Have investments in on-reserve health services and initiatives promoting community control improved First Nations’ health in Manitoba?

2010 ◽  
Vol 71 (4) ◽  
pp. 717-724 ◽  
Author(s):  
Josée Gabrielle Lavoie ◽  
Evelyn L. Forget ◽  
Tara Prakash ◽  
Matt Dahl ◽  
Patricia Martens ◽  
...  
2020 ◽  
Vol 57 (2) ◽  
pp. 346-362
Author(s):  
Corinne A Isaak ◽  
Natalie Mota ◽  
Maria Medved ◽  
Laurence Y Katz ◽  
Brenda Elias ◽  
...  

This qualitative study explored the fit between on-reserve First Nations community members’ conceptualizations of help-seeking for mental health concerns and the Andersen Behavioral Model of Health Services Use. Youth, adults and elders (N = 115) living and or working in eight distinct First Nations communities within a tribal council area in Canada participated in focus groups or individual interviews that were transcribed, coded and then analyzed using a thematic analysis approach informed by grounded theory methodology. Resulting themes were then mapped onto the Andersen Behavioral Model of Health Services Use. Participants’ conceptualizations of predisposing characteristics including social structures, health beliefs and mental illness, enabling and impeding resources had a high degree of fit with the model. While perspectives on perceived need for mental health care, and spirituality as a health and lifestyle practice had only moderate fit with the model, these domains could be modified to fit First Nations’ interpretations of help-seeking. Participants’ perceptions of avoidant strategies and non-use of mental health services, however did not map onto the model. These findings suggest conceptualizations of help-seeking for mental health issues in these First Nations communities are only partially characterized by the Andersen Behavioral Model, suggesting there are a number of considerations to Indigenize the model. Findings also highlight potential explanations for why some members of this population may not access or receive appropriate mental health treatment. Multi-pronged efforts are warranted to link culturally normed pathways of help-seeking with effective mental health supports for First Nations community members in Canada.


CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S92-S92
Author(s):  
P. McLane ◽  
D. Jagodzinsky ◽  
L. Bill ◽  
C. Barnabe ◽  
B. R. Holroyd ◽  
...  

Introduction: Emergency Departments (EDs) are frequently the first point of entry to access health services for First Nation (FN) members. In Alberta, FN members visit EDs at almost double the rate of non-FN persons. Furthermore, preliminary evidence demonstrates differences in ED experience for FN members as compared to the general population. The Alberta First Nations Information Governance Centre, Maskwacis Health Services, Yellowhead Tribal Council, Treaty 8 First Nations of Alberta, and Alberta Health Services are working together to research FN members ED experiences and concerns. Methods: This is participatory research guided by a two-eyed seeing approach that acknowledges the equal value of both Western and Indigenous worldviews. FN and non-FN leaders researchers are full partners in the development of the research project. Six sharing circles will be held in February 2018 across Alberta, with Elders, FN patients, FN and non-FN clinicians and FN and non-FN administrators. Sharing circles are similar to focus groups, but emphasize everyone having a turn to speak and demonstrating respect among participants in accordance with FN protocols. Elders will select the questions for discussion based on topics that arose in initial team meetings. Sharing circle discussions will be audio recorded and transcribed. Analysts will include both Western and Indigenous worldview researchers, who will collaboratively interpret findings. Elders will review, discuss, contextualize and expand upon study findings. The research is also guided by FN principles of Ownership, Control, Access, and Possession of FN information. It is through these principles that First Nation research projects can truly be classified as FN lead and driven. Results: Based on initial team meeting discussions, results of sharing circles are expected to provide insights on issues such as: healing, patient-provider communication (verbal and non-verbal), shared decision making, respect for patient preferences, experiences leading to trust or distrust, understandings of wait times and triage, times when multiple (repeat) ED presentations occur, distances travelled for care, choosing specific EDs when seeking care, impacts of stereotypes about FN patients, and racism and reconciliation. Conclusion: Understanding FN ED experience and bringing FN perspectives to Western conceptions of the goals and provision of ED care are important steps toward reconciliation.


