Native Research Articles

Gastroesophageal reflux disease and risk factors in schoolchildren

Aim. To study the association between family predisposition to gastrointestinal diseases with gastroesophageal reflux disease (GERD) in schoolchildren in ethnic populations of Tuva. Material and methods. A total of one thousand seventy nine children (761 Mongoloid-Tuvinian and 318 Caucasian) aged of 7–17 years in the Republic of Tyva were examined. Anamnestic data and information on gastrointestinal complaints in schoolchildren were obtained. The diagnostic criterion for GERD was complaints of weekly heartburn. Statistical analysis was performed using the Pearson chi-square test. Results. GERD children more often had anamnestic data on gastritis (p = 0.025), gastric ulcer (p = 0.039) and oncological diseases of the gastrointestinal tract (p = 0.052) in parents. At the same time, schoolchildren of the indigenous population with GERD manifestations had greater unfavourable conditions for a number of diseases in parents: gastritis (p = 0.01), gastric ulcer (p = 0.012). Whereas in Caucasians, a similar association was not established. The association between GERD in schoolchildren and gastrointestinal pathology in grandparents (2nd degree of kinship) also concerned only Tuvans in the presence of gastritis (p = 0.023). Summary data on family history of gastrointestinal diseases (1st and 2nd generation relatives) in GERD children, as expected, prevailed in Tuvans (gastritis (p = 0.004), peptic ulcer (p = 0.033) and specifically gastric ulcer (p = 0.02)). A more negative association between GERD in Tuvan children and a family predisposition to gastrointestinal diseases, in contrast to Caucasians, may be due to a higher prevalence of a number of gastrointestinal diseases in adults and is related with the functional features of the system, formed under the influence of the features of traditional life and nutrition. Conclusion. In the Republic of Tyva, GERD in native schoolchildren is associated with a wide range of gastrointestinal diseases in relatives.

Determinants of socioemotional and behavioral well-being among First Nations children living off-reserve in Canada: A cross-sectional study.

Few studies have focused on off-reserve Indigenous children and families. This nationally representative, cross-sectional study (data collected from 2006 to 2007) examined Indigenous- and non-Indigenous-specific determinants associated with positive socioemotional and behavioral well-being among First Nations children living off-reserve in Canada. The parents or other caregivers of 2990 two-to-five-year-old children (M = 3.65; 50.6% male) reported on their children's socioemotional and behavioral well-being and a range of child, parent, and housing characteristics. Being taught an Indigenous culture, greater community cohesion, caregiver nurturance, good parental/other caregiver health, and fewer household members were associated with better socioemotional and behavioral well-being. These results highlight the importance of leveraging Indigenous-specific determinants and acknowledging non-Indigenous-specific factors, to promote the well-being of First Nations children living off-reserve.

Geoparks Twinning Agreements, A Vision from Formality and Territorial Links. Mixteca Alta (Mexico) and Napo Sumaco (Ecuador) Geoparks as Comparative Cases

AbstractCurrently, geoparks represent territories with great potential for the generation of educational and conservation processes, with productive and community development strategies through geotourism, using their natural and unique attributes, in a coordinated effort to improve the quality of life of their communities, based on the sustainable use of sites of geological interest of global importance. On the way to the construction of geoparks, territories find elements in common with other territories pursuing similar objectives, which leads to the creation of synergies and commonwealths. Working together in a network represents one of the most solid pillars of the geoparks, being a fundamental contribution to society. Geopark twinning is an alternative to promote micro-partnerships between geoparks with similar conditions and characteristics, which allow strengthening internal processes, as well as the exchange of knowledge, strategies and experiences, and the strengthening of institutional and management capacities. In addition, twinning arrangements are management tools that also serve as instruments to merge and unite identities in territories that are compatible in several areas, beyond geological heritage. In this sense, the present work shows the case studies of Mixteca Alta UNESCO Global Geopark (MAUGG) and Napo Sumaco Aspiring UNESCO Global Geopark (NSAUGG), where twinning arises from aspects such as community management, traditions, cultural approaches, worldview towards the land and its use. In both territories there is a high population of local indigenous groups: Mixtecos (Mexico) and Napo Runa (Ecuador), with agricultural customs based on their limitations or environmental conditions, such as the development of lamabordos and chacras; moreover, the decision-making systems are based on the competence and trust that the population has in their leaders, and not in political or partisan conflicts (election by uses and customs). Finally, their vision of the territory is based on respect for the environment and the beings that are part of it, and on giving a sacred conception to what provides them with food and life.

