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Marchand T, Squires K, Daodu O, Brindle ME. Improving Indigenous health equity within the emergency department: a global review of interventions. CAN J EMERG MED 2024:10.1007/s43678-024-00687-3. [PMID: 38683290 DOI: 10.1007/s43678-024-00687-3] [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: 10/10/2023] [Accepted: 03/27/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Indigenous health equity interventions situated within emergency care settings remain underexplored, despite their potential to influence patient care satisfaction and empowerment. This study aimed to systematically review and identify Indigenous equity interventions and their outcomes within acute care settings, which can potentially be utilized to improve equity within Canadian healthcare for Indigenous patients. METHODS A database search was completed of Medline, PubMed, Embase, Google Scholar, Scopus and CINAHL from inception to April 2023. For inclusion in the review, articles were interventional and encompassed program descriptions, evaluations, or theoretical frameworks within acute care settings for Indigenous patients. We evaluated the methodological quality using both the Joanna Briggs Institute checklist and the Ways Tried and True framework. RESULTS Our literature search generated 122 publications. 11 articles were selected for full-text review, with five included in the final analysis. Two focusing on Canadian First Nations populations and three on Aboriginal Australians. The main intervention strategies included cultural safety training, integration of Indigenous knowledge into care models, optimizing waiting-room environments, and emphasizing sustainable evaluation methodologies. The quality of the interventions was varied, with the most promising studies including Indigenous perspectives and partnerships with local Indigenous organizations. CONCLUSIONS Acute care settings, serving as the primary point of access to health care for many Indigenous populations, are well-positioned to implement health equity interventions such as cultural safety training, Indigenous knowledge integration, and optimization of waiting room environments, combined with sustainable evaluation methods. Participatory discussions with Indigenous communities are needed to advance this area of research and determine which interventions are relevant and appropriate for their local context.
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Affiliation(s)
- Tyara Marchand
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Kaitlyn Squires
- Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Oluwatomilayo Daodu
- Surgery, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Mary E Brindle
- Surgery and Community Health Sciences, Cumming School of Medicine, Calgary, AB, Canada
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Acharibasam JB, Hurlbert M, Datta R, Wâsakâyâsiw Lewis K. Meanings of indigenous land-based healing and the implications for water governance. Explore (NY) 2024:S1550-8307(24)00060-0. [PMID: 38609742 DOI: 10.1016/j.explore.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
The continuous process of settler colonialism in Canada has profoundly impacted Indigenous Peoples' relationship with the Land and water, which holds immense significance in their healing journey. Reconnecting with the land and water through culturally rooted practices has far-reaching implications for the health and well-being of Indigenous communities. Maintaining a strong bond with the land and water is integral to Indigenous healing traditions. To gain insights into this connection we used a relational theoretical framework and engaged with Ministikwan Lake Cree Nation, a remote Indigenous community. Our approach centred around community-based participatory research, utilizing methods like deep listening, cultural camps and story-sharing to collect wisdom from community members, knowledge keepers, and Elders. The research findings show understanding the connection between Land-based healing practices and Indigenous-led water governance is critical to solving the water crises within remote Indigenous communities. This knowledge is indispensable for reshaping current water governance systems and ensuring the well-being of Indigenous communities across Canada.
