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Tremblay M, Sydora BC, Listener LJ, Kung JY, Lightning R, Rabbit C, Oster RT, Kruschke Z, Ross S. Indigenous gender and wellness: a scoping review of Canadian research. Int J Circumpolar Health 2023; 82:2177240. [PMID: 36803328 PMCID: PMC9946324 DOI: 10.1080/22423982.2023.2177240] [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: 02/21/2023] Open
Abstract
This scoping review examined research publications related to health and/or wellness along with gender among Canadian Indigenous populations. The intent was to explore the range of articles on this topic and to identify methods for improving gender-related health and wellness research among Indigenous peoples. Six research databases were searched up to 1 February 2021. The final selection of 155 publications represented empirical research conducted in Canada, included Indigenous populations, investigated health and/or wellness topics and focused on gender. Among the diverse range of health and wellness topics, most publications focused on physical health issues, primarily regarding perinatal care and HIV- and HPV-related issues. Gender diverse people were seldom included in the reviewed publications. Sex and gender were typically used interchangeably. Most authors recommended that Indigenous knowledge and culture be integrated into health programmes and further research. More health research with Indigenous peoples must be conducted in ways that discern sex from gender, uplift the strengths of Indigenous peoples and communities, privilege community perspectives, and attend to gender diversity; using methods that avoid replicating colonialism, promote action, change stories of deficit, and build on what we already know about gender as a critical social determinant of health.
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Affiliation(s)
- Melissa Tremblay
- Department of Educational Psychology, University of Alberta, 5-127 Education North, University of Alberta, Edmonton, Alberta, Canada,CONTACT Melissa Tremblay Department of Educational Psychology, University of Alberta, 5-127 Education North, University of Alberta, Edmonton, AB T6G 2G5, Canada
| | - Beate C. Sydora
- Department of Obstetrics & Gynecology, University of Alberta, Position: Research Associate, 626-1 Community Service Centre, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Luwana Joyce Listener
- Department of Obstetrics & Gynecology, University of Alberta, Position: Research Assistant, 5S141 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Janice Y. Kung
- University of Alberta, Position: Librarian, John W. Scott Health Sciences Library, 2K3.28 Walter C. Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada
| | | | - Chevi Rabbit
- Community member, Position: Human rights advocate
| | - Richard T. Oster
- Indigenous Wellness Core, Alberta Health Services, Edmonton, Alberta, Canada
| | - Zoë Kruschke
- Department of Educational Psychology, University of Alberta, Position: Research Coordinator, University of Alberta, Edmonton, Alberta, Canada
| | - Susan Ross
- Departments of Obstetrics and Gynecology, and Women and Children’s Health Research Institute (WCHRI) University of Alberta, Position: Professor and Cavarzan Chair of Mature Women’s Health Research, 5S141 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, Edmonton, Alberta, Canada
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Belaid L, Sarmiento I, Dion A, Pimentel JP, Rojas-Cárdenas A, Cockcroft A, Andersson N. How does participatory research work: protocol for a realist synthesis. BMJ Open 2023; 13:e074075. [PMID: 37775285 PMCID: PMC10546155 DOI: 10.1136/bmjopen-2023-074075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/20/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION Participatory research science deals with partnerships underlying research, governance and ownership of research products. It is concerned with relationships behind research objectives and methods. Participatory research has gained significant traction in design of health interventions, contextualising these to local settings and stakeholder groups. Despite a massive increase in participatory research exercises, the field remains undertheorised, and the mechanisms for improving health outcomes remain unclear. This realist review seeks to understand how and under what circumstances participatory research impacts health and social outcomes. METHODS AND ANALYSIS The review will follow four steps: (1) searching for and selecting evidence, (2) assessing the quality of evidence, (3) extracting and categorising data and (4) synthesising the data in the form of context-mechanism-outcomes configurations. The review will follow the Realist And Meta Narrative Evidence Syntheses: Evolving Standards (RAMESES) II guidelines for reporting realist evaluations. We categorise and synthesise data in four steps: (1) identifying outcomes, (2) identifying contextual components of outcomes, (3) theoretical redescription (abduction) and (4) identifying mechanisms. A retroductive analysis will identify mechanisms by moving between empirical data and theories, using inductive and deductive reasoning to explain the outcomes-context matches. The output will generate middle-range theories on how participatory research works, for whom and under what circumstances. ETHICS AND DISSEMINATION This study is a review of a published literature. It does not involve human participants. We will convene a workshop to share and discuss the preliminary results with partners and key stakeholders involved in participatory health research. We will publish the review results in peer-reviewed journals and academic conferences.
