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Cordes A, Bak M, Lyndon M, Hudson M, Fiske A, Celi LA, McLennan S. Competing interests: digital health and indigenous data sovereignty. NPJ Digit Med 2024; 7:178. [PMID: 38965365 PMCID: PMC11224364 DOI: 10.1038/s41746-024-01171-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/14/2024] [Indexed: 07/06/2024] Open
Abstract
Digital health is increasingly promoting open health data. Although this open approach promises a number of benefits, it also leads to tensions with Indigenous data sovereignty movements led by Indigenous peoples around the world who are asserting control over the use of health data as a part of self-determination. Digital health has a role in improving access to services and delivering improved health outcomes for Indigenous communities. However, we argue that in order to be effective and ethical, it is essential that the field engages more with Indigenous peoples´ rights and interests. We discuss challenges and possible improvements for data acquisition, management, analysis, and integration as they pertain to the health of Indigenous communities around the world.
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Affiliation(s)
- Ashley Cordes
- Environmental Studies Program and Department of Data Science, University of Oregon, Eugene, OR, USA
| | - Marieke Bak
- Institute of History and Ethics in Medicine, Department of Preclinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Ethics, Law and Humanities, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mataroria Lyndon
- Centre for Medical and Health Sciences Education, School of Medicine, The University of Auckland, Auckland, New Zealand
| | - Maui Hudson
- Te Kotahi Research Institute, University of Waikato, Hamilton, New Zealand
| | - Amelia Fiske
- Institute of History and Ethics in Medicine, Department of Preclinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Leo Anthony Celi
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stuart McLennan
- Institute of History and Ethics in Medicine, Department of Preclinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
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Mishra S, Walker JD, Wilhelm L, Larivière V, Bubela T, Straus SE. Use and misuse of research: Canada's response to covid-19 and its health inequalities. BMJ 2023; 382:e075666. [PMID: 37487605 DOI: 10.1136/bmj-2023-075666] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Affiliation(s)
- Sharmistha Mishra
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital-Unity Health Toronto, Toronto, Ontario, Canada
| | - Jennifer D Walker
- ICES, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Linda Wilhelm
- Canadian Arthritis Patient Alliance, Bloomfield, Kings County, New Brunswick, Canada (patient author)
| | | | - Tania Bubela
- Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sharon E Straus
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital-Unity Health Toronto, Toronto, Ontario, Canada
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Mendlowitz AB, Bremner KE, Feld JJ, Jones L, Hill E, Antone E, Liberty L, Boucher R, Krahn MD. Lessons from First Nations partnerships in hepatitis C research and the co-creation of knowledge. CANADIAN LIVER JOURNAL 2023; 6:46-55. [PMID: 36908573 PMCID: PMC9997512 DOI: 10.3138/canlivj-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/03/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND: Administrative health data provide a rich and powerful tool for health services research. Partnership between researchers and the Ontario First Nations HIV/AIDS Education Circle (OFNHAEC) allowed for comprehensive analyses of the health and economic impacts of hepatitis C virus (HCV) infection in First Nations populations across Ontario, using administrative data. Examples of meaningful involvement of First Nations partners in research using secondary data sources demonstrate how community-based participatory research principles can be adapted to empower First Nations stakeholders and decision-makers. The aim of this review is to summarize and reflect on lessons learned in producing meaningful and actionable First Nations HCV research using health administrative data, from the perspective of health services researchers who collaborated for the first time with First Nations partners. METHODS: We discuss how our relationship with OFNHAEC formed and how engagement contextualized findings and provided opportunities for fostering trust and mutual capacity building. Methods included adherence to data governance principles, agreements outlining ethical conduct, and establishing commitment between partners. RESULTS: Engagement with OFNHAEC enhanced cultural understandings in study conception, design, and analysis, and enabled meaningful lessons for both parties through contextualizing findings together. Partnership ensured attention to factors, such as strength-based approaches and limitations of administrative data in their representation of First Nations peoples, that are not considered in standard HCV health services research using administrative health data. CONCLUSIONS: Collaboration throughout the HCV research provided first-hand experience of the relevance, representation, and importance of incorporating First Nations perspectives in health services research using administrative data.
