Shifting practise: recognizing Indigenous rights holders in research ethics review

A Concept Analysis of Cultural Appreciation in Addressing the Wholistic Health Needs of Indigenous People

Aim: Cultural appreciation is found within the arts, psychology, counseling, health disciplines, and education. Currently, in the literature, there is not a strong link between cultural appreciation, nursing, and Indigenous people. The aim of this concept analysis is to analyze the concept of cultural appreciation for nurse educators, nurse researchers, and nurse leaders to apply to culturally appreciate Indigenous people within their geographical areas which can result in meeting their wholistic care needs. Design: This concept analysis of cultural appreciation uses Walker & Avant's (2019) approach to define cultural appreciation, antecedents, empirical referents, and consequences. Results: The antecedents of cultural appreciation are cultural appropriation, oppression, cultural prejudice, privilege, and lack of knowledge to integrate the wholistic health of Indigenous people into practice, education, and research. The defining attributes of cultural appreciation are awareness, knowledge acquisition, and desire. The consequence of cultural appreciation is wholistic care of Indigenous people as defined by their ways of knowing and being. Conclusion: The concept analysis of cultural appreciation integrates Indigenous wholistic health beliefs and ways of knowing and being that can advance holistic nursing knowledge for nurses, educators, and researchers.

Pathways: A guide for developing culturally safe and appropriate patient-reported outcome (PROMs) and experience measures (PREMs) with Indigenous peoples

BACKGROUND

Members of the Indigenous Health Program, BC Children's and Women's Hospitals and the University of British Columbia embarked on a joint project to describe best practices to support the creation of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) with Indigenous peoples.

METHODS

The project involved a review of previous research on patient-reported measures (surveys) that had been specifically developed for Indigenous populations. It also involved interviews with key stakeholders-Indigenous and non-Indigenous academic researchers, and Indigenous community leaders and community members. Themes from the interviews and the literature review were combined and synthesized into pathways/a framework for survey development.

RESULTS

The pathways document consisted of 13 protocols and associated teachings for guiding processes and framing survey questions. These encompassed building relationships, community engagement and consultation, benefits to community, ceremony and storytelling, two-way learning, participatory content development, governance and accountability. Findings emphasized the criticality of Indigenous leadership in setting priorities for PROMs and PREMS and establishing relationships that honour Indigenous experiences through all phases of a study. Assessment of the framework's validity with select research participants and the Project Advisory Committee was positive.

CONCLUSION

This is the first framework to guide development of PROMs and PREMs with Indigenous peoples and communities. It addresess both process and outcome and includes concrete steps that collaborators can take when establishing a partnership that is respectful and inclusive of Indigenous ways of knowing and being.

Exploring the dimensions of responsible research systems and cultures: a scoping review

The responsible conduct of research is foundational to the production of valid and trustworthy research. Despite this, our grasp of what dimensions responsible conduct of research (RCR) might contain-and how it differs across disciplines (i.e. how it is conceptualized and operationalized)-is tenuous. Moreover, many initiatives related to developing and maintaining RCR are developed within disciplinary and institutional silos which naturally limits the benefits that RCR practice can have. To this end, we are working to develop a better understanding of how RCR is conceived and realized, both across disciplines and across institutions in Europe. The first step in doing this is to scope existing knowledge on the topic, of which this scoping review is a part. We searched several electronic databases for relevant published and grey literature. An initial sample of 715 articles was identified, with 75 articles included in the final sample for qualitative analysis. We find several dimensions of RCR that are underemphasized or are excluded from the well-established World Conferences on Research Integrity (WCRI) Singapore Statement on Research Integrity and explore facets of these dimensions that find special relevance in a range of research disciplines.

Impact on mental health and wellbeing in Indigenous communities due to land loss resulting from industrial resource development: protocol for a systematic review

BACKGROUND

Indigenous Peoples are impacted by industrial resource development that takes place on, or near, their communities. Existing literature on impacts of industrial resource development on Indigenous Peoples primarily focus on physical health outcomes and rarely focus on the mental health impacts. To understand the full range of long-term and anticipated health impacts of industrial resource development on Indigenous communities, mental health impacts must be examined. It is well-established that there is a connection between the environment and Indigenous wellbeing, across interrelated dimensions of mental, physical, emotional, and spiritual health.

METHODS

This paper identifies how the Community Advisory Team and a team of Indigenous and settler scholars will conduct the review. The literature search will use the OVID interface to search Medline, Embase, PsycINFO, and Global Health databases. Non-indexed peer-reviewed journals related to Indigenous health or research will be scanned. Books and book chapters will be identified in the Scopus and PsycINFO databases. The grey literature search will also include Google and be limited to reports published by government, academic, and non-profit organizations. Reference lists of key publications will be checked for additional relevant publications, including theses, dissertations, reports, and other articles not retrieved in the online searches. Additional sources may be recommended by team members. Included documents will focus on Indigenous Peoples in North America, South America, Australia, Aotearoa New Zealand, and Circumpolar regions, research that reports on mental health, and research that is based on land loss connected to dams, mines, agriculture, or petroleum development. Literature that meets the inclusion criteria will be screened at the title/abstract and full-text stages by two team members in Covidence. The included literature will be rated with a quality appraisal tool and information will be extracted by two team members; a consensus of information will be reached and be submitted for analysis.