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Affiliation(s)
- Loubna Belaid
- Direction de la recherche et de l'enseignement, École Nationale d'Administration Publique (ÉNAP), Quebec, Quebec, Canada
- Family Medicine (CIET/ PRAM), McGill University, Montreal, Quebec, Canada
| | - Ivàn Sarmiento
- Family Medicine (CIET/ PRAM), McGill University, Montreal, Quebec, Canada
- Grupo de Estudios en Sistemas Tradicionales de Salud, Universidad del Rosario, Bogota, Cundinamarca, Colombia
| | - Anna Dion
- CHEO Research Institute, Ottawa, Ontario, Canada
| | - Juan Pablo Pimentel
- Department of Family Medicine and Public Health, Universidad de La Sabana, Chía, Colombia
| | | | - Anne Cockcroft
- Family Medicine (CIET/ PRAM), McGill University, Montreal, Quebec, Canada
| | - Neil Andersson
- Family Medicine (PRAM), McGill University, Montreal, Quebec, Canada
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
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Mendlowitz AB, Bremner KE, Feld JJ, Jones L, Hill E, Antone E, Liberty L, Boucher R, Krahn MD. Lessons from First Nations partnerships in hepatitis C research and the co-creation of knowledge. CANADIAN LIVER JOURNAL 2023; 6:46-55. [PMID: 36908573 PMCID: PMC9997512 DOI: 10.3138/canlivj-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/03/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND: Administrative health data provide a rich and powerful tool for health services research. Partnership between researchers and the Ontario First Nations HIV/AIDS Education Circle (OFNHAEC) allowed for comprehensive analyses of the health and economic impacts of hepatitis C virus (HCV) infection in First Nations populations across Ontario, using administrative data. Examples of meaningful involvement of First Nations partners in research using secondary data sources demonstrate how community-based participatory research principles can be adapted to empower First Nations stakeholders and decision-makers. The aim of this review is to summarize and reflect on lessons learned in producing meaningful and actionable First Nations HCV research using health administrative data, from the perspective of health services researchers who collaborated for the first time with First Nations partners. METHODS: We discuss how our relationship with OFNHAEC formed and how engagement contextualized findings and provided opportunities for fostering trust and mutual capacity building. Methods included adherence to data governance principles, agreements outlining ethical conduct, and establishing commitment between partners. RESULTS: Engagement with OFNHAEC enhanced cultural understandings in study conception, design, and analysis, and enabled meaningful lessons for both parties through contextualizing findings together. Partnership ensured attention to factors, such as strength-based approaches and limitations of administrative data in their representation of First Nations peoples, that are not considered in standard HCV health services research using administrative health data. CONCLUSIONS: Collaboration throughout the HCV research provided first-hand experience of the relevance, representation, and importance of incorporating First Nations perspectives in health services research using administrative data.
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Affiliation(s)
- Andrew B Mendlowitz
- Toronto Centre for Liver Disease/Viral Hepatitis Care Network (VIRCAN), Toronto General Hospital, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
| | - Karen E Bremner
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
| | - Jordan J Feld
- Toronto Centre for Liver Disease/Viral Hepatitis Care Network (VIRCAN), Toronto General Hospital, Toronto, Ontario, Canada
| | - Lyndia Jones
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Evelynne Hill
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Elly Antone
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Laura Liberty
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Rene Boucher
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Murray D Krahn
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada.,Deceased 01 07 22
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Belaid L, Sarmiento I, Dimiti A, Andersson N. Community Participation in Primary Healthcare in the South Sudan Boma Health Initiative: A Document Analysis. Int J Health Policy Manag 2022; 11:2869-2875. [PMID: 35418007 PMCID: PMC10105198 DOI: 10.34172/ijhpm.2022.6639] [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: 07/21/2021] [Accepted: 03/27/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Community participation is central to primary healthcare, yet there is little evidence of how this works in conflict settings. In 2016, South Sudan's Ministry of Health launched the Boma Health Initiative (BHI) to improve primary care services through community participation. METHODS We conducted a document analysis to examine how well the BHI policy addressed community participation in its policy formulation. We reviewed other policy documents and published literature to provide background context and supplementary data. We used a deductive thematic analysis that followed Rifkin and colleagues' community participation framework to assess the BHI policy. RESULTS The BHI planners included inputs from communities without details on how the needs assessment was conducted at the community level, what needs were considered, and from which community. The intended role of communities was to implement the policy under local leadership. There was no information on how the Initiative might strengthen or expand local women's leadership. Official documents did not contemplate local power relations or address gender imbalance. The policy approached households as consumers of health services. CONCLUSION Although the BHI advocated community participation to generate awareness, increase acceptability, access to services and ownership, the policy document did not include community participation during policy cycle.
