In Canada, cultural safety (CS) is emerging as a theoretical and practice lens to orient health care services to meet the needs of Aboriginal people. Evidence suggests Aboriginal peoples' encounters with health care are commonly negative, and there is concern that these experiences can contribute to further adverse health outcomes. In this article, we report findings based on participatory action research drawing on Indigenous methods. Our project goal was to interrogate practices within one hospital to see whether and how CS for Aboriginal patients could be improved. Interviews with Aboriginal patients who had accessed hospital services were conducted, and responses were collated into narrative summaries. Using interlocking analysis, findings revealed a number of processes operating to produce adverse health outcomes. One significant outcome is the production of structural violence that reproduces experiences of institutional trauma. Positive culturally safe experiences, although less frequently reported, were described as interpersonal interactions with feelings visibility and therefore, treatment as a "human being."
In this article, we discuss three broad research approaches: indigenous methodologies, participatory action research, and White studies. We suggest that a fusion of these three approaches can be useful, especially in terms of collaborative work with indigenous communities. More specifically, we argue that using indigenous methodologies and participatory action research, but refocusing the object of inquiry directly and specifically on the institutions and structures that indigenous peoples face, can be a particularly effective way of transforming indigenous peoples from the objects of inquiry to its authors. A case study focused on the development of appropriate research methods for a collaborative project with the urban aboriginal communities of the Okanagan Valley in British Columbia, Canada, provides an illustration of the methodological fusion we propose.
Participatory research is now a central approach for shaping relationships between the academy and marginalized communities and people. Somewhat less developed has been the concern for ensuring that participatory processes have research products that are inclusive and accessible as well. Participatory video has emerged as a key tool in putting together process and product in ways that provide avenues for marginalized communities to participate in both forms of self-research and ways of self-representation. In this essay, the authors discuss the development and progress of two participatory video projects underway with Métis communities in British Columbia. The conditioning factors for the degree and distribution of control over self-representation within participatory video are at least as complex as those within participatory research itself, but none the less doors are opening for marginalized communities via new digital technologies.
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