Pub Date : 2021-02-03DOI: 10.32799/IJIH.V16I1.33051
L. Hasan, J. Johnson
This paper describes a wise practice for collaborative change through the Trauma- Informed and Culturally Safe Emergency Care for Nuu-chah-nulth Elders project. For decades, Nuu-chah-nulth Elders have been avoiding emergency care due to colonial trauma and a lack of culturally safe care. To begin addressing this community priority, the First Nations Health Authority, in partnership with Island Health and university partners, organized a two-day workshop in September 2017 with Nuu-chah-nulth Elders, community members, and health partners. Key to ensuring the process was culturally sensitive was following the guidance of the West Coast General Hospital Cultural Safety Committee, a partnership between Nuu-chah-nulth people and health providers. Respect and trust were developed by centring the voices of Elders and giving them a safe space for discussion before developing recommendations with health partners. Feedback from participants was gathered from notes and audio recordings and thematically analyzed into eight major recommendations (i.e., increase engagement and relationship building; develop action plans; increase education and awareness; increase advocacy and support; incorporate First Nations medicine, healing, and foods; provide culturally safe spaces; develop policy and protocol; and link to comprehensive community support), with attention to preserving Elder voices. The recommendations were validated by returning and new participants at a gathering in June 2019. Elders noted that while experiences of unsafe care continue, noticeable improvements in cultural safety are being made and they feel heard.
{"title":"Paddling Together for Culturally Safe Emergency Care for Elders","authors":"L. Hasan, J. Johnson","doi":"10.32799/IJIH.V16I1.33051","DOIUrl":"https://doi.org/10.32799/IJIH.V16I1.33051","url":null,"abstract":"This paper describes a wise practice for collaborative change through the Trauma- Informed and Culturally Safe Emergency Care for Nuu-chah-nulth Elders project. For decades, Nuu-chah-nulth Elders have been avoiding emergency care due to colonial trauma and a lack of culturally safe care. To begin addressing this community priority, the First Nations Health Authority, in partnership with Island Health and university partners, organized a two-day workshop in September 2017 with Nuu-chah-nulth Elders, community members, and health partners. Key to ensuring the process was culturally sensitive was following the guidance of the West Coast General Hospital Cultural Safety Committee, a partnership between Nuu-chah-nulth people and health providers. Respect and trust were developed by centring the voices of Elders and giving them a safe space for discussion before developing recommendations with health partners. Feedback from participants was gathered from notes and audio recordings and thematically analyzed into eight major recommendations (i.e., increase engagement and relationship building; develop action plans; increase education and awareness; increase advocacy and support; incorporate First Nations medicine, healing, and foods; provide culturally safe spaces; develop policy and protocol; and link to comprehensive community support), with attention to preserving Elder voices. The recommendations were validated by returning and new participants at a gathering in June 2019. Elders noted that while experiences of unsafe care continue, noticeable improvements in cultural safety are being made and they feel heard.","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44744713","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 : 2021-01-28DOI: 10.32799/IJIH.V16I1.33225
G. Gaspard, David McAtackney, D. Sullivan, Mavis Sebastian
This project originated from nursing staff’s learning need for knowledge, approach, attitude, and skills in dementia care that was identified by the Gitxsan Health Society. In collaboration with the First Nations Health Authority, the Gitxsan Health Society sought to educate nurses on how to provide culturally appropriate care to older Gitxsan persons living with dementia, and also to increase the understanding of nurses, family caregivers, and the wider community about dementia as a chronic condition. This project involved a mixed-methods approach (multiple qualitative approaches, as well as a quantitative component). The team was guided at each stage by a Cultural Advisory Council of four Elders recognized as Knowledge Holder from the community. The project involved a strong element of reciprocal co-learning and knowledge exchange. From discussions and exchange with community members, three large interlinking themes emerged to guide the researchers: (a) loss and grief; (b) relationality; and (c) access and connection. These themes gave voice to the gaps and needs in care, but also highlighted the potential areas of strength that can be built on to improve care for the older Gitxsan person living with dementia. Family and other community members identified the need for more information regarding dementia, the need to access in-community and external supports, and the need to inform nurses about what considerations are required when caring for Gitxsan people living with dementia. A better understanding of the Gitxsan ways of knowing about dementia can help nurses incorporate more culturally safe practices into the care of persons living with dementia.