Indigenous communities and tourism-integrated climate change outcomes on subsistence within the hinterlands: a development management perspective

PurposeThe study focused on rural commodities, climate change and tourism activities for socioeconomic welfare and enhanced productivity within disadvantaged indigenous communities and remote areas. It relates primary and secondary data details on the Musina Municipality’s rural biodiversity, tourism management and integrated pastoral livelihoods, alongside climate change issues locally and abroad.Design/methodology/approachThe study employs focus group discussions and interviews to gather data. Descriptive statistics, cross-tabulation analysis and central tendencies, along with manual data sorting, provide non-inferential data analysis.FindingsThis study discloses a harmful connection between unsustainable integrated rural activities and tourism products and climate change-linked environmental consequences within such environs. Ultimately, the study has highlighted the need for proper biodiversity resource management and an agricultural approach to diminish climate change hazards and permit the indigenous communities of the municipality. Thus, there is a need for awareness and practices in responsible tourism, decent rural ecotourism and agro-tourism for enhanced productivity and sustainability achievements.Originality/valueMany rural citizens in the world naturally live in low-income areas. Southern Africa and Africa, with specific reference to the Musina Municipality in Limpopo Province, South Africa, are no exception. Despite the abundance of assorted natural and cultural biodiversity and rural tourism qualities, such regions are nonetheless prone to climate change consequences and the deprivation of socioeconomic sustainability.

Prevalence of Adverse Childhood Experiences in Child Population Samples: A Systematic Review and Meta-Analysis.

Exposure to adverse childhood experiences (ACEs) before the age of 18 years is a major contributor to the global burden of disease and disability. To meta-analyze data from samples with children 18 years or younger to estimate the average prevalence of ACEs, identify characteristics and contexts associated with higher or lower ACE exposure, and explore methodological factors that might influence these prevalence estimates. Studies that were published between January 1, 1998 and February 19, 2024, were sourced from MEDLINE, PsycINFO, CINHAL, and Embase. Inclusion criteria required studies to report the prevalence of 0, 1, 2, 3, or 4 or more ACEs using an 8- or 10-item ACEs questionnaire (plus or minus 2 items), include population samples of children 18 years or younger, and be published in English. Data from 65 studies, representing 490 423 children from 18 countries, were extracted and synthesized using a multicategory prevalence meta-analysis. These data were analyzed from February 20, 2024, through May 17, 2024. ACEs. The mean age of children across studies was 11.9 (SD, 4.3) years, the age range across samples was 0 to 18 years, and 50.5% were female. The estimated mean prevalences were 42.3% for 0 ACEs (95% CI, 25.3%-52.7%), 22.0% for 1 ACE (95% CI, 9.9%-32.7%), 12.7% for 2 ACEs (95% CI, 3.8%-22.3%), 8.1% for 3 ACEs (95% CI, 1.4%-16.8%), and 14.8% for 4 or more ACEs (95% CI, 5.1%-24.8%). The prevalence of 4 or more ACEs was higher among adolescents vs children (prevalence ratio, 1.16; 95% CI, 1.04-1.30), children in residential care (1.26; 95% CI, 1.10-1.43), with a history of juvenile offending (95% CI, 1.29; 1.24-1.34), and in Indigenous peoples (1.63; 95% CI, 1.28-2.08), as well as in studies where file review was the primary assessment method (1.29; 95% CI, 1.23-1.34). The prevalence of 0 ACEs was lower in questionnaire-based studies where children vs parents were informants (0.85; 95% CI, 0.80-0.90). In this study, ACEs were prevalent among children with notable disparities across participant demographic characteristics and contexts. As principal antecedent threats to child and adolescent well-being that can affect later life prospects, ACEs represent a pressing global social issue. Effective early identification and prevention strategies, including targeted codesigned community interventions, can reduce the prevalence of ACEs and mitigate their severe effects, thereby minimizing the harmful health consequences of childhood adversity in future generations.

