Objective At the request of Nunavik Inuit health authorities and organizations, the Qanuilirpitaa? 2017 Nunavik regional health survey included an innovative “community component” alongside youth and adult epidemiological cohort studies. The community component objective was to identify and describe community and culturally relevant concepts and processes that lead to health and well-being. Methods A qualitative, community-based research process involving workshops and semi-structured interviews was used to generate a corpus of data on health concepts and processes specific to Inuit communities in Nunavik. Thematic analysis and repeated community validation allowed for the identification of three key dimensions of health salient to Inuit experience and eight community-level health determinants. Results The health model consists of three linked concepts: ilusirsusiarniq, qanuinngisiarniq, and inuuqatigiitsianiq, which reflect distinct dimensions of Inuit health phenomenology. The determinants community, family, identity, food, land, knowledge, economy, and services were generated through analysis and reflect community-level sources of health and well-being. Conclusion The development of the culturally grounded health models and determinants is an exercise of epistemic inclusivity through which researchers and Indigenous communities may form new and equitable paths of knowledge creation.
Objective The overall objective of this study was to elicit understandings of community health among Inuit youth aged 12–18 in the region of Nunavik, northern Quebec, through identifying community conditions supporting health from their perspective and exploring how they conceptualize a healthy community. Methods In January and February 2020, 51 secondary students from three communities participated in a 1-week participatory photovoice activity during regular class time. Youth participated in three different sessions dedicated to the ethics of taking photographs, taking photos in the community, and group discussions of photographs. Discussions were analyzed via thematic analysis and validated with the youth in the fall of 2020. Results Twelve key community conditions supporting health were identified: family, food, culture, language, sense of community belonging, land, housing, services, community, connection, caring and somewhere to go. The youth understood a healthy community to be a place where “nothing was broken” and where community conditions supporting health could be visualized like the rocks in an inuksuk, a stone cairn used by Inuit for wayfinding on the tundra landscape. Participants chose the human form of inuksuk which has become widespread in northern and southern Canadian popular culture. Conclusion Findings from this study serve to confirm and strengthen existing models of Inuit health while also raising fresh perspectives and concepts relevant to the younger generation. Images and words of the youth identified in this study may be important in designing effective health promotion strategies that are accessible and relevant to younger generations, thus responding to an important research, programmatic and policy gap.
Objective This study aimed to develop a preliminary guide to culturally and contextually relevant indicators to assess community resources in the 14 communities of the Inuit territory of Nunavik, Quebec. Methods As part of the Community Component of Qanuilirpitaa? of the 2017 Nunavik Health Survey, data were collected from 354 organizations located across Nunavik. Data were collected via short structured interviews with representatives of the organization. An inductive qualitative analysis was conducted to identify emerging themes describing the contexts that influence organizations, how key informants conceptualized what is a successful resource, and the facilitators and needs to achieving these indicators of success. Inuit partners were involved throughout the project to offer insight and to ascertain its pertinence and validity. Results Interviews revealed structural and community realities that influenced organizations. Three main indicators were used to describe successes: (1) team efficiency and dynamics; (2) accessibility of the resource; and (3) ability to impact clients and the community. The third indicator was by far the most discussed indicator of success. Participants and leaders offer suggestions as to how to achieve these indicators and advocate for the conditions necessary for organizational sustainability. Conclusion This data-driven framework suggests that the measures of success that are frequently used by funding agencies (e.g., number of people reached, number of activities) may not fully represent the potential of local services in a given community. Indeed, services may be creating job opportunities for Inuit, instilling pride, offering cultural opportunities, and increasing capital (human, economic, health) within the community, all of which are equally important indicators of success that may more adequately further improve the social determinants of health among communities.
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