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Paul S, Haynes E, Rush K, Hiwi BT, Jakobi J, Robbins F. Hunting can increase physical activity of Indigenous peoples in Canada: pixem re yecwme'nstut. Appl Physiol Nutr Metab 2024; 49:818-823. [PMID: 38382052 DOI: 10.1139/apnm-2023-0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
This study examined whether Indigenous peoples could achieve the Canadian Physical Activity Guidelines (CPAG) for adults while engaging in the cultural practice of hunting. It was hypothesized that Indigenous hunters would achieve or surpass the physical activity (PA) thresholds set forth by the CPAG on days spent hunting. Step count and heart rate were recorded from six male participants during mule deer hunts and days spent on-reserve. Step count was not statistically different between days spent hunting (28 803 ± 10 657 steps) and on-reserve (15 086 ± 7536 steps) (p = 0.10). Time spent in light (257 ± 45 min; p = 0.04), moderate (118 ± 71 min; p = 0.03), and vigorous (45 ± 42 min; p = 0.04) activities while hunting was greater than on-reserve (light, 180 ± 86; moderate, 71 ± 73; vigorous, 7 ± 10 min). The duration of moderate-to-vigorous PA (119 ± 95 min) for an average day hunting nearly meets the weekly CPAG recommendation of 150 min per week and is 1.8× greater than on-reserve (67 ± 80 min). Data suggest that hunting is probably a viable mode of PA for Indigenous adults to achieve health benefits. A strength of this study is the 10 h of daily recording which includes vehicular transportation to remote hunting areas. The duration of very light/sedentary PA did not differ between hunting (233 ± 211 min) and on-reserve (327 ± 164 min; p = 0.10), and highlights the importance of modernized vehicles in traditional Indigenous activities. A larger sample size would facilitate greater exploration of transportation, as well as success of the hunt on PA. These data suggest that health researchers and clinicians should consider traditional activities such as hunting as a means for Indigenous adults to increase participation in sufficiently vigorous PA to incur health benefits.
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Affiliation(s)
- Sidney Paul
- Esk'etemc First Nation, Alkali Lake, BC, Canada
- School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Elijah Haynes
- School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Kathy Rush
- School of Nursing, Faculty of Health and Social Development, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Braden Te Hiwi
- Indigenous Studies, Faculty of Arts, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Jennifer Jakobi
- School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Fred Robbins
- Esk'etemc Indian Band, Secwépemc First Nation, Alkali Lake, BC, Canada
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Au-Yeung A, Marfatia D, Beers K, General DA, McQueen KCD, Martin-Hill D, Wekerle C, Green TJ. Exploring the feasibility of a mental health application (JoyPop TM) for Indigenous youth. Front Psychiatry 2023; 14:1269347. [PMID: 37867769 PMCID: PMC10588183 DOI: 10.3389/fpsyt.2023.1269347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/15/2023] [Indexed: 10/24/2023] Open
Abstract
Objective The purpose of the current study was to explore the acceptability and feasibility of a resilience-focused mobile application, JoyPop™, for use with Indigenous youth. Methods A Haudenosaunee community-based research advisory committee co-developed the research project, in accordance with OCAP™ principles. Adopting a mixed-method approach, five youths from an immersion school used the JoyPop™ app for four consecutive weeks, as well as completed pre-test questions and weekly usage surveys. Most participants also completed post-test questions and a semi-structured interview. Based on a semi-structured interview protocol, youth responded to questions, and the most common themes were categorized to capture the experience of using the app. Results All youth reported a positive impression, used the app daily, found it easy to navigate, and indicated that they would recommend it to a friend. All features were uniformly positively endorsed. There were features that youth used most often (Deep Breathing, "SquareMoves" game, and Art features) and moderately (Rate My Mood, Journaling, and SleepEase). The social connection feature, Circle of Trust, was least utilized, with youth reporting a preference for in-person problem-solving. The drop-down menu of crisis helplines was not used. Youth recommended more gaming options. In terms of cultural resonance, appreciation for the app's use of water sounds in the SleepEase feature was expressed, as was cultural consistency with the "Good Mind" perspective. Recommendations included additional nature sounds, Indigenous design elements, the inclusion of Native language words, and traditional stories. Discussion The JoyPop™ app was positively received by Six Nations youth, and ways to ensure its cultural appropriateness were identified. Moving forward, it is recommended that Indigenous designers create a new version with community design co-creation. Additional research with various groups of Indigenous youth is warranted as a pan-Indigenous approach is not recommended.
