Community engagement approaches for Indigenous health research: recommendations based on an integrative review

Abstract

ObjectiveCommunity engagement practices in Indigenous health research are promoted as a means of decolonising research, but there is no comprehensive synthesis of approaches in the literature. Our aim was to assemble and qualitatively synthesise a comprehensive list of actionable recommendations to enhance community engagement practices with Indigenous peoples in Canada, the USA, Australia and New Zealand.DesignIntegrative review of the literature in medical (Medline, Cumulative Index to Nursing and Allied Health Literature and Embase) and Google and WHO databases (search cut-off date 21 July 2020).Article selectionStudies that contained details regarding Indigenous community engagement frameworks, principles or practices in the field of health were included, with exclusion of non-English publications. Two reviewers independently screened the articles in duplicate and reviewed full-text articles.AnalysisRecommendations for community engagement approaches were extracted and thematically synthesised through content analysis.ResultsA total of 63 studies were included in the review, with 1345 individual recommendations extracted. These were synthesised into a list of 37 recommendations for community engagement approaches in Indigenous health research, categorised by stage of research. In addition, activities applicable to all phases of research were identified: partnership and trust building and active reflection.ConclusionsWe provide a comprehensive list of recommendations for Indigenous community engagement approaches in health research. A limitation of this review is that it may not address all aspects applicable to specific Indigenous community settings and contexts. We encourage anyone who does research with Indigenous communities to reflect on their practices, encouraging changes in research processes that are strengths based.

First Nations and Metis peoples’ access and equity challenges with early childhood oral health: a qualitative study

“…The CBPR approach has been previously successfully applied to engage Indigenous peoples and communities [ 22 ]. CBPR is a relationships based, decolonizing methodology that emphasizes respectful and mutually beneficial partnerships with Indigenous peoples and communities [ 23 , 24 ]. The study built on the already existing foundation of an oral health promotion initiative in Manitoba.…”

Are we walking the talk of participatory Indigenous health research? A scoping review of the literature in Atlantic Canada

“…There is a spectrum of community engagement in Indigenous health research [21,25,33,34]. At one end, a growing body of research is community-initiated and undertaken, however at the other end, there remains a breadth of largely academic-driven research with minimal Indigenous community involvement [13].…”

“…At one end, a growing body of research is community-initiated and undertaken, however at the other end, there remains a breadth of largely academic-driven research with minimal Indigenous community involvement [13]. While it is important that participatory research be context-specific and reflect the unique needs and preferences of the communities involved [20,33], this spectrum of community engagement raises questions regarding how to define and accurately measure the extent to which a research project is, in fact, participatory, and how to measure its degree of community engagement [35]. If research fails to appropriately engage Indigenous communities, it may not only compromise the potential benefits of the research for the Indigenous Peoples, communities, governments, and organizations involved, but it may also risk perpetuating the colonial narratives that this type of research is striving to contradict [13].…”

Culturally safe dementia care: Building nursing capacity to care for First Nation Elders with memory loss

“…Any future Indigenous dementia research must be done in collaboration with Indigenous communities and actively contribute to anti‐colonialism. There are resources available for those wishing to take up this challenge, including Lin et al's (2020) comprehensive list of community engagement strategies for Indigenous health research and a recent collection on collaborative dementia research with Indigenous people (Hulko et al, 2019). While it may be tempting to adopt or distribute CSDC across the province or country, this education programme is based on Secwepemc ways of knowing, being and doing; as such, it would need to be customised to other Nations through a collaborative process to properly respect their ontology, epistemology and methodology, and avoid pan‐Indigenizing.…”