Community-Based screening and triage versus standard referral of Aboriginal children

Abstract

Health solutions for Aboriginal children should be guided by their community and grounded in evidence. This manuscript presents a prospective cohort study protocol, designed by a community-university collaborative research team. The study’s goal is to determine whether community-based screening and triage lead to earlier identification of children’s emotional health needs, and to improved emotional health 1 year later, compared to the standard referral process. We are recruiting a community-based sample and a clinical sample of children (ages 8 to 18 years) within one Canadian First Nation. All participants will complete the Aboriginal Children’s Health and Well-being Measure (ACHWM)© and a brief triage assessment with a local mental health worker. All participants will be followed for 1 year. Children with newly identified health concerns will be immediately connected to local services, generating a new opportunity to improve health. The development of the research design and its execution were impacted by several events (e.g., disparate worldviews, loss of access to schools). This manuscript describes lessons learned that are important to guide future community-based research with First Nations people. The optimal research design in an Aboriginal context is one that responds directly to local decision makers’ needs and respectfully integrates Aboriginal ways of knowing with Western scientific principles. Such an approach is critical because it will generate meaningful results that will be rapidly adopted, thus reducing the knowledge-to-action gap.

Community-based screening and triage connecting First Nations children and youth to local supports: a cross-sectional study

“… Sampling results. Updated from Young et al 32 with permission from the International Journal of Indigenous Health . Note: ACHWM = Aaniish Naa Gegii: the Children’s Health and Well-being Measure, HP = healthy peers, NIN = newly identified needs, TT = typical treatment.…”

“…This was done via information packages sent home from community schools and the recreation centre. 32 The second cohort was expected to include 60 children currently undergoing mental health treatment based on referral records from previous years. This cohort was recruited by individual invitation at the Nadmadwin Mental Health Clinic in Wiikwemkoong Unceded Territory.…”

“…This cohort was recruited by individual invitation at the Nadmadwin Mental Health Clinic in Wiikwemkoong Unceded Territory. 32 This study was a community-based participatory action study in which the community members conducted the recruitment.…”

“…This study design was previously described 32 and approved by the Laurentian University’s Research Ethics Board and the Wiikwemkoong Chief and Council. The data analyzed in this article were gathered with informed consent.…”