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Affiliation(s)
- Allison Au-Yeung
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daksha Marfatia
- Department of Biochemistry and Biomedical Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Kamryn Beers
- Department of Health, Aging and Society, Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | | | | | - Dawn Martin-Hill
- Department of Anthropology, Indigenous Studies Program, McMaster University, Hamilton, ON, Canada
| | - Christine Wekerle
- Department of Pediatrics, Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Optentia Research Unit, North-West University, Potchefstroom, South Africa
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Blanchette V, Patry J, Brousseau-Foley M, Todkar S, Libier S, Leclerc AM, Armstrong DG, Tremblay MC. Diabetic foot complications among Indigenous peoples in Canada: a scoping review through the PROGRESS-PLUS equity lens. Front Endocrinol (Lausanne) 2023; 14:1177020. [PMID: 37645408 PMCID: PMC10461566 DOI: 10.3389/fendo.2023.1177020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/18/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction Indigenous peoples in Canada face a disproportionate burden of diabetes-related foot complications (DRFC), such as foot ulcers, lower extremity amputations (LEA), and peripheral arterial disease. This scoping review aimed to provide a comprehensive understanding of DRFC among First Nations, Métis, and Inuit peoples in Canada, incorporating an equity lens. Methods A scoping review was conducted based on Arksey and O'Malley refined by the Joanna Briggs Institute. The PROGRESS-Plus framework was utilized to extract data and incorporate an equity lens. A critical appraisal was performed, and Indigenous stakeholders were consulted for feedback. We identified the incorporation of patient-oriented/centered research (POR). Results Of 5,323 records identified, 40 studies were included in the review. The majority of studies focused on First Nations (92%), while representation of the Inuit population was very limited populations (< 3% of studies). LEA was the most studied outcome (76%). Age, gender, ethnicity, and place of residence were the most commonly included variables. Patient-oriented/centered research was mainly included in recent studies (16%). The overall quality of the studies was average. Data synthesis showed a high burden of DRFC among Indigenous populations compared to non-Indigenous populations. Indigenous identity and rural/remote communities were associated with the worse outcomes, particularly major LEA. Discussion This study provides a comprehensive understanding of DRFC in Indigenous peoples in Canada of published studies in database. It not only incorporates an equity lens and patient-oriented/centered research but also demonstrates that we need to change our approach. More data is needed to fully understand the burden of DRFC among Indigenous peoples, particularly in the Northern region in Canada where no data are previously available. Western research methods are insufficient to understand the unique situation of Indigenous peoples and it is essential to promote culturally safe and quality healthcare. Conclusion Efforts have been made to manage DRFC, but continued attention and support are necessary to address this population's needs and ensure equitable prevention, access and care that embraces their ways of knowing, being and acting. Systematic review registration Open Science Framework https://osf.io/j9pu7, identifier j9pu7.
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Affiliation(s)
- Virginie Blanchette
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- VITAM-Centre de Recherche en Santé Durable, Québec, QC, Canada
- Centre de Recherche du Centre Intégré de Santé et Services Sociaux de Chaudière-Appalaches, Lévis, QC, Canada
| | - Jérôme Patry
- Centre de Recherche du Centre Intégré de Santé et Services Sociaux de Chaudière-Appalaches, Lévis, QC, Canada
- Faculty of Medicine, Family and Emergency Medicine Department, Université Laval, Québec, QC, Canada
| | - Magali Brousseau-Foley
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Faculty of Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie et du Centre-du-Québec Affiliated with Université de Montréal, Trois-Rivières Family Medicine University Clinic, Trois-Rivières, QC, Canada
| | - Shweta Todkar
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Solène Libier
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Anne-Marie Leclerc
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - David G. Armstrong
- Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Marie-Claude Tremblay
- VITAM-Centre de Recherche en Santé Durable, Québec, QC, Canada
- Faculty of Medicine, Family and Emergency Medicine Department, Université Laval, Québec, QC, Canada
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Bally JMG, Spurr S, Mcharo K. "We Eat Without Thinking: We Just Eat, Eat, Eat" - A Thematic Exploration of Cultural Practices of Ethnically Diverse Youth and Their Parents Who Are at Risk for Prediabetes and Type 2 Diabetes. J Community Health Nurs 2023:1-15. [PMID: 37191357 DOI: 10.1080/07370016.2023.2211066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE Cultural beliefs and practices influence management of type 2 diabetes (T2D) in youth and their parents, and have been minimally explored, limiting our understanding and implementation of preventative healthcare. An enhanced evidence base may inform comprehensive, effective community health nursing (CHN). Thus, the purpose of this research was to explore the influence of youths' and their parents' understandings of cultural practices on risk for prediabetes and T2D. DESIGN A secondary thematic analysis was conducted. Qualitative data were obtained from semi-structured interviews with 24 participants who were purposefully recruited from two mid-western Canadian high schools. FINDINGS Three themes and one subtheme were developed including: 1) Food Culture and related subtheme, Acculturation to New Food Choices; 2) Exercise Culture: Adapting Physical Activity in a New Country; and, 3) Risk Perception of the Effects of T2D on Loved Ones: Behavior Modifications and Motivation. Cultural practices and acculturation to food such as dietary choices, preparation, large portions, different dietary staples, food availability, and food gathering patterns influenced health behaviors. Similarly, changes in exercise patterns including adapting to Western video game culture, weather in Canada, and the new way of life emerged as important factors that impacted health. Participants who perceived a familial risk of diabetes identified behavior modifications such as regular diabetes screening, nutrition counseling, healthier food choices, smaller food portions, and an increase in physical activity as strategies to reduce risk of prediabetes and diabetes. CONCLUSIONS There is a critical need for research aimed at prediabetes and T2D prevention, and intervention programs targeting ethnically diverse groups where prediabetes and T2D is most prevalent. CLINICAL EVIDENCE Community health nurses are at the core of implementing and supporting disease prevention and, therefore, may consider the findings from this research to develop family-focused, intergenerational, and culturally-based interventions.
