A community-based participatory research methodology to address, redress, and reassess disparities in respiratory health among First Nations

Abstract

BackgroundTo date, determinants of respiratory health in First Nations people living on reserves and means of addressing and redressing those determinants have not been well established. Hence the Saskatchewan First Nations Lung Health Project (FNLHP) is a new prospective cohort study of aboriginal people being conducted in two First Nations reserves to evaluate potential health determinants associated with respiratory outcomes. Using the population health framework (PHF) of Health Canada, instruments designed with the communities, joint ownership of data, and based on the 4-phase concept of the First Nations Regional Longitudinal Health Survey, the project aims to evaluate individual factors, contextual factors, and principal covariates on respiratory outcomes. The objective of this report is to clearly describe the methodology of (i) the baseline survey that consists of two components, an interviewer-administered questionnaire and clinical assessment; and (ii) potential intervention programs; and present descriptive results of the baseline data of longitudinal FNLHP.MethodsThe study is being conducted over 5 years (2012–2017) in two phases, baseline and longitudinal. Baseline survey has been completed and consisted of (i) an interviewer-administered questionnaire-based evaluation of individual and contextual factors of importance to respiratory health (with special focus on chronic bronchitis, chronic obstructive pulmonary disease, asthma and obstructive sleep apnea), and (ii) clinical lung function and allergy tests with the consent of study participants. The address-redress phase consists of potential intervention programs and is currently being rolled out to address-at community level (via green light program and environmental study), and redress-at policy level (via obesity reduction and improved diagnosis and treatment of obstructive sleep apnea) the issues that have been identified by the baseline data.ResultsInterviewer-administered surveys were conducted in 2012–2013 and collected data on 874 individuals living in 406 households from two reserve communities located in Saskatchewan, Canada. Four hundred and forty six (51%) females and 428 (49%) males participated in the FNLHP.ConclusionsThe information from this project will assist in addressing and redressing many of the issues involved including the provision of adequate housing, health lifestyle practices, and in planning for health service delivery.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1137-5) contains supplementary material, which is available to authorized users.

Risk Factors for Snoring in Two Canadian First Nations Communities

“…The First Nations Lung Health Project (FNLHP) is a prospective cohort study design being conducted using interviewer-administered surveys in two phases; baseline and follow-up [31]. The baseline survey was completed between 2012 and 2013.…”

Do discrimination, residential school attendance and cultural disruption add to individual-level diabetes risk among Aboriginal people in Canada?

“…The study was conducted as part of the First Nations Lung Health Project (FNLHP) that used a community-based participatory research approach. The methodology for the overall study has been described in detail elsewhere [ 23 ], but its main features and the specific elements of this research are also summarized here.…”

“…The first stage involved door-to-door canvassing to advertise the survey by distributing brochures and explaining the need and purpose of the study. For the second stage, every adult (18 years and older) was invited to visit the community health care center to complete interviewer-administered questionnaires and to participate in clinical assessments [ 23 ] (height, weight, waist circumference, blood pressure, pulmonary function and allergy skin prick tests). Finally, an identification number was assigned to each household using the community map, and a key informant from each household was asked to provide household level information.…”

“…Finally, an identification number was assigned to each household using the community map, and a key informant from each household was asked to provide household level information. The sampling frame and sample size calculations can be found in our Methods paper [ 23 ].…”

Community-based Participatory Research Is Needed to Address Pulmonary Health Disparities

“…However, few community interventions that incorporate CBPR approaches have addressed other populations or pulmonary diseases. The Saskatchewan First Nations Lung Health Project, an ongoing CBPR study of aboriginal people in Canada, is investigating how social health determinants at the individual level (such as health-harming behaviors) and at the community level (such as overcrowding and sociocultural factors including trauma related to colonization and racism) affect respiratory outcomes, including chronic bronchitis, chronic obstructive pulmonary disease, and obstructive sleep apnea, in addition to asthma (52).…”