Unveiling the Other: Animals, Oppression, and Visual Culture through Nanook of the North

This article critically examines early 20th-century exploration cinema, focusing onthe portrayal of nonhuman animals and indigenous peoples, using Nanook of theNorth (1922) as a representative example. The study highlights how these films,emerging during a period of intense Western exploration, established enduringvisual conventions that depicted nonhuman animals and indigenous humans ascultural Others. By moving beyond the aesthetic achievements of these films,such as Robert Flaherty's innovative use of long shots, the article brings attentionto the ethical concerns related to speciesism and anthropocentrism that haveoften been overlooked. It explores how the exploitation of nonhuman animalsboth on-screen and behind the scenes reflects broader speciesist powerdynamics, while also challenging the dichotomy between culture and nature asseen in indigenous hunting and gathering societies. The article argues for a reexaminationof these films through a multicultural and intersectional lens,bridging the gap between cinema studies and critical animal and media studies,and ultimately seeks to raise public awareness about the protection of animalrights by emphasizing the sentience and moral consideration due to nonhumananimals.

Resisting settler colonialism: comments from tribes on NEPA ‘modernization’

ABSTRACT In 1969, the United States passed the National Environmental Policy Act (NEPA), which became a model for environmental policies across the globe. These regulations were intended to improve federal agency actions by bringing information on social and environmental impacts into decision-making. In 2020, the United States Council on Environmental Quality (CEQ) drastically changed, or in their terms, ‘modernized’ NEPA regulations. Critics have called these changes socially and environmentally harmful. Indigenous peoples are disproportionately affected by changes to the NEPA process; thus, I argue that it is critical that we consider the viewpoints of Tribal-affiliated organizations and individuals on these changes. I analyze the officially submitted comments from Tribal-affiliated organizations and individuals on the 2020 NEPA rule changes. I provide quantitative and qualitative data demonstrating views on 1) the rulemaking process, 2) five specific NEPA changes, and 3) the proposed changes overall. Using these data, I explore how the NEPA changes represent continued settler colonialism, and how these comments represent a form of resistance.

Introduction to the Tenetehar-Tembé psychology through the rites of construction of women leaders

The article discusses psychological practices and knowledge from the Tenetehar-Tembé (an Indigenous people who live on many riverside regions in the states of Pará and Maranhão, Brazil) tradition. Their rites and narratives carry processes of construction of women as leaders. We argue that, through the community processes of construction of the person, Tenetehar-Tembé women effectively become references for decision-making inside each community and in the articulation between their communities. That is, through the rites and narratives, women become more deeply engaged in caring for the people in their communities. Women are progressively recognized for these practices among families and villages, where they actively participate in productive and political activities. Indigenous psychology, therefore, broadens the understanding of the processes of construction of the woman leader devoting attention to how participating in rites and sharing Indigenous narratives constitute the experiential basis for people’s feelings, thoughts, and actions reflexively oriented in the communities.

ECO_CARE Fieldtrip on the Rio Negro (municipality of Novo Airão, Comunidade Tiririca) and academic collaboration with indigenous women, traditional people and Master’s students

This report summarises the activities undertaken by the ECOCARE team during the week of November 3 to November 4, focusing on fieldwork on the Rio Negro, specifically in the municipality of Novo Airão and the Comunidade Tiririca. Additionally, the team organised a meeting with the indigenous women of the Amarn organization and an academic activity on storytelling and emotional literacy with the Master’s students of the Postgraduate Program in Law at the UFAM, emphasizing a hands-on approach to learning and mutual exchange of knowledge.The activities were part of a broader initiative to foster meaningful partnerships and enhance educational opportunities through direct interaction with indigenous communities and academic partners. This initiative aligns with our ongoing commitment to support indigenous scholarship and integrate it within academic frameworks, thereby enriching the educational experiences of all participants.

Healing through tradition: the role of Indigenous Elder support in child and youth mental health in Canada

The current mental health care system in Canada, with its focus on western biomedical and individualistic approaches, does not support Indigenous holistic views of wellness and silences Indigenous knowledges through colonial ideologies. This research identifies the vital support that mental health services must include to create culturally relevant and safe services: Elders. Elders provide holistic approaches to mental wellness that consider cultural, individual, family, and community needs to promote healing. To explore the roles of Elders in mental health services, a comprehensive narrative review was conducted. All 22 included studies were conducted by Indigenous scholars or with Indigenous communities. Findings were organized into three themes: (a) Elders are knowledge keepers: sharing wisdom; (b) need for cultural-based teachings, ceremonies, and land-based healing led by Elders; and (c) Importance of relationships for increasing youth’s mental wellness. Barriers were identified that prevent Elder involvement, and recommendations for mental health programmes are provided.

