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Driedger SM, Maier R, Capurro G, Jardine C, Tustin J, Chartrand F, Sanguins J, Kloss O. "There's a little bit of mistrust": Red River Métis experiences of the H1N1 and COVID-19 pandemics. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024. [PMID: 38286593 DOI: 10.1111/risa.14274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/24/2023] [Accepted: 12/28/2023] [Indexed: 01/31/2024]
Abstract
We examined the perspectives of the Red River Métis citizens in Manitoba, Canada, during the H1N1 and COVID-19 pandemics and how they interpreted the communication of government/health authorities' risk management decisions. For Indigenous populations, pandemic response strategies play out within the context of ongoing colonial relationships with government institutions characterized by significant distrust. A crucial difference between the two pandemics was that the Métis in Manitoba were prioritized for early vaccine access during H1N1 but not for COVID-19. Data collection involved 17 focus groups with Métis citizens following the H1N1 outbreak and 17 focus groups during the COVID-19 pandemic. Métis prioritization during H1N1 was met with some apprehension and fear that Indigenous Peoples were vaccine-safety test subjects before population-wide distribution occurred. By contrast, as one of Canada's three recognized Indigenous nations, the non-prioritization of the Métis during COVID-19 was viewed as an egregious sign of disrespect and indifference. Our research demonstrates that both reactions were situated within claims that the government does not care about the Métis, referencing past and ongoing colonial motivations. Government and health institutions must anticipate this overarching colonial context when making and communicating risk management decisions with Indigenous Peoples. In this vein, government authorities must work toward a praxis of decolonization in these relationships, including, for example, working in partnership with Indigenous nations to engage in collaborative risk mitigation and communication that meets the unique needs of Indigenous populations and limits the potential for less benign-though understandable-interpretations.
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Affiliation(s)
- S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ryan Maier
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gabriela Capurro
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Cindy Jardine
- Faculty of Health Sciences, University of the Fraser Valley, Chilliwack, British Columbia, Canada
| | - Jordan Tustin
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Frances Chartrand
- Health & Wellness Department, Manitoba Métis Federation, Winnipeg, Manitoba, Canada
| | - Julianne Sanguins
- Health & Wellness Department, Manitoba Métis Federation, Winnipeg, Manitoba, Canada
| | - Olena Kloss
- Health & Wellness Department, Manitoba Métis Federation, Winnipeg, Manitoba, Canada
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Stein S, Robin T, Wesley M, Valley W, Clegg DJ, Ahenakew C, Cohen TR. Confronting Colonialism in Canadian Dietetics Curricula. CAN J DIET PRACT RES 2023; 84:226-232. [PMID: 37737126 DOI: 10.3148/cjdpr-2023-017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Many Canadian universities have committed to becoming more accountable to Indigenous Peoples by confronting the systemic, historical, and ongoing colonialism and anti-Indigenous racism that shape their campuses. In this Perspective in Practice piece, we invite the field of dietetics to consider how colonialism has shaped dietetics research, teaching, and practice. We also consider how we might transform the field of dietetics in ways that accept settler responsibility for interrupting racism and colonial harm; support the resurgence of Indigenous food and health practices; and recognise the connections between struggles to ensure that Indigenous Peoples can access culturally appropriate food and health care, and struggles for Indigenous sovereignty and self-determination. We do this by reviewing the history of the dietetics field, examining critical responses to existing Indigenisation and decolonisation efforts, and reflecting on recent changes to required dietetics competencies. We argue that curricula in dietetics programmes must teach the history of the colonial food system and equip students to identify and interrupt the individual and institutional colonial dynamics that contribute to the ongoing dispossession of Indigenous Peoples' lands and food sources and negatively impact Indigenous patients.