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Affiliation(s)
- Andrew B Mendlowitz
- Toronto Centre for Liver Disease/Viral Hepatitis Care Network (VIRCAN), Toronto General Hospital, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
| | - Karen E Bremner
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
| | - Jordan J Feld
- Toronto Centre for Liver Disease/Viral Hepatitis Care Network (VIRCAN), Toronto General Hospital, Toronto, Ontario, Canada
| | - Lyndia Jones
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Evelynne Hill
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Elly Antone
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Laura Liberty
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Rene Boucher
- Ontario First Nations HIV/AIDS Education Circle (OFNHAEC), London, Ontario, Canada
| | - Murray D Krahn
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada.,Deceased 01 07 22
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Milne BJ. Longitudinal research in Aotearoa New Zealand using the Integrated Data Infrastructure: a review. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2072905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Barry J. Milne
- Centre of Methods and Policy Application in the Social Sciences, and School of Social Sciences, University of Auckland, Auckland, New Zealand
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Grath-Lone LM, Jay MA, Blackburn R, Gordon E, Zylbersztejn A, Wijlaars L, Gilbert R. What makes administrative data "research-ready"? A systematic review and thematic analysis of published literature. Int J Popul Data Sci 2022; 7:1718. [PMID: 35520099 PMCID: PMC9052961 DOI: 10.23889/ijpds.v6i1.1718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction Administrative data are a valuable research resource, but are under-utilised in the UK due to governance, technical and other barriers (e.g., the time and effort taken to gain secure data access). In recent years, there has been considerable government investment in making administrative data "research-ready", but there is no definition of what this term means. A common understanding of what constitutes research-ready administrative data is needed to establish clear principles and frameworks for their development and the realisation of their full research potential. Objective To define the characteristics of research-ready administrative data based on a systematic review and synthesis of existing literature. Methods On 29th June 2021, we systematically searched seven electronic databases for (1) peer-reviewed literature (2) related to research-ready administrative data (3) written in the English language. Following supplementary searches and snowball screening, we conducted a thematic analysis of the identified relevant literature. Results Overall, we screened 2,375 records and identified 38 relevant studies published between 2012 and 2021. Most related to administrative data from the UK and US and particularly to health data. The term research-ready was used inconsistently in the literature and there was some conflation with the concept of data being ready for statistical analysis. From the thematic analysis, we identified five defining characteristics of research-ready administrative data: (a) accessible, (b) broad, (c) curated, (d) documented and (e) enhanced for research purposes. Conclusions Our proposed characteristics of research-ready administrative data could act as a starting point to help data owners and researchers develop common principles and standards. In the more immediate term, the proposed characteristics are a useful framework for cataloguing existing research-ready administrative databases and relevant resources that can support their development.
