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Skov B, Grouzet FME, Briatico C, Jackson R, Masching R, Parsons M, Peltier D, Turner D. Helping Others Facilitates Well-Being for Indigenous Peoples Living With HIV/AIDS in Canada. AIDS Behav 2024:10.1007/s10461-024-04429-5. [PMID: 38995442 DOI: 10.1007/s10461-024-04429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/13/2024]
Abstract
Research has found that helping others facilitates well-being for Indigenous peoples living with HIV and AIDS, but limited research exists that investigates the mechanism(s) underlying this relationship. Indigenous perspectives posit that helping others facilitates well-being through the development of an individual's spiritual, physical, emotional, and mental aspects (four aspects). Similarly, self-determination theory posits that helping others facilitates well-being by satisfying basic psychological needs. In the present study, we examined if helping others facilitates well-being through the fulfillment of the spiritual, physical, emotional, and mental aspects among Indigenous peoples living with HIV and AIDS. We used a convergent parallel mixed methods design, coupled with a community-engaged approach grounded in the United Nations Greater Involvement of People Living with HIV and AIDS principles and Indigenous and decolonizing research methodologies. Survey (n = 117) and interview data (n = 9) collected by an Indigenous-led HIV/AIDS organization in Canada were employed to examine the relationship between helping, the four aspects, and well-being. Participants were primarily First Nations leaders and mentors who live with HIV/AIDS, with some Métis and Inuit. A parallel multiple mediation model and reflexive thematic analysis were used to analyze the relationship between helping, the four aspects, and well-being. Mixed-methods findings support the idea that helping others promotes well-being by fulfilling the emotional and mental aspects. Qualitative findings demonstrated this relationship for all four aspects. This research may facilitate the development of programs to support Indigenous peoples living with HIV/AIDS well-being and contribute to the literature on integrating Indigenous perspectives and methodologies within psychological research.
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Affiliation(s)
- B Skov
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada.
| | - F M E Grouzet
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - C Briatico
- Department of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - R Jackson
- Department of Health, Aging, and Society, McMaster University, Hamilton, ON, Canada
| | - R Masching
- CAAN Communities, Alliances & Networks, Fort Qu'Appelle, SK, Canada
| | - M Parsons
- Dalhousie University, Halifax, NS, Canada
- The Canadian HIV/AIDS and Chronic Pain Society, Ottawa, Canada
| | - D Peltier
- Feast Centre for Indigenous STBBI Research, McMaster University, Hamilton, ON, Canada
| | - D Turner
- Dudes Club, Chatham-Kent, ON, Canada
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Barton KS, Porter KM, Mai T, Claw KG, Hiratsuka VY, Carroll SR, Burke W, Garrison NA. Genetic research within Indigenous communities: Engagement opportunities and pathways forward. Genet Med 2024; 26:101158. [PMID: 38699966 DOI: 10.1016/j.gim.2024.101158] [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: 10/24/2023] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
PURPOSE Against a historical backdrop of researchers who violated trust through lack of benefit sharing, transparency, and engagement, efforts are underway to develop better approaches for genetic and genomic research with Indigenous communities. To increase engagement, there is a need to understand factors that affect researcher and community collaborations. This study aimed to understand the barriers, challenges, and facilitators of Indigenous Peoples in the United States participating in genetic research. METHODS We conducted 42 semistructured interviews with Tribal leaders, clinicians, researchers, policy makers, and Tribal research review board members across the United States to explore perceived risks, benefits, barriers, and facilitators of genetic research participation. RESULTS Participants, identifying as Indigenous (88%) or non-Indigenous allies (12%), described their concerns, hesitancy, and fears about genetic research, as well as the roles of trust, transparency, and respect for culture in facilitating partnerships. Previous harms-such as sample and data misuse, stigmatization, or misrepresentation by researchers-revealed strategies for building trust to create more equitable and reciprocal research partnerships. CONCLUSION Participants in this study offered strategies for increasing genetic research engagement. The pathway forward should foster transparent research policies and practices to facilitate informed research that supports the needs and priorities of participants, communities, and researchers.
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Affiliation(s)
- Krysta S Barton
- Biostatistics Epidemiology and Analytics for Research (BEAR) Core, Seattle Children's Research Institute, Seattle, WA
| | - Kathryn M Porter
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, Seattle, WA
| | - Thyvu Mai
- Institute for Public Health Genetics, University of Washington School of Medicine, Seattle, WA
| | - Katrina G Claw
- Department of Biomedical Informatics, Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Vanessa Y Hiratsuka
- Center for Human Development, College of Health, University of Alaska Anchorage, Anchorage, AK; Southcentral Foundation, Anchorage, AK
| | - Stephanie Russo Carroll
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ; Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ
| | - Wylie Burke
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA
| | - Nanibaa' A Garrison
- Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA; Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA; Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
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3
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Logie CH, Lys CL, Taylor SB, Lad A, Mackay KI, Hasham A, Gittings L, Malama K, Pooyak S, Monchalin R, Adamassu Z. Land-Based Retreats as a Method for Building Enabling Environments for HIV Prevention with Northern and Indigenous Adolescents in the Northwest Territories, Canada: Mixed-Methods Findings. AIDS Behav 2024:10.1007/s10461-024-04397-w. [PMID: 38900311 DOI: 10.1007/s10461-024-04397-w] [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] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
The Northwest Territories (NWT), Canada has high rates of sexually transmitted infections (STI) that elevate HIV acquisition risks. We conducted a mixed-methods study to explore the potential of land-based peer leader retreats (PLR) in building HIV prevention enabling environments among Northern and Indigenous youth in the NWT. PLRs are grounded in Indigenous principles and ways of knowing, acknowledging the land as a physical, spiritual, emotional, and intellectual being with the potential to facilitate (re)connection to culture, community, and self. We conducted one-week PLRs between 2016 and 2021 with adolescents aged 13-17 in the NWT. PLRs addressed HIV/STIs, safer sex, and gender equity. We conducted post-retreat focus groups (FGs) and pre/post-retreat surveys with youth participants (n = 353), and post-retreat FGs with PLR facilitators (n = 252). We applied thematic analysis to FGs and assessed pre/post-retreat changes in HIV/STI knowledge and safer sex efficacy (SSE) using paired sample t-tests. We assessed factors associated with post-test SSE and HIV/STI knowledge using multivariable linear regression. Youth participants (n = 353; mean age: 14.5, standard deviation [SD]: 1.3) were mostly Indigenous (71%) and women (66%). Participant narratives revealed PLRs enhanced technical communication (e.g., correct condom use). There were significant post-retreat HIV/STI knowledge increases; change score increases were lower for Indigenous participants. Qualitative narratives described how PLRs fostered transformative communication (e.g., sexual consent). There were significant post-retreat increases in SSE, and these were lower among men and sexually diverse (vs. heterosexual) participants. Land-based PLRs offer the potential to build technical and transformative communication to facilitate HIV prevention with youth in Canada's North.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada.
- United Nations University Institute for Water, Environment, and Health, Hamilton, Canada.
- Centre for Gender and Sexual Health Equity, Vancouver, Canada.
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.
| | - Candice L Lys
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, NT, Canada
- Aurora Research Institute, Yellowknife, NT, Canada
| | - Shira B Taylor
- Faculty of Environmental and Urban Change, York University, Toronto, ON, Canada
- SExT: Sex Education by Theatre, Toronto, ON, Canada
| | - Anoushka Lad
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | | | - Aryssa Hasham
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | - Lesley Gittings
- Faculty of Health Sciences, School of Health Studies, Western University, London, ON, Canada
| | - Kalonde Malama
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | - Sherri Pooyak
- Communities, Alliances, and Networks (CAAN), Fort Qu'Appelle, SK, Canada
| | - Renée Monchalin
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
- Well Living House, Li Ka Shing Knowledge Institute of Unity Health Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Zerihun Adamassu
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
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Vance A, McGaw J, O'Rorke D, White S, Eades S. The Development of Elder-Governed Adjuvant Cultural Therapy for Aboriginal and/or Torres Strait Islander Young People With Mental Health Conditions. QUALITATIVE HEALTH RESEARCH 2024:10497323241234010. [PMID: 38618903 DOI: 10.1177/10497323241234010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
A 10-year review of the 2008 Council of Australian Governments' (COAG) Close the Gap Strategy identified the lack of involvement of Indigenous people in developing policies as a key reason health disparities persist. It also posits that disconnection from Country and culture have been crucial factors. Physical and mental health cannot be separated from spiritual health and well-being amongst Indigenous Australians. This article describes the co-development of a cultural enrichment research study with Indigenous Elders, health service leaders, and community members that places culture at the centre of care to augment traditional Western mental health management. The study has been overseen and nurtured from its inception by a governance board of Traditional Custodian Elders and an Advisory Group of Indigenous health workers. Qualitative data were collected through community 'zoom-yarns' between an Indigenous research assistant and 44 community members during COVID-19 lockdowns. These yarns were analysed through an innovative, constructivist, multi-perspectival discursive grounded theory method. Findings have led to an Elder-governed adjuvant cultural therapy which is currently being trialled and will be evaluated using the same multi-perspectival discursive grounded theory research methodology. One third of all Indigenous Australians now live in capital cities, so developing models to bring culture and Country into urban health facilities are becoming increasingly important. The Indigenous-led research approach outlined in this paper suggests a model for engaging Indigenous communities that mainly distrust Western research and have been failed by Western mental health care. It has the potential to shape future policy.
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Affiliation(s)
- Alasdair Vance
- Wadja Aboriginal Family Place, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Janet McGaw
- Faculty of Architecture, Building and Planning, University of Melbourne, Melbourne, VIC, Australia
| | - Di O'Rorke
- Academic Child Psychiatry Unit, University of Melbourne, Melbourne, VIC, Australia
- Developmental Neuropsychiatry Program, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Selena White
- Wadja Aboriginal Family Place, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sandra Eades
- School of Population and Global Health | Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
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Reid AJ, McGregor DA, Menzies AK, Eckert LE, Febria CM, Popp JN. Ecological research 'in a good way' means ethical and equitable relationships with Indigenous Peoples and Lands. Nat Ecol Evol 2024; 8:595-598. [PMID: 38225427 DOI: 10.1038/s41559-023-02309-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Affiliation(s)
- Andrea J Reid
- Unceded xʷməθkʷəy̓əm (Musqueam) Territory, Centre for Indigenous Fisheries, Institute for the Oceans and Fisheries, The University of British Columbia, Vancouver, British Columbia, Canada.
| | - Deborah A McGregor
- Traditional Land of the Huron-Wendat, Seneca and Mississaugas of the Credit, Faculty of Environmental and Urban Change, York University, Toronto, Ontario, Canada
- Traditional Land of the Huron-Wendat, Seneca and Mississaugas of the Credit, Osgoode Hall Law School, York University, Toronto, Ontario, Canada
| | - Allyson K Menzies
- Traditional Land of the Mississaugas of the Credit, School of Environmental Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Lauren E Eckert
- Unceded Territories of the Lekwungen-speaking Songhees, Esquimalt and WSÁNEĆ Peoples, Raincoast Conservation Foundation, Department of Geography, University of Victoria, Victoria, British Columbia, Canada
| | - Catherine M Febria
- Traditional Territories of the Three Fires Confederacy of First Nations - Ojibway, Odawa and Potawatomi, Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
| | - Jesse N Popp
- Traditional Land of the Mississaugas of the Credit, School of Environmental Sciences, University of Guelph, Guelph, Ontario, Canada
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d'Agincourt-Canning L, Ziabakhsh S, Morgan J, Jinkerson-Brass ES, Joolaee S, Smith T, Loft S, Rosalie D. Pathways: A guide for developing culturally safe and appropriate patient-reported outcome (PROMs) and experience measures (PREMs) with Indigenous peoples. J Eval Clin Pract 2024; 30:418-428. [PMID: 38146592 DOI: 10.1111/jep.13947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Members of the Indigenous Health Program, BC Children's and Women's Hospitals and the University of British Columbia embarked on a joint project to describe best practices to support the creation of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) with Indigenous peoples. METHODS The project involved a review of previous research on patient-reported measures (surveys) that had been specifically developed for Indigenous populations. It also involved interviews with key stakeholders-Indigenous and non-Indigenous academic researchers, and Indigenous community leaders and community members. Themes from the interviews and the literature review were combined and synthesized into pathways/a framework for survey development. RESULTS The pathways document consisted of 13 protocols and associated teachings for guiding processes and framing survey questions. These encompassed building relationships, community engagement and consultation, benefits to community, ceremony and storytelling, two-way learning, participatory content development, governance and accountability. Findings emphasized the criticality of Indigenous leadership in setting priorities for PROMs and PREMS and establishing relationships that honour Indigenous experiences through all phases of a study. Assessment of the framework's validity with select research participants and the Project Advisory Committee was positive. CONCLUSION This is the first framework to guide development of PROMs and PREMs with Indigenous peoples and communities. It addresess both process and outcome and includes concrete steps that collaborators can take when establishing a partnership that is respectful and inclusive of Indigenous ways of knowing and being.
