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Blacksher E, Trinidad SB, Woodbury RB, Hopkins SE, Woodahl EL, Boyer BB, Burke W, Hiratsuka V. Tribal Deliberations about Precision Medicine Research: Addressing Diversity and Inequity in Democratic Deliberation Design and Evaluation. J Empir Res Hum Res Ethics 2022; 17:304-316. [PMID: 35225705 PMCID: PMC9173705 DOI: 10.1177/15562646221081267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Deliberative democratic engagement is used around the globe to gather informed public input on contentious collective questions. Yet, rarely has it been used to convene individuals exclusively from Indigenous communities. The relative novelty of using this approach to engage tribal communities and concerns about diversity and inequities raise important methodological questions. We describe the design and quality outcomes for a 2.5-day deliberation that elicited views of American Indian and Alaska Native (AIAN) leaders about the potential value and ethical conduct of precision medicine research (PMR), an emerging approach to research that investigates the health effects of individual genetic variation in tandem with variation in health-relevant practices, social determinants, and environmental exposures. The event met key goals, such as relationship and rapport formation, cross-site learning, equality of opportunity to participate, and respect among participants in the context of disagreement.
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Corso M, DeSouza A, Brunton G, Yu H, Cancelliere C, Mior S, Taylor-Vaisey A, MacLeod-Beaver K, Côté P. Integrating Indigenous healing practices within collaborative care models in primary healthcare in Canada: a rapid scoping review. BMJ Open 2022; 12:e059323. [PMID: 35710234 PMCID: PMC9207893 DOI: 10.1136/bmjopen-2021-059323] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES In November 2020, a series of reports, In Plain Sight, described widespread Indigenous-specific stereotyping, racism and discrimination limiting access to medical treatment and negatively impacting the health and wellness of Indigenous Peoples in British Columbia, Canada. To address the health inequalities experienced by Indigenous peoples, Indigenous healing practices must be integrated within the delivery of care. This rapid scoping review aimed to identify and synthesise strategies used to integrate Indigenous healing practices within collaborative care models available in community-based primary healthcare, delivered by regulated health professionals in Canada. ELIGIBILITY CRITERIA We included quantitative, qualitative and mixed-methods studies conducted in community-based primary healthcare practices that used strategies to integrate Indigenous healing practices within collaborative care models. SOURCES OF EVIDENCE We searched MEDLINE, Embase, Indigenous Studies Portal, Informit Indigenous Collection and Native Health Database for studies published from 2015 to 2021. CHARTING METHODS Our data extraction used three frameworks to categorise the findings. These frameworks defined elements of integrated healthcare (ie, functional, organisational, normative and professional), culturally appropriate primary healthcare and the extent of community engagement. We narratively summarised the included study characteristics. RESULTS We identified 2573 citations and included 31 in our review. Thirty-nine per cent of reported strategies used functional integration (n=12), 26% organisational (n=8), 19% normative (n=6) and 16% professional (n=5). Eighteen studies (58%) integrated all characteristics of culturally appropriate Indigenous healing practices into primary healthcare. Twenty-four studies (77%) involved Indigenous leadership or collaboration at each phase of the study and, seven (23%) included consultation only or the level of engagement was unclear. CONCLUSIONS We found that collaborative and Indigenous-led strategies were more likely to facilitate and implement the integration of Indigenous healing practices. Commonalities across strategies included community engagement, elder support or Indigenous ceremony or traditions. However, we did not evaluate the effectiveness of these strategies.
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Affiliation(s)
- Melissa Corso
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Astrid DeSouza
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Ginny Brunton
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
- EPPI-Centre, UCL Institute of Education, University College London, London, UK
| | - Hainan Yu
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Carolina Cancelliere
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Silvano Mior
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
- Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Anne Taylor-Vaisey
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | | | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
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Carron R, Kooienga S, Gilman-Kehrer E, Alvero R. Cultural Experiences, Patterns, and Practices of American Indian Women With Polycystic Ovary Syndrome: An Ethnonursing Study. J Transcult Nurs 2019; 31:162-170. [PMID: 31204601 DOI: 10.1177/1043659619856670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Knowledge is needed about the cultural experiences, patterns, and practices of American Indian women with polycystic ovary syndrome (PCOS), so nurses can provide culturally congruent care. Method: A qualitative, ethnonursing study based on Leininger's theory of culture care diversity and universality. Data were collected from 13 key informants living on a reservation in the Western United States. Data were analyzed with Leininger's four phases of qualitative analysis. Results: Three universal themes were identified: (1) control of PCOS symptoms is important for the cultural well-being of tribal women, (2) culturally congruent PCOS education and health care are important with variations in approaches to treatment, and (3) tribal culture is important with variations in use of tribal practices. Discussion: Tribal culture affects the health care beliefs and practices of American Indian women with PCOS. The findings can be used to improve culturally congruent care for women with this chronic condition.
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Morris AM, Doorenbos AZ, Haozous E, Meins A, Javid S, Flum DR. Perceptions of cancer treatment decision making among American Indians/Alaska Natives and their physicians. Psychooncology 2016; 25:1050-6. [PMID: 27279001 PMCID: PMC5014590 DOI: 10.1002/pon.4191] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/03/2016] [Accepted: 06/06/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE American Indian/Alaska Native (AI/AN) patients are significantly less likely than non-Hispanic whites to receive guideline-concordant cancer care. Our objective was to examine cancer treatment decision making among AI/AN patients and their providers. METHODS From 2011 to 2014, AI/AN cancer patients and their surgeons were identified through a hospital registry in Washington State. Patients were invited to participate in a mailed survey that queried socio-demographics, cultural affiliation, everyday perceived discrimination, and trust in providers. Both patients and surgeons were queried about decision-making quality (collaboration and satisfaction). The primary outcome was association between patient and provider assessments of decision-making quality. The secondary outcome was non-adherence to treatment. RESULTS Forty-nine patients (62% response rate) and 14 surgeons (37% response rate) returned surveys. Half of patients had not completed high school; 41% were living in poverty. Half of patients reported a strong tribal affiliation and most reported experiencing some form of discrimination. Patients endorsed high trust in surgeons and a high quality decision-making process; and surgeons' rated decision-making quality even more highly than patients did in every domain. Non-adherence to treatment recommendations was common (26%) and was significantly associated with lower patient-reported collaboration and satisfaction with decision making. CONCLUSIONS Given the importance of adherence to cancer treatment for survival, the many non-clinical reasons for non-adherence, and the currently demonstrated association between decision-making quality and adherence, it would be worthwhile to investigate how to increase AI/AN patient satisfaction with decision making and whether improving satisfaction yields improved adherence to the cancer treatment plan. Copyright © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Arden M Morris
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA
| | - Ardith Z Doorenbos
- University of Washington School of Nursing, Department of Biobehavioral Nursing and Health Systems, Seattle, WA, USA
| | - Emily Haozous
- University of New Mexico College of Nursing, Albuquerque, NM, USA
| | - Alexa Meins
- University of Washington School of Nursing, Department of Biobehavioral Nursing and Health Systems, Seattle, WA, USA
| | - Sara Javid
- University of Washington, School of Medicine Department of Surgery, Seattle, WA, USA
| | - David R Flum
- University of Washington, School of Medicine Department of Surgery, Seattle, WA, USA
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