ObjectivesChronic conditions represent an important source of major health issues among Indigenous People. The same applies to those, who live off-reserve and in urban areas. However, very few healthcare services are considered culturally safe, resulting in some avoidance of the public healthcare system. Our goal was to review the literature on culturally safe practices available to urban Indigenous People who suffer from chronic diseases.DesignWe conducted a scoping review to determine what culturally safe healthcare services are currently offered for the management of chronic conditions in urban Indigenous populations, to contribute to a tailored, holistic and safe space in mainstream healthcare systems.Eligibility criteriaPeer-reviewed original research articles had to be published by 27 October 2020, in English or French.Information source: In October 2020, we searched five academic databases (EBSCO, PsycArticles, SocINDEX, MEDLINE and PsycINFO) and also reviewed grey literature and the websites of organisations or governments. The data were extracted and collected in an EXCEL spreadsheet. Two reviewers independently screened 326 titles and abstracts, followed by an independent evaluation of 48 full text articles. A total of 19 studies were included in this scoping review, as well as 5 websites/documents from the grey literature.ResultsIn total, 19 studies were included in our analysis. We found that Elders, family and the assistance of an interpreter are crucial elements to include to make urban Indigenous feel safe when they seek healthcare services. With this scoping review, we report interventions that are successful in terms of healthcare delivery for this population. Our findings provide insight on what services should be in place in mainstream healthcare settings to create a culturally safe experience for urban Indigenous People.ConclusionsIn recent years, there appears to be a growing awareness of the need to provide culturally safe health services. This scoping review identified multiple strategies to promote cultural safety in this context, as well as barriers and facilitators to their implementation. These elements, which have been extensively documented in the literature, should be included in the chronic diseases management interventions to be developed by urban and primary care settings.
The world was caught off guard by the swift spread of the COVID-19 pandemic at the beginning of 2020. For vulnerable populations such as the urban Indigenous, the first wave of the pandemic was even more challenging for multiple reasons. Many of their usual culturally safe services were interrupted, thus they found themselves struggling on different levels. Our team conducted a needs assessment to shed light on how urban Indigenous people living in the X region, in the province of Quebec, Canada, dealt with this situation and what were the most important services regarding holistic health they wished they could have relied on. To respect Indigenous culture, data collection was completed through sharing circles in addition to a web-based survey. The results indicated that participants experienced anxiety and psychological distress during the pandemic. They identified unmet needs related to family services, support in homeschooling, access to traditional medicine and spiritual and cultural practices to name a few. Future work should involve the implementation of culturally safe services, adapted to the pandemic era, for Indigenous people living in urban areas
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