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Affiliation(s)
| | - Shabnam Ziabakhsh
- BC Children's and Women's Hospitals & Health Centre, Vancouver, Canada
| | - Jenny Morgan
- Indigenous Health Program, BC Children's and Women's Hospitals & Health Centre, Vancouver, Canada
| | | | | | - Tonya Smith
- Department of Forest Resources Management, University of British Columbia, Vancouver, Canada
| | - Shelby Loft
- Department of Geography, University of British Columbia, Vancouver, Canada
| | - Darci Rosalie
- Indigenous Health Program, BC Children's and Women's Hospitals & Health Centre, Vancouver, Canada
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Evans-Agnew R, LeClair J, Sheppard DA. Just-relations and responsibility for planetary health: The global nurse agenda for climate justice. Nurs Inq 2024; 31:e12563. [PMID: 37256546 DOI: 10.1111/nin.12563] [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: 12/19/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 06/01/2023]
Abstract
There is an urgent call for nurses to address climate change, especially in advocating for those most under threat to the impacts. Social justice is important to nurses in their relations with individuals and populations, including actions to address climate justice. The purpose of this article is to present a Global Nurse Agenda for Climate Justice to spark dialog, provide direction, and to promote nursing action for just-relations and responsibility for planetary health. Grounding ourselves within the Mi'kmaw concept of Etuaptmumk (two-eyed seeing), we suggest that climate justice is both call and response, moving nurses from silence to Ksaltultinej (love as action). We review the movement for climate justice in nursing, weaving between our own stories, our relations with Mi'kmaw ways of knowing, and the stories of the movement, with considerations for the (w)holistic perspectives foundational to nursing's metaparadigm of person, environment, and health. We provide a background to the work of the Global Nurse Agenda for Climate Justice steering committee including their role at the 26th United Nations Climate Change Conference in Glasgow, 2021, and share our own stories of action to frame this agenda. We accept our Responsibility for the challenges of climate justice with humility and invite others to join us.
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Affiliation(s)
- Robin Evans-Agnew
- School of Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, Washington, USA
| | - Jessica LeClair
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - De-Ann Sheppard
- Faculty of Science, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
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Sanders M, Tobin JN, Cassells A, Carroll J, Holder T, Thomas M, Fiscella K. Physical and psychosocial impact on peers with HIV co-leading an HIV intervention: A pilot theory-guided case-study. PEC INNOVATION 2023; 2:100139. [PMID: 37214499 PMCID: PMC10194128 DOI: 10.1016/j.pecinn.2023.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 05/24/2023]
Abstract
Objective To examine longitudinal changes in activation, HIV health outcomes, and social and psychological determinants of adherence to antiretroviral therapy (ART) among peer trainers with HIV. Methods A multi-method case study. The study population included peers (n = 4) from a randomized controlled trial about peers training patients with HIV (n = 359) to better manage their health. Each peer completed a semi-structured interview that we analyzed using Social Learning Theory (SLT) as a guiding framework. The peers also completed longitudinal surveys about their health after each training cohort (n = 5) over 3-years. Results Peers reported personal benefits from training others with HIV in self-management. Their self-reported activation, self-efficacy and some health outcomes increased overtime. The peers mentioned SLT principles during their interviews. Generally, the peers enjoyed and benefited from training others with HIV in a group-based learning environment. Conclusion Our findings suggest peer leadership can serve as a means for empowerment that is effective at both supporting improvements in health outcomes for patients and for themselves, which may be both scalable and sustainable. Innovation To our knowledge, this is the first mixed-methods study to show reciprocal long-term improvement in health behaviors in a diverse group of peers training others with HIV to self-manage their care.
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Affiliation(s)
- Mechelle Sanders
- University of Rochester Medical Center, 1381 South Ave., Rochester, NY 14620, USA
| | - Jonathan N. Tobin
- Clinical Directors Network, Inc. (CDN), 5 West 37 St., 10 Floor, New York, NY, USA
| | - Andrea Cassells
- Clinical Directors Network, Inc. (CDN), 5 West 37 St., 10 Floor, New York, NY, USA
| | - Jennifer Carroll
- University of Colorado, 13001 East 17th Place, Aurora, CO 80045, USA
| | - Tameir Holder
- Clinical Directors Network, Inc. (CDN), 5 West 37 St., 10 Floor, New York, NY, USA
| | - Marie Thomas
- University of Rochester Medical Center, 1381 South Ave., Rochester, NY 14620, USA
| | - Kevin Fiscella
- University of Rochester Medical Center, 1381 South Ave., Rochester, NY 14620, USA
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Burris MA, Evans-Agnew RA, Strack RW. Braiding the Healing Gifts of Photovoice for Social Change: The Means Are Ends in the Making. Health Promot Pract 2023; 24:1124-1132. [PMID: 37605546 DOI: 10.1177/15248399231192993] [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] [Indexed: 08/23/2023]
Abstract
Photovoice is an important participatory action method for motivating social change. The potential for this change within the processes of the method remains under-explored. We present the voice and perspectives of three health promotion practitioners who have important connections to photovoice: a grandmother and co-founder of the method, a nurse from Wales, and an early adopter seeking change. Through braided storytelling, the voices describe their history with photovoice and how their relationship to the method has changed over time, arguing ultimately that in photovoice the means are as important as the ends for advancing relations with others, understanding and working with power, and realizing the gifts the processes bring.
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Affiliation(s)
| | | | - Robert W Strack
- University of North Carolina Greensboro, Greensboro, NC, USA
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Wali S, Ssinabulya I, Muhangi CN, Kamarembo J, Atala J, Nabadda M, Odong F, Akiteng AR, Ross H, Mashford-Pringle A, Cafazzo JA, Schwartz JI. Bridging community and clinic through digital health: Community-based adaptation of a mobile phone-based heart failure program for remote communities in Uganda. BMC DIGITAL HEALTH 2023; 1:20. [PMID: 38800672 PMCID: PMC11116269 DOI: 10.1186/s44247-023-00020-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/11/2023] [Indexed: 05/29/2024]
Abstract
Background In Uganda, limited healthcare access has created a significant burden for patients living with heart failure. With the increasing use of mobile phones, digital health tools could offer an accessible platform for individualized care support. In 2016, our multi-national team adapted a mobile phone-based program for heart failure self-care to the Ugandan context and found that patients using the system showed improvements in their symptoms and quality of life. With approximately 84% of Ugandans residing in rural communities, the Medly Uganda program can provide greater benefit for communities in rural areas with limited access to care. To support the implementation of this program within rural communities, this study worked in partnership with two remote clinics in Northern Uganda to identify the cultural and service level requirements for the program. Methods Using the principles from community-based research and user-centered design, we conducted a mixed-methods study composed of 4 participatory consensus cycles, 60 semi-structured interviews (SSI) and 8 iterative co-design meetings at two remote cardiac clinics. Patient surveys were also completed during each SSI to collect data related to cell phone access, community support, and geographic barriers. Qualitative data was analyzed using inductive thematic analysis. The Indigenous method of two-eyed seeing was also embedded within the analysis to help promote local perspectives regarding community care. Results Five themes were identified. The burden of travel was recognized as the largest barrier for care, as patients were travelling up to 19 km by motorbike for clinic visits. Despite mixed views on traditional medicine, patients often turned to healers due to the cost of medication and transport. With most patients owning a non-smartphone (n = 29), all participants valued the use of a digital tool to improve equitable access to care. However, to sustain program usage, integrating the role of village health teams (VHTs) to support in-community follow-ups and medication delivery was recognized as pivotal. Conclusion The use of a mobile phone-based digital health program can help to reduce the barrier of geography, while empowering remote HF self-care. By leveraging the trusted role of VHTs within the delivery of the program, this will help enable more culturally informed care closer to home. Supplementary Information The online version contains supplementary material available at 10.1186/s44247-023-00020-5.
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Affiliation(s)
- Sahr Wali
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
- Centre for Digital Therapeutics, Toronto General Hospital, University Health Network, R. Fraser Elliott Building, 4th floor, 190 Elizabeth St, Toronto, ON M5G 2C4 Canada
| | - Isaac Ssinabulya
- Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- Uganda Heart Institute, MulagoNational Referral Hospital, Kampala, Uganda
| | | | | | | | - Martha Nabadda
- Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
| | | | - Ann R. Akiteng
- Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- Uganda Heart Institute, MulagoNational Referral Hospital, Kampala, Uganda
| | - Heather Ross
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON Canada
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON Canada
| | - Angela Mashford-Pringle
- Dalla Lana School of Public Health, Waakebiness-Bryce Institute for Indigenous Health, University of Toronto, Toronto, ON Canada
| | - Joseph A. Cafazzo
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
- Centre for Digital Therapeutics, Toronto General Hospital, University Health Network, R. Fraser Elliott Building, 4th floor, 190 Elizabeth St, Toronto, ON M5G 2C4 Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON Canada
- Department of Computer Science, University of Toronto, Toronto, ON Canada
| | - Jeremy I. Schwartz
- Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- Section of General Internal Medicine, Yale University School of Medicine, New Haven, USA
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Sullivan P, Starr V, Dubois E, Starr A, Acharibasam JB, McIlduff C. Where past meets present: Indigenous vaccine hesitancy in Saskatchewan. MEDICAL HUMANITIES 2023; 49:321-331. [PMID: 36604166 PMCID: PMC10439261 DOI: 10.1136/medhum-2022-012501] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
In Canada, colonisation, both historic and ongoing, increases Indigenous vaccine hesitancy and the threat posed by infectious diseases. This research investigated Indigenous vaccine hesitancy in a First Nation community in Saskatchewan, ways it can be overcome, and the influence of a colonial history as well as modernity. Research followed Indigenous research methodologies, a community-based participatory research design, and used mixed methods. Social media posts (interventions) were piloted on a community Facebook page in January and February (2022). These interventions tested different messaging techniques in a search for effective strategies. The analysis that followed compared the number of likes and views of the different techniques to each other, a control post, and community-developed posts implemented by the community's pandemic response team. At the end of the research, a sharing circle occurred and was followed by culturally appropriate data analysis (Nanâtawihowin Âcimowina Kika-Môsahkinikêhk Papiskîci-Itascikêwin Astâcikowina procedure). Results demonstrated the importance of exploring an Indigenous community's self-determined solution, at the very least, alongside the exploration of external solutions. Further, some sources of vaccine hesitancy, such as cultural barriers, can also be used to promote vaccine confidence. When attempting to overcome barriers, empathy is crucial as vaccine fears exist, and antivaccine groups are prepared to take advantage of empathetic failures. Additionally, the wider community has a powerful influence on vaccine confidence. Messaging, therefore, should avoid polarising vaccine-confident and vaccine-hesitant people to the point where the benefits of community influence are limited. Finally, you need to understand people and their beliefs to understand how to overcome hesitancy. To gain this understanding, there is no substitute for listening.