{"title":"Improving Dementia Care for Gitxsan First Nations People","authors":"G. Gaspard, David McAtackney, D. Sullivan, Mavis Sebastian","doi":"10.32799/IJIH.V16I1.33225","DOIUrl":"https://doi.org/10.32799/IJIH.V16I1.33225","url":null,"abstract":"\u0000 \u0000 \u0000This project originated from nursing staff’s learning need for knowledge, approach, attitude, and skills in dementia care that was identified by the Gitxsan Health Society. In collaboration with the First Nations Health Authority, the Gitxsan Health Society sought to educate nurses on how to provide culturally appropriate care to older Gitxsan persons living with dementia, and also to increase the understanding of nurses, family caregivers, and the wider community about dementia as a chronic condition. This project involved a mixed-methods approach (multiple qualitative approaches, as well as a quantitative component). The team was guided at each stage by a Cultural Advisory Council of four Elders recognized as Knowledge Holder from the community. The project involved a strong element of reciprocal co-learning and knowledge exchange. From discussions and exchange with community members, three large interlinking themes emerged to guide the researchers: (a) loss and grief; (b) relationality; and (c) access and connection. These themes gave voice to the gaps and needs in care, but also highlighted the potential areas of strength that can be built on to improve care for the older Gitxsan person living with dementia. Family and other community members identified the need for more information regarding dementia, the need to access in-community and external supports, and the need to inform nurses about what considerations are required when caring for Gitxsan people living with dementia. A better understanding of the Gitxsan ways of knowing about dementia can help nurses incorporate more culturally safe practices into the care of persons living with dementia. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46790965","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 : 2021-01-28DOI: 10.32799/IJIH.V16I1.33207
Grace Kyoon-Achan
The models of primary health care currently operating in First Nations communities are rooted in policies that were crafted without prior appropriate consultations. Many have continued to be applied even though they no longer adequately serve the needs of First Nations communities and people, if they ever did. Transforming primary health care will necessarily involve community- inclusive and self-determined reviewing of existing policies with a goal of implementing opportunities to update policies and models of care. This study was a partnership with university-based researchers, a First Nations health and social development entity separately established by a regional organization of First Nations Chiefs, and eight First Nations communities. A multi-pronged methodology was used in which five concurrent studies employing qualitative, quantitative, and case-study methods provided information on the primary health care experiences of First Nations and rural and remote communities. The program of research took a community-based participatory approach to engage participants in designing and carrying out data gathering while strengthening local capacity and encouraging long-term ownership of the process of research for change. Participating communities pointed out key setbacks to community- based primary health care, including differing models of care, jurisdictional complexities, funding that creates isolated programs within the same community, lack of promotion of cooperation among health care services, and a general acute approach to health care service delivery in the community. These barriers are both problems and opportunities for change. A borderless health care system that is jurisdictionally seamless and that promotes collaboration through cooperative funding models that reflect community priorities is recommended and advocated for all Manitoba First Nations communities.