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Affiliation(s)
- Jill M G Bally
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Shelley Spurr
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kasha Mcharo
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
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Ward A, Buffalo L, McDonald C, L'Heureux T, Charles L, Pollard C, Tian PG, Anderson S, Parmar J. Supporting First Nations Family Caregivers and Providers: Family Caregivers', Health and Community Providers', and Leaders' Recommendations. Diseases 2023; 11:diseases11020065. [PMID: 37218878 DOI: 10.3390/diseases11020065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/24/2023] Open
Abstract
Family caregivers and care providers are increasingly becoming more distressed and reaching a breaking point within current systems of care. First Nations family caregivers and the health and community providers employed in First Nations communities have to cope with colonial, discriminatory practices that have caused intergenerational trauma and a myriad of siloed, disconnected, and difficult-to-navigate federal-, provincial/territorial-, and community-level policies and programs. Indigenous participants in Alberta's Health Advisory Councils described Indigenous family caregivers as having more difficulty accessing support than other Alberta caregivers. In this article, we report on family caregivers', providers', and leaders' recommendations to support First Nations family caregivers and the health and community providers employed in First Nations. We used participatory action research methods in which we drew on Etuaptmumk (the understanding that being in the world is the gift of multiple perspectives) and that Indigenous and non-Indigenous views are complementary. Participants were from two First Nation communities in Alberta and included family caregivers (n = 6), health and community providers (n = 14), and healthcare and community leaders (n = 6). Participants advised that family caregivers needed four types of support: (1) recognize the family caregivers' role and work; (2) enhance navigation and timely access to services, (3) improve home care support and respite, and (4) provide culturally safe care. Participants had four recommendations to support providers: (1) support community providers' health and wellbeing; (2) recruit and retain health and community providers; (3) improve orientation for new providers; and (4) offer providers a comprehensive grounding in cultural awareness. While creating a program or department for family caregivers may be tempting to address caregivers' immediate needs, improving the health of First Nations family caregivers requires a population-based public health approach that focuses on meaningful holistic system change to support family caregivers.
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Affiliation(s)
- Amber Ward
- Faculty of Medicine, University of Victoria, Victoria, BC V6T 1Z3, Canada
| | | | | | - Tanya L'Heureux
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Lesley Charles
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Cheryl Pollard
- Faculty of Nursing, University of Regina, Regina, SK S4S 0A2, Canada
| | - Peter G Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Sharon Anderson
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Jasneet Parmar
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
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Cheran K, Murthy C, Bornemann EA, Kamma HK, Alabbas M, Elashahab M, Abid N, Manaye S, Venugopal S. The Growing Epidemic of Diabetes Among the Indigenous Population of Canada: A Systematic Review. Cureus 2023; 15:e36173. [PMID: 37065334 PMCID: PMC10103803 DOI: 10.7759/cureus.36173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/15/2023] [Indexed: 03/17/2023] Open
Abstract
Diabetes is one of the most well-known and well-researched non-communicable diseases known to humankind. The goal of this article is to show that the prevalence of diabetes is constantly increasing among indigenous people, a major population subgroup in Canada. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct this systematic review, and the databases used were PubMed and Google Scholar. Studies that were published in the last 15 years (2007-2022) were selected for this review, and after applying the inclusion and exclusion criteria, screening, and removing duplicates, 10 articles were selected for the final review - three qualitative studies, three observational studies, and four studies without a specified methodology. We used the JBI (Joanna Briggs Institute) checklist, NOS (Newcastle-Ottawa Scale) checklist, and SANRA (Scale for the Assessment of Narrative Review) checklist for quality assessment. We found that all the articles showed that the prevalence of diabetes is increasing in all the Aboriginal communities despite all the interventional programs already in place. Rigorous health plans, health education, and wellness clinics for primary prevention can all be effective in reducing the potential risks of diabetes. More studies exploring the prevalence, effects, and outcomes of diabetes in the indigenous population of Canada are needed to effectively understand the disease and its complications in this group.
