scholarly journals An Analysis of Journey Mapping to Create a Palliative Care Pathway in a Canadian First Nations Community: Implications for Service Integration and Policy Development

2017 ◽  
Vol 10 ◽  
pp. 117822421771944 ◽  
Author(s):  
Jessica Koski ◽  
Mary Lou Kelley ◽  
Shevaun Nadin ◽  
Maxine Crow ◽  
Holly Prince ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health Services ◽  
First Nations ◽  
Policy Development ◽  
Care Pathway ◽  
Indigenous Health ◽  
Service Integration ◽  
Indigenous Communities ◽  
Future Research ◽  
Nations Community

Providing palliative care in Indigenous communities is of growing international interest. This study describes and analyzes a unique journey mapping process undertaken in a First Nations community in rural Canada. The goal of this participatory action research was to improve quality and access to palliative care at home by better integrating First Nations’ health services and urban non-Indigenous health services. Four journey mapping workshops were conducted to create a care pathway which was implemented with 6 clients. Workshop data were analyzed for learnings and promising practices. A follow-up focus group, workshop, and health care provider surveys identified the perceived benefits as improved service integration, improved palliative care, relationship building, communication, and partnerships. It is concluded that journey mapping improves service integration and is a promising practice for other First Nations communities. The implications for creating new policy to support developing culturally appropriate palliative care programs and cross-jurisdictional integration between the federal and provincial health services are discussed. Future research is required using an Indigenous paradigm.

Conceptualizations of help-seeking for mental health concerns in First Nations communities in Canada: A comparison of fit with the Andersen Behavioral Model

2020 ◽  
Vol 57 (2) ◽  
pp. 346-362
Author(s):  
Corinne A Isaak ◽  
Natalie Mota ◽  
Maria Medved ◽  
Laurence Y Katz ◽  
Brenda Elias ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
First Nations ◽  
Help Seeking ◽  
Behavioral Model ◽  
Community Members ◽  
Health Services Use ◽  
Health Concerns ◽  
Andersen Behavioral Model ◽  
Nations Community

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.

scholarly journals The second clinical survey of the population-based study on health and living conditions in regions with Sami and Norwegian populations – the SAMINOR 2 Clinical Survey: Performing indigenous health research in a multiethnic landscape

2019 ◽  
Vol 48 (6) ◽  
pp. 583-593 ◽  
Author(s):  
Ann Ragnhild Broderstad ◽  
Solrunn Hansen ◽  
Marita Melhus
Keyword(s):  
Ethnic Groups ◽  
Indigenous Health ◽  
Participation Rate ◽  
Indigenous Communities ◽  
Glycated Haemoglobin ◽  
Population Based ◽  
Living Conditions ◽  
Future Research ◽  
Cross Sectional ◽  
Clinical Survey

Background Globally, there is a huge lack of relevant research about widespread lifestyle diseases and living conditions in indigenous communities. Northern and Middle Norway have a history of multiple ethnic groups and the Sami has been acknowledged as the indigenous people of Norway by the Norwegian State. The SAMINOR 2 Clinical Survey, a part of the SAMINOR Study, was carried out to provide health information about the Sami population in Norway. Methods The cross-sectional population-based SAMINOR 2 Clinical Survey consists of both questionnaires and a clinical examination performed in 10 municipalities during 2012–2014. Results In total, 6004 men and women (participation rate 48%) aged 40–79 years took part in this study. In inland Finnmark, the Sami are in the majority (80–90%) as opposed to the coastline of Troms and Nordland, where the Sami population form a minority (20%). More women than men participated (54% versus 43%, respectively). Obesity was prevalent in this sample and a high mean glycated haemoglobin was observed. Conclusions: This article describes the methods and data collection of the SAMINOR 2 Clinical Survey and presents some characteristics of the sample. The definition of ethnic groups is a core question in the survey and includes several criteria. To ensure that indigenous values and priorities are reflected in the research themes, we recommend that future research projects be directed in close collaboration with the Sami Parliament and the local communities.

‘Best Intentions’ Lives on: Untoward Health Outcomes of Some Contemporary Initiatives in Indigenous Affairs

2002 ◽  
Vol 36 (5) ◽  
pp. 575-584 ◽  
Author(s):  
Ernest Hunter
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Social Issues ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Indigenous Populations ◽  
Royal Commission ◽  
Indigenous Mental Health

Objective: A shortened version of a presentation to the Australian Institute of Aboriginal and Torres Strait Islander Studies, this paper raises questions regarding policy and program directions in Indigenous affairs with consequences for Indigenous health. Method: The author notes the inadequate Indigenous mental health database, and describes contemporary conflicts in the arena of Indigenous mental health, drawing on personal experience in clinical service delivery, policy and programme development. Results: Medicalized responses to the Stolen Generations report and constructions of suicide that accompanied the Royal Commission into Aboriginal Deaths in Custody are presented to demonstrate unforeseen health outcomes. Examples are also given of wellintentioned social interventions that, in the context of contemporary Indigenous society appear to be contributing to, rather than alleviating, harm. Problems of setting priorities that confront mental health service planners are considered in the light of past and continuing social disadvantage that informs the burden of mental disorder in Indigenous communities. Conclusions: The importance of acknowledging untoward outcomes of initiatives, even when motivated by concerns for social justice, is emphasized. The tension within mental health services of responding to the underpinning social issues versus providing equity in access to proven mental health services for Indigenous populations is considered.