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Affiliation(s)
- Patrick Sullivan
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Victor Starr
- Kihew Kawaskasit Health Services, Star Blanket Cree Nation, Saskatchewan, Canada
| | - Ethel Dubois
- Star Blanket Cree Nation, Star Blanket Cree Nation, Saskatchewan, Canada
| | - Alyssa Starr
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Cari McIlduff
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Smith MS, Teufel-Shone N. Editorial: Indigenous knowledge and chronic disease prevention among the first people of North America. Front Public Health 2023; 11:1150221. [PMID: 37293612 PMCID: PMC10246768 DOI: 10.3389/fpubh.2023.1150221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Affiliation(s)
- Melinda S. Smith
- Interdisciplinary Health, Northern Arizona University, Flagstaff, AZ, United States
| | - Nicolette Teufel-Shone
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, United States
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13
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Day SJ. Collectively Dreaming Toward Indigenized School Psychology Education and Training. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2023. [DOI: 10.1177/08295735221146357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Indigenous Peoples comprise a significant portion of the population whose mental health needs must be appropriately addressed, and schools are important contexts for this service provision. The author presents findings from a culturally-grounded, strengths-based, qualitative, Two-Eyed Seeing study that engaged with current and previous Indigenous graduate students from Canadian mainstream and Indigenized counseling psychology programs to explore their graduate school experience and dream for the future of psychological education and training. Community-led analysis with aspects of qualitative thematic analysis guided a collective results narrative. Eight findings emerged including: (1) the importance of relationality in education and training; (2) the significance of experiential learning (i.e., land and art-based, ceremonial, interpersonal relations); (3) diversity in knowledge sharers and inclusion of elders in psychology education; (4) critical decision-making about cohort member inclusion (i.e., all indigenous cohorts vs. mixed); (5) mandatory Indigenous pre-requisite courses; (6) cultural humility; (7) teachings about how to be a good person rather than how to be a good counselor; and (8) interviews for program entry. These findings are discussed in the context of future practice, intervention, education, and training of school, educational, counseling, and clinical psychologists, as well as pedagogical and curricular programmatic changes in multi-educational levels (i.e., K-12 and post-secondary). Considerations and areas of future research are discussed.
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MacDonald SE, Kenzie L, Letendre A, Bill L, Shea-Budgell M, Henderson R, Barnabe C, Guichon JR, Colquhoun A, Ganshorn H, Bedingfield N, Vandenboogaard PD, Bednarczyk RA, Glaze S, Nelson G. Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001406. [PMID: 36962871 PMCID: PMC10021254 DOI: 10.1371/journal.pgph.0001406] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/08/2022] [Indexed: 01/09/2023]
Abstract
Despite the availability of effective and safe human papillomavirus (HPV) vaccines that reduce the incidence and impact of cervical cancer and other cancers, HPV vaccine coverage rates remain persistently low and the cervical cancer burden disproportionately high among Indigenous people globally. This study aimed to systematically identify, appraise, and summarize the literature on documented barriers and supports to HPV vaccination in Indigenous populations internationally. Forty-three studies were included and an inductive, qualitative, thematic synthesis was applied. We report on 10 barrier themes and 7 support themes to vaccine uptake, and provide a quantitative summary of metrics. Focusing on Indigenous perspectives reported in the literature, we propose recommendations on community-research collaboration, culturally safe intergenerational and gender-equitable community HPV vaccine education, as well as multi-level transparency to ensure informed consent is secured in the context of reciprocal relationships. Although the voices of key informant groups (e.g., HPV-vaccine eligible youth and community Elders) are underrepresented in the literature, the identification of barriers and supports to HPV vaccination in a global Indigenous context might help inform researchers and health policy makers who aim to improve HPV vaccine uptake in Indigenous populations.
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Affiliation(s)
| | - Lisa Kenzie
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Angeline Letendre
- Cancer Prevention and Screening Innovation, Alberta Health Services, Edmonton, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | | | - Rita Henderson
- Department of Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Cheryl Barnabe
- Department of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Juliet R Guichon
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Amy Colquhoun
- Performance Reporting, Alberta Health, Edmonton, Canada
| | - Heather Ganshorn
- Libraries and Cultural Resources, University of Calgary, Calgary, Canada
| | - Nancy Bedingfield
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Robert A Bednarczyk
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Sarah Glaze
- Tom Baker Cancer Centre, University of Calgary, Calgary, Canada
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
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15
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Rudzinski K, Chan Carusone S, Ceranto A, Ibáñez-Carrasco F, McDonald L, Valentine D, Guta A, Hyshka E, O’Leary W, Cardow A, Strike C. Philanthropic donor perspectives about providing harm reduction services for people living with HIV/AIDS in a hospital setting. Harm Reduct J 2022; 19:124. [PMID: 36384634 PMCID: PMC9668384 DOI: 10.1186/s12954-022-00711-8] [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: 03/05/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Hospital-based harm reduction services are needed to reduce drug-related harms, facilitate retention in care, and increase medical treatment adherence for people who use drugs. Philanthropic donor support plays a key role in delivering such innovative services which might fall outside current funding streams. However, little is known about how the principles, implementation, and practice of harm reduction services, which are often highly stigmatized, may impact donor behaviours. We explored this issue within Casey House, a speciality hospital in Toronto, Canada. METHODS Our mixed methods study utilized an explanatory sequential design. A convenience sample of n = 106 philanthropic individual donors, recruited via email, completed an anonymous web-based survey, between July and October 2020, which assessed their knowledge of harm reduction services and the potential impact of implementing new hospital-based harm reduction services on donors' future support. Following this, we conducted semi-structured qualitative interviews with n = 12 of the donors who completed a survey and volunteered to be interviewed. Interviews examined donors' perspectives about harm reduction and their hopes/concerns for such programming at Casey House. Data were analysed using descriptive statistics and participatory-based thematic analysis. RESULTS Survey data show a high level of support for hospital-based harm reduction services, with participants reporting that they "strongly agree/agree" with providing harm reduction equipment (85%), supervised consumption services (82%), and prescription opioid treatment (76%) at Casey House. A majority of participants (66%) claimed that implementing new harm reduction services at the hospital would not impact their future donation, while 6% said they would be less inclined to donate. Interview participants were supportive of harm reduction services at Casey House, recognizing the benefits of providing such services for hospital clients and the wider community. However, some spoke of the potential impact that implementing hospital-based harm reduction services may have on "other" donors who might be opposed. Although some believed harm reduction services should be fully funded by the government, most saw a role for donors in supporting such services. CONCLUSIONS Our findings show support of hospital-based harm reduction services among philanthropic donors and provide insight into how donor support may be affected when such services are introduced.
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Affiliation(s)
- Katherine Rudzinski
- grid.267455.70000 0004 1936 9596School of Social Work, University of Windsor, 167 Ferry Street, Windsor, ON N9A 0C5 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7 Canada
| | - Soo Chan Carusone
- grid.498714.70000 0001 0351 7433Casey House, 119 Isabella St, Toronto, ON M4Y 1P2 Canada ,grid.25073.330000 0004 1936 8227McMaster Collaborative for Health and Aging, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Andre Ceranto
- grid.498714.70000 0001 0351 7433Casey House, 119 Isabella St, Toronto, ON M4Y 1P2 Canada
| | - Francisco Ibáñez-Carrasco
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7 Canada
| | - Lisa McDonald
- grid.498714.70000 0001 0351 7433Casey House, 119 Isabella St, Toronto, ON M4Y 1P2 Canada
| | - Dean Valentine
- grid.498714.70000 0001 0351 7433Casey House, 119 Isabella St, Toronto, ON M4Y 1P2 Canada
| | - Adrian Guta
- grid.267455.70000 0004 1936 9596School of Social Work, University of Windsor, 167 Ferry Street, Windsor, ON N9A 0C5 Canada
| | - Elaine Hyshka
- grid.17089.370000 0001 2190 316XSchool of Public Health, University of Alberta, 3-256 Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB T6G 1C9 Canada
| | - William O’Leary
- grid.498714.70000 0001 0351 7433Casey House, 119 Isabella St, Toronto, ON M4Y 1P2 Canada ,grid.268252.90000 0001 1958 9263Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, 120 Duke St W, Kitchener, ON N2H 6P6 Canada
| | - Andra Cardow
- grid.498714.70000 0001 0351 7433Casey House, 119 Isabella St, Toronto, ON M4Y 1P2 Canada
| | - Carol Strike
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7 Canada
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16
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Kyoon Achan G, Eni R, Phillips-Beck W, Lavoie JG, Kinew KA, Katz A. Canada First Nations Strengths in Community-Based Primary Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13532. [PMID: 36294110 PMCID: PMC9602454 DOI: 10.3390/ijerph192013532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/03/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION First Nation (FN) peoples and communities in Canada are still grappling with the effects of colonization. Health and social inequities result in higher disease burden and significant disparities in healthcare access and responsiveness. For resilience, survival, and self-determination, FN are looking inwards for strengths. This paper reports on the cultural, community, and family strengths that have supported FN communities in developing community-based primary healthcare (CBPHC) strategies to support health and wellbeing. METHODS The study was a partnership between university-based researchers; The First Nations Health and Social Secretariat of Manitoba; and eight First Nation communities in Manitoba. Community-based participatory research methods were used to engage the participating communities. One hundred and eighty-three in-depth, semi-structured key informant interviews were completed between 2014 and 2016 with key members of the First Nation communities, i.e., community-based health providers and users of primary healthcare services, representing all age and genders. Data-collection and analysis were conducted following iterative grounded theory analysis. RESULTS Community-based healthcare models based on local strengths support easier access and shorter wait times for care and compassionate care delivery. Resources such as homecare and medical transportation are helpful. Community cooperation, youth power, responsive leadership, and economic development as well as a strong cultural and spiritual base are key strengths supporting health and social wellbeing. CONCLUSIONS Locally led, self-determined care adds strength in FN communities, and is poised to create long-lasting primary healthcare transformation.
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Affiliation(s)
- Grace Kyoon Achan
- Education Indigenous Institute of Health and Healing, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Rachel Eni
- Independent Researcher, Victoria, BC V9C 0M1, Canada
| | - Wanda Phillips-Beck
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, First Nation Health and Social Secretariat Manitoba, University of Manitoba, Winnipeg, MB R3B 2B3, Canada
| | - Josée G. Lavoie
- Department Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P5, Canada
| | - Kathi Avery Kinew
- First Nation Health and Social Secretariat Manitoba, Winnipeg, MB R3B 2B3, Canada
| | - Alan Katz
- Department of Family Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3B 2B3, Canada
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17
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Okpalauwaekwe U, Ballantyne C, Tunison S, Ramsden VR. Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review. BMC Public Health 2022; 22:1630. [PMID: 36038858 PMCID: PMC9422134 DOI: 10.1186/s12889-022-14047-2] [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] [Received: 04/14/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Indigenous youth in Canada face profound health inequities which are shaped by the rippling effects of intergenerational trauma, caused by the historical and contemporary colonial policies that reinforce negative stereotypes regarding them. Moreover, wellness promotion strategies for these youth are replete with individualistic Western concepts that excludes avenues for them to access holistic practices grounded in their culture. Our scoping review explored strategies, approaches, and ways health and wellness can be enhanced by, for, and with Indigenous youth in Canada by identifying barriers/roadblocks and facilitators/strengths to enhancing wellness among Indigenous youth in Canada. METHODS We applied a systematic approach to searching and critically reviewing peer-reviewed literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews [PRISMA-ScR] as a reporting guideline. Our search strategy focused on specific keywords and MeSH terms for three major areas: Indigenous youth, health, and Canada. We used these keywords, to systematically search the following electronic databases published in English between January 01, 2017, to May 22, 2021: Medline [Ovid], PubMed, ERIC, Web of Science, Scopus, and iportal. We also used hand-searching and snowballing methods to identify relevant articles. Data collected were analysed for contents and themes. RESULTS From an initial 1695 articles collated, 20 articles met inclusion criteria for this review. Key facilitators/strengths to enhancing health and wellness by, for, and with Indigenous youth that emerged from our review included: promoting culturally appropriate interventions to engage Indigenous youth; using strength-based approaches; reliance on the wisdom of community Elders; taking responsibility; and providing access to wellness supports. Key barriers/roadblocks included: lack of community support for wellness promotion activities among Indigenous youth; structural/organizational issues within Indigenous communities; discrimination and social exclusion; cultural illiteracy among youth; cultural discordance with mainstream health systems and services; and addictions and risky behaviours. CONCLUSION This scoping review extracted 20 relevant articles about ways to engage Indigenous youth in health and wellness enhancement. Our findings demonstrate the importance of promoting health by, and with Indigenous youth, by engaging them in activities reflexive of their cultural norms, rather than imposing control measures that are incompatible with their value systems.