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Affiliation(s)
| | - Margot Hurlbert
- Johnson-Shoyama Graduate School of Public Policy, University of Regina, Canada
| | - Ranjan Datta
- Community Disaster Research at the Indigenous Studies, Department of Humanities, Mount Royal University, Canada
| | - Kevin Wâsakâyâsiw Lewis
- Translator and Transcriber at kâniyâsihk Culture Camps via kRDI, University of Saskatchewan, Canada
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McKivett A, Paul D. Recreating the future-Indigenous research paradigms in health professional education research. MEDICAL EDUCATION 2024; 58:149-156. [PMID: 37329219 DOI: 10.1111/medu.15154] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/27/2023] [Accepted: 06/05/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Health and self-determination are recognised as universal human rights. Health professional education research and practice hold the capacity to prioritise values, worldviews and agendas that envisage sustainable and equitable futures for the entire community served. This paper explores the need for the co-location of Indigenous research paradigms in health professional education research and teaching. Indigenous communities have a long history of science, research and sustainable living and are holders of ways of knowing, being and doing that can shape actions and priorities in health research that value equity and sustainability. DISCUSSION Knowledge construction in health professional education research does not occur in isolation nor is it value neutral. A continued dominance of the biomedical approach to health creates a system of innovation that is unbalanced and unable to deliver health outcomes demanded by contemporary society. As power and hierarchies are embedded in health professional education research and praxis, transformative action is required to bring forth marginalised voices in research processes. Critical reflexivity regarding the ontological, epistemological, axiological and methodological positioning of researchers is an important step towards creating and sustaining research structures that effectively value and co-locate different perspectives in knowledge production and translation. CONCLUSION Working towards more equitable and sustainable futures for Indigenous and non-Indigenous communities requires health care systems to be informed and guided by different knowledge paradigms. This can work to avoid the ongoing reproduction of inefficient biomedical structures and purposefully disrupt the status quo of health inequities. Realising this requires the effective co-location of Indigenous research paradigms and ways of working into health professional education research that centre relationality, wholism, interconnectedness and self-determination. This calls for a raising of the critical consciousness of health professional education research academies.
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Affiliation(s)
- Andrea McKivett
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - David Paul
- Fremantle Medical Program, National School of Medicine, University of Notre Dame Australia, Fremantle, Western Australia, Australia
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Hitchon CA, ONeil L, Peschken CA, Robinson DB, Fowler-Woods A, El-Gabalawy HS. Disparities in rheumatoid arthritis outcomes for North American Indigenous populations. Int J Circumpolar Health 2023; 82:2166447. [PMID: 36642913 PMCID: PMC9848324 DOI: 10.1080/22423982.2023.2166447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Advances in rheumatoid arthritis (RA) management have significantly improved clinical outcomes of this disease; however, some Indigenous North Americans (INA) with RA have not achieved the high rates of treatment success observed in other populations. We review factors contributing to poor long-term outcomes for INA with RA. We conducted a narrative review of studies evaluating RA in INA supplemented with regional administrative health and clinical cohort data on clinical outcomes and health care utilisation. We discuss factors related to conducting research in INA populations including studies of RA prevention. NA with RA have a high burden of genetic and environmental predisposing risk factors that may impact disease phenotype, delayed or limited access to rheumatology care and advanced therapy. These factors may contribute to the observed increased rates of persistent synovitis, premature end-stage joint damage and mortality. Novel models of care delivery that are culturally sensitive and address challenges associated with providing speciality care to patients residing in remote communities with limited accessibility are needed. Progress in establishing respectful research partnerships with INA communities has created a foundation for ongoing initiatives to address care gaps including those aimed at RA prevention. This review highlights some of the challenges of diagnosing, treating, and ultimately perhaps preventing, RA in INA populations.
