Cultural connectedness as a determinant of physical activity among Indigenous adults in Saskatchewan

Preventing type 2 diabetes among Indigenous youth: A systematic review of community-based interventions

A systematic review was conducted to assess evidence on effectiveness of community-based interventions promoting wellbeing and prevention of type 2 diabetes (T2D) among Indigenous youth. A convergent, segregated, mixed methods approach was used, with six databases and four grey literature sites searched from inception to May 2022. Articles selected for inclusion were about community-based interventions related to T2D prevention with Indigenous youth that evaluated effectiveness or youth experience published in English. Reference lists were also searched for relevant sources. Seven quantitative research articles met the inclusion and quality assessment criteria. No qualitative articles were identified. The results were synthesised through narrative analysis, while meta-analysis was not possible due to heterogenous study designs. Common foci across interventions included promoting physical wellness, improving physical activity and healthy eating patterns, enhancing knowledge, and psychosocial wellness. Interventions deemed effective addressed multiple areas, were school-based, and operated for at least a year. Findings support multi-strategy, community-based interventions implemented over longer periods of time. However, gaps in research and reporting included the extent to which interventions are culturally informed and based on community-driven priorities. Future research should include Indigenous, mixed and qualitative methods and Indigenous-driven measures of success to better understand effectiveness in alignment with Indigenous worldviews.

Association between yoga and related contextual factors with moderate-to-vigorous physical activity among children and youth aged 5 to 17 years across five Indian states

Physical inactivity is one of the four key preventable risk factors, along with unhealthy diet, tobacco use, and alcohol consumption, underlying most noncommunicable diseases. Promoting physical activity is particularly important among children and youth, whose active living behaviours often track into adulthood. Incorporating yoga, an ancient practice that originated in India, can be a culturally-appropriate strategy to promote physical activity in India. However, there is little evidence on whether yoga practice is associated with moderate-to-vigorous physical activity (MVPA) accumulation. Thus, this study aims to understand how yoga practice is associated with MVPA among children and youth in India. Data for this study were obtained during the coronavirus disease lockdown in 2021. Online surveys capturing MVPA, yoga practice, contextual factors, and sociodemographic characteristics, were completed by 5 to 17-year-old children and youth in partnership with 41 schools across 28 urban and rural locations in five states. Linear regression analyses were conducted to assess the association between yoga practice and MVPA. After controlling for age, gender, and location, yoga practice was significantly associated with MVPA among children and youth (β = 0.634, p < 0.000). These findings highlight the value of culturally-appropriate activities such as yoga, to promote physical activity among children and youth. Yoga practice might have a particularly positive impact on physical activity among children and youth across the world, owing to its growing global prevalence.

A scoping review of Indigenous community-specific physical activity measures developed with and for Indigenous Peoples in Canada, Australia, and New Zealand

Historical factors including colonization and ongoing socioeconomic inequities impact Indigenous Peoples' ability to mitigate chronic disease risks such as achieving recommended physical activity (PA) levels. Reliably assessing, reflecting, and promoting PA participation among Indigenous Peoples may be impacted by a lack of culturally appropriate assessment methods and meaningful engagement with Indigenous communities throughout the research process. The objectives of this scoping review were to examine: (1) How PA research with Indigenous Peoples used community-specific PA measures developed with and/or for Indigenous Peoples in Canada, Australia, and New Zealand; and (2) How the studies utilized community-based participatory research (CBPR) principles to engage communities. A systematic search was conducted in four electronic databases (Web of Science, Medline, University of Saskatchewan Indigenous Portal, and ProQuest Dissertations and Theses Global). Thirty-one (n = 31) articles were identified and data extracted for narrative synthesis. Studies using community-specific PA measures have been increasing over time. Adapting questionnaires to traditional Indigenous activities such as cultural dances, ceremonies, and food-gathering activities were the most frequent adjustments undertaken to use community-specific measures. There are, however, gaps in research partnering with communities with only 6% of studies including all eight CBPR principles. Practical ways researchers can engage Indigenous communities and build capacity such as training and employing community members were highlighted. More needs to be done to facilitate community self-determination and develop long-term sustainable initiatives. Using culturally appropriate and relevant methodologies including partnering with Indigenous communities may help identification and implementation of culturally relevant and sustainable health-promoting initiatives.