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Affiliation(s)
- Udoka Okpalauwaekwe
- Health Sciences Program, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5E5, Canada.
| | - Clifford Ballantyne
- Sturgeon Lake Youth Center, Sturgeon Lake First Nation, Sturgeon Lake, Saskatchewan, S0J 2E1, Canada
| | - Scott Tunison
- University of Saskatchewan, Saskatoon, Saskatchewan, S7N 0X1, Canada
| | - Vivian R Ramsden
- Research Division, Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, S7M 3Y5, Canada.
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18
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Yamane CYEW, Helm S. Indigenous Culture-as-Health: A Systematized Literature Review. JOURNAL OF PREVENTION (2022) 2022; 43:167-190. [PMID: 35286545 DOI: 10.1007/s10935-022-00666-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
This paper has two goals regarding cultural rigor, defined as privileging cultural ways of knowing and being as a means to achieving health and well-being for future generations. First, we move the continuum of health practices beyond cultural grounding to include Indigenous Culture-as-Health. Second, this project expands the concept of Indigenous Culture-as-Health in addiction and recovery to include a broader range of health, inclusive of prevention, to further understand this emerging model. Our review of the literature yielded an expanded cultural continuum that includes Indigenous Culture-as-Health, which appears to rely on four modalities: 1) Indigenous ways of knowing, 2) Indigenous cultural practices, 3) place-based/sacred sites, and 4) Indigenous spirituality. For Indigenous health, standards are defined by centuries of ancestral consciousness among Indigenous people across generations, in spite of settler-colonial systems that do not serve them. In other words, Indigenous Culture-as-Health practices contribute to self-determination, sovereignty, and liberation. Incorporating these strategies also will ameliorate other problems related to White supremacy and health, such as epistemic exploitation. Additional implications for prevention practice and policy are described.
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Affiliation(s)
- Cherry Y E W Yamane
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai`i at Mānoa, Honolulu, HI, USA.
| | - Susana Helm
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai`i at Mānoa, Honolulu, HI, USA
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19
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Fostering Resilience and Adaptation to Drought in the Southern High Plains: Using Participatory Methods for More Robust Citizen Science. SUSTAINABILITY 2022. [DOI: 10.3390/su14031813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Citizen science holds the potential and capacity to change the role of science in the face of current and impending environmental sustainability challenges. However, the sustainability science community must also address the ethical challenges inherent in the nature and outcomes of citizen participation and inclusion. In this article, we provide a brief history of Participatory Action Research (PAR), long popular in the social sciences, and explain how participatory methods can inform the process and products of citizen science to meet the dueling ideals of ethically engaging communities and producing more robust science. Our decade of human-environment research on drought resilience and adaptation in the Southern High Plains of the United States illustrates how PAR complements formal science and can contribute to community resilience and adaptation efforts. Synthesized into 10 entry points for more ethical and participatory science, our semi-chronological narrative offers concrete strategies informed by PAR principles and values, at various stages of research, and highlights the place-based, ethical, and methodological contexts for applying each strategy.
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20
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Redvers N, Celidwen Y, Schultz C, Horn O, Githaiga C, Vera M, Perdrisat M, Mad Plume L, Kobei D, Kain MC, Poelina A, Rojas JN, Blondin B. The determinants of planetary health: an Indigenous consensus perspective. Lancet Planet Health 2022; 6:e156-e163. [PMID: 35150624 DOI: 10.1016/s2542-5196(21)00354-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/08/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
Indigenous Peoples have resiliently weathered continued assaults on their sovereignty and rights throughout colonialism and its continuing effects. Indigenous Peoples' sovereignty has been strained by the increasing effects of global environmental change within their territories, including climate change and pollution, and by threats and impositions against their land and water rights. This continuing strain against sovereignty has prompted a call to action to conceptualise the determinants of planetary health from a perspective that embodied Indigenous-specific methods of knowledge gathering from around the globe. A group of Indigenous scholars, practitioners, land and water defenders, respected Elders, and knowledge-holders came together to define the determinants of planetary health from an Indigenous perspective. Three overarching levels of interconnected determinants, in addition to ten individual-level determinants, were identified as being integral to the health and sustainability of the planet, Mother Earth.
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Affiliation(s)
- Nicole Redvers
- Department of Indigenous Health, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, USA; Arctic Indigenous Wellness Foundation, Yellowknife, NT, Canada.
| | | | - Clinton Schultz
- Faculty of Medicine and Health Sciences, Bond University, Robina, QLD, Australia
| | - Ojistoh Horn
- Department of Family Medicine, McGill University, Montreal, QC, Canada; Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | | | - Melissa Vera
- School of Nursing, University of Washington, Seattle, WA, USA
| | | | - Lynn Mad Plume
- Department of Indigenous Health, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, USA
| | - Daniel Kobei
- Ogiek Peoples' Development Program, Egerton, Kenya
| | - Myrna Cunningham Kain
- El Fondo para el Desarrollo de los Pueblos Indígenas de América Latina y El Caribe, La Paz, Bolivia
| | - Anne Poelina
- Nulungu Research Institute, University of Notre Dame Australia, Broome, WA, Australia
| | - Juan Nelson Rojas
- Pull Together Now, Lincoln, MT, USA; Pipil Indigenous Council of Firekeepers and Healers, Santa Tecla, El Salvador
| | - Be'sha Blondin
- Arctic Indigenous Wellness Foundation, Yellowknife, NT, Canada
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21
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Philbin MM, Guta A, Wurtz H, Bradley-Perrin I, Kinnard EN, Goldsamt L. How Black and Latino young men who have sex with men in the United States experience and engage with eligibility criteria and recruitment practices: implications for the sustainability of community-based research. CRITICAL PUBLIC HEALTH 2022; 32:677-688. [PMID: 36439240 PMCID: PMC9697991 DOI: 10.1080/09581596.2021.1918329] [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: 01/03/2023]
Abstract
Research recruitment, eligibility, and who chooses to participate shape the resulting data and knowledge, which together inform interventions, treatment, and programming. Patterns of research participation are particularly salient at this moment given emerging biomedical prevention paradigms. This paper explores the perspectives of Black and Latino young men who have sex with men (BL-YMSM) regarding research recruitment and eligibility criteria, how their experiences influence willingness to enroll in a given study, and implications for the veracity and representativeness of resulting data. We examine inclusion and recruitment as a complex assemblage, which should not be reduced to its parts. From April-July 2018, we conducted in-depth interviews with 30 BL-YMSM, ages 18-29, in New York City. Interviews were recorded, transcribed, and analyzed using the constant comparative method. Black and Latino YMSM's responses unveiled tensions between researchers', recruiters', and participants' expectations, particularly regarding eligibility criteria (e.g., age, sex frequency), assumptions about 'risky behaviors,' and the 'target' community. Men preferred peer-to-peer recruitment, noting that most approaches miss key population segments. Findings highlight the need to critically examine the selected 'target' community, who sees themselves as participants, and implications for data comprehensiveness and veracity. Study eligibility criteria and recruitment approaches are methodological issues that shape knowledge production and the policies and programs deployed into communities. These findings can inform how future research studies frame recruitment and eligibility in order to better meet the needs of participants and ensure future engagement.
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Affiliation(s)
- Morgan M. Philbin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY
| | - Adrian Guta
- School of Social Work, University of Windsor, 167 Ferry Street, Windsor, ON N9A0C5
| | - Heather Wurtz
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY
| | - Ian Bradley-Perrin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY
| | - Elizabeth N. Kinnard
- Division of Epidemiology, University of California at Berkeley School of Public Health, 2121 Berkeley Way, Berkeley, CA 94720
| | - Lloyd Goldsamt
- College of Nursing, New York University, 433 First Avenue, 7th floor New York, NY
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22
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Landy R, Worthington C. "Do something with them!": developing "comfortable" engagement with Elders participating in an arts-based sexual health promotion and STBBI prevention workshop for Indigenous Youth in Labrador, Canada. Int J Circumpolar Health 2021; 80:1986250. [PMID: 34720064 PMCID: PMC8567953 DOI: 10.1080/22423982.2021.1986250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Although Indigenous Elders were traditionally involved in cross-generational health promotion and education, colonisation disrupted this role. Little research examines the role of Elders in contemporary health promotion for Indigenous youth and few strategies have been identified to engage Elders in health promotion or sexual health education. We explored engagement of Elders through participatory filmmaking in a sexual health and HIV education workshop for youth. Eleven youth and five Elders participated in this 3.5-day workshop. During the workshop, Elders indicated they wanted to make a film and attend a sexual health and HIV education session. Four Elders were interviewed about their experiences. Interview transcripts and the Elders’ film were analysed using content analysis. Although Elders initially felt hesitant to engage, the process of participatory filmmaking allowed Elders to co-create an environment for their “comfortable” workshop engagement. Elders’ feelings of comfort were created by having control and sense of ownership over their engagement; the presence of youth; peer-based dialogue; inclusion of traditional items; and an Indigenous sexual health educator. Findings suggest participatory filmmaking is a promising approach for engaging and empowering Elders to reclaim traditional roles in sexual health education and health promotion with Indigenous youth.
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Affiliation(s)
- Rachel Landy
- Department of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
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23
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Swann SA, Kaida A, Nicholson V, Brophy J, Campbell AR, Carter A, Elwood C, Gebremedhen T, Gormley R, King EM, Lee M, Lee V, Maan EJ, Magagula P, Nyman S, Pang D, Pick N, Povshedna T, Prior JC, Singer J, Tognazzini S, Murray MCM, Cote HCF. British Columbia CARMA-CHIWOS Collaboration (BCC3): protocol for a community-collaborative cohort study examining healthy ageing with and for women living with HIV. BMJ Open 2021; 11:e046558. [PMID: 34362800 PMCID: PMC8351488 DOI: 10.1136/bmjopen-2020-046558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Women living with HIV (WLWH) experience accelerated ageing and an increased risk of age-associated diseases earlier in life, compared with women without HIV. This is likely due to a combination of viral factors, gender differences, hormonal imbalance and psychosocial and structural conditions. This interdisciplinary cohort study aims to understand how biological, clinical and sociostructural determinants of health interact to modulate healthy ageing in WLWH. METHODS AND ANALYSIS The British Columbia Children and Women: AntiRetroviral therapy and Markers of Aging-Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CARMA-CHIWOS) Collaboration (BCC3) study will enrol WLWH (n=350) and sociodemographically matched HIV-negative women (n=350) living in British Columbia. A subset of BCC3 participants will be past participants of CARMA, n≥1000 women and children living with and without HIV, 2008-2018 and/or CHIWOS, n=1422 WLWH, 2013-2018. Over two study visits, we will collect biological specimens for virus serologies, hormones and biological markers as well as administer a survey capturing demographic and sociostructural-behavioural factors. Sociodemographics, comorbidities, number and type of chronic/latent viral infections and hormonal irregularities will be compared between the two groups. Their association with biological markers and psychostructural and sociostructural factors will be investigated through multivariable regression and structural equation modelling. Retrospective longitudinal analyses will be conducted on data from past CARMA/CHIWOS participants. As BCC3 aims to follow participants as they age, this protocol will focus on the first study visits. ETHICS AND DISSEMINATION This study has been approved by the University of British Columbia Children's and Women's Research Ethics Board (H19-00896). Results will be shared in peer-reviewed journals, conferences and at community events as well as at www.hivhearme.ca and @HIV_HEAR_me. WLWH are involved in study design, survey creation, participant recruitment, data collection and knowledge translation. A Community Advisory Board will advise the research team throughout the study.