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Affiliation(s)
| | - Matthew A. Jay
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, UK
| | - Ruth Blackburn
- Institute of Health Informatics, University College London, UK
| | - Emma Gordon
- Administrative Data Research UK, Economic & Social Research Council, UK
| | - Ania Zylbersztejn
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, UK
| | - Linda Wijlaars
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, UK
| | - Ruth Gilbert
- Institute of Health Informatics, University College London, UK
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, UK
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de Oliveira C, Gatov E, Rosella L, Chen S, Strauss R, Azimaee M, Paterno E, Guttmann A. Describing the linkage between administrative social assistance and health care databases in Ontario, Canada. Int J Popul Data Sci 2022; 7:1689. [PMID: 35310557 PMCID: PMC8900651 DOI: 10.23889/ijpds.v6i1.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background The linkage of records across administrative databases has become a powerful tool to increase information available to undertake research and analytics in a privacy protective manner. Objective The objective of this paper was to describe the data integration strategy used to link the Ontario Ministry of Children, Community and Social Services (MCCSS)-Social Assistance (SA) database with administrative health care data. Methods Deterministic and probabilistic linkage methods were used to link the MCCSS-SA database (2003-2016) to the Registered Persons Database, a population registry containing data on all individuals issued a health card number in Ontario, Canada. Linkage rates were estimated, and the degree of record linkage and representativeness of the dataset were evaluated by comparing socio-demographic characteristics of linked and unlinked records. Results There were a total of 2,736,353 unique member IDs in the MCCSS-SA database from the 1st January 2003 to 31st December 2016; 331,238 (12.1%) were unlinked (linkage rate = 87.9%). Despite 16 passes, most record linkages were obtained after 2 deterministic (76.2%) and 14 probabilistic passes (11.7%). Linked and unlinked samples were similar for most socio-demographic characteristics (i.e., sex, age, rural dwelling), except migrant status (non-migrant versus migrant) (standardized difference of 0.52). Linked and unlinked records were also different for SA program-specific characteristics, such as social assistance program, Ontario Works and Ontario Disability Support Program (standardized difference of 0.20 for each), data entry system, Service Delivery Model Technology only and both Service Delivery Model Technology and Social Assistance Management System (standardized difference of 0.53 and 0.52, respectively), and months on social assistance (standardized difference of 0.43). Conclusions Additional techniques to account for sub-optimal linkage rates may be required to address potential biases resulting from this data linkage. Nonetheless, the linkage between administrative social assistance and health care data will provide important findings on the social determinants of health.
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Affiliation(s)
- Claire de Oliveira
- ICES, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Centre for Health Economics and Hull York Medical School, University of York, York, United Kingdom,Corresponding author: Claire de Oliveira
| | | | - Laura Rosella
- ICES, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Ontario, Canada,Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada,Public Health Ontario, Toronto, Ontario, Canada
| | | | | | | | - Elizabeth Paterno
- Business Intelligence and Practice Division, Ministry of Children, Community and Social Services, Toronto, Ontario, Canada
| | - Astrid Guttmann
- ICES, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada,Division of Paediatric Medicine and Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada,Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
| | - Ministry of Children, Community and Social Services-ICES Working Group (Nelson Chong, Peter Lonescu, Sean Ji, Alexander Kopp, Annie Lan, Charlotte Ma, Miranda Pring, Priyanka Raj, Steven Ryan, Refik Saskin, Fiona Wong)
- ICES, Toronto, Ontario, Canada,Business Intelligence and Practice Division, Ministry of Children, Community and Social Services, Toronto, Ontario, Canada
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Mendlowitz A, Bremner KE, Walker JD, Wong WWL, Feld JJ, Sander B, Jones L, Isaranuwatchai W, Krahn M. Hepatitis C virus infection in First Nations populations in Ontario from 2006 to 2014: a population-based retrospective cohort analysis. CMAJ Open 2021; 9:E886-E896. [PMID: 34584007 PMCID: PMC8486470 DOI: 10.9778/cmajo.20200164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection causes substantial morbidity and mortality in Canada and is of concern among First Nations communities. In partnership with the Ontario First Nations HIV/AIDS Education Circle, we described trends in HCV testing and epidemiologic features among Status First Nations people in Ontario. METHODS In this retrospective study, we used health administrative databases for 2006-2014 in Ontario with 3 cohorts of Status First Nations people: those tested for HCV for the first time, those who tested positive for HCV antibodies or RNA, and those with no HCV laboratory or testing records. We examined cohort characteristics, and the annual prevalence and incidence of testing and diagnosis of HCV infection. Outcomes were stratified by region, sex and residence within or outside of First Nations communities. RESULTS During the study period, 2423 Status First Nations people were diagnosed with HCV infection, 20 481 received their first test, and 135 185 had no test record. The point prevalence of ever having been tested increased from 6.3 (95% confidence interval [CI] 6.2-6.5) per 100 people in 2006 to 16.2 (95% CI 16.0-16.4) per 100 people in 2014. The point prevalence of diagnosed HCV infection increased from 0.9 (95% CI 0.9-1.0) to 2.0 (95% CI 1.9-2.0) per 100 people. The incidence of first test and of diagnosis increased from 12.1 (95% CI 11.5-12.6) to 21.3 (95% CI 20.5-22.1) per 1000 person-years and from 1.3 (95% CI 1.1-1.5) to 2.3 (95% CI 2.1-2.6) per 1000 person-years, respectively. Testing, diagnosis and prevalence of HCV infection were consistently higher among people living outside of versus within First Nations communities, but larger increases over time were observed among those living within First Nations communities. INTERPRETATION Testing and diagnosis of HCV infection increased from 2006 to 2014 among Status First Nations people in Ontario. Our findings indicate the need for population-level efforts to eliminate hepatitis C in First Nations communities.
