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":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":"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":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":"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":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":"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":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":"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":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":"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":null,"pages":null},"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}
Pub Date : 2021-01-20DOI: 10.32799/IJIH.V16I2.33906
Carrie LaVallie, JoLee Sasakamoose
The aim of this paper is to propose a new way of understanding data contemplation for Indigenous methodologies. There is a need for Indigenous methods that allow us to explore and organize findings that are steeped in the contextualized story and grounded in the research relationship. A study that asked Cree Kehte-ayak (Old Ones) about the relevance in harmonizing Indigenous and Western ways of knowing in healing from addiction shows that Reflexive Reflection (RR) offers a respectful way for discovery. RR offers epistemological underpinnings for data consideration when engaging Indigenous methodologies. Culturally rooted addictions research can contribute to Indigenous wellness and cultural renewal by bringing awareness to the link between colonialism and addiction and by actively re-centring an Indigenous worldview and governance in the research process (Hall et al., 2015). While challenging colonialism is vital, the strength of Indigenous culture must be central to the overall project, with relational accountability that implies all parts of the research process are related, and that the researcher is responsible for nurturing and maintaining this relationship with the research process and with “all relations.” Indigenous research inquiry involves moments of contemplation that explore dreams, intuition, teachings, and connection to land. It also involves spending intimate hours listening to stories of the “old ones” that are rooted in a sense of kinshipresponsibility that relay culture, identity, and a sense of belonging that are essential to the life of the researcher. Reframing the language around aftercare services for Indigenous Peoples can take place through reflexive investigation and knowledge creation.
{"title":"Reflexive Reflection Co-created with Kehte-ayak (Old Ones) as an Indigenous Qualitative Methodological Data Contemplation Tool","authors":"Carrie LaVallie, JoLee Sasakamoose","doi":"10.32799/IJIH.V16I2.33906","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33906","url":null,"abstract":"\u0000 \u0000 \u0000The aim of this paper is to propose a new way of understanding data contemplation for Indigenous methodologies. There is a need for Indigenous methods that allow us to explore and organize findings that are steeped in the contextualized story and grounded in the research relationship. A study that asked Cree Kehte-ayak (Old Ones) about the relevance in harmonizing Indigenous and Western ways of knowing in healing from addiction shows that Reflexive Reflection (RR) offers a respectful way for discovery. RR offers epistemological underpinnings for data consideration when engaging Indigenous methodologies. Culturally rooted addictions research can contribute to Indigenous wellness and cultural renewal by bringing awareness to the link between colonialism and addiction and by actively re-centring an Indigenous worldview and governance in the research process (Hall et al., 2015). While challenging colonialism is vital, the strength of Indigenous culture must be central to the overall project, with relational accountability that implies all parts of the research process are related, and that the researcher is responsible for nurturing and maintaining this relationship with the research process and with “all relations.” Indigenous research inquiry involves moments of contemplation that explore dreams, intuition, teachings, and connection to land. It also involves spending intimate hours listening to stories of the “old ones” that are rooted in a sense of kinshipresponsibility that relay culture, identity, and a sense of belonging that are essential to the life of the researcher. Reframing the language around aftercare services for Indigenous Peoples can take place through reflexive investigation and knowledge creation. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47608509","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 : 2021-01-19DOI: 10.32799/IJIH.V16I1.33240
L. Wylie, S. McConkey, A. Corrado
Indigenous Peoples in Canada continue to experience racism and discrimination when accessing health care. Competencies of health care staff urgently need to be improved through cultural safety education and training programs to inform culturally appropriate and safe care practice among care providers serving Indigenous individuals and families. This paper explores current educational strategies, the perspectives of Indigenous and non-Indigenous care providers on training approaches, and recommendations for improving training. Qualitative semi-structured interviews were conducted with 31 participants to explore the current provision of culturally appropriate and safe care. Interviews were voice recorded and transcribed verbatim, and a thematic analysis was completed. The three key themes related to training that emerged from data analysis were (a) addressing the knowledge gaps, (b) challenges of current training approaches, and (c) recommendations for improvements in training. Each key theme had three subthemes that were further explored. Cultural safety training is a long and iterative process that has the potential to change care providers’ behaviours and attitudes. Various challenges to existing education and training included issues with implementation, limited follow up with health care staff to support practice changes, and/or limited commitment from senior leadership to change organizational policies and practices. As such, there is a clear need for systemic change within health care institutions to support staff participating in cultural safety training and to put that training into practice to create a culturally safe space for Indigenous individuals seeking health care.