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Affiliation(s)
- Shayda A Swann
- Experimental Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
| | - Angela Kaida
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Valerie Nicholson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Epidemiology and Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Jason Brophy
- Division of Infectious Diseases, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Amber R Campbell
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Allison Carter
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Faculty of Medicine, The Kirby Institute, Sydney, New South Wales, Australia
| | - Chelsea Elwood
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Obstetrics and Gynecology, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Tsion Gebremedhen
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Rebecca Gormley
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Epidemiology and Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Elizabeth M King
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Melanie Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Vonnie Lee
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Evelyn J Maan
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Patience Magagula
- Afro-Caribbean Positive Network of BC, Vancouver, British Columbia, Canada
| | - Sheila Nyman
- Bear Rock Consulting, Lone Butte, British Columbia, Canada
| | - Davi Pang
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Neora Pick
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Division of Infectious Diseases, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Tetiana Povshedna
- Pathology and Laboratory Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Jerilynn C Prior
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Centre for Menstrual Cycle and Ovulatory Research, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Joel Singer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shelly Tognazzini
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Melanie C M Murray
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Division of Infectious Diseases, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Helene C F Cote
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Pathology and Laboratory Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
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Murphy K, Branje K, White T, Cunsolo A, Latimer M, McMillan J, Sylliboy JR, McKibbon S, Martin D. Are we walking the talk of participatory Indigenous health research? A scoping review of the literature in Atlantic Canada. PLoS One 2021; 16:e0255265. [PMID: 34314455 PMCID: PMC8315539 DOI: 10.1371/journal.pone.0255265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 07/13/2021] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Participatory research involving community engagement is considered the gold standard in Indigenous health research. However, it is sometimes unclear whether and how Indigenous communities are engaged in research that impacts them, and whether and how engagement is reported. Indigenous health research varies in its degree of community engagement from minimal involvement to being community-directed and led. Research led and directed by Indigenous communities can support reconciliation and reclamation in Canada and globally, however clearer reporting and understandings of community-led research is needed. This scoping review assesses (a) how and to what extent researchers are reporting community engagement in Indigenous health research in Atlantic Canada, and (b) what recommendations exist in the literature regarding participatory and community-led research. METHODS Eleven databases were searched using keywords for Indigeneity, geographic regions, health, and Indigenous communities in Atlantic Canada between 2001-June 2020. Records were independently screened by two reviewers and were included if they were: peer-reviewed; written in English; health-related; and focused on Atlantic Canada. Data were extracted using a piloted data charting form, and a descriptive and thematic analysis was performed. 211 articles were retained for inclusion. RESULTS Few empirical articles reported community engagement in all aspects of the research process. Most described incorporating community engagement at the project's onset and/or during data collection; only a few articles explicitly identified as entirely community-directed or led. Results revealed a gap in reported capacity-building for both Indigenous communities and researchers, necessary for holistic community engagement. Also revealed was the need for funding bodies, ethics boards, and peer review processes to better facilitate participatory and community-led Indigenous health research. CONCLUSION As Indigenous communities continue reclaiming sovereignty over identities and territories, participatory research must involve substantive, agreed-upon involvement of Indigenous communities, with community-directed and led research as the ultimate goal.
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Affiliation(s)
- Kathleen Murphy
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karina Branje
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Tara White
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ashlee Cunsolo
- School of Arctic and Sub-Arctic Studies, Labrador Institute of Memorial University, Memorial University, Happy Valley-Goose Bay, Newfoundland & Labrador, Canada
| | - Margot Latimer
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jane McMillan
- Department of Anthropology, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - John R. Sylliboy
- Department of Integrated Studies in Education (DISE), McGill University, Montreal, Quebec, Canada
| | - Shelley McKibbon
- Kellogg Health Sciences Library, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Debbie Martin
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Peu MD, Mulaudzi FM, Rikhotso SR, Ngunyulu RN, Rasweswe MM. Reflections on accessing indigenous research settings: Encounters with traditional health practitioners and leaders in Vhembe district, South Africa. CULTURE & PSYCHOLOGY 2021. [DOI: 10.1177/1354067x20971249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Conducting research in indigenous settings in rural villages, where traditional leaders are the custodians of communities remains a challenge. Traditional health practitioners have to adapt their protocols to the needs of the cultural setting. When gaining access to a setting, researchers have to follow a process that respects the autonomy of individuals, thus adhering to one of the ethical principles of research with human participants. In this paper, the researchers reflect on gaining access to conduct research with traditional health practitioners and traditional leaders in Vhembe district, South Africa. Researchers participated in sharing circles, and identified five reflective themes. The themes included initiating agreement and rapport, continuous negotiation and compromise, Them and Us, adhering to local dress code and ritual performance. Researchers planning to conduct research with traditional health practitioners and traditional leaders should consider these themes in the preparation phase.
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Affiliation(s)
- MD Peu
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - FM Mulaudzi
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - SR Rikhotso
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - RN Ngunyulu
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - MM Rasweswe
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Redvers N. Patient-Planetary Health Co-benefit Prescribing: Emerging Considerations for Health Policy and Health Professional Practice. Front Public Health 2021; 9:678545. [PMID: 33996734 PMCID: PMC8119779 DOI: 10.3389/fpubh.2021.678545] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022] Open
Abstract
In addition to the importance of fostering and developing measures for better health-system resilience globally from the effects of climate change, there have been increasing calls for health professionals, as well as public health and medical education systems, to become partners in climate change mitigation efforts. Direct clinical practice considerations, however, have not been adequately fostered equitably across all regions with an often-confusing array of practice areas within planetary health and sustainable healthcare. This article calls for a more coordinated effort within clinical practice spaces given the urgency of global environmental change, while also taking lessons from Indigenous traditional knowledge systems—a viewpoint that is rarely heard from or prioritized in public health or medicine. Simpler and more coordinated messaging in efforts to improve patient and planetary health are needed. The creation of unifying terminology within planetary health-rooted clinical and public health practice has been proposed with the potential to bring forth dialogue between and within disciplinary offshoots and public health advocacy efforts, and within clinical and health-system policy spaces.
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Affiliation(s)
- Nicole Redvers
- Department of Family & Community Medicine, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, United States.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Crowshoe LL, Sehgal A, Montesanti S, Barnabe C, Kennedy A, Murry A, Roach P, Green M, Bablitz C, Tailfeathers E, Henderson R. The Indigenous primary health care and policy research network: Guiding innovation within primary health care with Indigenous peoples in Alberta. Health Policy 2021; 125:725-731. [PMID: 33685657 DOI: 10.1016/j.healthpol.2021.02.007] [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: 07/01/2020] [Revised: 12/29/2020] [Accepted: 02/21/2021] [Indexed: 10/22/2022]
Abstract
In 2015, the Truth and Reconciliation Commission of Canada released its Final Report with 94 Calls to Action, several of which called upon the health care sector to reform based on the principles of reconciliation. In the province of Alberta, Canada, numerous initiatives have arisen to address the health legacy Calls to Action, yet there is no formal mechanism to connect them all. As such, these initiatives have resulted in limited improvements overall. Recognizing the need for clear leadership, responsibility, and dedicated funding, stakeholders from across Alberta were convened in the Spring of 2019 for two full-day roundtable meetings to provide direction for a proposed Canadian Institutes of Health Research Network Environment for Indigenous Health Research that focused on primary health care and policy research. The findings from these roundtable meetings were synthesized and integrated into the foundational principles of the Indigenous Primary Health Care and Policy Research (IPHCPR) Network. The IPHCPR Network has envisioned a renewed and transformed primary health care system to achieve Indigenous health equity, aligned with principles and health legacy Calls to Action advocated by the Truth and Reconciliation Commission of Canada.
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Affiliation(s)
- Lynden Lindsay Crowshoe
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada
| | - Anika Sehgal
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada.
| | - Stephanie Montesanti
- School of Public Health, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada
| | - Cheryl Barnabe
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada
| | - Andrea Kennedy
- School of Nursing and Midwifery, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, AB T3E 6K6, Canada
| | - Adam Murry
- Department of Psychology, University of Calgary, 2500 University Drive, NW, Calgary, AB T2N 1N4, Canada
| | - Pamela Roach
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada; O'Brien Institute for Public Health, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada
| | - Michael Green
- Department of Family Medicine, Queen's University, 99 University Ave, Kingston, ON K7L 3N6, Canada
| | - Cara Bablitz
- Department of Family Medicine, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada
| | - Esther Tailfeathers
- AHS Population, Public, and Indigenous Health Strategic Clinical Network, AB, Canada
| | - Rita Henderson
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada; O'Brien Institute for Public Health, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada
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Contextual factors associated with depression among Northern and Indigenous adolescents in the Northwest Territories, Canada. Glob Ment Health (Camb) 2021; 8:e22. [PMID: 34249369 PMCID: PMC8246646 DOI: 10.1017/gmh.2021.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Persons in Arctic regions disproportionately experience depression. Knowledge gaps remain regarding factors associated with depression among adolescents in the Northwest Territories (NWT), Canada, where child and adolescent mental health hospitalizations are nearly 2.5 times the national rate. This study assesses correlates of depression among adolescents in the NWT. METHODS We conducted a cross-sectional survey with adolescents aged 13-18 in 17 NWT communities. We assessed associations between socio-demographic characteristics, dating violence, food insecurity and depression, measured with the 9-item Patient Health Questionnaire. We conducted ordered logistic regressions to assess associations with no, mild, or moderate/severe depression scores. RESULTS Participants (n = 399; mean age: 14.3, s.d.: 1.3) were mostly Indigenous (79%) and 45% reported food insecurity. Nearly half (47%) reported minimal/no depression symptoms, 25% mild symptoms and 28% moderate/severe symptoms. In multivariate analyses, participants who were cisgender women compared to other genders, sexually diverse v. heterosexual, and food insecure had double the odds of more severe depression symptoms. Among those dating, dating violence was associated with double the odds of moderate/severe depression symptoms. CONCLUSIONS Findings support tailored interventions to address material (food insecurity), relational (dating violence) and symbolic (gender and sexual orientation norms) contextual factors associated with depression among adolescents in the NWT.
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Poland B, Mashford-Pringle A, Bowra A. Many lenses for planetary health: seeding citizen engagement for sustainable futures visioning with new ways of seeing. Canadian Journal of Public Health 2020; 111:901-911. [PMID: 33140230 DOI: 10.17269/s41997-020-00424-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 09/21/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This pilot project sought to seed citizen engagement processes for sustainable futures visioning with ideas, perspectives, and processes informed by Indigenous ways of knowing. METHODS Five circle dialogues were convened with students, faculty, and members of the public, in the spring of 2019, using Indigenous talking circle methodology and intentionally seeded with "disruptive" ideas to encourage reflexivity and open space for "out-of-the-box" thinking. These were complemented by a series of one-on-one dialogues with members of the pan-Canadian research team. Pre- and post-dialogue surveys, notes taken by participants, team members, and co-facilitators, as well as notes from one-on-one interviews, constituted the data drawn upon for this paper. RESULTS Participants were overwhelmingly positive about their experience, noting they were able to go further and deeper in their thinking and listening, and that they valued the Indigenous talking circle methodology, even if they stopped short of claiming the experience had transformed their way of seeing the world. Key points raised in the dialogues included the need for a more relational worldview, the need to repair severed relations with the land and nature, the importance of Indigenous ways of knowing, the importance of community building, and the need to question the fundamental assumptions undergirding contemporary Western societies. CONCLUSIONS While caution must be exercised in drawing conclusions and extrapolating from this modest pilot project, our experience underscores the value of processes that intentionally catalyze critical reflexivity and openness to other ways of seeing, informed by Indigenous ways of knowing and talking circle methodology.