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Affiliation(s)
- Loubna Belaid
- CIET-PRAM (Participatory Research at McGill), Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Iván Sarmiento
- CIET-PRAM (Participatory Research at McGill), Department of Family Medicine, McGill University, Montreal, QC, Canada
- Grupo de Estudios en Sistemas Tradicionales de Salud, Universidad del Rosario, Bogotá, Colombia
| | - Alexander Dimiti
- Department of Reproductive Health, Ministry of Health, Juba, South Sudan
| | - Neil Andersson
- CIET-PRAM (Participatory Research at McGill), Department of Family Medicine, McGill University, Montreal, QC, Canada
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
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Indigenous participation in pediatric Indigenous health research in Canada: a systematic review. Pediatr Res 2022:10.1038/s41390-022-02361-9. [PMID: 36333537 DOI: 10.1038/s41390-022-02361-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/29/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
For health inequities to be successfully addressed through health research, it is necessary for researchers to strive for genuine engagement with stakeholders. Indigenous people provide critical perspectives in Indigenous health research. The objective of this review was to systematically review the existing pediatric Indigenous health research in Canada to determine the prevalence of Indigenous participation. Embase, MEDLINE, Cochrane Library were searched on April 15, 2017 and updated on July 16, 2020. A total of 798 studies focused on the health of Indigenous children ≤18 in Canada were included, of 17,752 abstracts screened in English and French. A total of 46.1% of articles indicated Indigenous participation, increasing over time. Organization/government was the most common form of Indigenous participation (62.8%) and Indigenous researcher as author was least common (10.9%). Participation by child age, geography and topic area varied. The most common category of topic researched was nutrition, lifestyle and anthropometrics. Indigeneity of researchers was determined by self-identification in the papers and may be an underestimate. Although improving over time, less than half of studies about Indigenous children in Canada included Indigenous participation in their execution. Journals and funding bodies must ensure fulsome participation of Indigenous people in research focused on Indigenous children. IMPACT: Indigenous participation in pediatric Indigenous health research is critical to producing ethical relevant and actionable results. This review describes the status of Indigenous participation in this body of work in Canada. This review highlights areas of concern and strength to improve the practices and ethics of medical researchers in this area, thereby increasing relevance of pediatric Indigenous health research to communities.
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Belaid L, Budgell R, Sauvé C, Andersson N. Shifting paradigm from biomedical to decolonised methods in Inuit public health research in Canada: a scoping review. BMJ Glob Health 2022; 7:e008311. [PMID: 36323455 PMCID: PMC9639062 DOI: 10.1136/bmjgh-2021-008311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The National Inuit Strategy on Research focuses on advancing Inuit governance in research, increasing ownership over data and building capacity. Responding to this call for Inuit self-determination in research, academic researchers should consider cultural safety in research and ways to promote Inuit-led methods. METHODS This scoping review collated academic literature on public health research in Inuit communities in Canada between 2010 and 2022. A critical assessment of methods used in public health research in Inuit communities examined cultural safety and the use of Inuit-attuned methods. Descriptive and analytical data were summarised in tables and figures. Knowledge user engagement in the research process was analysed with thematic analysis. RESULTS 356 articles met the inclusion criteria. Much of the published research was in nutrition and mental health, and few initiatives reported translation into promotion programmes. Almost all published research was disease or deficit focused and based on a biomedical paradigm, especially in toxicology, maternal health and chronic diseases. Recent years saw an increased number of participatory studies using a decolonial lens and focusing on resilience. While some qualitative research referred to Inuit methodologies and engaged communities in the research process, most quantitative research was not culturally safe. Overall, community engagement remained in early stages of co-designing research protocols and interventions. Discussion on governance and data ownership was limited. Recent years saw emerging discussions on these issues. Knowledge user capacity-building was limited to brief training on conventional data collection methods. CONCLUSIONS The last decade of published public health research has not responded to the National Inuit Strategy on Research. Participatory research is gaining ground, but has not reached its full potential. A shift from biomedical to decolonised methods is slowly taking place, and public health researchers who have not yet embraced this paradigm shift should do so.