{"title":"It’s a Journey Not a Check Box: Indigenous Cultural Safety From Training to Transformation","authors":"L. Wylie, S. McConkey, A. Corrado","doi":"10.32799/IJIH.V16I1.33240","DOIUrl":"https://doi.org/10.32799/IJIH.V16I1.33240","url":null,"abstract":"\u0000 \u0000 \u0000Indigenous Peoples in Canada continue to experience racism and discrimination when accessing health care. Competencies of health care staff urgently need to be improved through cultural safety education and training programs to inform culturally appropriate and safe care practice among care providers serving Indigenous individuals and families. This paper explores current educational strategies, the perspectives of Indigenous and non-Indigenous care providers on training approaches, and recommendations for improving training. Qualitative semi-structured interviews were conducted with 31 participants to explore the current provision of culturally appropriate and safe care. Interviews were voice recorded and transcribed verbatim, and a thematic analysis was completed. The three key themes related to training that emerged from data analysis were (a) addressing the knowledge gaps, (b) challenges of current training approaches, and (c) recommendations for improvements in training. Each key theme had three subthemes that were further explored. Cultural safety training is a long and iterative process that has the potential to change care providers’ behaviours and attitudes. Various challenges to existing education and training included issues with implementation, limited follow up with health care staff to support practice changes, and/or limited commitment from senior leadership to change organizational policies and practices. As such, there is a clear need for systemic change within health care institutions to support staff participating in cultural safety training and to put that training into practice to create a culturally safe space for Indigenous individuals seeking health care. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43880911","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 : 2021-01-17DOI: 10.32799/IJIH.V16I2.33082
J. Mcelhaney, Joy Helmer, Marion C. E. Briggs, M. Andrew, K. McGilton, Taima Moeke-Pickering, L. J. Pulver, Elder Betty McKenna
The purpose of this paper is to provide a narrative of our experience with community-driven change using our “Developer/Adapter” research method in Northern Ontario, Canada, so it can be explored in other First Nations contexts. The goal of our currently funded research is to identify community solutions and knowledge and implement community-developed interventions to better support older Indigenous persons, especially those in rural and remote communities, to “age in place” and remain independent in the community through timely access to relevant care. Our Developer/Adapter research method was developed in response to the community-identified need for self-determination to overcome the limitations of traditional Western approaches and effectively plan and execute change in Indigenous communities. Our approach commits to supporting a self- determining voice for Indigenous people and working collaboratively to develop wholistic care interventions. We believe this approach can generate compelling data for policy and practice change in both Canada and Australia.
{"title":"Developer/Adapter Method: A Community-Based Approach to Improve Health in Indigenous Communities","authors":"J. Mcelhaney, Joy Helmer, Marion C. E. Briggs, M. Andrew, K. McGilton, Taima Moeke-Pickering, L. J. Pulver, Elder Betty McKenna","doi":"10.32799/IJIH.V16I2.33082","DOIUrl":"https://doi.org/10.32799/IJIH.V16I2.33082","url":null,"abstract":"\u0000 \u0000 \u0000The purpose of this paper is to provide a narrative of our experience with community-driven change using our “Developer/Adapter” research method in Northern Ontario, Canada, so it can be explored in other First Nations contexts. The goal of our currently funded research is to identify community solutions and knowledge and implement community-developed interventions to better support older Indigenous persons, especially those in rural and remote communities, to “age in place” and remain independent in the community through timely access to relevant care. Our Developer/Adapter research method was developed in response to the community-identified need for self-determination to overcome the limitations of traditional Western approaches and effectively plan and execute change in Indigenous communities. Our approach commits to supporting a self- determining voice for Indigenous people and working collaboratively to develop wholistic care interventions. We believe this approach can generate compelling data for policy and practice change in both Canada and Australia. \u0000 \u0000 \u0000","PeriodicalId":54163,"journal":{"name":"International Journal of Indigenous Health","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44589166","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 : 2021-01-17DOI: 10.32799/IJIH.V16I2.33932
E. Fast, Melissa L. Lefebvre, C. Reid, Brooke Wahsontiiostha Deer, Dakota Swiftwolfe, Moe Clark, Vicky Boldo, J. Mackie, R. Mackie
Knowledge gathered about the impacts of land-based teachings on Indigenous youth is limited. Many Indigenous people and government commissions have pointed to targeted assimilation and land theft as central to historical and ongoing collective dissociation of Indigenous Peoples from their ways of being in relation with the land. It is thus paramount that Indigenous youth be given the opportunities to (re)connect with their cultures in safe, accessible spaces/places. Demonstrating the many ways learning from the land is beneficial for Indigenous youth, the Restoring Our Roots participatory action research project contributes to the knowledge base in this area to centre Indigeneity and reclaim our cultures by enacting Indigenous methodologies and pedagogies. An Indigenous youth advisory committee developed a four-day land-based retreat, held in July 2018, that focused on (re)connecting Indigenous youth to land-based teachings and ceremony. In interviews following the retreat, youth participants spoke about positive changes related to identity, belonging, well-being, and feeling free from violence in this space that engaged land-based teachings led by Elders, Knowledge Holders, and youth themselves. Some Indigenous youth who identify as Two-Spirit, non-binary, and/or LGBTQIA+ attended the retreat and shared how important it is to have safe spaces that are inclusive of diverse gender roles and identities. Restoring Our Roots created an inclusive community of support, sharing, and learning for Indigenous youth, extending into participants’ everyday lives in the city. This project has since grown into Land As Our Teacher, a five- year research project funded by the Social Sciences and Humanities Research Council of Canada, that explores benefits of land-based pedagogies for Indigenous youth.
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