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Affiliation(s)
- Blake Poland
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.
| | - Angela Mashford-Pringle
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.,Waakebiness-Bryce Institute for Indigenous Health, University of Toronto, Toronto, ON, Canada
| | - Andrea Bowra
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.,Waakebiness-Bryce Institute for Indigenous Health, University of Toronto, Toronto, ON, Canada
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Jacklin K, Pitawanakwat K, Blind M, Lemieux AM, Sobol A, Warry W. Peace of mind: A community-industry-academic partnership to adapt dementia technology for Anishinaabe communities on Manitoulin Island. J Rehabil Assist Technol Eng 2020; 7:2055668320958327. [PMID: 32999732 PMCID: PMC7509219 DOI: 10.1177/2055668320958327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Aging Technologies for Indigenous Communities in Ontario (ATICON) explores the technology needs of Anishinaabe older adults in the Manitoulin region of Northern Ontario. Our program of research addresses inequitable access to supportive technologies that may allow Indigenous older adults to successfully age in place. Methods Using Indigenous research methodologies (IRM) and community-based participatory research (CBPR) we explored the acceptability of CareBand - a wearable location and activity monitoring device for people living with dementia using a LoRaWAN, a low-power wide-area network technology. We conducted key informant consultations and focus groups with Anishinaabe Elders, formal and informal caregivers, and health care providers (n = 29) in four geographically distinct regions. Results Overall, participants agreed that CareBand would improve caregivers' peace of mind. Our results suggest refinement of the technology is necessary to address the challenges of the rural geography and winter weather; to reconsider aesthetics; address privacy and access; and to consider the unique characteristics of Anishinaabe culture and reserve life. Conclusion All three partners in this research, including the Indigenous communities, industry partner, and academic researchers, benefited from the use of CBPR and IRM. As CareBand is further developed, community input will be crucial for shaping a useful and valued device.
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Affiliation(s)
- Kristen Jacklin
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
| | | | - Melissa Blind
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
| | - Andrine M Lemieux
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
| | | | - Wayne Warry
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
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Best A, Ong N, Cooper P, Davison C, Coatta K, Berland A, Herbert C, Mitton C, Millar J, Reichert S, Cano A. Evaluating complex transformation. J Health Organ Manag 2020; 34:313-324. [PMID: 32364344 DOI: 10.1108/jhom-05-2019-0139] [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
PURPOSE The purpose of this paper is to present a detailed case study of the evaluation strategies of a complex, multi-faceted response to a public health emergency: drug-related overdose deaths. It sets out the challenges of evaluating such a complex response and how they were overcome. It provides a pragmatic example of the rationale and issues faced to address the what, the why and particularly the how of the evaluation. DESIGN/METHODOLOGY/APPROACH The case study overviews British Columbia's Provincial Response to the Overdose Public Health Emergency, and the aims and scope of its evaluation. It then outlines the conceptual approach taken to the evaluation, setting out key methodological challenges in evaluating large-scale, multi-level, multisectoral change. FINDINGS The evaluation is developmental and summative, utilization focused and system informed. Defining the scope of the evaluation required a strong level of engagement with government leads, grantees and other evaluation stakeholders. Mixed method evaluation will be used to capture the complex pattern of relationships that have informed the overdose response. Working alongside people with drug use experience to both plan and inform the evaluation is critical to its success. ORIGINALITY/VALUE This case study builds on a growing literature on evaluating large-scale and complex service transformation, providing a practical example of this.
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Affiliation(s)
- Allan Best
- InSource Research Group, West Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | | | | | - Carolyn Davison
- Ministry of Mental Health and Addictions, Government of British Columbia, Victoria, Canada
| | | | | | | | - Craig Mitton
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - John Millar
- Department of Population Health, InSource Research Group, West Vancouver, Canada
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Cultural Neuropsychology Considerations in the Diagnosis of HIV-Associated Neurocognitive Disorders. Curr Top Behav Neurosci 2020; 50:193-223. [PMID: 32157665 DOI: 10.1007/7854_2019_121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Human Immunodeficiency Virus Type-I (HIV) is a health disparities issue that affects culturally and linguistically diverse (CALD) and underrepresented minority populations to a greater degree than non-Hispanic white populations. Neurologically speaking, CALD populations experience worse HIV-related health outcomes, which are exacerbated by inadequate neurocognitive measures, poor normative samples, and the complex interplay of sociocultural factors that may affect test interpretation. Although cross-cultural neuropsychologists are working diligently to correct this gap in the literature, currently, studies examining neurocognitive outcomes among CALD populations are sparse. The most well-studied CALD groups are of African American/Black and Latinx adults in the US, and the chapter therefore focuses on these studies. There is more limited work among other populations in the US, such as Asians, Native Hawaiians, Pacific Islanders, and American Indians/Alaskan Natives, and even fewer studies for many CALD populations outside of the US. For example, HIV neuropsychology data is rare or nonexistent in the First Peoples of Australia and Indigenous People of Canada. It is often not adequately reported in Europe for the migrant populations within those countries or other world regions that have historically large multicultural populations (e.g., South America, Caribbean countries, Asia, and Africa). Therefore, this chapter reviews HIV-related health disparities faced by CALD populations with focus on North American research where it has been specifically studied, with particular attention given to disparities in HIV-Associated Neurocognitive Disorders (HAND). International data was also included for research with focus on First Peoples of Australia and Indigenous People of Canada. The chapter also examines other sociocultural and health factors, including global and regional (e.g., rural versus urban) considerations, migration, and gender. Further, guidelines for incorporating sociocultural consideration into assessment and interpretation of neurocognitive data and HAND diagnosis when working with HIV-positive CALD populations that would be relevant internationally are provided.
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Kyoon-Achan G, Lavoie J, Kinew KA, Ibrahim N, Sinclair S, Katz A. What Changes Would Manitoba First Nations Like to See in the Primary Healthcare They Receive? A Qualitative Investigation. Healthc Policy 2019; 15:85-99. [PMID: 32077847 PMCID: PMC7020803 DOI: 10.12927/hcpol.2019.26069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND First Nations (FN) have unique perspectives and experiences of health and healthcare services, which are critical to the provision of effective community-based primary healthcare (CBPHC). OBJECTIVE This paper shares FN perspectives on primary healthcare (PHC), taking geographical, cultural and historical realities into account, to elucidate opportunities to improve current healthcare services. METHODS Semi-structured in-depth qualitative interviews were completed with 183 residents of 8 Manitoba FN communities. Grounded theory-guided data analysis was conducted. RESULTS Improving PHC performance requires delivering timely and holistic healthcare that integrates traditional health knowledge, comprehensive CBPHC increasing services such as healthcare and medical transportation, healthy food as an important preventative measure and a culturally informed workforce backed by local leadership and promoting cultural respect. CONCLUSION The relationship between self-determination and health is a critical factor in the implementation of CBPHC. FN must be respected to decide healthcare priorities that reflect the needs and visions of each community.
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Affiliation(s)
- Grace Kyoon-Achan
- Research Fellow, Departments of Community Health Sciences and Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, Ongomiizwiin Research - Institute of Indigenous Health and Healing, Winnipeg, MB
| | - Josée Lavoie
- Director, Manitoba First Nations Centre for Aboriginal Health Research, Professor, Department of Community Health Science Rady Faculty of Health Sciences, Winnipeg, MB, Wanda Phillips-Beck, RN, BN, MSC, NANAANDAWEWIGAMIG, Nurse Manager, First Nations Health and Social Secretariat of Manitoba, Winnipeg, MB
| | - Kathi Avery Kinew
- NANAANDAWEWIGAMIG, Research Manager, First Nations Health and Social Secretariat of Manitoba, Winnipeg, MB
| | - Naser Ibrahim
- Research Associate, Ongomiizwin Research - Indigenous Institute of Health and Healing, Department of Community Health Sciences, College of Medicine, University of Manitoba, Winnipeg, MB
| | - Stephanie Sinclair
- NANAANDAWEWIGAMIG, Research Coordinator, First Nations Health and Social Secretariat of Manitoba, Winnipeg, MB
| | - Alan Katz
- Director, Manitoba Centre for Health Policy (MCHP), Professor, Departments of Community Health Sciences and Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, Winnipeg, MB
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Bull J, Beazley K, Shea J, MacQuarrie C, Hudson A, Shaw K, Brunger F, Kavanagh C, Gagne B. Shifting practise: recognizing Indigenous rights holders in research ethics review. QUALITATIVE RESEARCH IN ORGANIZATIONS AND MANAGEMENT: AN INTERNATIONAL JOURNAL 2019. [DOI: 10.1108/qrom-04-2019-1748] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
For many Indigenous nations globally, ethics is a conversation. The purpose of this paper is to share and mobilize knowledge to build relationships and capacities regarding the ethics review and approval of research with Indigenous peoples throughout Atlantic Canada. The authors share key principles that emerged for shifting practices that recognize Indigenous rights holders through ethical research review practice.
Design/methodology/approach
The NunatuKavut Inuit hosted and led a two-day gathering on March 2019 in Happy Valley-Goose Bay, Newfoundland and Labrador, to promote a regional dialogue on Indigenous Research Governance. It brought together Indigenous Nations within the Atlantic Region and invited guests from institutional ethics review boards and researchers in the region to address the principles-to-policy-to-practice gap as it relates to the research ethics review process. Called “Naalak”, an Inuktitut word that means “to listen and to pay close attention”, the gathering created a dynamic moment of respect and understanding of how to work better together and support one another in research with Indigenous peoples on Indigenous lands.
Findings
Through this process of dialogue and reflection, emergent principles and practices for “good” research ethics were collectively identified. Open dialogue between institutional ethics boards and Indigenous research review committees acknowledged past and current research practices from Indigenous peoples’ perspectives; supported and encouraged community-led research; articulated and exemplified Indigenous ownership and control of data; promoted and practiced ethical and responsible research with Indigenous peoples; and supported and emphasized rights based approaches within the current research regulatory system. Key principles emerged for shifting paradigms to honour Indigenous rights holders through ethical research practice, including: recognizing Indigenous peoples as rights holders with sovereignty over research; accepting collective responsibility for research in a “good” way; enlarging the sphere of ethical consideration to include the land; acknowledging that “The stories are ours” through Indigenous-led (or co-led) research; articulating relationships between Indigenous and Research Ethics Board (REB) approvals; addressing justice and proportionate review of Indigenous research; and, means of identifying the Indigenous governing authority for approving research.
Research limitations/implications
Future steps (including further research) include pursuing collective responsibilities towards empowering Indigenous communities to build their own consensus around research with/in their people and their lands. This entails pursuing further understanding of how to move forward in recognition and respect for Indigenous peoples as rights holders, and disrupting mainstream dialogue around Indigenous peoples as “stakeholders” in research.
Practical implications
The first step in moving forward in a way that embraces Indigenous principles is to deeply embed the respect of Indigenous peoples as rights holders across and within REBs. This shift in perspective changes our collective responsibilities in equitable ways, reflecting and respecting differing impetus and resources between the two parties: “equity” does imply “equality”. Several examples of practical changes to REB procedures and considerations are detailed.
Social implications
What the authors have discovered is that it is not just about academic or institutional REB decolonization: there are broad systematic issues at play. However, pursuing the collective responsibilities outlined in our paper should work towards empowering communities to build their own consensus around research with/in their people and their lands. Indigenous peoples are rights holders, and have governance over research, including the autonomy to make decisions about themselves, their future, and their past.
Originality/value
The value is in its guidance around how authentic partnerships can develop that promote equity with regard to community and researcher and community/researcher voice and power throughout the research lifecycle, including through research ethics reviews that respect Indigenous rights, world views and ways of knowing. It helps to show how both Indigenous and non-Indigenous institutions can collectively honour Indigenous rights holders through ethical research practice.