DISCUSSION

The synthesized evidence from this review is relevant for land use policy, health impact assessments, economic development, mental health service planning, and communities engaging in development projects.

SYSTEMATIC REVIEW REGISTRATION

Registered in the International Prospective Register of Systematic Reviews (PROSPERO; Registration number CRD42021253720 ).

Knowledge translation approaches and practices in Indigenous health research: A systematic review

Knowledge translation (KT) is a critical component of any applied health research. Indigenous Peoples' health research and KT largely continues to be taught, developed, designed, regulated, and conducted in ways that do not prioritize local Indigenous Peoples' ways of sharing knowledges. This review was governed and informed by Indigenous health scholars, Knowledge Guardians, and Elders. Our systematic review focused on answering, what are the promising and wise practices for KT in the Indigenous health research field? Fifty-one documents were included after screening published literature from any country and grey literature from what is now known as Canada. This included contacting 73 government agencies at the federal, territorial, and provincial levels that may have funded Indigenous health research. Only studies that: a) focused on Indigenous Peoples' health and wellness; b) documented knowledge sharing activities and rationale; c) evaluated the knowledge sharing processes or outcomes; and d) printed in English were included and appraised using the Well Living House quality appraisal tool. The analysis was completed using an iterative and narrative synthesis approach. Our systematic review protocol has been published elsewhere. We highlight and summarize the varied aims of Indigenous health research KT, types of KT methodologies and methods used, effectiveness of KT efforts, impacts of KT on Indigenous Peoples' health and wellness, as well as recommendations and lessons learned. Few authors reported using rigorous KT evaluation or disclosed their identity and relationship with the Indigenous communities involved in research (i.e. self-locate). The findings from this review accentuate, reiterate and reinforce that KT is inherent in Indigenous health research processes and content, as a form of knowing and doing. Indigenous health research must include inherent KT processes, if the research is by, for, and/or with Indigenous Peoples.

Are Indigenous research principles incorporated into maternal health research? A scoping review of the global literature

BACKGROUND

Indigenous women world-wide are diverse and heterogenous, yet many have similar experiences of colonization, land dispossession, and discrimination. These experiences along with inequitable access to, and quality of, maternal healthcare increase adverse maternal health outcomes. To improve health outcomes for Indigenous women, studies must be conducted with Indigenous involvement and reflect Indigenous research principles. Objectives/Aim: The aim of this review was to explore the range, extent, and nature of Indigenous maternal health research and to assess the reporting of Indigenous research principles in the global Indigenous maternal health literature.

METHODS

Following a systematic scoping review protocol, four scholarly electronic databases were searched. Articles were included if they reported empirical research published between 2000 and 2019 and had a focus on Indigenous maternal health. Descriptive data were extracted from relevant articles and descriptive analysis was conducted. Included articles were also assessed for reporting of Indigenous research principles, including Indigenous involvement, context of colonization, Indigenous conceptualizations of health, community benefits, knowledge dissemination to participants or communities, and policy or intervention recommendations.

RESULTS

Four-hundred and forty-one articles met the inclusion criteria. While studies were conducted in all continents except Antarctica, less than 3% of articles described research in low-income countries. The most researched topics were access to and quality of maternity care (25%), pregnancy outcome and/or complications (18%), and smoking, alcohol and/or drug use during pregnancy (14%). The most common study design was cross-sectional (49%), and the majority of articles used quantitative methods only (68%). Less than 2% of articles described or reported all Indigenous research principles, and 71% of articles did not report on Indigenous People's involvement.

CONCLUSIONS

By summarizing the trends in published literature on Indigenous maternal health, we highlight the need for increased geographic representation of Indigenous women, expansion of research to include important but under-researched topics, and meaningful involvement of Indigenous Peoples.

Indigenous and Tribal Peoples Data Governance in Health Research: A Systematic Review

There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles; (2) identify and describe data governance frameworks; and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance; (2) institutional ethics; (3) socio-political dynamics; (4) data management and data stewardship; and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research.

“Awakening the sleeping giant”: re-Indigenization principles for transforming biodiversity conservation in Canada and beyond

Precipitous declines in biodiversity threaten planetary boundaries, requiring transformative changes to conservation. Colonial systems have decimated species and ecosystems and dispossessed Indigenous Peoples of their rights, territories, and livelihoods. Despite these challenges, Indigenous-governed lands retain a large proportion of biodiversity-rich landscapes. Indigenous Peoples have stewarded the land in ways that support people and nature in respectful relationship. Biodiversity conservation and resurgence of Indigenous autonomies are mutually compatible aims. To work towards these aims requires significant transformation in conservation and re-Indigenization. Key to both are systems that value people and nature in all their diversity and relationships. This paper introduces Indigenous principles for re-Indigenizing conservation: ( i) embracing Indigenous worldviews of ecologies and M’sɨt No’kmaq, ( ii) learning from Indigenous languages of the land, ( iii) Natural laws and Netukulimk, ( iv) correct relationships, ( v) total reflection and truth, ( vi) Etuaptmumk—“two-eyed seeing,” and “strong like two people”, and ( vii) “story-telling/story-listening”. Although the principles derive primarily from a Mi’kmaw worldview, many are common to diverse Indigenous ways of knowing. Achieving the massive effort required for biodiversity conservation in Canada will entail transformations in worldviews and ways of thinking and bold, proactive actions, not solely as means but as ongoing imperatives.