Interventions to improve cancer survivorship among Indigenous Peoples and communities: a systematic review with a narrative synthesis

Abstract

Purpose The purpose of this systematic review is to synthesize the evidence on the types of interventions that have been utilized by Indigenous Peoples living with cancer, and report on their relevance to Indigenous communities and how they align with holistic wellness. Methods A systematic review with narrative synthesis was conducted. Results The search yielded 7995 unique records; 27 studies evaluating 20 interventions were included. The majority of studies were conducted in USA, with five in Australia and one in Peru. Study designs were cross-sectional (n=13); qualitative (n=5); mixed methods (n=4); experimental (n=3); and quasi-experimental (n=2). Relevance to participating Indigenous communities was rated moderate to low. Interventions were diverse in aims, ingredients, and outcomes. Aims involved (1) supporting the healthcare journey, (2) increasing knowledge, (3) providing psychosocial support, and (4) promoting dialogue about cancer. The main ingredients of the interventions were community meetings, patient navigation, arts, and printed/online/audio materials. Participants were predominately female. Eighty-nine percent of studies showed positive influences on the outcomes evaluated. No studies addressed all four dimensions of holistic wellness (physical, mental, social, and spiritual) that are central to Indigenous health in many communities. Conclusion Studies we found represented a small number of Indigenous Nations and Peoples and did not meet relevance standards in their reporting of engagement with Indigenous communities. To improve the cancer survivorship journey, we need interventions that are relevant, culturally safe and effective, and honoring the diverse conceptualizations of health and wellness among Indigenous Peoples around the world.

Understanding culturally safe cancer survivorship care with inuit in an urban community

“…Healy & Tagak [21] have identified that although novel research approaches have sought to involve Inuit patients, such as participatory action research, these approaches are still fundamentally grounded in Western ideologies and epistemologies. A recent systematic review on cancer survivorship interventions utilised among Indigenous people found studies predominately used research methodologies that do not represent Indigenous approaches to knowledge development [66]. For example, a study with American Indian and Alaska Natives reported that participants were not receptive to the survey as a form of data collection, however they positively engaged with the arts based intervention [67].…”

A mixed‐methods systematic review of interventions to improve leadership competencies of managers supervising nurses

“…We chose to use a numerical rating system for quality assessment that is not present in JBI tools, so we used the McMaster Critical Review tool for quantitative and qualitative studies (Law et al, 1998;Letts et al, 2007). We adopted a scoring system used in previously published systematic reviews (Gifford et al, 2018(Gifford et al, , 2021. For each article, a rating score was derived by taking the number obtained in the quality rating and dividing it by the total number of possible points allowed, giving each manuscript a total quality rating between 0 and 1.…”

Sâkipakâwin: Assessing Indigenous Cancer Supports in Saskatchewan Using a Strength-Based Approach

“…Additionally, other studies have indicated that creating safe spaces to talk about diagnosis was often missing in the cancer support system [ 19 ]. Indigenous patients may experience marginalization in the health system, limited social support, or a reluctance to face social stigma around cancer diagnosis [ 17 , 19 , 28 ]. Factors such as limited local services, lack of education, and barriers to screening can be associated with later diagnosis in First Nations [ 13 , 19 ].…”

“…Factors such as limited local services, lack of education, and barriers to screening can be associated with later diagnosis in First Nations [ 13 , 19 ]. Although studies in Canada have investigated Indigenous-specific cancer care access [ 29 ], decision-making [ 30 ], epidemiology [ 31 ], and the role of spirituality during the cancer journey [ 28 ], current studies about Indigenous cancer care in Saskatchewan are either outdated or scarce [ 10 , 31 ]. Some research has examined Indigenous cancer patient experiences using sharing circle methods [ 25 , 32 ], or explored cancer care supports from service provider views [ 8 ].…”