{"title":"Collaborative and Systems Approach to Transforming Primary Health Care in Manitoba First Nations Communities","authors":"Grace Kyoon-Achan","doi":"10.32799/IJIH.V16I1.33207","DOIUrl":"https://doi.org/10.32799/IJIH.V16I1.33207","url":null,"abstract":"\u0000 \u0000 \u0000The models of primary health care currently operating in First Nations communities are rooted in policies that were crafted without prior appropriate consultations. Many have continued to be applied even though they no longer adequately serve the needs of First Nations communities and people, if they ever did. Transforming primary health care will necessarily involve community- inclusive and self-determined reviewing of existing policies with a goal of implementing opportunities to update policies and models of care. This study was a partnership with university-based researchers, a First Nations health and social development entity separately established by a regional organization of First Nations Chiefs, and eight First Nations communities. A multi-pronged methodology was used in which five concurrent studies employing qualitative, quantitative, and case-study methods provided information on the primary health care experiences of First Nations and rural and remote communities. The program of research took a community-based participatory approach to engage participants in designing and carrying out data gathering while strengthening local capacity and encouraging long-term ownership of the process of research for change. Participating communities pointed out key setbacks to community- based primary health care, including differing models of care, jurisdictional complexities, funding that creates isolated programs within the same community, lack of promotion of cooperation among health care services, and a general acute approach to health care service delivery in the community. These barriers are both problems and opportunities for change. A borderless health care system that is jurisdictionally seamless and that promotes collaboration through cooperative funding models that reflect community priorities is recommended and advocated for all Manitoba First Nations communities. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47701737","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 : 2021-01-28DOI: 10.32799/IJIH.V16I1.33218
D. Manton, Megan Williams
While professional education in medicine and nursing in Australia has been implementing strategies to increase accessibility for Indigenous Australians, allied health professions remain underdeveloped in this area. Failure to improve the engagement of allied health professions with Indigenous Australians, and failure to increase the numbers of Indigenous staff and students risks perpetuating health inequities, intergenerational disadvantage, and threatens the integrity of professions who have publically committed to achieving cultural safety and health equity between Indigenous and non-Indigenous people. Knowing this, leaders in the allied health professions are asking “What needs to change?” This paper presents a critical reflection on experiences of a university-based Indigenous Health Unit leading the embedding of Indigenous perspectives in allied health curriculum, informed by Indigenous community connections, literature reviews, and research in the context of an emerging community of practice on Indigenous health education. Key themes from reflections are presented in this paper, identifying barriers as well as enablers for change, which include Indigenous community relationship building, education of staff and students, and collaborative research and teaching on Indigenous Peoples’ allied health needs and models of care. These enablers are inherently anti-racism strategies that redress negative stereotypes perpetuated about Indigenous Australians and encourage the promotion of valuable Indigenous knowledges, principles, and practices as strategies that may also help meet the health needs of the general community.
{"title":"Strengthening Indigenous Australian Perspectives in Allied Health Education: A Critical Reflection","authors":"D. Manton, Megan Williams","doi":"10.32799/IJIH.V16I1.33218","DOIUrl":"https://doi.org/10.32799/IJIH.V16I1.33218","url":null,"abstract":"\u0000 \u0000 \u0000While professional education in medicine and nursing in Australia has been implementing strategies to increase accessibility for Indigenous Australians, allied health professions remain underdeveloped in this area. Failure to improve the engagement of allied health professions with Indigenous Australians, and failure to increase the numbers of Indigenous staff and students risks perpetuating health inequities, intergenerational disadvantage, and threatens the integrity of professions who have publically committed to achieving cultural safety and health equity between Indigenous and non-Indigenous people. Knowing this, leaders in the allied health professions are asking “What needs to change?” This paper presents a critical reflection on experiences of a university-based Indigenous Health Unit leading the embedding of Indigenous perspectives in allied health curriculum, informed by Indigenous community connections, literature reviews, and research in the context of an emerging community of practice on Indigenous health education. Key themes from reflections are presented in this paper, identifying barriers as well as enablers for change, which include Indigenous community relationship building, education of staff and students, and collaborative research and teaching on Indigenous Peoples’ allied health needs and models of care. These enablers are inherently anti-racism strategies that redress negative stereotypes perpetuated about Indigenous Australians and encourage the promotion of valuable Indigenous knowledges, principles, and practices as strategies that may also help meet the health needs of the general community. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44550141","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 : 2021-01-28DOI: 10.32799/IJIH.V16I1.33369
Christine Shawana, Chaneesa Ryan, Abrar Ali
Between 2015 and 2019, over 100 Indigenous women from six provinces and two territories have come forward to say that they were forced or coerced to undergo a sterilization procedure in Canada. Despite this, government action is lacking. Through this paper, the research team aims to collect and synthesize the recommendations that have been made in response to the recent cases of forced or coerced sterilization of Indigenous women in Canada. Through a secondary analysis of data, we outline the findings of a thematic analysis of 162 recommendations from four selected sources: (a) Tubal Ligation in the Saskatoon Health Region: The Lived Experience of Aboriginal Women, an external review by Senator Yvonne Boyer and Dr. Judith Bartlett, July 22, 2017; (b) a meeting of the Senate Committee on Human Rights, April 3, 2019; (c) meetings of the House of Commons Standing Committee on Health, June 13 and 18, 2019; and (d) a letter from Bill Casey, Member of Parliament and Chair of the House of Commons Standing Committee on Health, to three federal ministers, August 2, 2019. Seven themes emerged following the thematic analysis of the 162 recommendations: (a) Services and Supports (b)Accountability, (c) Training and Education, (d) Legislation and Policy, (e) Criminalization, (f) Data Collection, and g) Investigation. These themes represent seven areas where immediate government action is required to meaningfully and appropriately respond to the recent cases of forced or coerced sterilization of First Nations, Inuit, and Metis women in Canada.