S-LCA of lithium mining in Chile and its potential impacts on water and the local community

Abstract Purpose Lithium is critical to the clean energy transition, specifically for lithium-ion batteries in electric vehicles and grid-level energy storage. Chile is a major source of lithium hydroxide and lithium carbonate from brine. The main production facilities are in the Salar de Atacama (SdA), a hyper-arid region home to indigenous communities. A social life cycle assessment (S-LCA) was conducted to better understand the potential impacts of lithium mining on these communities, particularly in relation to water consumption as this is a concern within the region. Methods A cradle-to-gate S-LCA on lithium was performed from brine extraction to the gate of the chemical plant. A hotspot analysis using the Social Hotspots Database (SHDB), in combination with literature and local discussions, was used to prioritize stakeholder groups and subcategories for data collection. Local community, Worker, and Society were selected as stakeholder groups. Subcategories for the Local community included Access to material resources (with a focus on freshwater), Cultural heritage, Respect of indigenous rights, Community engagement, and Local employment. Data sources included primary data from a mining company and interviews with the local community during a site visit. The reference scale approach was applied using Chilean laws and international best practices. Results and discussion Two scoring approaches yielded different scores on the reference scale. With an average scoring approach, all subcategories were at compliance level or above for all stakeholders. The mining company has many projects and initiatives ongoing to improve the wellbeing of the local community. Policies and projects lead to higher scores when applying the average scoring approach. However, with a precautionary approach, where the worst performing indicator determines the score, four subcategories were identified as potential issues for the Local community: Access to material resources — freshwater, Access to material resources — agriculture, Delocalization and migration, and Respect of indigenous rights. For Access to material resources — freshwater, local community members had varying perspectives on freshwater scarcity, but some connected it to lithium mining and also described the cultural importance of water. Conclusions The results of this S-LCA can be used to better understand the potential social impacts from lithium production and how they can be improved. Recommendations are provided to address the potential social impacts of lithium mining in the SdA, including continuing increased communication and projects with the communities, fostering initiatives to improve the understanding of the lithium production process, and considering that community members have equal access to benefit from projects.

Interdisciplinary insights into the cultural and chronological context of chili pepper (Capsicum annuum var. annuum L.) domestication in Mexico

This study investigates the temporal and spatial factors driving the domestication of Capsicum annuum var. annuum L. in Mexico. This species exhibits the greatest morphological diversity in fruit among Capsicum species-a characteristic that is even more pronounced in contemporary landraces cultivated by indigenous communities. Despite the chili pepper's integral role in regional culinary traditions, its domestication history in this region remains poorly understood, often subject to scholarly interpretations that marginalize or oversimplify archaeological evidence. To address this gap, our interdisciplinary team of archaeologists, botanists, and ecologists combine modern and archaeological Capsicum seed data, diachronic archaeological site locations, and ecological niche modeling to identify potential regions where early human populations and the closest wild ancestors may have coexisted. Our results show spatial correlations between early Capsicum distribution and archaeological site prevalence, suggesting that the beginning of the domestication process occurred in ecologically suitable areas for both wild Capsicum and human settlement. These findings challenge previous hypotheses regarding highland/dry cave domestication regions, as our data indicate that lowland regions-specifically the Yucatán Peninsula and southern coastal Guerrero-were more conducive to early encounters between wild Capsicum and humans. We propose a geographically diffuse and protracted model of chili pepper domestication-driven by a ruderal pathway-which involved at least two asynchronous events across Mexico.

Worldviews of Employment in Coast Salish Communities

Abstract While Canadian law has started to seriously grapple with questions that relate to reconciliation with Indigenous communities and laws, much of the focus is on specific, often resource-based, projects. As a result, there has been relatively little attention paid to other aspects of reconciliation, such as how legal aspects of employment may be re-evaluated. Employment law is a useful place to start as employment is a fundamental aspect of a person’s life, providing both financial support and a contributory role in society. This paper examines how different societal values impact employment law and in particular, how Coast Salish worldviews and law may impact, facilitate, and resist, the employment legislation in force in British Columbia.

An Interview with Anthony C.K. Kakooza, J.D., Ph.D.

In this insightful interview, Anthony Kakooza engages in a comprehensive exploration of legal frameworks and their intersection with traditional cultural expressions (TCEs). The dialogue, facilitated by Sara R. Benson and Siyao Cheng from the Journal of Copyright in Education and Librarianship (JCEL), delves into a nuanced analysis of the role that copyright law plays in protecting TCEs. The conversation extends to encompass a wide array of topics related to the ongoing debates surrounding TCEs. Specifically, Kakooza addresses the prevalent misunderstandings associated with TCEs and sheds light on the intricate challenges posed by a regional framework for TCE protections. Furthermore, the conversation navigates to the merits of the sui generis approach to TCE protection and explores the implications of adopting a legal framework for indigenous communities and their TCEs. Drawing on Kakooza’s educational background and field experience, the interview serves as a valuable reference for readers aiming to grasp the complex dynamics between legal mechanisms and the protection of TCEs. Keywords: copyright, traditional cultural expressions, intellectual property, sui generis, indigenous communities

Vector-borne diseases on Borneo island: a scoping review.

