A scoping study of cultural interventions to treat addictions in Indigenous populations: methods, strategies and insights from a Two-Eyed Seeing approach

Abstract

BackgroundThis paper describes the methods, strategies and insights gained from a scoping study using a “Two-Eyed Seeing” approach. An evolving technique, Two-Eyed Seeing respects and integrates the strengths of Indigenous knowledge and Western sciences, often “weaving back and forth” between the two worldviews. The scoping study was used to inform a tool for measuring the impact of culturally based addictions treatment services on wellness in Indigenous populations. It formed part of a three-year study, Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment. The scoping study identified and mapped literature on cultural interventions in addictions treatment, and described the nature, extent and gaps in literature.MethodsUsing a Two-Eyed Seeing approach, we adapted, applied and enhanced a common framework of scoping studies. In the end stage of the scoping review process, an Ad Hoc Review Group, led by our project Elder, reviewed and interpreted Indigenous and Western understandings within the mapped information. Elements of the scoping study were joined with results from community focus groups with staff at treatment centres.ResultsTwo-Eyed Seeing contributed differently at each stage of the scoping study. In early stages, it clarified team expertise and potential contributions. At the mid-point, it influenced our shift from a systematic to a scoping review. Near the end, it incorporated Western and Indigenous knowledge to interpret and synthesize evidence from multiple sources.ConclusionsThis paper adds to the collective work on augmenting the methodology of scoping studies. Despite the challenges of a Two-Eyed Seeing approach, it enables researchers using scoping studies to develop knowledge that is better able to translate into meaningful findings for Indigenous communities.

Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives

“…An Indigenous process of adaptation, a “two-eyed seeing” approach (39–41), “looks at”, gives equal weight to, and attempts to integrate both Indigenous and Western worldviews to address health concerns such as addictive behaviors (42–44). Similarly, Wood et al (17) stressed the necessity of providing “interventions that are evidence-based and culturally appropriate and that have the full participation of the affected community (designing, planning, implementation and evaluation)” (p. 39).…”

“…While MAT has yielded improved quality of life (57, 58), additional interventions may be needed to maximize these changes (59) including integration of Western medicine with Indigenous ways in a “two-eyed seeing” approach (44). It is important to capitalize on these traditional healers who can “translate” evidence-based Western treatments within an AI/AN framework of holistic wellness and balance.…”

Reclaiming Indigenous identities: Culture as strength against suicide among Indigenous youth in Canada

“…As part of a larger three-year study, Rowan et al engaged in a scoping review of cultural interventions to treat problematic substance use among Indigenous populations that incorporated both Western and Indigenous knowledge and assessed at least one of four holistic outcomes (e.g., spiritual, physical/behavioural, mind/mental, heart/social/emotional). 14 Using an Indigenized methodology -the "Two-Eyed Seeing" approach 15 -19 studies included interventions demonstrating considerable variability across each of the measured domains but all of them supporting the development of "culturally-based instruments to meaningfully measure wellness arising from participation in cultural interventions offered in the context of addictions treatment for Indigenous people." 14 Another example in the United States is the partnership between academics and the Blackfeet reservation.…”

Adaptation culturelle d’un programme de prévention universel des dépendances pour les enfants autochtones innus

“…En effet, comme le raconte un animateur, le manque de prise en charge du PRA par des enseignants aurait limité la qualité de certains projets : Tshakapesh, 2009 ;Roy, 2006 ;. De plus, la transmission des connaissances chez les Autochtones est généralement effectuée de façon holistique par l'entremise d'enseignements traditionnels (Castellano, 2000), contrairement aux connaissances occidentales qui découlent majoritairement de méthodes positivistes privilégiant la hiérarchie et les évidences, transmises de façon linéraire (Fornssler, McKenzie, Dell, Laliberte et Hopkins, 2014 ;Rowan et al, 2015). Ainsi, la façon d'apprendre des enfants innus est plutôt sensorielle et simultanée, contrairement à leurs pairs québécois qui, de façon générale, réussissent mieux à l'aide d'un apprentissage séquentiel (Institut Tshakapesh, 2009 ;Roy, 2006 ; (Drapeau, 2011).…”