Vulnerability to physical inactivity: evidence of content validity and response processes

OBJECTIVE

To analyze content validity evidence and response processes of a bank of items for measuring vulnerability to physical inactivity in adults.

METHOD

Methodological study, with 13 specialists and 46 representatives of the target population. The Content Validity Index (CVI) and binomial test were calculated; data obtained through validity based on response processes were collected through interviews.

RESULTS

Of the 105 constructed items, 16 were excluded (CVI<0.78); 89 items showed agreement <80% in the psychometric criteria, being modified. Of the 101 items that remained (CVI>0.78), 34 were changed and 4 were deleted after evaluating the evidence of response processes. In the end, 97 items remained, with a global CVI of 0.92, organized into two dimensions: Subject (CVI=0.91) and Social (CVI=0.94).

CONCLUSION

The items presented adequate parameters and evidence of validity; and can subsidize the construction of instruments that consider the subject's and social vulnerability in understanding physical inactivity.

First Nations Peoples' Eating and Physical Activity Behaviors in Urban Areas: A Mixed-Methods Approach

The dietary transition from traditional to commercial foods and a decrease in physical activity (PA) have impacted the health of the First Nations people of Quebec (Canada), resulting in many suffering from multiple chronic diseases. This study had two objectives: (1) to examine eating and PA behaviors among First Nations peoples in urban areas and (2) to explore the associated health representations. To achieve these objectives, a mixed-methods approach, including a questionnaire (n = 32) and a semi-structured interview (n = 14), was used to explore the participants' lifestyle profiles and health experiences. The questionnaire focused on the eating and PA behaviors of First Nations people and their underlying motivations. At the same time, the interviews investigated their health views on diet and PA behaviors based on the conceptual framework of health and its determinants. According to the participants, health is the autonomy to live without pain by maintaining a balance between physical and psychological aspects, eating healthy and exercising. Family and work influence participants' PA and eating behaviors. Exploring First Nations people's beliefs and perceptions and the motivations underlying their health behaviors could help encourage the maintenance of a healthy lifestyle despite multiple chronic health conditions.

Spirituality, Community Belonging, and Mental Health Outcomes of Indigenous Peoples during the COVID-19 Pandemic

We aimed to assess the association between community belonging, spirituality, and mental health outcomes among Indigenous Peoples during the COVID-19 pandemic. This cross-sectional observational study used online survey distribution and targeted outreach to the local Indigenous community to collect a convenience sample between 23 April 2020 and 20 November 2020. The surveys included demographic information, self-reported symptoms of depression (PHQ-2) and anxiety (GAD-2), and measures of the sense of community belonging and the importance of spirituality. Multivariate logistic regression was used to model the association between the sense of community belonging and spirituality, and symptoms of anxiety and depression. Of the 263 self-identified Indigenous people who participated, 246 participants had complete outcome data, including 99 (40%) who reported symptoms of depression and 110 (45%) who reported symptoms of anxiety. Compared to Indigenous participants with a strong sense of community belonging, those with weak community belonging had 2.42 (95% CI: 1.12–5.24)-times greater odds of reporting symptoms of anxiety, and 4.40 (95% CI: 1.95–9.89)-times greater odds of reporting symptoms of depression. While spirituality was not associated with anxiety or depression in the adjusted models, 76% of Indigenous participants agreed that spirituality was important to them pre-pandemic, and 56% agreed that it had become more important since the pandemic began. Community belonging was associated with positive mental health outcomes. Indigenous-led cultural programs that foster community belonging may promote the mental health of Indigenous Peoples.

An Indigenous food sovereignty initiative is positively associated with well-being and cultural connectedness in a survey of Syilx Okanagan adults in British Columbia, Canada

BACKGROUND

For the Syilx Okanagan Nation in Canada, salmon has vital nutritional, cultural, and spiritual significance. Yet, the Okanagan Sockeye salmon population came to near extinction, resulting in a drastic decline in salmon consumption from high historical levels. Thus, restoring and protecting salmon is crucial to Syilx well-being and way of life. A Syilx-led food sovereignty initiative re-established the Okanagan Sockeye salmon population, which has resulted in a rise in fish harvesting. The aim of this study was to assess whether engaging with this initiative was associated with health, well-being, and cultural connectedness (i.e., degree to which one is integrated in their culture) among Syilx adults. Eating Okanagan Sockeye salmon was conceptualized as a proxy for engaging with this Indigenous food sovereignty initiative.

