Inuit parent perspectives on sexual health communication with adolescent children in Nunavut: “It's kinda hard for me to try to find the words”

Abstract

BackgroundFor Inuit, the family unit has always played a central role in life and in survival. Social changes in Inuit communities have resulted in significant transformations to economic, political and cultural aspects of Inuit society. Where the family unit was once the setting for dialogue on family relations and sexuality, this has largely been replaced by teachings from the medical community and/or the school system.ObjectiveThe purpose of this study was to explore Inuit parent perspectives on sharing knowledge with teenage children about sexual health and relationships.MethodA qualitative Indigenous knowledge approach was used for this study with a focus on Inuit ways of knowing as described in the Piliriqattigiinniq Community Health Research Partnership Model. Interviews were conducted with 20 individual parents in 3 Nunavut communities in 2011. Parents were asked about whether and how they talk to their children about sexual health and relationships. An analytical approach building on the concept of Iqqaumaqatigiiniq (“all knowing coming into one”), which is similar to “immersion and crystallization,” was used to identify story elements, groupings or themes in the data. The stories shared by parents are honoured, keeping their words intact as often as possible in the presentation of results.ResultsParents shared stories of themselves, family members and observations of the community. Fifteen of 17 mothers in the study reported having experienced sexual abuse as children or adolescents. Parents identified the challenges that they have and continue to experience as a result of forced settlement, family displacement and the transition of Inuit society. They expressed a desire to teach their children about sexual health and relationships and identified the need for emotional support to do this in the wake of the trauma they have experienced. Parents highly valued elders and the knowledge they have about family relationships and childrearing.ConclusionThere are powerful, unresolved healing issues in Inuit communities. The traumatic experiences of the settlement and residential school era continue to have an impact on present-day family relationships. To support parent–child dialogue on sexual health and relationships, parents identified a need to repair relationships between youth and elders, and to provide culturally sensitive support to parents to heal from trauma.

Youth perspectives on sexually transmitted infections and sexual health in Northern Canada and implications for public health practice

“…They almost universally rejected the school system, the nurse/community health representative and the Internet as preferred sources of knowledge about sexual health and relationships. The protective benefits of parent–adolescent communication about sexual health are well known (8,10,27,52). In a youth sexual health study in Greenland, Rink, Montgomery-Anderson and Anastario found that the influence of having a parent/guardian to speak with about topics related to sex, including the consequences of pregnancy, was a key protective factor in reducing STIs among Greenlandic youth (44).…”

“…Westernization and colonization have been identified in the literature as negative influences on sexual health because of the loss of the accumulated wisdom and knowledge of Inuit regarding the life cycle, reproductive health and family planning which are no longer shared by Inuit families, and contributed to many Inuit parents and grandparents no longer feeling competent to instruct their children (1,18,26,27). …”

“…High rates of STIs in the Arctic have been a focus of recent research, and youth are believed to be at greatest risk of infection (26,27,44,45). There is a paucity of research that has focused on understanding youth perspectives on sexual health.…”

Teen pregnancy in Inuit communities – gaps still needed to be filled

“…From 2003 to 2009, the rate of teenage pregnancy has grown from 118.8 to 161.3/1,000 in Nunavut, roughly four times higher than for other Canadian teens in the same year (7,9). In comparison to the Canadian population as a whole in 2009, 20% of births in Nunavut occurred among women aged between 15 and 19 years, in contrast with only 4% for Canadian women within the same age group (6).…”

“…The youngest generation of adults has suffered from this cultural break and had to learn about sexuality almost solely from medical resources, school system and internet (9,20,47). Inuit parents from Nunavut admitted having trouble explaining the concepts of a healthy sexual life to their teenaged children partly due to the traumatic experiences of residential schools (9). In 2004, the majority of Inuit students felt that they were not taught enough in school about sexually transmitted infections and contraception (20).…”