Indigenous-led health care partnerships in Canada

Allen, Lindsay; Hatala, Andrew R.; Ijaz, Sabina; Courchene, Elder David; Bushie, Elder Burma

doi:10.1503/cmaj.190728

Cited by 105 publications

(100 citation statements)

References 30 publications

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“…It reflects the experiences of a small group of researchers. It does align, however, with previous work of Indigenous elders and researchers who developed tools and procedures that fit with traditional concepts and values, 18 59 and who have highlighted the need of ‘two eyed seeing.’ 24 60 The commitment, approval and full participation of traditional midwives made the researchers feel confident that they considered this work appropriate.…”

Section: Limitations and Challengesmentioning

confidence: 99%

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Bridging Western and Indigenous knowledge through intercultural dialogue: lessons from participatory research in Mexico

Sarmiento¹,

Zuluaga

Paredes-Solís

et al. 2020

BMJ Glob Health

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Indigenous communities in Latin America and elsewhere have complex bodies of knowledge, but Western health services generally approach them as vulnerable people in need of external solutions. Intercultural dialogue recognises the validity and value of Indigenous standpoints, and participatory research promotes reciprocal respect for stakeholder input in knowledge creation.As part of their decades-long community-based work in Mexico’s Guerrero State, researchers at the Centro de Investigación de Enfermedades Tropicales responded to the request from Indigenous communities to help them address poor maternal health. We present the experience from this participatory research in which both parties contributed to finding solutions for a shared concern. The aim was to open an intercultural dialogue by respecting Indigenous skills and customs, recognising the needs of health service stakeholders for scientific evidence.Three steps summarise the opening of intercultural dialogue. Trust building and partnership based on mutual respect and principles of cultural safety. This focused on understanding traditional midwifery and the cultural conflicts in healthcare for Indigenous women. A pilot randomised controlled trial was an opportunity to listen and to adjust the lexicon identifying and testing culturally coherent responses for maternal health led by traditional midwives. Codesign, evaluation and discussion happened during a full cluster randomised trial to identify benefits of supporting traditional midwifery on maternal outcomes. A narrative mid-term evaluation and cognitive mapping of traditional knowledge offered additional evidence to discuss with other stakeholders the benefits of intercultural dialogue. These steps are not mechanistic or invariable. Other contexts might require additional steps. In Guerrero, intercultural dialogue included recovering traditional midwifery and producing high-level epidemiological evidence of the value of traditional midwives, allowing service providers to draw on the strengths of different cultures.

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Section: Limitations and Challengesmentioning

confidence: 99%

“… 23 Emerging evidence suggests that active involvement of Indigenous participation in health promotion increases access to care and improves health outcomes in these communities. 24 …”

Section: Introductionmentioning

confidence: 99%

Bridging Western and Indigenous knowledge through intercultural dialogue: lessons from participatory research in Mexico

Sarmiento¹,

Zuluaga

Paredes-Solís

et al. 2020

BMJ Glob Health

View full text Add to dashboard Cite

show abstract

“…While the COVID-19 pandemic is undoubtedly a global health crisis, its impacts reach far beyond the health sector (Humphreys 2020). Indigenous scholarship in particular is becoming increasingly recognised as a tool for advocacy and social change (Allen et al 2020;Richmond and Cook 2016). As governments around the world heed advice from local and international public health experts, making the difficult yet necessary decision to close college and university campuses (Canadian Press 2020), these closures have significantly disrupted the learning and research of those engaged in the field of Indigenous health research.…”

Section: Introductionmentioning

confidence: 99%

Education in uncertainty: Academic life as Indigenous health scholars during COVID-19

et al. 2020

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As the COVID-19 crisis continues to develop, communities around the world find themselves living in new and uncertain times. School and university closures are significantly disrupting the lives of students, educators and researchers alike. With the sudden shift to online learning platforms, the limitations on research projects and the lack of standardised policies and procedures, many concerns arise surrounding the unequal impacts of this crisis. This article brings together diverse perspectives on the effects of COVID-19 on post-secondary life for students and scholars engaged in the field of Indigenous health research. The authors reflect on how this time has impacted them as a graduating student, incoming PhD student, junior faculty member and mid-career faculty member respectively. Their experiences of teaching and learning at a large, research-intensive university in Toronto, Canada have been profoundly transformed, and will continue to change the way they work, research and interact at the graduate level. Working with Indigenous communities and organisations requires relationship building, collaboration and ceremony. In these unprecedented times, scholars cannot simply continue "business as usual". They must adapt everything, including how they teach, learn and work with Indigenous peoples, who are particularly vulnerable to this pandemic. Reflecting on the impacts that have already occurred and those that are still likely to come, the authors discuss what changes may need to be made in academia to support diverse actors within their scholarly community. They suggest changes to their scholarship with Indigenous communities in Canada to help them continue to work in a respectful, reciprocal and culturally appropriate way.

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“…Another important consideration, particularly relevant in the Canadian context, is the diversity of cultural groups, whose perspectives and values about health and wellbeing may differ from the dominant culture [ 41 ]. For example, First Nations, Inuit and Métis Peoples in Canada have cultural worldviews and definitions of health that are not reflected in the dominant biomedical approach to health care, and as result they may face important challenges to accessing and using health services [ 42 , 43 ]. Respect and understanding of these different views, including diverse expectations and responsibilities of patients and healthcare providers, are crucial for appropriate care delivery.…”

Section: Discussionmentioning

confidence: 99%

From symptom to cancer diagnosis: Perspectives of patients and family members in Alberta, Canada

et al. 2020

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Background Significant intervals from the identification of suspicious symptoms to a definitive diagnosis of cancer are common. Streamlining pathways to diagnosis may increase survival, quality of life post-treatment, and patient experience. Discussions of pathways to diagnosis from the perspective of patients and family members are crucial to advancing cancer diagnosis. Aim To examine the perspectives of a group of patients with cancer and family members in Alberta, Canada, on factors associated with timelines to diagnosis and overall experience. Methods A qualitative approach was used. In-depth, semi-structured interviews with patients with cancer (n = 18) and patient relatives (n = 5) were conducted and subjected to a thematic analysis. Findings Participants struggled emotionally in the diagnostic period. Relevant to their experience were: potentially avoidable delays, concerns about health status, and misunderstood investigation process. Participants emphasized the importance of their active involvement in the care process, and had unmet supportive care needs. Conclusion Psychosocial supports available to potential cancer patients and their families are minimal, and may be important for improved experiences before diagnosis. Access to other patients' lived experiences with the diagnostic process and with cancer, and an enhanced supportive

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Indigenous-led health care partnerships in Canada

Cited by 105 publications

References 30 publications

Bridging Western and Indigenous knowledge through intercultural dialogue: lessons from participatory research in Mexico

Bridging Western and Indigenous knowledge through intercultural dialogue: lessons from participatory research in Mexico

Education in uncertainty: Academic life as Indigenous health scholars during COVID-19

From symptom to cancer diagnosis: Perspectives of patients and family members in Alberta, Canada

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