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Willows N, Blanchet R, Wasonti Io Delormier T. Decolonizing research in high-income countries improves Indigenous peoples' health and wellbeing. Appl Physiol Nutr Metab 2023; 48:1-4. [PMID: 36472342 DOI: 10.1139/apnm-2022-0334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Noreen Willows
- 4-378 Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Rosanne Blanchet
- Department of Social and Preventive Medicine (DMSP), School of Public Health, Université de Montréal (ESPUM), Montréal, QC H3N 1X9, Canada
| | - Treena Wasonti Io Delormier
- School of Human Nutrition, Centre for Indigenous Peoples' Nutrition & Environment (CINE), McGill University, Ste. Anne de Bellevue, QC, H9X 3V9, Canada
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Bonin L, Levasseur-Puhach S, Guimond M, Gabbs M, Wicklow B, Vandenbroeck B, Copenace S, Delaronde M, Mosienko L, McGavock J, Katz LY, Roos LE, Diffey L, Dart A. Walking in two worlds with type 2 diabetes: a scoping review of prevention and management practices incorporating traditional indigenous approaches. Int J Circumpolar Health 2022; 81:2141182. [DOI: 10.1080/22423982.2022.2141182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Lynette Bonin
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
| | - Sydney Levasseur-Puhach
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Michelle Guimond
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Melissa Gabbs
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Pediatric and Child Health, Winnipeg, Manitoba, Canada
| | - Brandy Wicklow
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Pediatric and Child Health, Winnipeg, Manitoba, Canada
| | - Belinda Vandenbroeck
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
| | - Sherry Copenace
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
| | - Meagan Delaronde
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Lucas Mosienko
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Jonathan McGavock
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Pediatric and Child Health, Winnipeg, Manitoba, Canada
| | - Laurence Y. Katz
- University of Manitoba, Max Rady College of Medicine, Department of Psychiatry, Winnipeg, Manitoba, Canada
| | - Leslie E. Roos
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Linda Diffey
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Community Health Sciences, Winnipeg, Manitoba, Canada
| | - Allison Dart
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Pediatric and Child Health, Winnipeg, Manitoba, Canada
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A Socio-Cognitive Review of Healthy Eating Programs in Australian Indigenous Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159314. [PMID: 35954672 PMCID: PMC9367833 DOI: 10.3390/ijerph19159314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 02/05/2023]
Abstract
Purpose: This paper aims to understand the challenges to healthy eating for Indigenous Australians using a Social Cognitive Theory lens. Understanding the environmental, cognitive, and behavioural barriers to healthy eating for Indigenous populations in Australia will help identify current gaps and highlight future actions needed in this area to close the gap for Indigenous Australians. Study design: Narrative review of interventions of healthy eating programs in Australian Indigenous communities sourced using a systematic search protocol to understand the environmental, cognitive, and behavioural barriers to healthy eating among Indigenous Australians and to identify gaps and future actions needed to address this from 2010–2020. Results: The search produced 486 records, after duplicates were removed and the inclusion and exclusion process were utilised, seven interventions were retained in nine studies. The seven interventions had multiple study designs, from randomised control trials to case studies. Conclusions: Further work needs to explore the long-term feasibility of providing fruit and vegetable discounts and the impact of remoteness for the delivery of healthy food. Dietary interventions need to be clearly described, and fidelity and process of the design and implementation process to help with replication of work.
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Fernandes S, Caperchione CM, Thornton LE, Timperio A. A qualitative exploration of perspectives of physical activity and sedentary behaviour among Indian migrants in Melbourne, Australia: how are they defined and what can we learn? BMC Public Health 2021; 21:2085. [PMID: 34774007 PMCID: PMC8590373 DOI: 10.1186/s12889-021-12099-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background Although perceptions of what constitutes physical activity (PA) may vary between culturally diverse populations, very little research has explored the perceptions of PA among Indian migrants. This study aimed to identify how PA and sedentary behaviour (SB) are defined and describe how these definitions are shaped by cultural background and migration among a sample of Indian migrants living in Australia. Methods Using an exploratory qualitative approach, semi-structured interviews were conducted with twenty-one Indian migrants living in Melbourne (10 men and 11 women; age range: 18 to 65 years). Interviews were audio-recorded and transcribed verbatim. Data were coded and analysed inductively using thematic analyses. Results Data revealed two emerging themes: 1) Holistic perspectives related to PA, where although the majority of participants described PA as “any sort of movement”, or “physical exercise”, several of these descriptions had interwoven ideas related to the mind (mind-body connect), social, cultural, and to the outdoor environment; 2) Broader perspectives for SB, where descriptions of SB as “not having movement”, “doing nothing” or “being lazy”, were shaped with ideas of purpose and duration. Women spoke about how their perspectives of PA and SB may be shaped by native Indian experiences, particularly the gender roles, social caste, and regional subcultural norms which they perceived were important to consider among women who migrate to western settings. Conclusions Cultural background is important in shaping the perspectives of PA and SB among Indian migrants in Australia. Practitioners and researchers should consider the varying perspectives of PA to communicate and promote PA among migrant populations more effectively. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12099-4.
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Affiliation(s)
- Siona Fernandes
- Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Cristina M Caperchione
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Moore Park Precinct, Sydney, NSW, Australia
| | - Lukar E Thornton
- Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Anna Timperio
- Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Sanchez-Pimienta CE, Masuda J. From controlling to connecting: M'Wikwedong as a place of urban Indigenous health promotion in Canada. Health Promot Int 2021; 36:703-713. [PMID: 33020831 DOI: 10.1093/heapro/daaa066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In recent years, health promotion has come under critique for being framed according to the contexts and priorities of Western communities, with the notion of 'control' underpinning much of its theoretical and practical development. Ceding space to Indigenous voices and knowledge is one way forward to overcoming this limitation and decolonizing the field. This paper reports on insights gained from a participatory digital storytelling project focused on Indigenous health promotion that took place at M'Wikwedong Indigenous Friendship Centre in the city of Owen Sound, Canada. The research team was formed by M'Wikwedong's Executive Director, five Indigenous youth and two university researchers. We co-created data through an 8-month digital storytelling process that involved 13 weekly research meetings, the creation of 4 digital stories and video screenings. We analysed data from seven group interview transcriptions, field notes and video transcripts through qualitative coding and theme building. The four themes we identified speak to the ways M'Wikwedong reinforced connections to youth, their sense of self, place in the city and Indigenous cultures. From our findings, we theorize that egalitarianism of knowledge, restoring balance in relationships and Indigenous leadership are core components of an 'ethos of connection' that underlies Indigenous health promotion. The 'ethos of connection' challenges Western notions of 'control' and brings attention to the unique expertise and practices of urban Indigenous communities and organizations as a primary basis for health promotion.