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Affiliation(s)
- Andrew Mendlowitz
- Institute of Health Policy, Management and Evaluation (Mendlowitz, Sander, Isaranuwatchai, Krahn), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Mendlowitz, Bremner, Sander, Krahn), University Health Network; ICES Central (Mendlowitz, Walker, Sander, Krahn), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; School of Pharmacy (Wong), University of Waterloo, Waterloo, Ont.; Toronto Centre for Liver Disease (Feld), Toronto General Hospital; Public Health Ontario (Sander), Toronto, Ont.; Ontario First Nations HIV/AIDS Education Circle (Jones), London, Ont.; St. Michael's Hospital (Isaranuwatchai), Unity Health Toronto, Toronto, Ont.
| | - Karen E Bremner
- Institute of Health Policy, Management and Evaluation (Mendlowitz, Sander, Isaranuwatchai, Krahn), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Mendlowitz, Bremner, Sander, Krahn), University Health Network; ICES Central (Mendlowitz, Walker, Sander, Krahn), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; School of Pharmacy (Wong), University of Waterloo, Waterloo, Ont.; Toronto Centre for Liver Disease (Feld), Toronto General Hospital; Public Health Ontario (Sander), Toronto, Ont.; Ontario First Nations HIV/AIDS Education Circle (Jones), London, Ont.; St. Michael's Hospital (Isaranuwatchai), Unity Health Toronto, Toronto, Ont
| | - Jennifer D Walker
- Institute of Health Policy, Management and Evaluation (Mendlowitz, Sander, Isaranuwatchai, Krahn), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Mendlowitz, Bremner, Sander, Krahn), University Health Network; ICES Central (Mendlowitz, Walker, Sander, Krahn), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; School of Pharmacy (Wong), University of Waterloo, Waterloo, Ont.; Toronto Centre for Liver Disease (Feld), Toronto General Hospital; Public Health Ontario (Sander), Toronto, Ont.; Ontario First Nations HIV/AIDS Education Circle (Jones), London, Ont.; St. Michael's Hospital (Isaranuwatchai), Unity Health Toronto, Toronto, Ont
| | - William W L Wong
- Institute of Health Policy, Management and Evaluation (Mendlowitz, Sander, Isaranuwatchai, Krahn), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Mendlowitz, Bremner, Sander, Krahn), University Health Network; ICES Central (Mendlowitz, Walker, Sander, Krahn), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; School of Pharmacy (Wong), University of Waterloo, Waterloo, Ont.; Toronto Centre for Liver Disease (Feld), Toronto General Hospital; Public Health Ontario (Sander), Toronto, Ont.; Ontario First Nations HIV/AIDS Education Circle (Jones), London, Ont.; St. Michael's Hospital (Isaranuwatchai), Unity Health Toronto, Toronto, Ont
| | - Jordan J Feld
- Institute of Health Policy, Management and Evaluation (Mendlowitz, Sander, Isaranuwatchai, Krahn), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Mendlowitz, Bremner, Sander, Krahn), University Health Network; ICES Central (Mendlowitz, Walker, Sander, Krahn), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; School of Pharmacy (Wong), University of Waterloo, Waterloo, Ont.; Toronto Centre for Liver Disease (Feld), Toronto General Hospital; Public Health Ontario (Sander), Toronto, Ont.; Ontario First Nations HIV/AIDS Education Circle (Jones), London, Ont.; St. Michael's Hospital (Isaranuwatchai), Unity Health Toronto, Toronto, Ont
| | - Beate Sander
- Institute of Health Policy, Management and Evaluation (Mendlowitz, Sander, Isaranuwatchai, Krahn), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Mendlowitz, Bremner, Sander, Krahn), University Health Network; ICES Central (Mendlowitz, Walker, Sander, Krahn), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; School of Pharmacy (Wong), University of Waterloo, Waterloo, Ont.; Toronto Centre for Liver Disease (Feld), Toronto General Hospital; Public Health Ontario (Sander), Toronto, Ont.; Ontario First Nations HIV/AIDS Education Circle (Jones), London, Ont.; St. Michael's Hospital (Isaranuwatchai), Unity Health Toronto, Toronto, Ont
| | - Lyndia Jones