{"title":"Forced or Coerced Sterilization in Canada: An Overview of Recommendations for Moving Forward","authors":"Christine Shawana, Chaneesa Ryan, Abrar Ali","doi":"10.32799/IJIH.V16I1.33369","DOIUrl":"https://doi.org/10.32799/IJIH.V16I1.33369","url":null,"abstract":"\u0000 \u0000 \u0000Between 2015 and 2019, over 100 Indigenous women from six provinces and two territories have come forward to say that they were forced or coerced to undergo a sterilization procedure in Canada. Despite this, government action is lacking. Through this paper, the research team aims to collect and synthesize the recommendations that have been made in response to the recent cases of forced or coerced sterilization of Indigenous women in Canada. Through a secondary analysis of data, we outline the findings of a thematic analysis of 162 recommendations from four selected sources: (a) Tubal Ligation in the Saskatoon Health Region: The Lived Experience of Aboriginal Women, an external review by Senator Yvonne Boyer and Dr. Judith Bartlett, July 22, 2017; (b) a meeting of the Senate Committee on Human Rights, April 3, 2019; (c) meetings of the House of Commons Standing Committee on Health, June 13 and 18, 2019; and (d) a letter from Bill Casey, Member of Parliament and Chair of the House of Commons Standing Committee on Health, to three federal ministers, August 2, 2019. Seven themes emerged following the thematic analysis of the 162 recommendations: (a) Services and Supports (b)Accountability, (c) Training and Education, (d) Legislation and Policy, (e) Criminalization, (f) Data Collection, and g) Investigation. These themes represent seven areas where immediate government action is required to meaningfully and appropriately respond to the recent cases of forced or coerced sterilization of First Nations, Inuit, and Metis women in Canada. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42440105","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 : 2021-01-26DOI: 10.32799/IJIH.V16I2.33903
Amy Sanderson, Flo Ranville, Lulu Gurney, B. Borden, S. Pooyak, K. Shannon, Andrea Krüsi
Indigenous women living with HIV are disproportionately affected by the criminalization of HIV nondisclosure. The purpose of this paper is to better understand how the criminalization of HIV nondisclosure shapes the lived experiences of HIV-related stigma, disclosure, and health service among cis and transgender Indigenous women living with HIV (IWLWH). This study was developed based on a community roundtable on HIV criminalization with engagement of legal experts, HIV service organizations, and IWLWH on the unceded traditional territory of the Coast Salish Peoples, including the ter̓ritories of the xwməθkwəy̓ əm (Musqueam), Sḵwx̱ wú7mesh (Squamish), and Səlílwətaɬ (Tsleil-Waututh) Nations (Vancouver, British Columbia, Canada) in 2016 to 2018. Drawing on community-based participatory photovoice methodology, Indigenous Peer Researchers played a central role throughout this project, including planning, facilitation of photo-voice workshops, and analysis. This analysis includes 17 IWLWH. Through a peer-engaged analysis process, the photovoice images and narratives illustrated how the criminalization of HIV nondisclosure is intertwined with colonial violence to shape experiences of social isolation and exclusion, disclosure, access to safe health care, responsibility, fear, and resilience. The legal requirements of HIV nondisclosure are unattainable for many IWLWH who are not able to safely disclose their HIV status, negotiate condom use, and maintain a low viral load. In line with the Truth and Reconciliation Commission of Canada and National Inquiry into Missing and Murdered Indigenous Women and Girls, the justice system must be reoriented from punishment and oppression to healing and wellbeing for all Indigenous women living with HIV. Simultaneously, we call for culturally safe services that protect privacy and recognize strengths of IWLWH.