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Affiliation(s)
- Carlos E Sanchez-Pimienta
- School of Kinesiology and Health Studies, Queen's University, 28 Division St, Kingston, ON K7L 3N6, Canada
| | - Jeff Masuda
- School of Kinesiology and Health Studies, Queen's University, 28 Division St, Kingston, ON K7L 3N6, Canada
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12
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Oosman S, Nisbet C, Smith L, Abonyi S. Health promotion interventions supporting Indigenous healthy ageing: a scoping review. Int J Circumpolar Health 2021; 80:1950391. [PMID: 34313553 PMCID: PMC8317950 DOI: 10.1080/22423982.2021.1950391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Aging well is a priority in Canada and globally, particularly for older Indigenous adults experiencing an increased risk of chronic conditions. Little is known about health promotion interventions for older Indigenous adults and most literature is framed within Eurocentric paradigms that are not always relevant to Indigenous populations. This scoping review, guided by Arksey and O'Malley's framework and the PRISMA-ScR Checklist, explores the literature on Indigenous health promoting interventions across the lifespan, with specific attention to Indigenous worldview and the role of older Indigenous adults within these interventions. To ensure respectful and meaningful engagement of Indigenous peoples, articles were included in the Collaborate or Shared Leadership categories on the Continuum of Engagement. Fifteen articles used Indigenous theories and frameworks in the study design. Several articles highlighted engaging Elders as advisors in the design and/or delivery of programs however only five indicated Elders were active participants. In this scoping review, we suggest integrating a high level of community engagement and augmenting intergenerational approaches are essential to promoting health among Indigenous populations and communities. Indigenous older adults are keepers of essential knowledge and must be engaged (as advisors and participants) in intergenerational health promotion interventions to support the health of all generations.
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Affiliation(s)
- Sarah Oosman
- School of Rehabilitation, College of Medicine Researcher, Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada
| | - Christine Nisbet
- School of Rehabilitation, College of Medicine Researcher, Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada
| | - Liris Smith
- School of Rehabilitation, College of Medicine Researcher, Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada
| | - Sylvia Abonyi
- School of Rehabilitation, College of Medicine Researcher, Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada
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Belita E, Schofield R, Currie G, Dietrich Leurer M, Dosani A, Cusack C, Danaher A, Dilworth K, Etowa J, Filion F, Joseph C, Lukewich J, MacDonald JA, Reid-Haughian C. Advancing Excellence in Community Health Nursing Through Evidence-Based National Standards of Practice. J Contin Educ Nurs 2021; 52:168-175. [PMID: 34038234 DOI: 10.3928/00220124-20210315-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Current standards of practice are necessary to ensure safe nursing practice in Canada and across the world. This article aimed to describe and present findings from the rigorous review process undertaken to update the 2011 Canadian Community Health Nursing Standards of Practice. METHOD A revision process included a scoping review of the literature, focus groups, and a modified Delphi method. RESULTS Through the inclusive consultation process, 495 community health nurses enhanced the content of the standards with respect to cultural safety, cultural humility, Indigenous health and ways of knowing, health equity, and evidence-informed practice. CONCLUSION This comprehensive revision process can guide other nursing specialty groups developing or revising specialized practice standards in Canada and across the world. [J Contin Educ Nurs. 2021;52(4):168-175.].
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Gerhardt-Strachan K. Exploring the place of spirituality in Canadian health promotion. Health Promot Int 2021; 37:6146752. [PMID: 33619568 DOI: 10.1093/heapro/daab027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The field of health promotion advocates a socioecological approach to health that addresses a variety of physical, social, environmental, political and cultural factors. Encouraging a holistic approach, health promotion examines many aspects of health and wellbeing, including physical, mental, sexual, community, social and ecological health. Despite this holism, there is a noticeable absence of discussion surrounding spirituality and spiritual health. This research study explored how leading scholars in Canadian health promotion understand the place of spirituality in health promotion. Using the fourth edition of Health Promotion in Canada (Rootman et al., 2017) as the sampling frame of recognized leaders in the field, 13 semi-structured qualitative interviews were conducted with authors from the book. This study is situated within a critical health promotion approach that utilizes methodologies aiming for social justice, equity and ecological sustainability. I argue that by avoiding spirituality within health promotion frameworks and education, the secularism of health promotion and its underlying values of Eurocentric knowledge production and science remain invisible and rarely critiqued. This study intends to open up possibilities for centering spiritual and non-Western epistemologies and ways of knowing that have been marginalized, such as Indigenous understandings of health and wellbeing. Restoring right relations with Indigenous peoples in Canada has taken on new urgency with the calls to action of the Truth & Reconciliation Commission report (NCTR, 2015). This is one important way that health promotion can fulfill its promise of being inclusive, relevant and effective for human and planetary wellbeing.