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Affiliation(s)
- Sharon Stein
- Department of Educational Studies, Faculty of Education, University of British Columbia, BC
| | - Tabitha Robin
- Applied Biology, Faculty of Land and Food Systems, University of British Columbia, BC
| | - Michael Wesley
- Indigenous Health and Nutrition Consulting, Kelowna, BC
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, BC
| | - Will Valley
- Centre for Sustainable Food Systems, Faculty of Land and Food Systems, University of British Columbia, BC
| | - Daniel J Clegg
- Centre for Sustainable Food Systems, Faculty of Land and Food Systems, University of British Columbia, BC
| | - Cash Ahenakew
- Department of Educational Studies, Faculty of Education, University of British Columbia, BC
| | - Tamara R Cohen
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, BC
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Brand G, Wise S, Bedi G, Kickett R. Embedding Indigenous knowledges and voices in planetary health education. Lancet Planet Health 2023; 7:e97-e102. [PMID: 36608956 DOI: 10.1016/s2542-5196(22)00308-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 11/01/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
Internationally, the health-care sector has been slower than many other sectors in reducing its carbon emissions and broader environmental footprint. Incrementally, tertiary education institutions are changing their focus to integrate environmental and social objectives, including planetary health, into teaching, research, and how the campus is operated. Planetary health and sustainable health-care are emerging topics in the education of health professionals. However, they have largely been limited to specific knowledge rooted in western epistemology with ad hoc curricula that do not consider the complex interdependence of ecosystems and human health. Because of the need to prepare the current and future health-care workforce for planetary consciousness and related practices, in this Personal View we provide an innovative case study that uses Indigenist health humanities (eg, narrative portraiture) and arts-based education strategies to offer a different way of seeing, knowing, and understanding planetary health. Embedding Indigenous knowledges and voices into planetary health education is an important first step in decolonising learning in health professional education.
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Affiliation(s)
- Gabrielle Brand
- Monash Nursing and Midwifery, Monash University, Frankston, VIC, Australia; Monash Centre for Scholarship in Health Education, Monash University, Frankston, VIC, Australia.
| | - Steve Wise
- 27Creative Photography Design, Perth, WA, Australia; Medical Multimedia Design Department, Royal Perth Hospital, Perth, WA, Australia; Australian Institute of Medical and Biological Illustration, Melbourne, VIC, Australia
| | - Gitanjali Bedi
- Monash Sustainable Development Institute, Monash University, Frankston, VIC, Australia
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Razack S, Naidu T. Honouring the multitudes: removing structural racism in medical education. Lancet 2022; 400:2021-2023. [PMID: 36502830 DOI: 10.1016/s0140-6736(22)02454-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Saleem Razack
- Department of Pediatrics (Critical Care Medicine) and the Centre for Health Education Scholarship, University of British Columbia, Vancouver, BC V6H0B3, Canada.
| | - Thirusha Naidu
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Wilby KJ. The unexpected intersection of personal and professional identities: Reflections from cultural safety teaching for LGBTAQI+ health. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:106-109. [PMID: 35125188 DOI: 10.1016/j.cptl.2021.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/14/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE Teaching can be likened to a performance. Instructors can portray themselves as they wish, concealing their personal identities and vulnerabilities to whatever extent they choose. For certain topics, such as cultural safety, there may be a role for intersecting personal and professional identities and sharing one's own personal experiences in order to better connect with students. DESCRIPTION Tasked to develop and implement Lesbian, Gay, Bisexual, Transgender, Asexual, Queer/Questioning, Intersexual, and others (LGBTAQI+) health content for the first time, I stepped outside my comfort zone by exposing my vulnerabilities and sharing personal experiences with students as an LGBTAQI+ community member. I partnered with a Māori colleague who helped to relate cultural safety concepts back to previous teaching on Indigenous health. ANALYSIS/INTERPRETATION This experience taught me that simply providing facts, statistics, and textbook descriptions would have been suboptimal for instilling knowledge and shifting the mindset of students when considering LGBTAQI+ health. Incorporation of personal experiences into teaching was effective at stimulating reflective thought and will hopefully result in better resonation of concepts in practice. CONCLUSIONS Traditional textbook-based teaching methods may not be optimal for all topics. The role of personalizing content through sharing and connection should be further explored as a strategy to promote cultural safety in pharmacy education. IMPLICATIONS Educators and institutions should promote reflective practice for curricula designed to facilitate cultural safety. Sharing oneself with students may not always be a favored strategy but there could be other strategies identified through further reflection and research.
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Affiliation(s)
- Kyle John Wilby
- College of Pharmacy, Faculty of Health, Dalhousie University, 5968 College Street, Halifax, Nova Scotia, Canada.
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Roher SIG, Yu Z, Martin DH, Benoit AC. How is Etuaptmumk/Two-Eyed Seeing characterized in Indigenous health research? A scoping review. PLoS One 2021; 16:e0254612. [PMID: 34283831 PMCID: PMC8291645 DOI: 10.1371/journal.pone.0254612] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/30/2021] [Indexed: 11/18/2022] Open
Abstract
Our scoping review sought to consider how Etuaptmumk or Two-Eyed Seeing is described in Indigenous health research and to compare descriptions of Two-Eyed Seeing between original authors (Elders Albert and Murdena Marshall, and Dr. Cheryl Bartlett) and new authors. Using the JBI scoping review methodology and qualitative thematic coding, we identified seven categories describing the meaning of Two-Eyed Seeing from 80 articles: guide for life, responsibility for the greater good and future generations, co-learning journey, multiple or diverse perspectives, spirit, decolonization and self-determination, and humans being part of ecosystems. We discuss inconsistencies between the original and new authors, important observations across the thematic categories, and our reflections from the review process. We intend to contribute to a wider dialogue about how Two-Eyed Seeing is understood in Indigenous health research and to encourage thoughtful and rich descriptions of the guiding principle.
