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Roher SIG, Fairman K. Reflecting on the use of Etuaptmumk/Two-Eyed seeing in a study examining hospital-based Indigenous wellness services in the Northwest Territories, Canada. Int J Circumpolar Health 2024; 83:2406107. [PMID: 39350701 PMCID: PMC11445909 DOI: 10.1080/22423982.2024.2406107] [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] [Received: 05/28/2024] [Revised: 09/03/2024] [Accepted: 09/13/2024] [Indexed: 10/03/2024] Open
Abstract
Etuaptmumk/Two-Eyed Seeing (E/TES) is a Mi'kmaw guiding principle that emphasises the importance of bringing together the strengths of Indigenous knowledges and Western knowledges to improve the world for future generations. Since its introduction to the academic community, E/TES has been taken up more frequently in Indigenous health research. However, as it is increasingly used, Elders and scholars have affirmed that it is at risk of being watered down or tokenised. This article reports on how E/TES was used in a community-engaged research study that examined hospital-based Indigenous wellness services in the Northwest Territories, Canada. As a living, relational, and spiritual principle, E/TES was used in the study in three interrelated ways. E/TES: (1) guided the study ontologically, shaping the research team's conceptualisation of knowledge and knowledge generation; (2) informed the research team's approach to relationship-building; and (3) guided reflexivity amongst team members. By reporting on how E/TES was used in the study, and critically reflecting on the strengths and challenges of the approach, this article seeks to contribute to growing scholarship about how E/TES is characterised and taken up in Indigenous health research.
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Affiliation(s)
- Sophie Isabelle Grace Roher
- Department of Anthropology, University of Mississauga, Mississauga, Ontario, Canada
- Institute for Circumpolar Health Research, Yellowknife, NT, Canada
| | - Kimberly Fairman
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
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Bohr Y, Hankey J, Thomas A, Abdelmaseh M, Armour L, McCague H, Barnhardt J, Oskalns M, Garvey N, Singh Y, Danz C, Singoorie C, Qaunaq R, Oshoweetok I, Lucassen M, Merry S, Shepherd M, Bornstein MH, Ahmad F, Shulman S, Weiss J. A Nunavut community-directed Inuit youth mental wellness initiative: making I-SPARX fly. Int J Circumpolar Health 2024; 83:2401210. [PMID: 39388613 PMCID: PMC11468022 DOI: 10.1080/22423982.2024.2401210] [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] [Received: 05/21/2024] [Revised: 09/02/2024] [Accepted: 09/02/2024] [Indexed: 10/12/2024] Open
Abstract
Inuit youth in Nunavut (NU) are resilient but face a protracted suicide crisis. The SPARX serious game and e-intervention, developed originally in New Zealand, teaches youth cognitive behavioural therapy (CBT) skills to ameliorate stress and depression. Inuit youth in NU reviewed and culturally adapted SPARX and an existing wellness outcome measure for Inuit. One hundred and twenty-one youth, aged 13 to 24, across NU then tested, played, and evaluated I(nuit)-SPARX, showing improvement in several areas of wellbeing post-play. Youth completed a CBT skills survey, engaged in sharing circles to assess CBT skill retention, and shared their thoughts about the usefulness and cultural fit of I-SPARX with Inuit Qaujimajatuqangit (IQ). Communication Skills, Listening Skills, and Problem Solving emerged as the most helpful learned CBT skills, and NU youth provided real-world examples of using I-SPARX skills to support their mental wellness. Several principles of IQ were exemplified and upheld in the content of the adapted SPARX tool and the process of the project as a whole. Empirically grounded, asynchronous e-tools, developed in collaboration with Inuit communities to ensure cultural specificity, may support psychological wellness in communities where mental health resources are scarce.
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Affiliation(s)
- Yvonne Bohr
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Jeffrey Hankey
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Alaina Thomas
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Marette Abdelmaseh
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Leigh Armour
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Hugh McCague
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Jenna Barnhardt
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Megis Oskalns
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Nichaela Garvey
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Yogita Singh
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | - Cassie Danz
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
| | | | - Reuben Qaunaq
- Ikpiarjuk/Δᒃᐱᐊᕐᔪᒃ/Arctic Bay, Arctic Bay, NU, Canada
| | | | - Mathijs Lucassen
- Nunabox, Iqaluit, NU, Canada
- School of Health and Medical Sciences, City, University of London, London, UK
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sally Merry
- School of Health and Medical Sciences, City, University of London, London, UK
| | | | - Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
- International Research Fellow, Institute for Fiscal Studies, London, UK
- Senior Advisor Research for ECD Parenting Programmes, UNICEF, New York city, NY, USA
| | - Farah Ahmad
- School of Health Policy & Management, Faculty of Health, York University, Toronto, ON, Canada
| | - Shmuel Shulman
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Jonathan Weiss
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- LaMarsh Centre for Child and Youth Research, Toronto, ON, Canada
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Rice E, Mashford‐Pringle A, Qiang J, Henderson L, MacLean T, Rhoden J, Simms A, Stutz S. Frameworks, guidelines, and tools to develop a learning health system for Indigenous health: An environmental scan for Canada. Learn Health Syst 2024; 8:e10376. [PMID: 38249848 PMCID: PMC10797576 DOI: 10.1002/lrh2.10376] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 05/14/2023] [Accepted: 05/19/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction First Nations, Inuit, and Métis (FNIM) peoples experience systemic health disparities within Ontario's healthcare system. Learning health systems (LHS) is a rapidly growing interdisciplinary area with the potential to address these inequitable health outcomes through a comprehensive health system that draws on science, informatics, incentives, and culture for ongoing innovation and improvement. However, global literature is in its infancy with grounding theories and principles still emerging. In addition, there is inadequate information on LHS within Ontario's health care context. Methods We conducted an environmental scan between January and April 2021 and again in June 2022 to identify existing frameworks, guidelines, and tools for designing, developing, implementing, and evaluating an LHS. Results We found 37 relevant sources. This paper maps the literature and identifies gaps in knowledge based on five key pillars: (a) data and evidence-driven, (b) patient-centeredness, (c) system-supported, (d) cultural competencies enabled, and (e) the learning health system. Conclusion We provide recommendations for implementation accordingly. The literature on LHS provides a starting point to address the health disparities of FNIM peoples within the healthcare system but Indigenous community partnerships in LHS development and operation will be key to success.
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Affiliation(s)
- Emma Rice
- Waakebiness‐Bryce Institute for Indigenous Health, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Angela Mashford‐Pringle
- Waakebiness‐Bryce Institute for Indigenous Health, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Jinfan Qiang
- University of Toronto at MississaugaMississaugaOntarioCanada
| | - Lynn Henderson
- Department of Clinical StudiesUniversity of GuelphGuelphOntarioCanada
| | - Tammy MacLean
- Waakebiness‐Bryce Institute for Indigenous Health, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Justin Rhoden
- Department of Geography and PlanningUniversity of TorontoTorontoOntarioCanada
| | - Abigail Simms
- Waakebiness‐Bryce Institute for Indigenous Health, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Sterling Stutz
- Waakebiness‐Bryce Institute for Indigenous Health, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
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