An integrated knowledge translation approach to develop a shared decision-making strategy for use by Inuit in cancer care: a qualitative study.

J Jull,I D Graham,A J Sheppard,G Joudain,A Kewayosh,D Dorschner,A Hizaka,The Inuit Medical Interpreter Team ,M Rand,M Habash,J Plourde,P Doering,L Macleod

doi:10.3747/co.26.4729

J Jull, I D Graham + Show 11 more

Open Access

https://doi.org/10.3747/co.26.4729

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Abstract

In relation to the general Canadian population, Inuit face increased cancer risks and barriers to health services use. In shared decision-making (sdm), health care providers and patients make health care decisions together. Enhanced participation in cancer care decisions is a need for Inuit. Integrated knowledge translation (kt) supports the development of research evidence that is likely to be patient-centred and applied in practice. Using an integrated kt approach, we set out to promote the use of sdm by Inuit in cancer care. An integrated kt study involving researchers with a Steering Committee of cancer care system partners who support Inuit in cancer care ("the team") consisted of 2 theory-driven phases:■ using consensus-building methods to tailor a previously developed sdm strategy and developing training in the sdm strategy; and■ training community support workers (csws) in the sdm strategy and testing the sdm strategy with community members. The team developed a sdm strategy that included a workshop and a booklet with 6 questions for use by csws with patients. The sdm strategy (training and booklet) was finalized based on feedback from 5 urban-based Inuit csws who were recruited and trained in using the strategy. Trained csws were matched with 8 community members, and use of the sdm strategy was assessed during interviews, reported as 6 themes. Participants found the sdm strategy to be useful and feasible for use. An integrated kt approach of structured research processes with partners developed a sdm strategy for use by Inuit in cancer care. Further work is needed to test the sdm strategy.

Highlights

In relation to the general Canadian population, Inuit face increased cancer risks and barriers to health services use
Trained csws were matched with 8 community members, and use of the sdm strategy was assessed during interviews, reported as 6 themes
An integrated kt approach of structured research processes with partners developed a sdm strategy for use by Inuit in cancer care

Summary

Introduction

In relation to the general Canadian population, Inuit face increased cancer risks and barriers to health services use. Inuit are inventive and resourceful and are dedicated to supporting the well-being of their community and loved ones. In mainstream Western-oriented health care settings, a lack of cultural awareness has been shown to have a deleterious effect on the health services participation rates of Inuit, First Nations, and Métis (Indigenous) peoples[4,5,6,7], increasing the risk that Indigenous people will encounter racism when seeking care[8,9]. Inuit must overcome intimidating and unfamiliar bureaucratic barriers to obtain cancer care. All of those conditions might undermine opportunities for health and wellness. Inuit must navigate the complexities of an unfamiliar health care system, often while facing significant language barriers[13]

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