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Affiliation(s)
- Loubna Belaid
- Direction de la Recherche et de l'Enseignement, École Nationale d'Administration Publique, Montréal, Québec, Canada
- Family Medicine (CIET/PRAM), McGill University, Montréal, Québec, Canada
| | - Richard Budgell
- Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Caroline Sauvé
- Direction de l'Enseignement et de l'Académie, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Neil Andersson
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
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Loukes KA, Ferreira C, Gaudet JC, McGuire-Adams T. A methodological protocol for conducting a scoping review of health research on/by/with Indigenous women in North America. Syst Rev 2022; 11:233. [PMID: 36307820 PMCID: PMC9615379 DOI: 10.1186/s13643-022-02080-6] [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] [Received: 12/28/2021] [Accepted: 09/23/2022] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND Indigenous women in North America experience multiple inequities in terms of health and well-being when compared to non-Indigenous women and Indigenous men. In an effort to understand these health disparities, there has been a surge of research in the field of Indigenous women's health and well-being over the last 20 years. The objective of this study is to conduct a scoping review of the most current research in this field to determine which theoretical frameworks are being used to study which topics in Indigenous women's health and well-being in North America. METHODS The scoping review protocol used was designed to follow an iterative six-step process as laid out by Arksey and O'Malley. Peer-reviewed, academic articles from the following databases were identified: Academic Search Complete, Native Health Database, Web of Science, Google Scholar, Bibliography of Native North America, Sociological Abstracts, Gender Watch, and Indigenous Peoples of North America. Two team members subsequently conducted two screens of titles and abstracts to include articles which focused exclusively on Indigenous women's health and well-being published between 2011 and 2021. The literature considered focused on Indigenous women's health and well-being and explicitly states their use of critical theoretical frameworks (e.g., Indigenous feminist, intersectionality, Indigenous resurgence, feminist, critical race) or community-based participatory research (CBPR). Data analysis will involve quantitative and qualitative descriptions. DISCUSSION The results of our scoping review (in progress) will map out the current field of Indigenous women's health research. Our findings will highlight the theoretical frameworks operationalized in research on Indigenous women's health, identify gaps therein, and provide a basis for understanding how these theoretical lenses shape questions, methodologies, analysis, and implications of academic research.
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Affiliation(s)
- Keira A Loukes
- School of Outdoor Recreation, Parks, and Tourism, Lakehead University, Thunder Bay, Canada. .,School of Human Kinetics, University of Ottawa, Ottawa, Canada.
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Deeb-Sossa N, Manzo RD, Kelty J, Aranda A. Community-responsive scholar-activist research: conceptualizing capacity building and sustainability in a Northern California community-university partnership. JOURNAL OF COMMUNITY PRACTICE 2022; 30:71-83. [PMID: 37920749 PMCID: PMC10621030 DOI: 10.1080/10705422.2022.2033375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
We critically examine the ongoing development of a collaborative, responsive, activist research process between academics and farmworkers. Drawing upon in-depth interviews with community-based researchers and scholar-activists, we assess our team's understanding of community capacity building and research sustainability as the conceptual and operational definitions of these concepts lack academic consensus. The definitions we present reflect a 12-year effort to respond to community needs through interdisciplinary research, planning, and action. Our community-university team's evolving understanding of community capacity building and research sustainability is contextualized by our community-driven, community-responsive, and collaborative process. We discuss strengths and limitations encountered when conducting community-responsive, scholar-activist research and conclude by offering the lessons learned.
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Affiliation(s)
| | - Rosa D. Manzo
- Health Sciences Research Institute, University of California, Merced, Merced, California, USA
| | - Jacklyn Kelty
- Environmental and Occupational Health Sciences Institute, Rutgers University, New Brunswick, New Jersey, USA
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