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Hilgendorf A, Guy Reiter A, Gauthier J, Krueger S, Beaumier K, Corn R, Moore TR, Roland H, Wells A, Pollard E, Ansell S, Oshkeshequoam J, Adams A, Christens BD. Language, Culture, and Collectivism: Uniting Coalition Partners and Promoting Holistic Health in the Menominee Nation. HEALTH EDUCATION & BEHAVIOR 2020; 46:81S-87S. [PMID: 31549556 DOI: 10.1177/1090198119859401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recent perspectives on Indigenous health have recognized language, culture, and values as central to well-being and recovery from historical trauma. Health coalitions, which identify community health concerns and mobilize members to implement strategies for change, have begun to shift their focus from programs to policy, systems, and environmental change but have been slower to recognize the possibilities of centering Indigenous ways of being in their work. This article details a case study of the Menominee Wellness Initiative, an Indigenous health coalition that has increasingly made language, culture, and collective values the focus of their health promotion work, and often due to the participation and influence of community organizers in the coalition. The study is presented as a collaborative writing effort between coalition members and academic partners. Qualitative data were gathered through observations of coalition meetings; in-depth, semistructured interviews with coalition members; and interactive data analysis discussions within the collaborative writing team. In the results, we describe how the shift in the coalition's framework came to be and the influence this shift has had on the coalition, its activities, and its community impacts. These findings illustrate and extend understanding of several principles of Collaborating for Equity and Justice and supports literature and practice related to health promotion through the centering of Indigenous ways.
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Affiliation(s)
| | | | - Jennifer Gauthier
- Menominee County/Nation University of Wisconsin-Extension, Keshena, WI, USA
| | | | | | - Ron Corn
- Woodland Boys & Girls Club, Neopit, WI, USA
| | | | - Hugh Roland
- University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Sara Ansell
- University of Wisconsin-Madison, Madison, WI, USA
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16
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Locke SR, Dix G, Te Hiwi B, Oelke ND, Rush KL, Berg S, Dinwoodie M, Jung ME, Martin Ginis KA. Improving Diabetes Care in the British Columbia Southern Interior: Developing Community‒University Initiatives to Address Service Gaps. Can J Diabetes 2020; 45:5-14.e2. [PMID: 32800448 DOI: 10.1016/j.jcjd.2020.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/23/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Diabetes rates in the British Columbia (BC) interior are rising more rapidly compared with the rest of Canada, whereas diabetes service provision is limited within this region. The purposes of this article were: 1) to identify characteristics of diabetes service delivery; and 2) to co-develop community‒university diabetes research projects to address service barriers and gaps in the BC southern interior across urban, rural and Indigenous populations. METHODS A 3-step approach was used. In step 1, a web search was conducted to identify diabetes-related services. In step 2, 10 community members working or volunteering in diabetes organizations participated in semistructured telephone interviews pertaining to diabetes service access, priorities, barriers, benefits and gaps. In step 3, a meeting of researchers and community members (n=25) was held to foster collaboration and co-develop research projects. RESULTS Seventy-eight urban, rural and Indigenous diabetes-related services were identified in the BC southern interior. Provision of care to those with new type 1 diabetes and gestational diabetes diagnoses was identified in the interviews as a key priority; the needs of these groups contribute to a deficiency of resources to deliver prediabetes programs. The meeting produced plans for 2 collaborative projects: (1) the development of a diabetes patient journey map, and (2) development of a diabetes service hub with navigators for patients. CONCLUSIONS Together, community members and researchers have identified service gaps and formulated research projects to improve diabetes management for urban, rural and Indigenous peoples living in the BC southern interior.
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Affiliation(s)
- Sean R Locke
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, British Columbia, Canada.
| | - Gabriel Dix
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, British Columbia, Canada
| | - Braden Te Hiwi
- Community, Culture, and Global Studies, Irving K. Barber School of Arts and Sciences, University of British Columbia, British Columbia, Canada
| | - Nelly D Oelke
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, British Columbia, Canada
| | - Kathy L Rush
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, British Columbia, Canada
| | - Stephen Berg
- Okanagan School of Education, Faculty of Education, University of British Columbia, British Columbia, Canada
| | - Miranda Dinwoodie
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, British Columbia, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, British Columbia, Canada
| | - Kathleen A Martin Ginis
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, British Columbia, Canada
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Abstract
Abstract
Objective
There is no single study that has examined nursing research priorities in Vietnam. This study aimed to gain consensus from experts on the nursing research priorities in Vietnam.
Methods
A three-round modified Delphi study was used in this study. A focus group discussion among experts was conducted in round I to identify the nursing research priorities (n=23). Data in round I were analyzed using content analysis. In round II, participants were invited to rate the importance of each nursing priority topic in a 5-point Likert scale questionnaire, which had a 74% (n=17) response rate. In round III, the questionnaire was returned to the experts (n=17) until consensus was reached. Data from round II and round III were analyzed to produce mean score and final rank.
Results
The top 12 research priority lists were identified, which included subthemes and areas of possible investigations. All priorities were classified into three groups in the rank order, namely: (i) nursing management and leadership, which included (1) nursing care quality, (2) management and leadership of nurse managers, (3) nursing image, (4) professional nurse competency, and (5) human resource management; (ii) nursing education, which included (1) knowledge-specific domain, (2) the linkage between education and practice, and (3) nurse teacher workforce; and (iii) nursing service, which included (1) adult nursing concern, (2) patient safety, (3) public health nursing concern, and (4) quality of life of patients and nurses.
Conclusions
Consensus among experts was achiever, and the findings are considered as the basis of resources to the most essential research needs in Vietnam.