- Institute of Health Policy, Management and Evaluation (Mendlowitz, Sander, Isaranuwatchai, Krahn), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Mendlowitz, Bremner, Sander, Krahn), University Health Network; ICES Central (Mendlowitz, Walker, Sander, Krahn), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; School of Pharmacy (Wong), University of Waterloo, Waterloo, Ont.; Toronto Centre for Liver Disease (Feld), Toronto General Hospital; Public Health Ontario (Sander), Toronto, Ont.; Ontario First Nations HIV/AIDS Education Circle (Jones), London, Ont.; St. Michael's Hospital (Isaranuwatchai), Unity Health Toronto, Toronto, Ont
| | - Wanrudee Isaranuwatchai
- Institute of Health Policy, Management and Evaluation (Mendlowitz, Sander, Isaranuwatchai, Krahn), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Mendlowitz, Bremner, Sander, Krahn), University Health Network; ICES Central (Mendlowitz, Walker, Sander, Krahn), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; School of Pharmacy (Wong), University of Waterloo, Waterloo, Ont.; Toronto Centre for Liver Disease (Feld), Toronto General Hospital; Public Health Ontario (Sander), Toronto, Ont.; Ontario First Nations HIV/AIDS Education Circle (Jones), London, Ont.; St. Michael's Hospital (Isaranuwatchai), Unity Health Toronto, Toronto, Ont
| | - Murray Krahn
- Institute of Health Policy, Management and Evaluation (Mendlowitz, Sander, Isaranuwatchai, Krahn), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Mendlowitz, Bremner, Sander, Krahn), University Health Network; ICES Central (Mendlowitz, Walker, Sander, Krahn), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; School of Pharmacy (Wong), University of Waterloo, Waterloo, Ont.; Toronto Centre for Liver Disease (Feld), Toronto General Hospital; Public Health Ontario (Sander), Toronto, Ont.; Ontario First Nations HIV/AIDS Education Circle (Jones), London, Ont.; St. Michael's Hospital (Isaranuwatchai), Unity Health Toronto, Toronto, Ont
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Rowe RK, Carroll SR, Healy C, Rodriguez-Lonebear D, Walker JD. The SEEDS of Indigenous population health data linkage. Int J Popul Data Sci 2021; 6:1417. [PMID: 34212119 PMCID: PMC8218891 DOI: 10.23889/ijpds.v6i1.1417] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Globally, the ways that Indigenous data are collected, used, stored, shared, and analyzed are advancing through Indigenous data governance movements. However, these discussions do not always include the increasingly sensitive nature of linking Indigenous population health (IPH) data. During the International Population Data Linkage Network Conference in September of 2018, Indigenous people from three countries (Canada, New Zealand, and the United States) gathered and set the tone for discussions around Indigenous-driven IPH data linkage. OBJECTIVES Centering IPH data linkage and research priorities at the conference led to budding discussions from diverse Indigenous populations to share and build on current IPH data linkage themes. This paper provides a braided summary of those discussions which resulted in the SEEDS principles for use when linking IPH data. METHODS During the Conference, two sessions and a keynote were Indigenous-led and hosted by international collaborators that focused on regional perspectives on IPH data linkage. A retrospective document analysis of notes, discussions, and artistic contributions gathered from the conference resulted in a summary of shared common approaches to the linkage of IPH data. RESULTS The SEEDS Principles emerge as collective report that outlines a living and expanding set of guiding principles that: 1) prioritizes Indigenous Peoples' right to Self-determination; 2) makes space for Indigenous Peoples to Exercise sovereignty; 3) adheres to Ethical protocols; 4) acknowledges and respects Data stewardship and governance, and; 5) works to Support reconciliation between Indigenous nations and settler states. CONCLUSION Each of the elements of SEEDS need to be enacted together to create a positive data linkage environment. When implemented together, the SEEDS Principles can lead to more meaningful research and improved Indigenous data governance. The mindful implementation of SEEDS could lead to better measurements of health progress through linkages that are critical to enhancing health care policy and improving health and wellness outcomes for Indigenous nations.
