Decolonising qualitative research to explore the experiences of Manitoba’s urban Indigenous population living with type 2 diabetes mellitus, obesity and bariatric surgery

Abstract

IntroductionObesity and type 2 diabetes mellitus (T2DM) are growing global health concerns associated with significant morbidity, mortality and healthcare expenditures. Due to histories of colonisation and contemporary marginalisation, Canada’s Indigenous populations are disproportionately burdened by obesity, T2DM and many other chronic illnesses. Culturally appropriate research on experiences and outcomes of Indigenous patients undergoing bariatric surgery in Canada is scarce. This qualitative study protocol will use a decolonising approach guided by an Indigenous Elder to explore the perspectives and experiences of urban Indigenous Manitobans with respect to T2DM, obesity and bariatric surgery. This knowledge will guide the development and implementation of culturally sensitive bariatric care.Methods and analysisSequential sharing circles (SSCs) and semistructured conversational interviews that have been purposefully designed to be culturally relevant with the guidance of an Indigenous Elder and advisory group (IAG) will be carried out in Winnipeg, Manitoba, Canada. Indigenous adults who are obese (body mass index >35 kg/m2), have T2DM and live in an urban centre will be recruited. Three groups will be investigated: (1) those who have had bariatric surgery; (2) those on the wait list for bariatric surgery and (3) those not associated with a bariatric surgery programme. Each group of 10–12 participants will be guided through a semistructured script led by an Indigenous Elder. Elder-facilitated conversational interviews will also be completed following the SSCs. All content will be audio recorded and transcribed. Thematic analysis will be used to identify emerging patterns using a constructive grounded theory approach.Ethics and disseminationThis study has received ethical approval from the University of Manitoba Health Research Ethics Board. Findings will inform the development and implementation of culturally sensitive programmes at Manitoba’s Centre for Metabolic and Bariatric Surgery. Results will be disseminated in peer-reviewed scientific journals, at obesity and Indigenous health conferences, and knowledge sharing ceremonies.

Recruitment of Indigenous Study Participants in Canada: Obligations or Constraints? An Ethical Reflection

“…Recruitment of Indigenous research participants for a study may appear challenging for non-Indigenous researchers, for many of the reasons presented previously. Several influential research studies (26)(27)(28)(29) have been completed by non-Indigenous researchers by applying Indigenous research perspectives during the recruitment process. There are several methods for each ethical research principle that can be applied by non-Indigenous researchers in their recruitment practices with Indigenous populations (Table 1).…”

“…Respect for the Indigenous ways of knowing and research interests is the foundation of any successful recruitment process involving this population. A recent research protocol, developed with Indigenous culturally appropriate research views to gain knowledge of urban Indigenous populations living with obesity and type 2 diabetes mellitus with reference to bariatric surgery (26), can be a helpful model. Recruitment methods were designed in consultation with Indigenous elders and a • Indigenous perspective for recruitment -community comes together for all • Recruitment for participating in a research study will benefit Indigenous individuals and communities • Ensure power balance between researcher and community community advisory group, and included sequential sharing circles and semi-structured conversational interviews to highlight Indigenous ways of communication.…”

Exploring the Landscape of Type 2 Diabetes Mellitus Research: A Comprehensive Review of 670 Scopus-Enrolled Journal Articles (2003-2022) by Pakistani authors

“…There is research on genetics, insulin resistance, beta cell function, obesity, and lifestyle therapy. Pharmaceutical medicines, risk factor understanding, and diabetes management technology and methodologies have all evolved as a result of these investigations 14 . Many types 2 diabetes treatments have been developed by pharmaceutical corporations and researchers.…”