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My experiences with kidney care: A qualitative study of adults in the Northern Territory of Australia living with chronic kidney disease, dialysis and transplantation. PLoS One 2019; 14:e0225722. [PMID: 31856215 PMCID: PMC6922340 DOI: 10.1371/journal.pone.0225722] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/10/2019] [Indexed: 12/26/2022] Open
Abstract
Background Australian healthcare quality and safety accreditation standards recommend health services partner with health care users, to ensure the highest quality of care. Aboriginal Australians with chronic and end stage kidney disease have high health care access needs. Aim To describe the experiences of health care users of a large government kidney healthcare service provider. Methods Within a government renal health service in the Top-End of the Northern Territory, we undertook a qualitative study involving in-depth interviews with 26 adult clients from urban, regional and remote settings who were living with kidney health conditions. Results Client characteristics included a mean age of 55 years, 55% female and 81% identifying as Aboriginal. The kidney related conditions of client participants included CKD (11, 42.3%), haemodialysis (12, 46.2%), peritoneal dialysis (1, 3.9%), and transplant (2, 7.7%). Key themes emerging from patient interviews related to perceived gaps for clients and carers including: 1) knowledge gaps about the health condition, 2) the impact of relocation in order to access centrally-based renal care, 3) healthcare staff professionalism and qualities and 4) service environments. Overall, the experiences centred on a greater need for client-centred, respectful and culturally based healthcare support. Clients recommended the need for patient-led collective care, including sustaining an Indigenous Patient Reference Group to support ongoing healthcare service decision processes. Participants included in almost equal proportion, clients with CKD (without dialysis) and clients utilising renal replacement therapy, which adds significant weight to the client-identified recommendations for highest quality of kidney care across a wide spectrum of kidney function. Conclusion Four major themes identified by clients related to their experience with renal care provided by this major regional health care provider: knowledge gaps of their own condition, the lived impacts of relocating to access health care, service environments, and Health Care Provider Quality. An Indigenous Patient Reference Group was one mechanism recommended to support the co-design of preferred care models.
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Joo JY, Liu MF. Experience of Culturally-Tailored Diabetes Interventions for Ethnic Minorities: A Qualitative Systematic Review. Clin Nurs Res 2019; 30:253-262. [PMID: 31690114 DOI: 10.1177/1054773819885952] [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: 12/25/2022]
Abstract
This qualitative systematic review synthesizes recent qualitative studies of culturally tailored interventions to better understand the experiences that individuals who are members of ethnic minorities have when undergoing type 2 diabetes treatment in the United States. Such interventions have been shown to be effective among ethnic minority populations; however, no qualitative synthesis has reported on recent findings from studies of these interventions. This systematic review identified seven relevant qualitative studies from five electronic databases-CINAHL, PsycINFO, PubMed, Ovid, and Web of Science-published from 2009 to 2019, and used a thematic synthesis review methodology. Methodological rigor was assessed for an appraisal of study quality. Five themes were identified as experiences of culturally tailored diabetes interventions: culturally appropriate healthy lifestyle behaviors, knowledge about diabetes care, emotional supports, access to the healthcare system, and family involvement. The findings of this review can be utilized as resources for improving diabetes care for ethnic minorities.
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Affiliation(s)
- Jee Young Joo
- Associate Professor, College of Nursing, Gachon University, Incheon, Korea
| | - Megan F Liu
- Associate Professor, School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei
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Stanimirovic A, Francis T, Shahid N, Sutakovic O, Merritt R, Brent MH, Rac VE. Tele-retina screening of diabetic retinopathy among at-risk populations: an economic analysis. Can J Ophthalmol 2019; 55:8-13. [PMID: 31712029 DOI: 10.1016/j.jcjo.2019.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/09/2019] [Accepted: 06/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the cost-effectiveness of the pilot Toronto tele-retina screening program in comparison with existing standard of care (SOC) diabetic retinopathy (DR) screening for patients with diabetes mellitus and in a simulated Pan-Ontarian cohort. METHODS Decision trees were constructed to compare tele-retina to SOC in the pilot and Pan-Ontarian cohort. Cost-effectiveness was assessed as cost per case detected (true-positive) and cost per case correctly diagnosed (true-positive and true-negative results). RESULTS Pilot program screening costs were $95.77 and $137.56 for tele-retina and SOC, respectively. In the base-case analysis, cost per case correctly detected was $379.06 with tele-retina and $985.56 with SOC, and the cost per case correctly diagnosed was $109.29 and $315.22, respectively. In the sensitivity analysis, cost per case correctly detected was $467.29 with tele-retina and $894.93 with SOC, and the cost per case correctly diagnosed was $136.88 and $250.35, respectively. Pan-Ontarian screening costs were $57.58 and $137.56 for tele-retina and SOC, respectively. The cost per case correctly detected was $281.10 with tele-retina and $982.00 with SOC, and the cost per case correctly diagnosed was $82.21 and $314.14, respectively. For both pilot and Pan-Ontarian sensitivity analyses, tele-retina remained the dominant strategy (ICER <0). CONCLUSIONS Findings from this study suggest that tele-retina is a more cost-effective means of screening for diabetic retinopathy than the SOC in urban and rural underscreened communities. Subsequent economic studies should focus on evaluations that consider the impact of tele-retina on the prevention of severe vision loss in underscreened urban and rural communities.
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Affiliation(s)
- Aleksandra Stanimirovic
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario
| | - Troy Francis
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario
| | - Nida Shahid
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario; Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario
| | - Olivera Sutakovic
- Donald K. Johnson Eye Institute, University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario; Diabetes Action Canada, CIHR SPOR Network
| | | | - Michael H Brent
- Donald K. Johnson Eye Institute, University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario; Diabetes Action Canada, CIHR SPOR Network
| | - Valeria E Rac
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario; Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario; Diabetes Action Canada, CIHR SPOR Network; Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario.