scholarly journals Reforming Indigenous policing: Understanding the context for change

2020 ◽  
Vol 5 (4) ◽  
pp. 144-155
Author(s):  
Rick Ruddell ◽  
John Kiedrowski
Keyword(s):  
First Nations ◽  
Indigenous People ◽  
Urban Areas ◽  
Policy Development ◽  
Public Safety ◽  
Indigenous Communities ◽  
Social Spending ◽  
Urban Policing ◽  
Research And Policy

Protests over the policing of Black and Indigenous people and people of Colour that started after the death of George Floyd in May 2020 at the hands of the Minneapolis police set the stage for debates about the role of the Canadian police in ensuring public safety. These protests have resulted in calls for police reforms, including reallocating police funding to other social spending. The public’s attention has focused on urban policing, and there has been comparatively little focus on policing rural Indigenous communities. We address this gap in the literature, arguing that Indigenous policing is distinctively different than what happens in urban areas and the challenges posed in these places are unlike the ones municipal officers confront. We identify ten specific challenges that define the context for Indigenous policing that must be considered before reforms are undertaken. Implications for further research and policy development are identified, including founding a commission to oversee First Nations policing.

scholarly journals Moving Towards an Indigenous Research Process: A Reflexive Approach to Empirical Work With First Nations Communities in Canada

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Elaine Toombs ◽  
Alexandra S Drawson ◽  
Lori Chambers ◽  
Tina L. R. Bobinski ◽  
John Dixon ◽  
...  
Keyword(s):  
First Nations ◽  
Empirical Work ◽  
Indigenous Communities ◽  
Research Process ◽  
Careful Examination ◽  
Future Research ◽  
Advisory Group ◽  
Indigenous Research ◽  
Community Values ◽  
Qualitative Research Study

Moving towards reconciliation within Indigenous research requires the careful examination of existing practices at all stages of the research process. Engagement in and dissemination of reflexive processes may increase the relevance of research results for Indigenous communities and partners. This article describes and contextualizes the results obtained from this qualitative research study examining parenting needs and child reunification in these communities. The initial results were deemed relevant by the partnering community but research stakeholders reported that they did not reflect all community values. Based on the advice of the Research Advisory Group, the research team decided to further analyze the results to address these shortcomings. The reanalysis process focused on improving the perceived meaningfulness and relevance to communities. Exploration of how these results were re-situated in an Indigenous framework of wellbeing is discussed. Researcher reflections about the project processes and considerations for future research are explored.

scholarly journals Demographic and Clinical Presentations of Youth using Enhanced Mental Health Services in Six Indigenous Communities from the ACCESS Open Minds Network

2021 ◽  
pp. 070674372110554
Author(s):  
Patricia Boksa ◽  
Daphne Hutt-MacLeod ◽  
Lacey Clair ◽  
Gregory Brass ◽  
Shirley Bighead ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
First Nations ◽  
Indigenous Communities ◽  
Youth Mental Health ◽  
Suicidal Thoughts ◽  
The People ◽  
Clinical Presentations ◽  
Suicidal Thoughts And Behaviors

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

scholarly journals Toward a New Era of Policy: Health Care Service Delivery to First Nations

2011 ◽  
Vol 2 (1) ◽  
Author(s):  
Miranda D Kelly
Keyword(s):  
Health Care ◽  
Health Policy ◽  
First Nations ◽  
Policy Development ◽  
Indigenous Health ◽  
Care Service ◽  
Health Care Service ◽  
New Era ◽  
Recent Developments ◽  
Health Care Service Delivery

The disproportionate burdens of ill health experienced by First Nations have been attributed to an uncoordinated, fragmented health care system. This system is rooted in public policies that have created jurisdictional gaps and a long-standing debate between federal, provincial and First Nations governments as to who is responsible for First Nations health care. This article examines: (1) the policies that shape First Nations health care in Canada and in the province of British Columbia (BC) specifically; (2) the interests of the actors involved in First Nations health policy; and (3) recent developments in BC that present an opportunity for change to First Nations health policy development and have broader implications for Indigenous health policy across Canada and worldwide.

scholarly journals Renewable energy and energy autonomy: how Indigenous peoples in Canada are shaping an energy future

2019 ◽  
Vol 27 (1) ◽  
pp. 95-105 ◽  
Author(s):  
Robert D. Stefanelli ◽  
Chad Walker ◽  
Derek Kornelsen ◽  
Diana Lewis ◽  
Debbie H. Martin ◽  
...  
Keyword(s):  
Climate Change ◽  
Renewable Energy ◽  
First Nations ◽  
Indigenous Peoples ◽  
Keyword Search ◽  
Grey Literature ◽  
Clean Energy ◽  
Indigenous Communities ◽  
Future Research ◽  
Energy Autonomy

