Client and staff experiences assessing adverse childhood experiences in a clinical setting: Results from the First Nations ACE Study

Abstract

BackgroundConducting culturally-relevant research with Indigenous populations requires a balance of approaches that benefit Indigenous communities, while perceiving and mitigating the potential risk of harm when engaging in research-related activities. Reducing the burden of research is especially useful for research with Indigenous populations as ongoing systemic marginalization and discrimination through historical colonial practices may result in a higher likelihood of experiencing harm from research activities. One way to ensure that stakeholder experiences with the research processes are not burdensome, and to understand how study implementation practices are perceived across research teams, supporting organizations, and individual participants is to build this into the study method. ObjectiveThe current study describes stakeholder experiences within a broader research study, entitled the First Nations ACE Study, which examined early childhood experiences and health outcomes for Indigenous people seeking treatment for substance use. Participants and settingFive treatment centre staff participated in ongoing consultations with the research team and described their experiences within a Community-Based Participatory Research (CBPR) study. MethodA document review of client satisfaction questionnaires of seventy-five participants provided quantitative feedback on experiences in addition to qualitative interviews with staff. ResultsOverall, experiences of both treatment centre staff and clients were generally positive. Additional results described the importance of continuous stakeholder participation, and ongoing study adaptations to remain aligned with CBPR approaches as pressure for expediency and convenience have the potential to encroach upon CBPR values. The study method was described to mitigate participant and staff burden, as well as risk of participant harm. ConclusionsDirections for future research are discussed, including discussion of modifications that will be made to future iterations of the presented research study.