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Affiliation(s)
- Carol A Hitchon
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada,CONTACT Carol A Hitchon Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, CAN, RR149 800 Sherbrook Street, Winnipeg, ManitobaR3A 1M4Canada
| | - Liam ONeil
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christine A Peschken
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada,Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - David B Robinson
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amanda Fowler-Woods
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hani S El-Gabalawy
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, 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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Jull J, Fairman K, Oliver S, Hesmer B, Pullattayil AK. Interventions for Indigenous Peoples making health decisions: a systematic review. Arch Public Health 2023; 81:174. [PMID: 37759336 PMCID: PMC10523645 DOI: 10.1186/s13690-023-01177-1] [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: 04/07/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Shared decision-making facilitates collaboration between patients and health care providers for informed health decisions. Our review identified interventions to support Indigenous Peoples making health decisions. The objectives were to synthesize evidence and identify factors that impact the use of shared decision making interventions. METHODS An Inuit and non-Inuit team of service providers and academic researchers used an integrated knowledge translation approach with framework synthesis to coproduce a systematic review. We developed a conceptual framework to organize and describe the shared decision making processes and guide identification of studies that describe interventions to support Indigenous Peoples making health decisions. We conducted a comprehensive search of electronic databases from September 2012 to March 2022, with a grey literature search. Two independent team members screened and quality appraised included studies for strengths and relevance of studies' contributions to shared decision making and Indigenous self-determination. Findings were analyzed descriptively in relation to the conceptual framework and reported using guidelines to ensure transparency and completeness in reporting and for equity-oriented systematic reviews. RESULTS Of 5068 citations screened, nine studies reported in ten publications were eligible for inclusion. We categorized the studies into clusters identified as: those inclusive of Indigenous knowledges and governance ("Indigenous-oriented")(n = 6); and those based on Western academic knowledge and governance ("Western-oriented")(n = 3). The studies were found to be of variable quality for contributions to shared decision making and self-determination, with Indigenous-oriented studies of higher quality overall than Western-oriented studies. Four themes are reflected in an updated conceptual framework: 1) where shared decision making takes place impacts decision making opportunities, 2) little is known about the characteristics of health care providers who engage in shared decision making processes, 3) community is a partner in shared decision making, 4) the shared decision making process involves trust-building. CONCLUSIONS There are few studies that report on and evaluate shared decision making interventions with Indigenous Peoples. Overall, Indigenous-oriented studies sought to make health care systems more amenable to shared decision making for Indigenous Peoples, while Western-oriented studies distanced shared decision making from the health care settings. Further studies that are solutions-focused and support Indigenous self-determination are needed.
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Affiliation(s)
- Janet Jull
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Kimberly Fairman
- Institute for Circumpolar Health Research, Northwest Territories, Yellowknife, Canada
| | | | - Brittany Hesmer
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON Canada
| | | | - Not Deciding Alone Team
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
- Institute for Circumpolar Health Research, Northwest Territories, Yellowknife, Canada
- University College London, London, UK
- Queen’s University, Kingston, ON Canada
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Erb T, Stelkia K. Best Practices to Support the Self-Determination of Indigenous Communities, Collectives, and Organizations in Health Research through a Provincial Health Research Network Environment in British Columbia, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6523. [PMID: 37569063 PMCID: PMC10418653 DOI: 10.3390/ijerph20156523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023]
Abstract
In Canada, the health research funding landscape limits the self-determination of Indigenous peoples in multiple ways, including institutional eligibility, priority setting, and institutional structures that deprioritize Indigenous knowledges. However, Indigenous-led research networks represent a promising approach to transforming the funding landscape to better support the self-determination of Indigenous peoples in health research. The British Columbia Network Environment for Indigenous Health Research (BC NEIHR) is one of nine Indigenous-led networks across Canada that supports research leadership among Indigenous (First Nations, Métis, and Inuit) communities, collectives, and organizations (ICCOs). In this paper, we share three best practices to support the self-determination of ICCOs in health research based on three years of operating the BC NEIHR: (1) creating capacity-bridging initiatives to overcome funding barriers; (2) building relational research relationships with ICCOs ("people on the ground"); and (3) establishing a network of partnerships and collaborations to support ICCO self-determination. Supporting the self-determination of ICCOs and enabling them to lead their own health research is a critical pathway toward transforming the way Indigenous health research is funded and conducted in Canada.