2019 ◽  
Author(s):  
Marita Hefler ◽  
Vicki Kerrigan ◽  
Anne Grunseit ◽  
Becky Freeman ◽  
James Kite ◽  
...  

BACKGROUND Facebook is widely used by Australia’s First Nations people and has significant potential to promote health. However, evidence-based guidelines for its use in health promotion are lacking. Smoking prevalence among Australia’s First Nations people is nearly 3 times higher than other Australians. Locally designed programs in Aboriginal Community Controlled Health Services (ACCHOs) to reduce smoking often use Facebook. OBJECTIVE This study reports on an analysis of the reach and engagement of Facebook posts with smoking prevention and cessation messages posted by ACCHOs in the Northern Territory, Australia. METHODS Each service posted tobacco control content at least weekly for approximately 6 months. Posts were coded for the following variables: service posted, tailored First Nations Australian content, local or nonlocally produced content, video or nonvideo, communication technique, and emotional appeal. The overall reach, shares, and reactions were calculated. RESULTS Compared with posts developed by the health services, posts with content created by other sources had greater reach (adjusted incident rate ratio [IRR] 1.92, 95% CI 1.03-3.59). Similarly, reactions to posts (IRR 1.89, 95% CI 1.40-2.56) and shared posts (IRR 2.17, 95% CI 1.31-3.61) with content created by other sources also had more reactions, after controlling for reach, as did posts with local First Nations content compared with posts with no First Nations content (IRR 1.71, 95% CI 1.21-2.34). CONCLUSIONS Facebook posts with nonlocally produced content can be an important component of a social media campaign run by local health organizations. With the exception of nonlocally produced content, we did not find a definitive set of characteristics that were clearly associated with reach, shares, and reactions. Beyond reach, shares, and likes, further research is needed to understand the extent that social media content can influence health behavior.


Author(s):  
Heather Richards ◽  
Kim Varas ◽  
Samantha Magnus ◽  
Jinhwa Oh ◽  
Christine Voggenreiter

IntroductionA newly developed BC Ministry of Health geography classification has enabled a standardized approach for community-level analysis of health needs and service provision. An innovative methodology was developed and applied to health administrative data, creating more opportunities to identify variations in health status and utilization across the health system. Objectives and ApproachTwo design principles informed the development of the new geographies. Firstly, they reflect where people live and the communities with which they identify, and secondly, they will assist with identifying where health services are needed for local populations. The objective was to provide the Ministry and health authorities with a framework to identify and work towards providing the optimal delivery of services at the local level. A working group was established for this project and included representatives from the Ministry, each regional health authority, Provincial Health Services Authority, First Nations Health Authority, and BC Stats. ResultsThe building block for the geography classification is the Census Dissemination Block, the lowest unit of geography available in the Standard Geography Classification maintained by Statistics Canada. The geographies were assigned urban-rural designations based on an algorithm that considered the presence of a population centre, the size of the population centre, and the proportion of the population living in it, among other aspects. One of the main goals of the urban-rural designations was to provide meaningful peer groups for cross-jurisdictional studies. The project also reengineered the methods to geocode addresses to improve accuracy to use street addresses (over past method that used postal codes) so that assignment to Census Dissemination Block would be precise. The end result was 218 community geographies with urban-rural designations. Conclusion/ImplicationsThis geography standard allows health system stakeholders to better understand of geographic variation in utilization and access to health care. The ability to link and share information to profile community health between health administrative data and Census data available from Statistics Canada is better due to improved geocoding of addresses.


2021 ◽  
pp. 070674372110554
Author(s):  
Patricia Boksa ◽  
Daphne Hutt-MacLeod ◽  
Lacey Clair ◽  
Gregory Brass ◽  
Shirley Bighead ◽  
...  