Borneo, the third largest island in the world, is facing a significant burden of emerging and re-emerging vector-borne diseases due to rapid changes in primary tropical rainforests and urban landscapes. These vector-borne diseases include the endemic epidemic cycles that occur in the more populated and urbanized areas, as well as the possible transmission through enzootic and sylvatic transmission cycles that occur mainly in the overlapping landscapes or among the indigenous population in the forest. The island will be changed significantly in the future due to the increase in human activities, especially mega events such as the relocation of the Indonesian capital to Nusantara in East Kalimantan Borneo, increasing urbanization, agriculture, hydropower projects, ecotourism activities in Sabah, North Borneo, and Sarawak, Central and South Borneo. Therefore, an overview of the current situation of vector-borne diseases is crucial for the next possible epidemic preparedness. This study conducted the PRISMA-ScR scoping review and formulated a set of research questions to identify current trends in vector-borne diseases in Borneo. These questions aim to identify which diseases have been studied, what geographical areas have been covered by the research, how the One Health approach-encompassing human, animal and environmental factors-is integrated, and what gaps and challenges exist in addressing these diseases. A total of 2241 references were screened for eligibility and 117 articles were selected for review. The majority of the materials focused on mosquitoes and malaria, and the One Health elements focused mainly on humans. This review has identified the most and least studied vector-borne diseases and highlighted some of the gaps in knowledge and research on vector-borne diseases on the island of Borneo. Future studies should particularly focus on other neglected diseases such as Zika, chikungunya, Japanese encephalitis, filariasis and tick-borne diseases. In addition, advanced surveillance systems will be developed to improve early detection and response specifically for remote regions where vector-borne diseases are endemic or emerging.

Indigenizing pre-teacher education: reflections on utilizing traditional storytelling to gather language data from Sámi children

The aim of this study was to develop research-based pre-teacher education pedagogies in the context of Indigenous teacher education, focusing on Sámi (Indigenous people of Sápmi—northern Scandinavia and northwest Russia) communities and investigating the reflections of preservice teachers on their participation in research-based pre-teacher education as part of a Sámi teacher education development project in Norway. Utilizing the storytelling method, preservice teachers collected language data from Sámi children in kindergartens and schools. The study sought to understand the experiences of five participative preservice teachers during the data collection process, as recorded in their diaries. This study proposes a method to indigenize research courses within Indigenous teacher education programmes at tertiary education levels. Research in higher education practices within Indigenous institutions contributes to the advancement of Indigenous higher education and provides critical insights into diverse methods, goals, and contexts of conducting research in higher education settings.

A strengths-based exploration of Māori student success at university using the Mana model

Māori (the Indigenous people of New Zealand) are commonly framed as priority learners, a term that implicitly problematises Māori and anticipates struggle rather than success in their academic trajectories. This study resists such a framing and instead uses a strengths-based theoretical framework—the Mana model—to explore four Māori undergraduate students’ experiences at a New Zealand university. We investigate the extent to which the five elements of the Mana model, originally developed in secondary schooling contexts, supported their success at university. Three of the five elements—mana ūkaipō (sense of place), mana tū (sense of resilience), and mana whānau (sense of family)—were prominent in the students’ accounts of what enabled their success, and the remaining two elements played smaller but still important roles. By bringing the Mana model into the higher education context, this study offers promising indications that this model can inform future research, policy, and practice to foster success at university for Māori students.