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Affiliation(s)
- Tara Erb
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Krista Stelkia
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada;
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Cidro J, Wodtke L, Hayward A, Nychuk A, Doenmez C, Sinclair S. Fair compensation and the affective costs for indigenous doulas in Canada: A qualitative study. Midwifery 2023; 116:103497. [PMID: 36223661 DOI: 10.1016/j.midw.2022.103497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/06/2022] [Accepted: 09/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND In Canada, Indigenous doulas, or birth workers, who provide continuous, culturally appropriate perinatal support to Indigenous families, build on a long history of Indigenous birth work to provide accessible care to their underserviced communities, but there is little research on how these doulas organize and administer their services. METHODS Semi-structured interviews were conducted in 2020 with five participants who each represented an Indigenous doula collective in Canada. One interview was conducted in person while the remaining four were conducted over Zoom due to COVID-19. Participants were selected through Internet searches and purposive sampling. Interview transcripts were approved by participants and subsequently coded by the entire research team to identify key themes. RESULTS One of the five emergent themes in these responses is the issue of fair compensation, which includes two sub-themes: the need for fair payment models and the high cost of affective labour in the context of cultural responsibility and racial discrimination. DISCUSSION Specifically, participants discuss the challenges and limitations of providing high quality care to families with complex needs and who cannot afford to pay for their services while ensuring that they are fairly compensated for their labour. An additional tension arises from these doulas' sense of cultural responsibility to support their kinship networks during one of the most sacred and vulnerable times in their lives within a colonial context of racism and a Western capitalist economy that financializes and medicalizes birth. CONCLUSION These Indigenous birth workers regularly expend more affective labour than mainstream non-racialized counterparts yet are often paid less than a living wage. Though there are community-based doula models across the United States, the United Kingdom, and Sweden that serve underrepresented communities, further research needs to be conducted in the Canadian context to determine an equitable, sustainable pay model for community-based Indigenous doulas that is accessible for all Indigenous families.
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Affiliation(s)
- Jaime Cidro
- Kishaadigeh Collaborative Research Centre, The University of Winnipeg, 515 Portage Avenue, Winnipeg, MB R3B 2E9, Canada
| | - Larissa Wodtke
- Kishaadigeh Collaborative Research Centre, The University of Winnipeg, 515 Portage Avenue, Winnipeg, MB R3B 2E9, Canada.
| | - Ashley Hayward
- Kishaadigeh Collaborative Research Centre, The University of Winnipeg, 515 Portage Avenue, Winnipeg, MB R3B 2E9, Canada
| | - Alexandra Nychuk
- Kishaadigeh Collaborative Research Centre, The University of Winnipeg, 515 Portage Avenue, Winnipeg, MB R3B 2E9, Canada
| | - Caroline Doenmez
- Department of Anthropology, University of Minnesota, 301 19th Avenue S, Minneapolis, MN 55454, United States
| | - Stephanie Sinclair
- Department of Native Studies, University of Manitoba, 66 Chancellors Circle, Winnipeg, Manitoba R3T 2N2, Canada
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Leeies M, Grunau B, Askin N, Fesehaye L, Kornelsen J, McColl T, Ratana P, Gruber J, Hrymak H, Hrymak C. Equity-relevant sociodemographic variable collection in emergency medicine: A systematic review, qualitative evidence synthesis, and recommendations for practice. Acad Emerg Med 2022. [PMID: 36398908 DOI: 10.1111/acem.14629] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objective was to conduct a systematic review and qualitative evidence synthesis (QES) to identify best practices, benefits, harms, facilitators, and barriers to the routine collection of sociodemographic variables in emergency departments (EDs). METHODS This work is a systematic review and QES. We conducted a comprehensive search of Medline (Ovid), CINAHL (Ebsco), Cochrane Central (OVID), EMBASE (Ovid), and the multidisciplinary Web of Science Core database using peer-reviewed search strategies, complemented by a gray literature search. We included citations containing perspectives on routine sociodemographic variable collection in EDs and recommendations on definitions or processes of collection or benefits, harms, facilitators, or barriers related to the routine collection of sociodemographic variables in EDs. We conducted this systematic review and QES adhering to the Joanna Briggs Institute guidelines. Two reviewers independently selected included studies and extracted data. We conducted a best-fit framework synthesis and paired inductive thematic analysis of the included studies. We generated recommendations based on the QES. RESULTS We included 21 unique reports that enrolled 10,454 patients or respondents in our systematic review and QES. Publication dates of included studies ranged from 2011 to 2021. Included citations were published in Australia, Canada, and the United States. We synthesized 11 benefits, 14 potential harms, 15 barriers, and 19 facilitators and identified 14 best practice recommendations from included citations. CONCLUSIONS Health systems should routinely collect sociodemographic variables in EDs guided by recommendations that minimize harms and maximize benefits and consider relevant barriers and facilitators. Our recommendations can serve as a guide for the equity-focused reformation of emergency medicine health information systems.
