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

Abstract

Given that the health care system for Indigenous people tends to be complex, fragmented, and multi-jurisdictional, their cancer experiences may be especially difficult. This needs assessment study examined system-level barriers and community strengths regarding cancer care experiences of Indigenous people in Saskatchewan. Guided by an advisory committee including Indigenous patient and family partners, we conducted key informant interviews with senior Saskatchewan health care administrators and Indigenous leaders to identify supports and barriers. A sharing circle with patients, survivors, and family members was used to gather cancer journey experiences from Indigenous communities from northern Saskatchewan. Analyses were presented to the committee for recommendations. Key informants identified cancer support barriers including access to care, coordination of care, a lack of culturally relevant health care provision, and education. Sharing circle participants discussed strengths and protective factors such as kinship, connection to culture, and spirituality. Indigenous patient navigation, inter-organization collaboration, and community relationship building were recommended to ameliorate barriers and bolster strengths. Recognizing barriers to access, coordination, culturally relevant health care provision, and education can further champion community strengths and protective factors and frame effective cancer care strategies and equitable cancer care for Indigenous people in Saskatchewan.

Perceptions of Inuit Women and Non-Inuit Healthcare Providers on the Implementation of Human Papillomavirus Self-Sampling as an Alternative Cervical Cancer Screening Method in Nunavik, Northern Quebec

“…The findings from this study are largely in line with other published literature across different Indigenous groups (Adcock et al, 2019; Butler et al, 2020; Dodd et al, 2021; Kolahdooz et al, 2014; Maar et al, 2013, 2016; Manderson & Hoban, 2006; Nugus et al, 2018; Whop et al, 2021; Witham et al, 2021). Namely, a common theme that arises across studies is the importance of providing culturally competent care when it comes to cervical cancer screening (Adcock et al, 2019; Butler et al, 2020; Kolahdooz et al, 2014; Witham et al, 2021). This need holds true for other healthcare services as well, as shown in a study exploring traumatic brain injury among women survivors of intimate partner violence within Indigenous populations in Canada, which discusses challenges around the need for culturally safe healthcare practices within Inuit communities (Haag et al, 2019).…”

“…The findings from this study are largely in line with other published literature across different Indigenous groups (Adcock et al, 2019; Butler et al, 2020; Dodd et al, 2021; Kolahdooz et al, 2014; Maar et al, 2013, 2016; Manderson & Hoban, 2006; Nugus et al, 2018; Whop et al, 2021; Witham et al, 2021). Namely, a common theme that arises across studies is the importance of providing culturally competent care when it comes to cervical cancer screening (Adcock et al, 2019; Butler et al, 2020; Kolahdooz et al, 2014; Witham et al, 2021).…”

“…A suggested method that came up in some studies to alleviate issues related to a lack of culturally safe care, at least in part, was the training of healthcare providers to increase cultural awareness and sensitivity (Maar et al, 2013). Along similar lines, a common facilitator that was reflected in this study as well as others was the emphasis on having educational initiatives rooted in the culture of the target population in order to render information on cervical cancer and screening more relevant and accessible (Adcock et al, 2019;Dodd et al, 2021;Maar et al, 2013Maar et al, , 2016Witham et al, 2021). For example, in a study exploring healthcare provider perspectives of structural barriers to cervical cancer screening across 11 First Nations communities in Northern Ontario, the majority of which were community members themselves, many participants agreed that "education is the biggest thing."…”

“Somebody That can Meet you on Your Level:” Cancer Survivors’ Perspectives on the Role of Indigenous Patient Navigators in Cancer Care

“…The support systems for Indigenous cancer survivors are well documented in qualitative research, and the important role of the family is evident ( Carr et al, 2020 ; Gifford et al, 2019 ; Roberts et al, 2020 ). In Witham and colleagues’ study, Indigenous patients, survivors, and family members highlighted the value of kinship ( Witham et al, 2022 ). The authors identified that family could play an important role in providing support for those who need to travel to attend medical appointments by hosting family members and attending appointments with them ( Witham et al, 2022 ).…”

“…A knowledge synthesis on trust and worldview in shared decision-making with Indigenous patients revealed that historical trauma, lack of system support, and lack of reciprocal respect contributed to a decreased trust in healthcare providers ( Groot et al, 2020 ). A needs assessment study, entitled Sâkipakâwin, explored the barriers to cancer support for First Nations and Métis people in Saskatchewan and highlighted the need for better support for Indigenous cancer survivors ( Witham et al, 2022 ).…”