As a strengths-based alternative to Western notions of enculturation and acculturation theory, cultural continuity describes the integration of people within their culture and the methods through which traditional knowledge is maintained and transmitted. Through reviewing relevant, original research with Indigenous Peoples in Canada and the United States, the purpose of this metasynthesis is to describe and interpret qualitative research relating to cultural continuity for Indigenous Peoples in North America. This metasynthesis was conducted through the selection, appraisal, and synthesis of 11 qualitative studies. Across the selected studies, five key themes arose: the connection between cultural continuity and health and well-being, conceptualizations of cultural continuity and connectedness, the role of knowledge transmission, journeys of cultural (dis)continuity, and barriers to cultural continuity.

OBJECTIVES: This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada.METHODS: This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. RESULTS:When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings.CONCLUSIONS: Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.KEY WORDS: Indigenous population; traditional medicine; self determination; holistic health La traduction du résumé se trouve à la fin de l'article.

Insights from both western science and traditional knowledge were applied to identify, and begin to address, climate change and water impacts at Stellat'en First Nation, British Columbia, Canada. Qualitative data from interviews and surveys of Stellat'en community members were compiled and compared with air temperature, precipitation, and hydrometric data from meteorological stations and proximal rivers. Community Elders noted changes to river water levels and shifts in fish populations. The quantitative data revealed a 2.3 °C rise in air temperature, 5 percent increase in precipitation, and 10 percent decline in snowfall over a 40‐year period. Results from these analyses were reported in two knowledge intersection workshops at Stellat'en First Nation, and information sharing took place to: facilitate discussion and awareness between traditional and western knowledge holders, gain insights on the community's views of climate change and water, and identify strategies for action. Recommendations formulated and implemented by Stellat'en First Nation include improved policies, and community and individual actions. Les changements climatiques et les ressources en eau dans la Première nation Stellat'en, Colombie‐Britannique, Canada : les connaissances issues de la science occidentale et des savoirs traditionnels Le recours aux connaissances issues de la science occidentale et des savoirs traditionnels a permis d'identifier, puis d'aborder les répercussions des changements climatiques sur les ressources en eau dans la Première nation Stellat'en, Colombie‐Britannique, Canada. Les données qualitatives obtenues au moyen d'entrevues et d'enquêtes menées auprès de membres de la communauté Stellat'en ont été colligées et comparées à des données de température de l'air, de précipitations et d'hydrométrie recueillies de stations météorologiques et de rivières des environs. Les sages de la communauté ont observé des changements des niveaux d'eau de la rivière ainsi que des variations dans les populations de poissons. Les données quantitatives mettent en évidence une hausse de 2,3 °C de la température de l'air, une augmentation des précipitations de l'ordre de 5 pour cent, et une réduction des chutes de neige de l'ordre de 5 pour cent sur une période de 40 ans. Les résultats qui ressortent de ces analyses ont été présentés au cours de deux ateliers d’échanges sur les savoirs dans la Première nation Stellat'en. Les informations ont ainsi été partagées afin de rendre plus aisées la discussion et la sensibilisation entre les détenteurs de savoirs traditionnels et occidentaux, d'accroître les connaissances sur les opinions de la communauté au sujet des changements climatiques et les ressources en eau, et de fixer des stratégies d'action. L'amélioration des politiques et les actions à l’échelle communautaire et individuelle comptent parmi les recommandations formulées et mises en œuvre par la Première nation Stellat'en.

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