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Affiliation(s)
- Murdoch Leeies
- Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Section of Critical Care Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Health Sciences Centre Emergency Department, Shared Health, Winnipeg, Manitoba, Canada.,Winnipeg Regional Health Authority, Emergency Medicine Program, Winnipeg, Manitoba, Canada
| | - Brian Grunau
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicole Askin
- Winnipeg Regional Health Authority Virtual Library, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lula Fesehaye
- Health Sciences Centre Emergency Department, Shared Health, Winnipeg, Manitoba, Canada
| | - Jodi Kornelsen
- Health Sciences Centre Emergency Department, Shared Health, Winnipeg, Manitoba, Canada
| | - Tamara McColl
- Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Winnipeg Regional Health Authority, Emergency Medicine Program, Winnipeg, Manitoba, Canada.,St. Boniface Hospital Emergency Department, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Paul Ratana
- Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Winnipeg Regional Health Authority, Emergency Medicine Program, Winnipeg, Manitoba, Canada.,St. Boniface Hospital Emergency Department, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Jackie Gruber
- Respect, Diversity and Inclusion Department, British Columbia Institute of Technology, Burnaby, British Columbia, Canada
| | - Haley Hrymak
- Peter A. Allard School of Law, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carmen Hrymak
- Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Section of Critical Care Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Health Sciences Centre Emergency Department, Shared Health, Winnipeg, Manitoba, Canada.,Winnipeg Regional Health Authority, Emergency Medicine Program, Winnipeg, Manitoba, Canada
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10
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Lee RS, Brown HK, Salih S, Benoit AC. Systematic review of Indigenous involvement and content in mental health interventions and their effectiveness for Indigenous populations. Aust N Z J Psychiatry 2022; 56:1230-1251. [PMID: 35379008 PMCID: PMC9513504 DOI: 10.1177/00048674221089837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the effects of psychological, psychosocial, educational and alternative interventions on mental health outcomes of Indigenous adult populations in Australia, Canada, New Zealand and the United States and the Indigenous involvement and content in each study. METHODS We systematically searched databases, key journals and gray literature, for records until June 2020. Eligible studies were in English or French and examined the impact of interventions on mental health outcomes including anxiety disorders, posttraumatic stress disorder, depression, psychological distress or stress for Indigenous adults (⩾16 years). Data were extracted using a modified Cochrane Data Extraction Form and the Template for Intervention Description and Replication. Quality was evaluated using the Effective Public Health Practice Project quality assessment form. RESULTS In total, 21 studies were eligible, comprising 8 randomized controlled trials, 10 single-group pre-post studies and 3 pre-post studies with comparison groups. Twenty studies had Indigenous individuals or organizations involved in some decision-making capacity, though extent of involvement varied widely. In total, 9 studies were rated moderate and 12 weak in the Effective Public Health Practice Project quality assessment. Eight studies measuring depression, three measuring posttraumatic stress disorder, three measuring psychological distress and two measuring stress showed statistically significant improvements following the intervention. CONCLUSION A wide range of interventions demonstrated mental health improvements. However, it is difficult to draw generalizable conclusions on intervention effectiveness, given heterogeneity among studies. Studies should employ a thorough assessment of the Indigenous involvement and content of their interventions for reporting and for critical consideration of the implications of their research and whether they address Indigenous determinants of mental health.