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Affiliation(s)
- Robyn K. Rowe
- School of Rural and Northern Health, Laurentian University, Sudbury, ON., Canada, P3E2C6
| | - Stephanie Russo Carroll
- Mel and Enid Zuckerman College of Public Health and the Native Nations Institute at the Udall Center for Studies in Public Policy, University of Arizona, Tucson, Arizona, USA
| | - Chyloe Healy
- Blackfoot Confederacy Tribal Council, First Nations Health & Social Secretariat of Manitoba
| | | | - Jennifer D. Walker
- School of Rural and Northern Health, Laurentian University, Sudbury, ON., Canada, P3E2C6
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Nicholson V, Bratu A, McClean AR, Jawanda S, Aran N, Hillstrom K, Hennie E, Cardinal C, Benson E, Beaver K, Benoit AC, Hogg B, Jaworsky D. Indigenizing our research: indigenous community leadership in HIV epidemiology research. Int J Popul Data Sci 2021; 6:1386. [PMID: 34036181 PMCID: PMC8135074 DOI: 10.23889/ijpds.v6i1.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The use of data intensive health research has allowed for greater understandings of population health. When conducting data intensive health research, engaging and involving the community is essential for conducting meaningful research that is responsive to the public's needs. Particularly, when engaging Indigenous communities in research, there is a need to understand historical and ongoing impacts of colonialism and recognize the strengths in Indigenous Peoples' knowledges and experiences while supporting Indigenous leadership and self-determination in research. This article describes the approach our research team/organization used to engage and involve Indigenous people living with HIV in three research projects using large, linked datasets and looking at HIV outcomes of Indigenous populations in Canada. The foundation of these projects was simultaneously: 1) supporting Indigenous people living with HIV to be involved as research team members, 2) developing research questions to answer with available datasets, and 3) integrating Indigenous and Western ways of knowing. We have identified important considerations and suggestions for engaging and involving Indigenous communities and individuals in the generation of research ideas and analysis of linked data using community-based participatory research approaches through our work. These include engaging stakeholders at the start of the project and involving them throughout the research process, honouring Indigenous ways of knowing, the land, and local protocols and traditions, prioritizing Indigenous voices, promoting co-learning and building capacity, and focusing on developing longitudinal relationships. We describe keys to success and learnings that emerged. Importantly, the methodology practiced and presented in this manuscript is not a qualitative study design whereby research subjects are surveyed about their experiences or beliefs. Rather, the study approach described herein is about engaging people with living experience to co-lead as researchers. Our approach supported Indigenous people to share research that addresses their research priorities and responds to issues relevant to Indigenous Peoples and communities.