METHODS

265 Syilx adults completed a survey including a traditional food frequency questionnaire and questions on health status (e.g., BMI, self-assessed physical health), well-being (e.g., life satisfaction, stress levels), and cultural connectedness (e.g., sense of belonging, importance of cultural practices). Participants were divided into 3 groups based on their wild salmon eating during the year prior to the survey: (1) adults who ate Okanagan Sockeye salmon, (2) adults who ate salmon but did not usually know the species of the salmon they ate, or who solely ate salmon that were not Okanagan Sockeye; and (3) adults who did not eat any salmon.

RESULTS

A statistically significant gradient was observed for enhanced well-being and cultural connectedness, with individuals in group 1 having better indicators than those in group 2, and adults in groups 1 and 2 having better indicators than adults in group 3. No differences were observed in physical health outcomes between the three groups.

CONCLUSION

Findings suggest that the initiative to re-establish Okanagan Sockeye salmon in the Okanagan River system may have led to better well-being and cultural connectedness among Syilx adults. This study highlights the importance of Indigenous food sovereignty as a way to enhance well-being and cultural connectedness among First Nations in Canada. Findings also reinforce the importance of assessing health and well-being in a wholistic way in Indigenous health research.

Social Determinants Associated with Physical Activity among Indigenous Adults at the University of Saskatchewan

Colonization impacts Indigenous Peoples' way of life, culture, language, community structure and social networks. Links between social determinants of health and physical activity (PA) among Indigenous Peoples in Saskatchewan, with 16% Indigenous residents, are unclear. This cross-sectional study guided by Indigenous Community Advisors, compared moderate-to-vigorous PA (MVPA), traditional Indigenous PA and musculoskeletal PA with social determinants of Indigenous, (n=124), including First Nations (n=80, including 57 Cree/Nehiyawak) and Métis (n=41), adults in Saskatchewan. Participants completed Godin-Shephard Leisure-Time PA, Social Support Index and traditional Indigenous PA participation questionnaires. Regression associated positive perception of social support with MVPA (R=0.306, p=0.02), while residential school experiences (R=0.338, p=0.02) and community support (R=0.412, p=0.01) were associated with traditional Indigenous PA participation. Among Métis, discrimination experiences were associated with traditional Indigenous PA participation (R=0.459, p=0.01). Traditional Indigenous PA participation was associated with community support among First Nations (R=0.263, p=0.04), and also foster care placement (R=0.480, p=0.01) for Cree/Nehiyawak First Nations specifically. Among Cree/Nehiyawak, family support (R=0.354, p=0.04), discrimination experiences (R=0.531, p=0.01) and positive perceptions of support (R=0.610, p=0.003) were associated with musculoskeletal PA. Greater community, family and perceived social support, and experiences of discrimination, residential school and foster care are associated with more PA for Indigenous Peoples. Novelty: • Positive support perceptions predict physical activity among Indigenous Peoples • Family support, discrimination experiences and positive support perceptions predict physical activity for Cree/Nehiyawak First Nations. Traditional physical activity was predicted by residential school experiences and community support (Indigenous Peoples), discrimination experiences (Métis), community support (First Nations), and foster care experiences (Cree/Nehiyawak).

Smart Indigenous Youth: The Smart Platform Policy Solution for Systems Integration to Address Indigenous Youth Mental Health

Indigenous youth mental health is an urgent public health issue, which cannot be addressed with a one-size-fits-all approach. The success of health policies in Indigenous communities is dependent on bottom-up, culturally appropriate, and strengths-based prevention strategies. In order to maximize the effectiveness of these strategies, they need to be embedded in replicable and contextually relevant mechanisms such as school curricula across multiple communities. Moreover, to engage youth in the twenty-first century, especially in rural and remote areas, it is imperative to leverage ubiquitous mobile tools that empower Indigenous youth and facilitate novel Two-Eyed Seeing solutions. Smart Indigenous Youth is a 5-year community trial, which aims to improve Indigenous youth mental health by embedding a culturally appropriate digital health initiative into school curricula in rural and remote Indigenous communities in Canada. This policy analysis explores the benefits of such upstream initiatives. More importantly, this article describes evidence-based strategies to overcome barriers to implementation through the integration of citizen science and community-based participatory research action.