On the move: Exploring health service providers’ perspectives about family participation in care in Nunavik, a qualitative study.

Abstract

BackgroundLiterature on participation in health and social services suggests that youth are difficult to engage within health and social services. Indigenous youth are less likely to access services or to actively participate in decision-making regarding their personal care. This article analyzes health and social service providers’ perspectives, experiences and expectations regarding the roles of a particular group of Indigenous youth, families and community in care settings in Nunavik, Quebec.MethodsA snowball sampling method was used to recruit participants. A total of 58 participants were interviewed including psychiatrists, general practitioners, nurses, social workers, school principals, teachers, student counsellors, representatives of local committees (education committee, health committee), and police officers. Of the 58 participants, 39 were non-Inuit and 19 were Inuit. The interviews focused on three broad themes: 1) participants’ current and past positions/roles; 2) participants’ perceptions of the clientele (youth and their families) they work with; and 3) participants’ understanding of collaborations taking place within and between services (who works with whom) and community. Applied thematic analyses were conducted. The model that we present allows us to describe health service provider expectations and experiences regarding patient and community participation. ResultsWe organize findings around three themes: I) The most commonly described interventions, II) different types of challenges to and within participation; and III) what successful participation can look like according to service providers. Participants speak of the challenges for families to go towards services as well as the challenges for services providers to go towards youth and families, including personal, organisational and historical factors. ConclusionWe adopt a critical lens to reflect on the key findings in order to tease out points of tension and paradoxes that might hinder the participation of youth and families. We then use a constructive lens to amalgamate and build on service providers’ descriptions of challenges and successes to identify promising approaches that seem to encourage participation of youth and families.