INDIGENOUS SUPPORT SERVICES IN CANADIAN CARDIAC CENTRES

Abstract

BackgroundIndigenous people have a higher frequency of cardiovascular disease (CVD) compared to the general Canadian population associated with earlier onset of common risk factors. Additionally, disparities in income, housing, education, access to health care services, also contribute to increasing and unmeasured risk of CVD in Indigenous people. Historical and ongoing colonial structures resulting in systemic racial discrimination, loss of language and cultural identity, negatively influence the health of Indigenous people. A strategy of interest to diminish CVD health disparities focuses on access to CVD care, with the goal of improving CVD management in Canada. Evidence suggests that culturally specific support services during a patient’s disease trajectory result in increased engagement in treatment and follow-up care. Specifically in Canada, privately and government funded Indigenous patient support services exist, as a strategy to diminish the ongoing impacts of colonialism. However, what is unknown is whether these services are being accessed or used appropriately within Canadian cardiac centres.Methods and ResultsWe surveyed physician leads at Canadian cardiac centres through SurveyMonkey. Of the 44 Canadian cardiac centres, 20 responses were received and analyzed (response rate 45%). Of respondents, 70% were from an academic centre. The responding centres were from Western Canada (20%), the Prairies (10%), Central Canada (60%), and the Maritimes (10%). Most respondents (70%) regularly care for Indigenous patients and correspondingly, 60% of respondents have access to or are required to complete Indigenous cultural safety training. However, most respondents (59%) report lack of knowledge or experience with Indigenous patient support services as the largest barrier to use of these services (see figure 1). Most respondents (75%) have Indigenous patient support services within their cardiac centre, but only 55% of respondents have accessed these services at some point. Only a quarter of respondents consistently refer their Indigenous patients to culturally specific support services. 15% of respondents do not have Indigenous patients support services at all. Transportation and accommodation services were the most accessed with almost no access to Indigenous patient support groups or Indigenous Elders. Furthermore, most respondents (75%) report that Indigenous patient support personnel rarely or never participate in person for decisions related to the care of Indigenous patients.Conclusion BackgroundIndigenous people have a higher frequency of cardiovascular disease (CVD) compared to the general Canadian population associated with earlier onset of common risk factors. Additionally, disparities in income, housing, education, access to health care services, also contribute to increasing and unmeasured risk of CVD in Indigenous people. Historical and ongoing colonial structures resulting in systemic racial discrimination, loss of language and cultural identity, negatively influence the health of Indigenous people. A strategy of interest to diminish CVD health disparities focuses on access to CVD care, with the goal of improving CVD management in Canada. Evidence suggests that culturally specific support services during a patient’s disease trajectory result in increased engagement in treatment and follow-up care. Specifically in Canada, privately and government funded Indigenous patient support services exist, as a strategy to diminish the ongoing impacts of colonialism. However, what is unknown is whether these services are being accessed or used appropriately within Canadian cardiac centres. Indigenous people have a higher frequency of cardiovascular disease (CVD) compared to the general Canadian population associated with earlier onset of common risk factors. Additionally, disparities in income, housing, education, access to health care services, also contribute to increasing and unmeasured risk of CVD in Indigenous people. Historical and ongoing colonial structures resulting in systemic racial discrimination, loss of language and cultural identity, negatively influence the health of Indigenous people. A strategy of interest to diminish CVD health disparities focuses on access to CVD care, with the goal of improving CVD management in Canada. Evidence suggests that culturally specific support services during a patient’s disease trajectory result in increased engagement in treatment and follow-up care. Specifically in Canada, privately and government funded Indigenous patient support services exist, as a strategy to diminish the ongoing impacts of colonialism. However, what is unknown is whether these services are being accessed or used appropriately within Canadian cardiac centres. Methods and ResultsWe surveyed physician leads at Canadian cardiac centres through SurveyMonkey. Of the 44 Canadian cardiac centres, 20 responses were received and analyzed (response rate 45%). Of respondents, 70% were from an academic centre. The responding centres were from Western Canada (20%), the Prairies (10%), Central Canada (60%), and the Maritimes (10%). Most respondents (70%) regularly care for Indigenous patients and correspondingly, 60% of respondents have access to or are required to complete Indigenous cultural safety training. However, most respondents (59%) report lack of knowledge or experience with Indigenous patient support services as the largest barrier to use of these services (see figure 1). Most respondents (75%) have Indigenous patient support services within their cardiac centre, but only 55% of respondents have accessed these services at some point. Only a quarter of respondents consistently refer their Indigenous patients to culturally specific support services. 15% of respondents do not have Indigenous patients support services at all. Transportation and accommodation services were the most accessed with almost no access to Indigenous patient support groups or Indigenous Elders. Furthermore, most respondents (75%) report that Indigenous patient support personnel rarely or never participate in person for decisions related to the care of Indigenous patients. We surveyed physician leads at Canadian cardiac centres through SurveyMonkey. Of the 44 Canadian cardiac centres, 20 responses were received and analyzed (response rate 45%). Of respondents, 70% were from an academic centre. The responding centres were from Western Canada (20%), the Prairies (10%), Central Canada (60%), and the Maritimes (10%). Most respondents (70%) regularly care for Indigenous patients and correspondingly, 60% of respondents have access to or are required to complete Indigenous cultural safety training. However, most respondents (59%) report lack of knowledge or experience with Indigenous patient support services as the largest barrier to use of these services (see figure 1). Most respondents (75%) have Indigenous patient support services within their cardiac centre, but only 55% of respondents have accessed these services at some point. Only a quarter of respondents consistently refer their Indigenous patients to culturally specific support services. 15% of respondents do not have Indigenous patients support services at all. Transportation and accommodation services were the most accessed with almost no access to Indigenous patient support groups or Indigenous Elders. Furthermore, most respondents (75%) report that Indigenous patient support personnel rarely or never participate in person for decisions related to the care of Indigenous patients. Conclusion