In 2015, the Liberal Party of Canada formed a majority federal government on a platform that included prioritizing Nation-to-Nation relationships with Indigenous (First Nations, Inuit, and Métis) peoples in the country and re-asserting global leadership in climate change action by moving away from fossil-fuel based extraction and toward renewable energy initiatives. It may be argued that addressing both of these issues, advancing Indigenous–Settler reconciliation, and mitigating climate change, can be done in the same space. Indeed, though Indigenous peoples in Canada and elsewhere have recently moved forward with renewable energy initiatives within their Territories, there has been very little critical analysis on just how such projects have been operationalized and whether renewable energy can or even should be considered a vehicle for reconciliation efforts. In this paper, we present a systematic review of Canadian literature (spanning from 1980 to 2017) concerning Indigenous peoples’ involvement in renewable energy to better understand the stated motivations and desires of Indigenous peoples in Canada taking leadership, partnering in, and (or) participating in the renewable energy sector. Using a series of keyword search strings across three academic databases, two theses databases, and a grey literature search, we retrieved literature (n = 980) that was subjected to four exclusionary forms and then thematically analyzed the included literature (n = 26). Our findings suggest Indigenous peoples’ experiences and motivations are varied, yet many are developing renewable energy in their Territories to: break free of colonial ties, move towards energy autonomy, establish more reliable energy systems, and reap the long-term financial benefits that clean energy can provide. Despite the apparent advantages seen throughout most of the literature reviewed here, we suggest further research in this area is necessary before this kind of positive rhetoric of renewable energy in Indigenous communities builds enough momentum that proponents become blind to possible shortcomings. We conclude with a broader discussion of the interactions between Indigenous–Settler reconciliation in the context of renewable energy projects as well as offering indicators for future research to fill current knowledge gaps.

scholarly journals Ethical research engagement with Indigenous communities

2020 ◽  
Vol 7 ◽  
pp. 205566832092270
Author(s):  
Carrie Bourassa ◽  
Jennifer Billan ◽  
Danette Starblanket ◽  
Sadie Anderson ◽  
Marlin Legare ◽  
...  
Keyword(s):  
First Nations ◽  
Advisory Committee ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Cultural Safety ◽  
Community Research ◽  
Training Module ◽  
Research Engagement ◽  
Morning Star ◽  
Tribal Council

Introduction Canada’s colonial policies and practices have led to barriers for Indigenous older adults’ access to healthcare and research. As a result, there is a need for Indigenous-led research and culturally safe practices. Morning Star Lodge is developing a training module to assist AgingTech researchers on ethical, culturally safe ways to engage Indigenous communities. This includes exploring Indigenous health research, community-based partnerships, reciprocal learning, and cultural safety; this is presented through a case study on ethically engaged research. Methods Morning Star Lodge developed a research partnership agreement with File Hills Qu’Appelle Tribal Council and established a Community Research Advisory Committee representing the eleven First Nations within the Tribal Council. The work designing the culturally safe training module is in collaboration with the Community Research Advisory Committee. Results Building research partnerships and capacities has changed the way the eleven First Nation communities within File Hills Qu’Appelle Tribal Council view research. As a result, they now disseminate the Knowledge within their own networks. Conclusions Indigenous Peoples are resilient in ensuring their sustainability and have far more community engagement and direction. Developing culturally safe approaches to care for Indigenous communities leads to self-determined research. Culturally safe training modules can be applied to marginalized demographics.

scholarly journals Commentary - The Climate Change and Health Adaptation Program: Indigenous Climate Leaders’ Championing Adaptation Efforts

2019 ◽  
Vol 39 (4) ◽  
pp. 127-130 ◽  
Author(s):  
Gabrielle Richards ◽  
Jim Frehs ◽  
Erin Myers ◽  
Marilyn Van Bibber
Keyword(s):  
Climate Change ◽  
First Nations ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
First Nation ◽  
Health Impacts ◽  
Community Based ◽  
Health Canada ◽  
Climate Change And Health ◽  
Impacts Of Climate Change

The Climate Change and Health Adaptation Program (CCHAP) is a program within the First Nations Inuit Health Branch of Indigenous Services Canada (which was previously under the responsibility of Health Canada). The CCHAP supports Inuit and First Nation communities in mitigating and adapting to the health impacts of climate change. The impacts of climate change on Indigenous health can be observed in multiple areas including, but not limited to, food security, cultural medicines, mental health and landbased practices. This program seeks to address the needs of climate change and health in First Nation and Inuit communities to support resiliency and adaptation to a changing climate both now and in the future through its emphasis on youth and capacity building. The commentary is based on the Program’s eleven years of experience working with and for Indigenous communities and provides an overview of the CCHAP model and the work it has and continues to support. This paper demonstrates three examples of community-based projects to mitigate and adapt to the health impacts of climate change to demonstrate climate change resiliency within Indigenous communities.

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