携带艾滋病毒的土著妇女受到不披露艾滋病毒的刑事定罪的不成比例的影响。本文的目的是更好地理解艾滋病毒不披露的刑事化如何影响土著顺性和跨性别艾滋病毒感染者(IWLWH)的艾滋病毒相关耻辱，披露和卫生服务的生活经历。这项研究是在2016年至2018年期间，由法律专家、艾滋病毒服务组织和IWLWH参与的关于艾滋病毒刑事定罪的社区圆桌会议的基础上开展的，会议涉及沿海萨利希民族的未被割让的传统领土，包括xwm æ θkw æ y k æ m (Musqueam)、Sḵwx´wú7mesh (Squamish)和S´lílw´ta æ (Tsleil-Waututh)民族(加拿大不列颠哥伦比亚省温哥华)的ter æ领土。利用基于社区的参与式光声方法，土著同伴研究人员在整个项目中发挥了核心作用，包括规划、促进光声讲习班和分析。该分析包括17个IWLWH。通过同行参与的分析过程，照片语音图像和叙述说明了对艾滋病毒保密的刑事定罪如何与殖民暴力交织在一起，形成了社会孤立和排斥、披露、获得安全保健、责任、恐惧和复原力的经历。对于许多无法安全地披露自己的艾滋病毒状况、协商使用安全套和保持低病毒载量的IWLWH来说，保密的法律要求是无法实现的。根据加拿大真相与和解委员会和失踪与被谋杀土著妇女和女孩全国调查，司法系统必须从惩罚和压迫转向为所有感染艾滋病毒的土著妇女提供治疗和福祉。同时，我们呼吁提供文化上安全的服务，保护隐私，并认识到IWLWH的优势。
{"title":"Indigenous Women Voicing Experiences of HIV Stigma and Criminalization Through Art","authors":"Amy Sanderson, Flo Ranville, Lulu Gurney, B. Borden, S. Pooyak, K. Shannon, Andrea Krüsi","doi":"10.32799/IJIH.V16I2.33903","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33903","url":null,"abstract":"\u0000 \u0000 \u0000Indigenous women living with HIV are disproportionately affected by the criminalization of HIV nondisclosure. The purpose of this paper is to better understand how the criminalization of HIV nondisclosure shapes the lived experiences of HIV-related stigma, disclosure, and health service among cis and transgender Indigenous women living with HIV (IWLWH). This study was developed based on a community roundtable on HIV criminalization with engagement of legal experts, HIV service organizations, and IWLWH on the unceded traditional territory of the Coast Salish Peoples, including the ter̓ritories of the xwməθkwəy̓ əm (Musqueam), Sḵwx̱ wú7mesh (Squamish), and Səlílwətaɬ (Tsleil-Waututh) Nations (Vancouver, British Columbia, Canada) in 2016 to 2018. Drawing on community-based participatory photovoice methodology, Indigenous Peer Researchers played a central role throughout this project, including planning, facilitation of photo-voice workshops, and analysis. This analysis includes 17 IWLWH. Through a peer-engaged analysis process, the photovoice images and narratives illustrated how the criminalization of HIV nondisclosure is intertwined with colonial violence to shape experiences of social isolation and exclusion, disclosure, access to safe health care, responsibility, fear, and resilience. The legal requirements of HIV nondisclosure are unattainable for many IWLWH who are not able to safely disclose their HIV status, negotiate condom use, and maintain a low viral load. In line with the Truth and Reconciliation Commission of Canada and National Inquiry into Missing and Murdered Indigenous Women and Girls, the justice system must be reoriented from punishment and oppression to healing and wellbeing for all Indigenous women living with HIV. Simultaneously, we call for culturally safe services that protect privacy and recognize strengths of IWLWH. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45460546","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 : 2021-01-26DOI: 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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}
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