Envirocare

In Higher Education, and across Australia, there is a persistent disparity in the understanding of Indigenous knowledges and histories (Bodkin-Andrews et al., 2022; Page et al., 2020). Therefore, as part of their indigenous strategy Universities Australia calls upon universities to commit to ensuring all students encounter and engage with Aboriginal and Torres Strait Islander content (Unviersities Australia, 2017). The challenge for educators and universities is navigating how to implement this within the curriculum for multifaceted reasons, including the variance between Eurocentric curricula and Indigenous ways of knowing (Cooper et al., 2024). Approaches that bringing the voice of First Nations Australians into university learning, to allow Indigenous peoples to represent themselves in this process, are vital. However, to date there are limited models of how to do this while balancing the cultural load and workload for First Nations peoples (Bodkin-Andrews et al., 2022). As one method, Envirocare has been developed as a digital learning space aimed for bringing into Australian university curricula Indigenous cultural intelligence. The project aimed to create equitable, open-access Technology Enhanced Learning that supports culturally appropriate content delivery and assessment methods nationwide. The concept emerged from collaborative efforts involving Deakin University and the Australian Council of Environmental Deans and Directors. This was guided entirely by collaborative partnerships with First Nations rangers and educators through interviews to bring authentic and relevant voices to leaners (Dahl et al., 2004; Keddie, 2012). Thus, Envirocare represents a milestone in open education practice with digital learning spaces. The project underscores the importance of collaborative, culturally informed approaches in educational innovation, aiming to enhance student learning experiences and promote broader community engagement. Envirocare can be accessed by web address at any time, and from any device with internet connection. As learners enter Envirocare, they are immersed in the content and challenged to examine their own positions, fostering their cultural intelligence, including what they think about First Nations ways of knowing, doing and being and whether they have thought about how they think about science before. Through reflection, and engaging in deep listening, they identify what might be feasible for future actions and choose a way forward. The resultant digital learning space enables educators to incorporate learnings into university curricula, with modular content that is adaptable for various educational levels. This presentation will reflect on the project's evolution, the significance of building trust with 9 different people from different communities and the value of inclusive content creation processes. Through sharing methodologies and outcomes, this Pecha Kucha presentation encourages similar initiatives, advocating for respectful integration of Indigenous knowledge into educational frameworks. The presentation will showcase the project journey to emphasise this emerging digital learning space and how it might influence the sociocultural norms of higher education.

Māori ancestral knowledge of communication

Emerging from a need for culturally grounded speech-language therapy in Aotearoa (New Zealand), this study examined Māori (Indigenous people of New Zealand) values and perspectives on communication held within a data set of 2,669 pepeha (ancestral sayings). Analysis of literal translations, context, literary features, and philosophical meanings led to identification of 368 sayings relevant to communication. Thematic analysis of these sayings resulted in eight themes: (a) āhuatanga karere (message and messenger characteristics), (b) mana reo (power and influence of language), (c) reo ā-tinana (body language), (d) te whē (sound), (e) tohu (signs, instructions, marks, visions, omens), (f) whakarongo (listening, hearing, obeying), (g) whanaungatanga (relationships), and (h) whatumanawa (open expression of emotion). These themes identify a holistic view, beyond interpersonal interactions, emphasising the interconnectedness of the human, spiritual, and natural worlds in ancestral communication. Findings contribute a deeper understanding of traditional Māori communication and add to the foundations guiding culturally grounded therapeutic approaches.

Nats'eji (healing): Examining patient and provider experiences with hospital-based Indigenous wellness services in Northwest Territories, Canada.

This study aimed to examine how Indigenous patients and biomedical healthcare providers understand and experience the Indigenous wellness services at a hospital in the Northwest Territories. The qualitative study (May 2018-June 2022) was overseen by a regional Indigenous Community Advisory Committee. Guided by Two-Eyed Seeing and post-colonial theory, the study employed a community-engaged research design, and included two strategies for data generation: (1) interviews with Indigenous Elders, patient advocates, biomedical healthcare providers, policy makers, and hospital administrators (n = 41), and (2) iterative sharing circles with Indigenous Elders (n = 4). Data from the interviews and first sharing circle were transcribed, thematically analyzed, and presented to the sharing circle Elders for validation. The study revealed three overarching and related themes: (1) Elders and patient advocates emphasized that while the Indigenous wellness services at the hospital play a pivotal role connecting patients with cultural supports, the hospital was still not effectively bringing Indigenous healing practices into hospital care; (2) participants identified that structural factors (i.e., policy and governance decisions) shaped patients' experiences with the wellness services; and (3) participants underscored that deeply rooted forces (i.e., racism, colonialism, and biomedical dominance) inhibit the integration of Indigenous healing practices. The findings extend understandings of hospital-based Indigenous wellness services by surfacing relationships between deeply rooted forces, organizational structures, and Indigenous patients' experiences. Altogether, they suggest that to advance care for Indigenous patients and improve the integration of Indigenous healing practices, a system-wide transformation is necessary, which includes Indigenous governance at the hospital and a recognition of the value of Indigenous healing practices.