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Conway J, Lawn S, Crail S, McDonald S. Indigenous patient experiences of returning to country: a qualitative evaluation on the Country Health SA Dialysis bus. BMC Health Serv Res 2018; 18:1010. [PMID: 30594208 PMCID: PMC6311048 DOI: 10.1186/s12913-018-3849-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Rates of End-Stage Kidney Disease among Aboriginal and Torres Strait Islander (Indigenous) Australians in remote areas are disproportionately high; however, haemodialysis is not currently offered in most remote areas. People must therefore leave their 'Country' (with its traditions and supports) and relocate to metropolitan or regional centres, disrupting their kinship and the cultural ties that are important for their wellbeing. The South Australian Mobile Dialysis Truck is a service which visits remote communities for one to two week periods; allowing patients to have dialysis on 'Country', reuniting them with their friends and family, and providing a chance to take part in cultural activities. The aims of the study were to qualitatively evaluate the South Australian Mobile Dialysis Truck program, its impact on the health and wellbeing of Indigenous dialysis patients, and the facilitators and barriers to using the service. METHODS Face to face semi-structured interviews were conducted with 15 Indigenous dialysis patients and 10 nurses who had attended trips across nine dialysis units. Realist evaluation methodology and thematic analysis established patient and nursing experiences with the Mobile Dialysis Truck. RESULTS The consequences of leaving Country included grief and loss. Barriers to trip attendance included lower trip frequencies, ineffective trip advertisement, lack of appropriate or unavailable accommodation for staff and patients and poor patient health. Benefits of the service included the ability to fulfil cultural commitments, minimisation of medical retrievals from patients missing dialysis to return to remote areas, improved trust and relationships between patients and staff, and improved patient quality of life. The bus also provided a valuable cultural learning opportunity for staff. Facilitators to successful trips included support staff, clinical back-up and a co-ordinator role. CONCLUSIONS The Mobile Dialysis Truck was found to improve the social and emotional wellbeing of Indigenous patients who have had to relocate for dialysis, and build positive relationships and trust between metropolitan nurses and remote patients. The trust fostered improved engagement with associated health services. It also provided valuable cultural learning opportunities for nursing staff. This format of health service may improve cultural competencies with nursing staff who provide regular care for Indigenous patients.
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Affiliation(s)
| | - Sharon Lawn
- Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, Adelaide, Australia
| | - Susan Crail
- Central Adelaide Renal and Transplantation Service, Adelaide, Australia
| | - Stephen McDonald
- Country Health SA Local Health Network, SA Health and Medical Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
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Tremblay MC, Martin DH, McComber AM, McGregor A, Macaulay AC. Understanding community-based participatory research through a social movement framework: a case study of the Kahnawake Schools Diabetes Prevention Project. BMC Public Health 2018; 18:487. [PMID: 29650020 PMCID: PMC5897940 DOI: 10.1186/s12889-018-5412-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 04/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A longstanding challenge of community-based participatory research (CBPR) has been to anchor evaluation and practice in a relevant theoretical framework of community change, which articulates specific and concrete evaluative benchmarks. Social movement theories provide a broad range of theoretical tools to understand and facilitate social change processes, such as those involved in CBPR. Social movement theories have the potential to provide a coherent representation of how mobilization and collective action is gradually developed and leads to systemic change in the context of CBPR. The current study builds on a social movement perspective to assess the processes and intermediate outcomes of a longstanding health promotion CBPR project with an Indigenous community, the Kahnawake Schools Diabetes Prevention Project (KDSPP). METHODS This research uses a case study design layered on a movement-building evaluation framework, which allows progress to be tracked over time. Data collection strategies included document (scientific and organizational) review (n = 51) and talking circles with four important community stakeholder groups (n = 24). RESULTS Findings provide an innovative and chronological perspective of the evolution of KSDPP as seen through a social movement lens, and identify intermediate outcomes associated with different dimensions of movement building achieved by the project over time (mobilization, leadership, vision and frames, alliance and partnerships, as well as advocacy and action strategies). It also points to areas of improvement for KSDPP in building its potential for action. CONCLUSION While this study's results are directly relevant and applicable to the local context of KSDPP, they also highlight useful lessons and conclusions for the planning and evaluation of other long-standing and sustainable CBPR initiatives. The conceptual framework provides meaningful benchmarks to track evidence of progress in the context of CBPR. Findings from the study offer new ways of thinking about the evaluation of CBPR projects and their progress by drawing on frameworks that guide other forms of collective action.
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Affiliation(s)
- Marie-Claude Tremblay
- Department of Family Medicine and Emergency Medicine, Office of Education and Continuing Professional Development, Université Laval, 1050, de la Médecine, Pavillon Ferdinand-Vandry, 2881-F, Québec, QC, G1V 0A6, Canada.
| | - Debbie H Martin
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Alex M McComber
- Kahnawake Schools Diabetes Prevention Project, Kahnawake, QC, Canada.,Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Amelia McGregor
- Kahnawake Schools Diabetes Prevention Project, Kahnawake, QC, Canada
| | - Ann C Macaulay
- Department of Family Medicine, McGill University, Montreal, QC, Canada
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