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Affiliation(s)
- Sophie I. G. Roher
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Circumpolar Health Research, Yellowknife, Northwest Territories, Canada
| | - Ziwa Yu
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Debbie H. Martin
- Health Promotion Division, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anita C. Benoit
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute-Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
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Anang P, Gottlieb N, Putulik S, Iguptak S, Gordon E. Learning to Fail Better: Reflections on the Challenges and Risks of Community-Based Participatory Mental Health Research With Inuit Youth in Nunavut. Front Public Health 2021; 9:604668. [PMID: 33777879 PMCID: PMC7996061 DOI: 10.3389/fpubh.2021.604668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/17/2021] [Indexed: 11/13/2022] Open
Abstract
Community-based participatory research (CBPR) is a mine field of moral dilemmas. Even when carefully planned for and continuously critically reflected upon, conflicts are likely to occur as part of the process. This paper illustrates the lessons learned from "Building on Strengths in Naujaat", a resiliency initiative with the objective of promoting sense of belonging, collective efficacy, and well-being in Inuit youth. Naujaat community members over time established strong meaningful relationships with academic researchers. Youth took on the challenge of organizing community events, trips out on the land, and fundraisers. While their creativity and resourcefulness are at the heart of the initiative, this paper explores conflicts and pitfalls that accompanied it. Based on three themes - struggles in coming together as academic and community partners, the danger of perpetuating colonial power structures, and the challenges of navigating complex layers of relations within the community - we examine the dilemmas unearthed by these conflicts, including an exploration of how much we as CBPR researchers are at risk of reproducing colonial power structures. Acknowledging and addressing power imbalances, while striving for transparency, accountability, and trust, are compelling guiding principles needed to support Indigenous communities on the road toward health equity.
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Affiliation(s)
- Polina Anang
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Nora Gottlieb
- Department of Health Care Management, Berlin Technical University, Berlin, Germany.,Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | | | | | - Ellen Gordon
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
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Ireland S, Maypilama EL. "We are sacred": An intercultural and multilingual approach to understanding reproductive health literacy for Yolŋu girls and women in remote Northern Australia. Health Promot J Austr 2021; 32 Suppl 1:192-202. [PMID: 33159372 DOI: 10.1002/hpja.439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/10/2022] Open
Abstract
ISSUE ADDRESSED Indigenous women continue to experience reproductive health inequities. While enhancing health literacy is suggested as an approach for reducing disparities and increasing equity, there is a paucity of literature exploring Indigenous women's conceptualisation of reproductive health literacy. This paper demonstrates one approach to developing a reproductive health literacy framework for Yolŋu (Indigenous) women in a remote Northern Australian setting. METHODS Using a decolonising participatory action research approach, a senior Yolŋu researcher led interviews, group story sharing sessions, historic site visits and on-country cultural demonstration sessions with participants on reproductive health topics. Data were collected in the participants' first language(s) and occasionally in English. Data were digitally recorded on camera, Dictaphone, video and in handwritten notes. The senior Yolŋu researcher worked with a Yolŋu interpreter to translate the data into English. Data underwent a progressive verbal relational content analysis to map and build a framework. RESULTS A reproductive health literacy framework that privileges Yolŋu reproductive knowledge, practices and language was successfully co-designed. The framework was embedded in the metaphor of Pandanus mat and uses key cultural domains of Yolŋu identity as a connecting foundation to women's reproductive knowledges and ceremonial milestones. CONCLUSIONS The framework offers a culturally responsive and multilingual approach to sensitively discuss and operationalise reproductive health literacy. The framework empowers Yolŋu cultural identities; accounts for both Yolŋu and Western medical knowledges; and honours participants' requests for "Two-Way" learning. SO WHAT?: This research demonstrates an innovative approach to co-designing a culturally responsive framework for reproductive health literacy in a complex and multilingual context. Such approaches offer a promising way forward for empowering Indigenous women to define reproductive health literacy and contribute to improving their reproductive health outcomes.
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Affiliation(s)
- Sarah Ireland
- Molly Wardaguga Research Centre, Charles Darwin University, Casuarina, NT, Australia
| | - Elaine L Maypilama
- The Northern Institute, Charles Darwin University, Casuarina, NT, Australia
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