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Affiliation(s)
- Valerie Nicholson
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
| | - Andreea Bratu
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
| | - Alison R McClean
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
- Building More Bridges Research Team, Vancouver, BC, Canada
- University of British Columbia, School of Population and Public Health, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Simran Jawanda
- University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Niloufar Aran
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
| | - Knighton Hillstrom
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
| | - Evelyn Hennie
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
| | - Claudette Cardinal
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
| | - Elizabeth Benson
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
| | - Kerrigan Beaver
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
| | - Anita C Benoit
- Women’s College Research Institute, Toronto, ON, Canada
- University of Toronto, 27 King’s College Cir, Toronto, ON, M5S 1A1, Canada
| | - Bob Hogg
- British Columbia Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada
| | - Denise Jaworsky
- University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
- University of Toronto, 27 King’s College Cir, Toronto, ON, M5S 1A1, Canada
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Dahl LT, Katz A, McGrail K, Diverty B, Ethier JF, Gavin F, McDonald JT, Paprica PA, Schull M, Walker JD, Wu J. The SPOR-Canadian Data Platform: a national initiative to facilitate data rich multi-jurisdictional research. Int J Popul Data Sci 2020; 5:1374. [PMID: 34007883 PMCID: PMC8104066 DOI: 10.23889/ijpds.v5i1.1374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Administrative health data is recognized for its value for conducting population-based research that has contributed to numerous improvements in health. In Canada, each province and territory is responsible for administering its own publicly funded health care program, which has resulted in multiple sets of administrative health data. Challenges to using these data within each of these jurisdictions have been identified, which are further amplified when the research involves more than one jurisdiction. The benefits to conducting multi-jurisdictional studies has been recognized by the Canadian Institutes of Health Research (CIHR), which issued a call in 2017 for proposals that address the challenges. The grant led to the creation of Health Data Research Network Canada (HDRN), with a vision is to establish a distributed network that facilitates and accelerates multi-jurisdictional research in Canada. HDRN received funding for seven years that will be used to support the objectives and activities of an initiative called the Strategy for Patient-Oriented Research Canadian Data Platform (SPOR-CDP). In this paper, we describe the challenges that researchers face while using, or considering using, administrative health data to conduct multi-jurisdictional research and the various ways that the SPOR-CDP will attempt to address them. Our objective is to assist other groups facing similar challenges associated with undertaking multi-jurisdictional research.
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Affiliation(s)
- Lindsey Todd Dahl
- Manitoba Centre for Health Policy (MCHP), Rady Faculty of Health Sciences, Winnipeg, Manitoba R3E 3P5
| | - Alan Katz
- University of Manitoba, Departments of Community Health Sciences and Family Medicine; Director, Manitoba Centre for Health Policy (MCHP), Rady Faculty of Health Sciences, Winnipeg, Manitoba R3E 3P5
| | - Kimberlyn McGrail
- Centre for Health Services and Policy Research, School of Population and Public Health, Vancouver, British Columbia V6T 1Z3
| | - Brent Diverty
- Vice President, Programs Division, Canadian Institute for Health Information, Ottawa, Ontario K2A 4H6
| | - Jean-Francois Ethier
- Associate professor, GRIIS, Université de Sherbrooke, Sherbrooke, Quebec J1K 2R1; Scientist, Centre de Recherche sur le vieillissement, 1036 Rue Belvédère S, Sherbrooke, Quebec J1H 4C4
| | - Frank Gavin
- Public Advisory Council, Health Data Research Network Canada, Toronto, Ontario M4S 1M4
| | - James Ted McDonald
- Director, New Brunswick Institute for Research, Data and Training; Professor of Economics, University of New Brunswick, Fredericton, New Brunswick E3B 5A3
| | - P. Alison Paprica
- Executive Advisor and Affiliate Scientist, Institute for Clinical Evaluative Sciences (ICES), 2075 Bayview Ave, Toronto, Ontario M4N 3M5
| | - Michael Schull
- CEO, Institute for Clinical Evaluative Sciences (ICES), 2075 Bayview Ave, Toronto, Ontario M4N 3M5; Senior Scientist, Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, Ontario M4N 3M5; Professor, University of Toronto, Institute for Health Policy Management and Evaluation, 155 College Street, Suite 425, Toronto, Ontario M5T 3M6
| | - Jennifer D Walker
- Indigenous Lead, Institute for Clinical Evaluative Sciences (ICES), 2075 Bayview Ave, Toronto, Ontario M4N 3M5; Canada Research Chair in Indigenous Health, School of Rural and Northern Health, Laurentian University, Sudbury Ontario P3E 2C6
| | - Juliana Wu
- Manager, Corporate Data Request Program, Canadian Institute for Health Information (CIHI), Toronto, Ontario M2P 2B7,
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