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Affiliation(s)
- Rachel Seungyun Lee
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Department of Health and Society, University of Toronto Scarborough, Scarborough, ON, Canada,Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada
| | - Sarah Salih
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anita C Benoit
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Department of Health and Society, University of Toronto Scarborough, Scarborough, ON, Canada,Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada,Anita C Benoit, Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON M1C 1A4, Canada.
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11
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Bryant J, Freund M, Ries N, Garvey G, McGhie A, Zucca A, Hoberg H, Passey M, Sanson-Fisher R. Volume, scope, and consideration of ethical issues in Indigenous cognitive impairment and dementia research: A systematic scoping review of studies published between 2000-2021. DEMENTIA 2022; 21:2647-2676. [PMID: 36054372 DOI: 10.1177/14713012221119594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION High quality research involving Indigenous people with cognitive impairment and dementia is critical for informing evidence-based policy and practice. We examined the volume, scope and ethical considerations of research related to dementia with Indigenous populations globally from January 2000-December 2021. METHODS Studies were included if they were published in English from 2000 to 2021 and provided original data that focused on cognitive impairment or dementia in any Indigenous population. RESULTS The search yielded 13,009 papers of which, 76 met inclusion criteria. The overall number of papers increased over time. Studies were mostly conducted in Australia with Aboriginal and Torres Strait Islander people (n = 30; 39%). Twenty-six papers directly involved Indigenous participants with cognitive impairment or dementia. Of these studies, ethics approval was commonly required from two or more committees (n = 23, 88.5%). Ethical and legal governance frameworks were rarely discussed. DISCUSSION There is a clear need for further robust studies examining cognitive impairment and dementia with Indigenous populations. Future research should consider the ethical aspects of involving Indigenous participants with cognitive impairment in research.
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Affiliation(s)
- Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Megan Freund
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Nola Ries
- Faculty of Law, 1994University of Technology Sydney, Sydney, NSW, Australia
| | - Gail Garvey
- Wellbeing and Preventable Chronic Diseases Division, Charles Darwin University, 10095Menzies School of Health Research, Causarina, Northern Territory, Australia
| | - Alexandra McGhie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alison Zucca
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Hana Hoberg
- Wellbeing and Preventable Chronic Diseases Division, Charles Darwin University, 10095Menzies School of Health Research, Causarina, Northern Territory, Australia
| | - Megan Passey
- University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Bauer HF, Neal EC, Lizon ME, Jacek CC, Fritz KM. Indigenous Peoples and occupational therapy in Canada: A scoping review. Can J Occup Ther 2022; 89:249-260. [PMID: 35603659 PMCID: PMC9511236 DOI: 10.1177/00084174221088410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background. Calls to Action outlined by the Truth and Reconciliation Commission (TRC) necessitate critical reflection and urgent action to improve occupational therapy with Indigenous Peoples in Canada. Purpose. This scoping review aims to synthesize the literature related to Indigenous Peoples and occupational therapy practice, research, and education in Canada, and appraise empirical research using adapted Indigenous Health Research criteria. Method. A scoping review was conducted across published academic and grey literature with additional appraisal of empirical studies. Findings. A total of 6 themes emerged from 47 articles spanning from 1970 to 2020: recognizing colonial history, responding to the TRC, participating in personal and professional reflection, identifying Western ideologies, engaging in partnership in practice, and recognizing social and systemic barriers. Empirical studies met appraisal criteria inconsistently. Implications. To meaningfully engage in reconciliation, the profession of occupational therapy must generate Indigenous-led and relevant research, critically transform curricula, and address tensions between themes in practice.
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Affiliation(s)
- Hannah F. Bauer
- Hannah F. Bauer, 144 Trout Lake Road, Lawrencetown, NS B0S 1M0, Canada.
| | - Ellen C. Neal
- Ellen C. Neal, 75-590 North Service Road, Stoney Creek, ON L8E 0K5, Canada.
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Siddiqui W, Sharp RR. Beyond the Belmont Report. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:1-4. [PMID: 34554060 DOI: 10.1080/15265161.2021.1972649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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