Objective In many Indigenous communities, youth mental health services are inadequate. Six Indigenous communities participating in the ACCESS Open Minds (AOM) network implemented strategies to transform their youth mental health services. This report documents the demographic and clinical presentations of youth accessing AOM services at these Indigenous sites. Methods Four First Nations and two Inuit communities contributed to this study. Youth presenting for mental health services responded to a customized sociodemographic questionnaire and presenting concerns checklist, and scales assessing distress, self-rated health and mental health, and suicidal thoughts and behaviors. Results Combined data from the First Nations sites indicated that youth across the range of 11–29 years accessed services. More girls/women than boys/men accessed services; 17% identified as LBGTQ+. Most (83%) youth indicated having access to at least one reliable adult and getting along well with the people living with them. Twenty-five percent of youth reported difficulty meeting basic expenses. Kessler (K10) distress scores indicated that half likely had a moderate mental health problem and a fourth had severe problems. Fifty-five percent of youth rated their mental health as fair or poor, while 50% reported suicidal thoughts in the last month. Anxiety, stress, depression and sleep issues were the most common presenting problems. Fifty-one percent of youth either accessed services themselves or were referred by family members. AOM was the first mental health service accessed that year for 68% of youth. Conclusions This report is the first to present a demographic and clinical portrait of youth presenting at mental health services in multiple Indigenous settings in Canada. It illustrates the acceptability and feasibility of transforming youth mental health services using core principles tailored to meet communities’ unique needs, resources, and cultures, and evaluating these using a common protocol. Data obtained can be valuable in evaluating services and guiding future service design. Trial registration name and number at Clinicaltrials.gov: ACCESS Open Minds/ACCESS Esprits ouverts, ISRCTN23349893


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Adalberto Loyola-Sanchez ◽  
Ingris Pelaez-Ballestas ◽  
Lynden Crowshoe ◽  
Diane Lacaille ◽  
Rita Henderson ◽  
...  

Abstract Background Arthritis is a highly prevalent disease and leading cause of disability in the Indigenous population. A novel model of care consisting of a rheumatology outreach clinic in an on-reserve primary healthcare center has provided service to an Indigenous community in Southern Alberta since 2010. Despite quality assessments suggesting this model of care improves accessibility and is effective in meeting treatment targets, substantial improvements in patient-reported outcomes have not been realized. Therefore, the objective of this study was to explore the experiences of Indigenous persons with arthritis and healthcare providers involved in this model of care to inform the development of health service improvements that enhance patient outcomes. Methods This was a narrative-based qualitative study involving a purposeful sample of 32 individuals involved in the Indigenous rheumatology model of care. In-depth interviews were conducted to elicit experiences with the existing model of care and to encourage reflections on opportunities to improve it. A two-stage analysis was conducted. The first stage aimed to produce a narrative synthesis of concepts through a dialogical method comparing people with arthritis and health providers’ narratives. The second stage involved a collective effort to synthesize concepts and propose specific recommendations to improve the quality of the current model of care. Triangulation, through participant checking and discussion among researchers, was used to increase the validity of the final recommendations. Results Ten Indigenous people with arthritis lived experience, 14 health providers and 8 administrative staff were interviewed. One main overarching theme was identified, which reflected the need to provide services that improve people’s physical and mental functioning. Further, the following specific recommendations were identified: 1) enhancing patient-provider communication, 2) improving the continuity of the healthcare service, 3) increasing community awareness about the presence and negative impact of arthritis, and 4) increasing peer connections and support among people living with arthritis. Conclusions Improving the quality of the current Indigenous rheumatology model of care requires implementing strategies that improve functioning, patient-provider communication, continuity of care, community awareness and peer support. A community-based provider who supports people while navigating health services could facilitate the implementation of these strategies.


2017 ◽  
Vol 69 (4) ◽  
pp. 467-474 ◽  
Author(s):  
Cheryl Barnabe ◽  
C. Allyson Jones ◽  
Sasha Bernatsky ◽  
Christine A. Peschken ◽  
Don Voaklander ◽  
...  

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