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McGinnis A, Tesarek Kincaid A, Barrett MJ, Ham C. Strengthening Animal-Human Relationships as a Doorway to Indigenous Holistic Wellness. ECOPSYCHOLOGY 2019; 11:162-173. [PMID: 31598191 PMCID: PMC6777485 DOI: 10.1089/eco.2019.0003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 03/12/2019] [Indexed: 11/12/2022]
Abstract
One of the most devastating effects of colonization has been fragmented relations among humans and their more-than-human counterparts. Traditionally, Indigenous peoples positioned animals as equitable partners in interconnected human and more-than human networks, animated with spirit and the ability to act and communicate. Many Indigenous peoples continue to regard animals as sacred and utilize the gifts that they bestow in traditional healing settings. Indigenous understandings of interwoven and reciprocal social networks of human and more-than-human relations must be restored and supported in contemporary health settings in order to "do no further harm" and facilitate Indigenous peoples' healing journeys. Reconciliation across Western and Indigenous contexts requires learning to work together with the more-than-human world and developing ethical spaces for health research in which holistic wellness is appreciated and understood in the context of all our relations. In order to help (re)connect and strengthen human relations with the more-than-human world, a culturally adapted and locally refined animal-human relationship workshop was delivered in a rural Saskatchewan First Nation community where traditional Elders, adults, and youth participants shared stories about the role of animals for their healing and holistic wellness trajectories. The results revealed that animal-human relationships are physical and spiritual in nature, with both domestic and wild animals playing various important person roles in the lives of community members; these person roles are not metaphorical but rather assume all the sentience and agency that the term person implies. The findings have clear practical and policy implications for health services, education, environmental sustainability, and bioresource management.
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Affiliation(s)
| | | | - M J Barrett
- University of Saskatchewan, Saskatoon, Canada
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Hopkins D, Joly TL, Sykes H, Waniandy A, Grant J, Gallagher L, Hansen L, Wall K, Fortna P, Bailey M. “Learning Together”: Braiding Indigenous and Western Knowledge Systems to Understand Freshwater Mussel Health in the Lower Athabasca Region of Alberta, Canada. J ETHNOBIOL 2019. [DOI: 10.2993/0278-0771-39.2.315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Debra Hopkins
- Alberta Environment and Parks, Alberta Government, 10th Floor, Oxbridge Place, 9820-106 Street, Edmonton, Alberta, T5K 2J6
| | - Tara L. Joly
- Willow Springs Strategic Solutions, Inc., Cochrane, Alberta
| | - Harvey Sykes
- Fort McMurray Métis Local 1935, Fort McMurray, Alberta
| | | | - John Grant
- Fort McMurray Métis Local 1935, Fort McMurray, Alberta
| | | | | | - Kaitlyn Wall
- Alberta Environment and Parks, Alberta Government, 10th Floor, Oxbridge Place, 9820-106 Street, Edmonton, Alberta, T5K 2J6
| | - Peter Fortna
- Willow Springs Strategic Solutions, Inc., Cochrane, Alberta
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Abstract
Indigenous leaders remain concerned that systemic oppression and culturally unsafe care impede Indigenous peoples living with HIV from accessing health services that make up the HIV cascade of care. We conducted a systematic review to assess the evidence related to experiences of the HIV care cascade among Indigenous peoples in Australia, Canada, New Zealand, and United States. We identified 93 qualitative and quantitative articles published between 1996 and 2017 reporting primary data on cascade outcomes disaggregated by Indigenous identity. Twelve involved data from Australia, 52 from Canada, 3 from New Zealand and 26 from United States. The majority dealt with HIV testing/diagnosis (50). Relatively few addressed post-diagnosis experiences: linkage (14); retention (20); treatment initiation (21); adherence (23); and viral suppression (24). With the HIV cascade of care increasingly the focus of global, national, and local HIV agendas, it is critical that culturally-safe care for Indigenous peoples is available at all stages.
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Handlovsky I, Bungay V, Oliffe J, Johnson J. Developing Resilience: Gay Men's Response to Systemic Discrimination. Am J Mens Health 2018; 12:1473-1485. [PMID: 29683025 PMCID: PMC6142121 DOI: 10.1177/1557988318768607] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 11/16/2022] Open
Abstract
Gay men experience marked health disparities compared to heterosexual men, associated with profound discrimination. Resilience as a concept has received growing attention to increase understanding about how gay men promote and protect their health in the presence of adversity. Missing in this literature are the perspectives and experiences of gay men over 40 years. This investigation, drawing on grounded theory methods, examined how gay men over 40 years of age develop resilience over the course of their lives to promote and protect their health. In-depth interviews were undertaken with 25 men ranging between 40 and 76 years of age who experienced an array of health concerns including depression, anxiety, suicidality, and HIV. Men actively resist discrimination via three interrelated protective processes that dynamically influence the development of resilience over their life course: (a) building and sustaining networks, (b) addressing mental health, and (c) advocating for respectful care encounters. Initiatives to promote and protect the health of gay men must be rooted in the recognition of the systemic role of discrimination, while supporting men's resilience in actively resisting discrimination.
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Affiliation(s)
| | | | - John Oliffe
- UBC School of Nursing, Vancouver, BC, Canada
| | - Joy Johnson
- Vice President Research, Simon Fraser Faculty of Health Sciences, Burnaby, BC, Canada
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Hojjati A, Beavis ASW, Kassam A, Choudhury D, Fraser M, Masching R, Nixon SA. Educational content related to postcolonialism and indigenous health inequities recommended for all rehabilitation students in Canada: a qualitative study. Disabil Rehabil 2017; 40:3206-3216. [PMID: 28969457 DOI: 10.1080/09638288.2017.1381185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Postcolonial analysis can help rehabilitation providers understand how colonization and racialization create and sustain health inequities faced by indigenous peoples. However, there is little guidance in the literature regarding inclusion of postcolonialism within rehabilitation educational curricula. Therefore, this study explored perspectives regarding educational content related to postcolonialism and indigenous health that rehabilitation students in Canada should learn to increase health equity. METHODS This qualitative study involved in-depth, semi-structured interviews with 19 individuals with insight into postcolonialism and health in Canada. Data were analyzed collaboratively to identify, code, and translate themes according to a structured six-phase method. RESULTS Four themes emerged regarding educational content for rehabilitation students: (1) the historic trauma of colonization and its ongoing impacts on rehabilitation for indigenous peoples; (2) disproportionate health burden and inequitable access to health services; (3) how rehabilitation is related to Indigenous ways of knowing; and (4) why rehabilitation is well-positioned to address health inequities with Indigenous Peoples. CONCLUSION Results call for reflection on assumptions underpinning the rehabilitation professions that may unintentionally reinforce health inequities. A postcolonial lens can help rehabilitation educators promote culturally safe services for people whose ill health and disability are linked to the effects of colonization. Implications for Rehabilitation Given the powerful, ongoing effects of colonization and racialization on health and disability, recommendation #24 from the Truth and Reconciliation Commission of Canada calls for the education of health professionals related to Indigenous history, rights, and anti-racism. However, there is little curricula on these areas in the education of rehabilitation professional students or in continuing education programs for practicing clinicians. This is the first study to investigate expert perspectives on content related to postcolonialism and indigenous-settler inequities that should be included in the education of rehabilitation students in Canada. According to the participants in this study, rehabilitation educators in Canada should consider incorporating the following four themes into curricula to better address Indigenous-settler inequities in the context of rehabilitation: (1) the historic trauma of colonization and its ongoing impacts on rehabilitation for Indigenous Peoples in Canada; (2) disproportionate health burden and inequitable access to health services; (3) how rehabilitation is related to Indigenous ways of knowing; and (4) why rehabilitation is well-positioned to rise to the challenge of addressing health inequities with Indigenous Peoples in Canada. Postcolonialism is useful for rehabilitation providers because it is an approach that redirects the focus of problems from Indigenous People to the systems of oppression (specifically colonization and racialization) that cause ill health and disability.
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Affiliation(s)
- Ala Hojjati
- a Department of Physical Therapy , University of Toronto , Toronto , ON , Canada.,b Global Health Division , Canadian Physiotherapy Association , Ottawa , ON , Canada
| | - Allana S W Beavis
- a Department of Physical Therapy , University of Toronto , Toronto , ON , Canada.,b Global Health Division , Canadian Physiotherapy Association , Ottawa , ON , Canada
| | - Aly Kassam
- a Department of Physical Therapy , University of Toronto , Toronto , ON , Canada
| | - Daniel Choudhury
- a Department of Physical Therapy , University of Toronto , Toronto , ON , Canada
| | - Michelle Fraser
- a Department of Physical Therapy , University of Toronto , Toronto , ON , Canada
| | - Renée Masching
- c Canadian Aboriginal AIDS Network , Dartmouth , NS , Canada
| | - Stephanie A Nixon
- a Department of Physical Therapy , University of Toronto , Toronto , ON , Canada.,d International Centre for Disability and Rehabilitation , University of Toronto , Toronto , ON , Canada
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Lister C, Payne H, Hanson CL, Barnes MD, Davis SF, Manwaring T. The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths. Front Public Health 2017; 5:192. [PMID: 28824899 PMCID: PMC5545580 DOI: 10.3389/fpubh.2017.00192] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/18/2017] [Indexed: 11/13/2022] Open
Abstract
Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.
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Affiliation(s)
- Cameron Lister
- Department of Health Science, Brigham Young University, Provo, UT, United States
| | - Hannah Payne
- Department of Health Science, Brigham Young University, Provo, UT, United States
| | - Carl L Hanson
- Department of Health Science, Brigham Young University, Provo, UT, United States
| | - Michael D Barnes
- Department of Health Science, Brigham Young University, Provo, UT, United States
| | - Siena F Davis
- Department of Health Science, Brigham Young University, Provo, UT, United States
| | - Todd Manwaring
- Ballard Center for Economic Self-Reliance, Brigham Young University, Provo, UT, United States
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Davies MA, Balai E, Adams J, Carter JH, Judge A, Newton JL, Arden NK. The consultation of rugby players in co-developing a player health study: feasibility and consequences of sports participants as research partners. RESEARCH INVOLVEMENT AND ENGAGEMENT 2017; 3:8. [PMID: 29062533 PMCID: PMC5611584 DOI: 10.1186/s40900-017-0055-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/27/2017] [Indexed: 06/07/2023]
Abstract
PLAIN ENGLISH SUMMARY Many funding bodies within the United Kingdom and globally have encouraged public involvement in research. The Department of Health has also called public involvement a sign of good research. Despite the wide acceptance of public involvement improving many aspects of research, from its design to its communication, involvement has varied levels of implementation across different fields of research. Sports people have rarely been involved in research, partly as this research tends not to be funded by mainstream funding bodies. This may lead to a lower research quality, not founded in player ('service user') experiences. When creating a study of former rugby player health, we were very keen to involve rugby players, understand their thoughts on player health, and their playing experiences. This article explains how rugby players were involved in several ways, but mainly in group discussions during the design stage. These groups helped to inform our study's aims and questionnaire, ensure the questionnaire would capture player experiences and answer questions relevant to players, that they would like to understand after their participation in rugby. We found that these groups were easy to arrange, and that in only one session with each group, we were given many ideas of how to improve the questionnaire and study. We believe that other studies in sports should involve sports people, and that this is a useful activity that will change data collection forms and processes, improving the research, helping researchers, and making studies more suitable for players who take part in them. ABSTRACT Background Patient and public involvement ('involvement') in the UK has increased in accordance with funding requirements, patient-centered health policy initiatives and reporting of the positive impact of involvement for those involved, research and researchers. However, involvement has not been implemented equally across all disease areas and populations. The aim of this process was to involve rugby players across the research cycle of a player health study, ensure the study is player-centred, and that players had approved and informed the design of the study and its questionnaire from their playing experiences. Methods Two group discussions were undertaken with current students who were playing rugby at a Collegiate University. All male and female University rugby players and two College rugby teams were approached to become involved. Sessions were chaired by a player-lead using a topic guide and were audio-recorded and transcribed. Player suggestions were extracted by the player-lead and discussed within the study team for inclusion in the player health study and its questionnaire. Results Players readily engaged with the sessions and made many contributions to the development of the study and the questionnaire. Players discussed whether certain topics were being collected satisfactorily, and whether the questionnaire would encompass their playing experiences or that of other players. Players suggested where answers might be less reliable, and ways in which this could be improved. Players recommended additions to the questionnaire, and questioned researchers on the choice of language, motivation for question inclusion and if measures were standardised or novel. Alterations were made to the questionnaire based on suggestions, where these were agreed by the study team. Conclusions Involving a group of players in the design of a player health study and questionnaire was not an arduous process and was rewarding for researchers. The process resulted in numerous alterations to the questionnaire and its functionality, which may improve response rate, the experience of players participating in the player health study, and their ability to report relevant information aligned with their previous experience. Player involvement in research was feasible to implement and improved not only the questionnaire, but also researcher confidence in the project and player experiences being accurately captured and leading a reliable data collection processes in a population with the potential for cultural bias to affect the ascertainment of health, pain and injury.
