpinned by a kaupapa Maori approach. The objective was to explore the barriers to early presentation and diagnosis of lung cancer, barriers identified by Maori. The team worked with four rural Maori communities, with whom we aimed to co-design local interventions that would promote earlier diagnosis of lung cancer. This article highlights and unpacks the complexities of carrying out community- engaged co-design with Maori who live in rural communities. In particular, we draw attention to the importance of flexibility and adaptability in the research process. We highlight issues pertaining to timelines and budgets, and also the intricacies of involving co-governance and advisory groups. Overall, through this article, we argue that health researchers need to prioritise working with and for participants, rather than on them, especially when working with Maori communities.","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45951369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.32799/IJIH.V16I2.33346
A. Medley, Sarah Levine, A. Norton
First Nations people and communities have long been championing the provision of holistic, self-determining, culturally safe, and responsive health care. In April 2016, a catastrophic rise in illicit drug overdose deaths in the province of British Columbia (BC), Canada, led to the declaration of a public health emergency. Due to the compounding historical and ongoing impacts of colonialism, including trauma and inequitable access to health services, First Nations people in BC are disproportionately impacted by this crisis. In response, the First Nations Health Authority created Not Just Naloxone (NJN), a train-the-trainer workshop designed to build Indigenous harm reduction knowledge and skills within First Nations communities. This article describes the NJN program and presents the results of a follow-up evaluation of 37 participants from six NJN workshops held between December 2017 and October 2018. Core strengths of the training included an Indigenized approach and the opportunity to build networks of support. Respondents reported increased knowledge and confidence presenting about harm reduction and feeling more prepared to respond to overdoses. Areas for improvement included maintaining up-to-date training materials and navigating emotional triggers for participants. Trainees went on to train over 2,400 community members in naloxone and Indigenous harm reduction, and reported that communities’ awareness and attitudes around harm reduction began to change. Challenges providing community trainings included buy-in from local leadership and persistent abstinence-based beliefs. This evaluation demonstrates the impact of holistic, culturally safe harm reduction training and the need for a connected community of Indigenous harm reduction champions.
{"title":"Putting Indigenous Harm Reduction to Work: Developing and Evaluating “Not Just Naloxone”","authors":"A. Medley, Sarah Levine, A. Norton","doi":"10.32799/IJIH.V16I2.33346","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33346","url":null,"abstract":"\u0000 \u0000 \u0000First Nations people and communities have long been championing the provision of holistic, self-determining, culturally safe, and responsive health care. In April 2016, a catastrophic rise in illicit drug overdose deaths in the province of British Columbia (BC), Canada, led to the declaration of a public health emergency. Due to the compounding historical and ongoing impacts of colonialism, including trauma and inequitable access to health services, First Nations people in BC are disproportionately impacted by this crisis. In response, the First Nations Health Authority created Not Just Naloxone (NJN), a train-the-trainer workshop designed to build Indigenous harm reduction knowledge and skills within First Nations communities. This article describes the NJN program and presents the results of a follow-up evaluation of 37 participants from six NJN workshops held between December 2017 and October 2018. Core strengths of the training included an Indigenized approach and the opportunity to build networks of support. Respondents reported increased knowledge and confidence presenting about harm reduction and feeling more prepared to respond to overdoses. Areas for improvement included maintaining up-to-date training materials and navigating emotional triggers for participants. Trainees went on to train over 2,400 community members in naloxone and Indigenous harm reduction, and reported that communities’ awareness and attitudes around harm reduction began to change. Challenges providing community trainings included buy-in from local leadership and persistent abstinence-based beliefs. This evaluation demonstrates the impact of holistic, culturally safe harm reduction training and the need for a connected community of Indigenous harm reduction champions. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44149231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-20DOI: 10.32799/IJIH.V16I1.33078
S. Leeuw, Roseann M. Larstone, B. Fell, N. Cross, M. Greenwood, Katriona Auerbach, J. Sutherland
Well-documented disparities in health status persist between Indigenous and non- Indigenous people in Canada. Medical schools have a responsibility to address underlying causes of these inequities, in part by developing future physicians’ cultural humility and their capacities in cultural safety by increasing critical anti- racism knowledge and understandings about First Nations, Inuit, and Métis Peoples. Undergraduate medical education relies heavily on, among other pedagogies, experiential learning. Moreover, a growing body of research is evidencing the value of applying humanities-informed approaches to medical education in order to produce “better doctors” (i.e., physicians who are more empathetic, compassionate, and attuned to wholistic orientations to patient wellness). The combined impact of these two approaches (experiential learning and humanities-informed pedagogies) on medical students’ development of cultural humility and capacities in cultural safety with Indigenous Peoples is unknown. This paper describes how the First Nations Community Education Program—an innovative humanities-informed Indigenous cultural immersion program—was developed and implemented as a collaborative project of the Northern Medical Program (itself the result of a partnership between the University of British Columbia’s Faculty of Medicine and the University of Northern British Columbia), the First Nations Health Authority, and Northern Health. The paper also documents impacts of the program and provides a resource for other medical education programs considering similar initiatives focused on cultural humility or the Truth and Reconciliation Commission’s Calls to Action.
{"title":"Educating Medical Students’ “Hearts and Minds”: A Humanities-Informed Cultural Immersion Program in Indigenous Experiential Community Learning","authors":"S. Leeuw, Roseann M. Larstone, B. Fell, N. Cross, M. Greenwood, Katriona Auerbach, J. Sutherland","doi":"10.32799/IJIH.V16I1.33078","DOIUrl":"https://doi.org/10.32799/IJIH.V16I1.33078","url":null,"abstract":"\u0000 \u0000 \u0000Well-documented disparities in health status persist between Indigenous and non- Indigenous people in Canada. Medical schools have a responsibility to address underlying causes of these inequities, in part by developing future physicians’ cultural humility and their capacities in cultural safety by increasing critical anti- racism knowledge and understandings about First Nations, Inuit, and Métis Peoples. Undergraduate medical education relies heavily on, among other pedagogies, experiential learning. Moreover, a growing body of research is evidencing the value of applying humanities-informed approaches to medical education in order to produce “better doctors” (i.e., physicians who are more empathetic, compassionate, and attuned to wholistic orientations to patient wellness). The combined impact of these two approaches (experiential learning and humanities-informed pedagogies) on medical students’ development of cultural humility and capacities in cultural safety with Indigenous Peoples is unknown. This paper describes how the First Nations Community Education Program—an innovative humanities-informed Indigenous cultural immersion program—was developed and implemented as a collaborative project of the Northern Medical Program (itself the result of a partnership between the University of British Columbia’s Faculty of Medicine and the University of Northern British Columbia), the First Nations Health Authority, and Northern Health. The paper also documents impacts of the program and provides a resource for other medical education programs considering similar initiatives focused on cultural humility or the Truth and Reconciliation Commission’s Calls to Action. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49462975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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