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Affiliation(s)
- Madeleine A.M. Davies
- Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, UK
| | - Edward Balai
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Jo Adams
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | - Andrew Judge
- Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Julia L. Newton
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, UK
| | - Nigel K. Arden
- Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
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Rachlis B, Burchell AN, Gardner S, Light L, Raboud J, Antoniou T, Bacon J, Benoit A, Cooper C, Kendall C, Loutfy M, Wobeser W, McGee F, Rachlis A, Rourke SB. Social determinants of health and retention in HIV care in a clinical cohort in Ontario, Canada. AIDS Care 2016; 29:828-837. [PMID: 28027668 DOI: 10.1080/09540121.2016.1271389] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Continuous HIV care supports antiretroviral therapy initiation and adherence, and prolongs survival. We investigated the association of social determinants of health (SDH) and subsequent retention in HIV care in a clinical cohort in Ontario, Canada. The Ontario HIV Treatment Network Cohort Study is a multi-site cohort of patients at 10 HIV clinics. Data were collected from medical charts, interviews, and via record linkage with the provincial public health laboratory for viral load tests. For participants interviewed in 2009, we used three-category multinomial logistic regression to identify predictors of retention in 2010-2012, defined as (1) continuous care (≥2 viral loads ≥90 days in all years; reference category); (2) discontinuous care (only 1 viral load/year in ≥1 year); and (3) a gap in care (≥1 year in 2010-2012 with no viral load). In total, 1838 participants were included. In 2010-2012, 71.7% had continuous care, 20.9% had discontinuous care, and 7.5% had a gap in care. Discontinuous care in 2009 was predictive (p < .0001) of future retention. SDH associated with discontinuous care were Indigenous ethnicity, being born in Canada, being employed, reporting hazardous drinking, and non-injection drug use. Being a heterosexual male was associated with having a gap in care, and being single and younger were associated with discontinuous care and a gap in care. Various SDH were associated with retention. Care discontinuity was highly predictive of future gaps. Targeted strategic interventions that better engage those at risk of suboptimal retention merit exploration. ABBREVIATIONS AOR: adjusted odds ratio; ART: antiretroviral therapy; AUDIT: Alcohol Use Disorders Identification Test; CES-D: Center for Epidemiologic Studies Depression Scale; CIs: confidence intervals; HIV: human immunodeficiency virus; IQR: interquartile range; MSM: men who have sex with men; NA-ACCORD: North American AIDS Cohort Collaboration on Research and Design; OCS: Ontario HIV Treatment Network Cohort Study; OHTN: Ontario HIV Treatment Network; OR: odds ratio; PHOL: Public Health Ontario Laboratories; REB: Research Ethics Board; SDH: social determinants of health; US: United States.
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Affiliation(s)
- Beth Rachlis
- a Ontario HIV Treatment Network , Toronto , Canada.,b Division of Clinical Public Health, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | - Ann N Burchell
- c Division of Epidemiology , Dalla Lana School of Public Health, University of Toronto , Toronto , Canada.,d Department of Family and Community Medicine , St. Michael's Hospital, Toronto , Canada.,e Department of Family and Community Medicine , University of Toronto , Toronto , Canada.,f Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto , Canada
| | - Sandra Gardner
- g Division of Biostatistics, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.,h Rotman Research Institute , Baycrest, Toronto , Canada
| | - Lucia Light
- a Ontario HIV Treatment Network , Toronto , Canada
| | - Janet Raboud
- g Division of Biostatistics, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.,i Toronto General Research Institute, University Health Network , Toronto , Canada
| | - Tony Antoniou
- d Department of Family and Community Medicine , St. Michael's Hospital, Toronto , Canada.,e Department of Family and Community Medicine , University of Toronto , Toronto , Canada.,f Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto , Canada
| | - Jean Bacon
- a Ontario HIV Treatment Network , Toronto , Canada
| | - Anita Benoit
- j Women's College Research Institute, Women's College Hospital , Toronto , Canada
| | - Curtis Cooper
- k Ottawa Hospital Research Institute , Ottawa , Canada
| | - Claire Kendall
- l Bruyère Research Institute , Ottawa , Canada.,m Department of Family Medicine , University of Ottawa , Ottawa , Canada
| | - Mona Loutfy
- n Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health , Toronto , Canada.,o Department of Medicine , Women's College Research Institute, Women's College Hospital , Toronto , Canada.,p Department of Medicine , University of Toronto , Toronto , Canada
| | - Wendy Wobeser
- q Department of Medicine , Queen's University , Kingston , Canada.,r Hotel Dieu Hospital , Kingston , Canada
| | - Frank McGee
- s AIDS Bureau, Ontario Ministry of Health and Long Term Care , Toronto , Canada
| | - Anita Rachlis
- p Department of Medicine , University of Toronto , Toronto , Canada.,t Sunnybrook Health Science Centre , Toronto , Canada
| | - Sean B Rourke
- a Ontario HIV Treatment Network , Toronto , Canada.,f Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto , Canada.,u Department of Psychiatry , University of Toronto , Toronto , Canada
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- a Ontario HIV Treatment Network , Toronto , Canada
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Rand JR. Inuit women's stories of strength: informing Inuit community-based HIV and STI prevention and sexual health promotion programming. Int J Circumpolar Health 2016; 75:32135. [PMID: 27938640 PMCID: PMC5149655 DOI: 10.3402/ijch.v75.32135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/05/2016] [Accepted: 09/27/2016] [Indexed: 11/23/2022] Open
Abstract
Background There is a dearth of literature to guide the development of community-based HIV and sexually transmitted infection (STI) prevention and sexual health promotion programs within Inuit communities. Objective The aim of this study was to create a dialogue with Inuit women to address the lack of information available to inform programming to improve the sexual health of Inuit women, their families, and their communities in the Canadian Arctic. Design This study used Indigenous methodologies and methods by drawing from Inuit Qaujimajatuqangit and postcolonial research theory in a framework of Two-Eyed Seeing, and using storytelling sessions to gather data. Community-based participatory research principles informed the design of the study, ensuring participants were involved in all stages of the project. Nine storytelling sessions took place with 21 Inuit women aged 18–61 years. Storytelling sessions were audio recorded and transcribed verbatim, and Atlas.ti aided in the organization of the data for collaborative thematic analysis within three participatory analysis sessions with 13 of the participating women. Results From the storytelling and analysis sessions, five major themes emerged: (a) the way it used to be, (b) change, (c) family, (d) intimate relationships and (e) holistic strategies. Participating women emphasized that HIV and STI prevention and sexual health promotion programming needs to take a holistic, community-wide, family-focused and youth-centred approach within their communities. Conclusion Participants identified several important determinants of sexual health and shared ideas for innovative approaches they believe will work as prevention efforts within their communities. This article specifically focuses on key characteristics of programming aimed at STI and HIV prevention and sexual health promotion that were identified throughout participants’ stories. This study has provided a narrative to complement the epidemiological data that highlight the urgent need for prevention programming.
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Affiliation(s)
- Jenny R Rand
- Interdisciplinary PhD Program, Faculty of Graduate Studies, Dalhousie University, Halifax, NS, Canada;
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Closson K, McNeil R, McDougall P, Fernando S, Collins AB, Baltzer Turje R, Howard T, Parashar S. Meaningful engagement of people living with HIV who use drugs: methodology for the design of a Peer Research Associate (PRA) hiring model. Harm Reduct J 2016; 13:26. [PMID: 27717364 PMCID: PMC5054577 DOI: 10.1186/s12954-016-0116-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/24/2016] [Indexed: 11/25/2022] Open
Abstract
Background Community-based HIV, harm reduction, and addiction research increasingly involve members of affected communities as Peer Research Associates (PRAs)—individuals with common experiences to the participant population (e.g. people who use drugs, people living with HIV [PLHIV]). However, there is a paucity of literature detailing the operationalization of PRA hiring and thus limited understanding regarding how affected communities can be meaningfully involved through low-barrier engagement in paid positions within community-based participatory research (CBPR) projects. We aim to address this gap by describing a low-threshold PRA hiring process. Results In 2012, the BC Centre for Excellence in HIV/AIDS and the Dr. Peter AIDS Foundation collaborated to develop a mixed-method CBPR project evaluating the effectiveness of the Dr. Peter Centre (DPC)—an integrative HIV care facility in Vancouver, Canada. A primary objective of the study was to assess the impact of DPC services among clients who have a history of illicit drug use. In keeping with CBPR principles, affected populations, community-based organizations, and key stakeholders guided the development and dissemination of a low-barrier PRA hiring process to meaningfully engage affected communities (e.g. PLHIV who have a history of illicit drug use) in all aspects of the research project. The hiring model was implemented in a number of stages, including (1) the establishment of a hiring team; (2) the development and dissemination of the job posting; (3) interviewing applicants; and (4) the selection of participants. The hiring model presented in this paper demonstrates the benefits of hiring vulnerable PLHIV who use drugs as PRAs in community-based research. Conclusions The provision of low-barrier access to meaningful research employment described herein attempts to engage affected communities beyond tokenistic involvement in research. Our hiring model was successful at engaging five PRAs over a 2-year period and fostered opportunities for future paid employment or volunteer opportunities through ongoing collaboration between PRAs and a diverse range of stakeholders working in HIV/AIDS and addictions. Additionally, this model has the potential to be used across a range of studies and community-based settings interested in meaningfully engaging communities in all stages of the research process. Electronic supplementary material The online version of this article (doi:10.1186/s12954-016-0116-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,BC Centre for Excellence in HID/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - R McNeil
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - P McDougall
- Dr. Peter AIDS Foundation, Vancouver, Canada
| | - S Fernando
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - A B Collins
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,BC Centre for Excellence in HID/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | | | - T Howard
- Positive living society and the British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - S Parashar
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada. .,BC Centre for Excellence in HID/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
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Understanding Addictions among Indigenous People through Social Determinants of Health Frameworks and Strength-Based Approaches: a Review of the Research Literature from 2013 to 2016. CURRENT ADDICTION REPORTS 2016. [DOI: 10.1007/s40429-016-0116-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Whitewater S, Reinschmidt KM, Kahn C, Attakai A, Teufel-Shone NI. Flexible Roles for American Indian Elders in Community-Based Participatory Research. Prev Chronic Dis 2016; 13:E72. [PMID: 27253635 PMCID: PMC4894723 DOI: 10.5888/pcd13.150575] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Community-based participatory research builds partnerships between communities and academic researchers to engage in research design, decision making, data collection, and dissemination of health promotion initiatives. Community-based participatory projects often have formal agreements or defined roles for community and academic partners. Our project (November 2012-November 2014) was designed to document life narratives of urban American Indian elders as a foundation for developing a resilience-based health promotion curriculum for urban American Indian adolescents aged 12 to 18. We used a flexible method for engaging community partners that honored the individual strengths of elders, encouraged them to describe how they wanted to contribute to the project, and provided multiple ways for elders to engage with university partners. We invited elders to participate in one or more of the following roles: as members of consensus panels to develop interview questions, as members of a community advisory board, or as participants in individual qualitative interviews. The flexibility of roles gave elders the opportunity to serve as advisors, co-developers, interviewees, or reviewers during 2 years of curriculum development. Engaging American Indian elders in the research process acknowledged the multiple layers of expertise they had as traditional leaders in the community while promoting trust in and ownership of the project. This flexible technique can be used by other communities that may not be comfortable with structured processes of engagement.
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Affiliation(s)
- Shannon Whitewater
- Mel and Enid Zuckerman College of Public Health, University of Arizona, PO Box 245209, Tucson, AZ 85724.
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