Aboriginal Communities In Canada Research Articles

Correlates of physical activity among First Nations children residing in First Nations communities in Canada.

Physical activity has numerous mental, emotional, spiritual and physical benefits. The factors influencing physical activity among First Nations children have not been well studied. The objective was to examine the associations between several intrapersonal, family and community factors and physical activity among First Nations school-aged children residing in First Nations communities. Participants consisted of 3,184 children (6-11 years old) from the 2008/10 First Nations Regional Health Survey, a representative sample of First Nations persons who reside in on-reserve and northern First Nations communities. The survey addresses a holistic range of health issues. Primary caregivers completed interviews to assess each child's moderate-to-vigorous physical activity (MVPA), participation in traditional physical activities, six intrapersonal factors, four family factors and two community factors. Based on primary caregiver reports, 72% of children accumulated a daily average of ≥60 minutes of MVPA and 54% participated in at least one traditional First Nations physical activity in the past year. Older age, having more people in the household, and having more relatives help the child understand their culture were independently associated with accumulating ≥60 minutes of MVPA. School attendance, use of First Nations language, having parents with a high school education, smaller community size, and having more community members help the child understand their culture were independently associated with participation in traditional First Nations physical activities. Among First Nations children, there are several correlates of physical activity from diverse ecological levels.

Faculty analysis of distributed medical education in Northern Canadian Aboriginal communities

In 2005 the Northern Ontario School of Medicine (NOSM) in Canada implemented the world's first and (still) only mandatory Aboriginal community placement for all its medical students. The Aboriginal placement was created in part to address social accountability, defined as the obligation of medical schools to direct education, research and service activities towards addressing the priority health concerns of the community they serve. Concurrently, Aboriginal health policies have increasingly emphasized the need to involve Aboriginal people in healthcare planning and design health care that involves Aboriginal concepts of health and culturally safe care. Aboriginal delegates provided recommendations for the development of an Aboriginal health curriculum, which included the need for the medical school to acknowledge and respect Aboriginal history, health priorities and develop an Aboriginal community placement for all medical students. To anticipate the challenges (e.g., distance, communication, technologies, student and cultural safety, pedagogical effectiveness/appropriateness) presented by a mandatory placement for first-year students in Aboriginal communities a pilot placement project was designed. The locations of the communities were carefully selected in order to assess a variety of challenges that might be encountered with rural and remote Aboriginal community placements. Pilot lessons included managing student expectations, which leaned towards a clinical rather than a community-based cultural placement focus. Areas for increased coordination and administrative support were identified, as well as the need for more extensive community level support. The students had an overall positive experience and learned about the realities of health care in the communities. Aboriginal community staff commented that the experience with the students was fulfilling and beneficial. It was also recognized that curriculum delivery methods required major adjustments and that the students required significant Aboriginal health curriculum in preparation to move forward from the pilot placement to a sustainable Aboriginal community curriculum. Two medical anthropologists, assisted and supported by an historian of medicine, identified and developed the core areas of academic knowledge required for students to begin their journey towards becoming culturally safe medical practitioners. Another important aspect of preparing students was a series of mandatory sessions led by the Aboriginal Affairs Office designed to complement academic sessions with practical information such as how to conduct oneself in the community, and current politics and treaties. A self-study project was developed to guide students through a process of increasing self-awareness of their own attitudes and perceptions about Aboriginal people and communities, and develop their competence to provide culturally safe medical care. New learning from several iterations of the placement was employed to fine-tune the curriculum, information technologies and supporting policies as the placement evolved into a cornerstone of the curriculum. Cultural immersion in Aboriginal communities is a way for medical students to gain an understanding of the needs and strengths of Aboriginal communities and learn what physicians might do to contribute effectively to Aboriginal health and wellbeing. Research is required to improve understanding about the aspects of this education experience that are most effective.

Weaving Together Two Ways of Knowing: Archaeological Organic Artifact Analysis and Indigenous Textile Arts

In 2007, a Canadian Aboriginal community, Metepenagiag Mi'kmaq Nation, opened a major archaeology interpretation and cultural center. This center emerged out of 40 years of collaborative, community driven archaeology, and is informed by a Mi'kmaq concept of two ways of knowing, or “Two-eyed Seeing.” One of the first initiatives of this center was a workshop on archaeological textiles that sought to bring together traditional basket-makers with archaeological textile researchers, to seek mechanisms to increase this dialogue and expand the common ground between traditional archaeological perspectives in a co-learning environment. This article explores the development of the workshop, and the way in which it illustrates a comprehensive and profound commitment to respectful sharing of knowledge and working together.

A clash of paradigms? Western and indigenous views on health research involving Aboriginal peoples.

To explore the issues of data management and data ownership with regard to health research conducted in aboriginal or indigenous populations in Canada. Research with aboriginal communities in Canada has often been conducted by researchers who had little or no understanding of the community in which the research was taking place. This led to 'helicopter' research, which benefitted the researcher but not the community. National aboriginal leadership developed the ownership, control, access, and possession (OCAP) principles, which outline how to manage research data regarding aboriginal people and to counteract disrespectful methodologies. However, these principles present their own set of challenges to those who would conduct research with aboriginal populations. Documents from the Assembly of First Nations, the Government of Canada, Aboriginal writers and researchers, and Nursing theorists and researchers. This is a methodology paper that reviews the issues of data ownership when conducting research with Aboriginal populations. The authors explore indigenous and Western views of knowledge development, outline and discuss the OCAP principles, and present the Canadian Institute of Health Research's guidelines for health research involving aboriginal people as a guide for those who want to carry out ethical and culturally competent research, do no harm and produce research that can benefit aboriginal peoples. There are special considerations associated with conducting research with Aboriginal populations. The Assembly of First Nations wants researchers to use the Ownership, Control, Access and Possession (OCAP) principles with First Nations data. These principles are restrictive and need to be discussed with stakeholders before research is undertaken. In Canada, it is imperative that researchers use the Canadian Institute of Health Research Guidelines for Health Research Involving Aboriginal People to ensure culturally sensitive and ethical conduct during the course of the research with Aboriginal populations. However, some communities may also want to use the OCAP principles and these principles will need to be taken into consideration when designing the study.

Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community

Community-based first aid training is the collaborative development of locally relevant emergency response training. The Sachigo Lake Wilderness Emergency Response Education Initiative was developed, delivered, and evaluated through two intensive 5-day first aid courses. Sachigo Lake First Nation is a remote Aboriginal community of 450 people in northern Ontario, Canada, with no local paramedical services. These courses were developed in collaboration with the community, with a goal of building community capacity to respond to medical emergencies. Most first aid training programs rely on standardized curriculum developed for urban and rural contexts with established emergency response systems. Delivering effective community-based first aid training in a remote Aboriginal community required specific adaptations to conventional first aid educational content and pedagogy. Three key lessons emerged during this program that used collaborative principles to adapt conventional first aid concepts and curriculum: (1) standardized approaches may not be relevant nor appropriate; (2) relationships between course participants and the people they help are relevant and important; (3) curriculum must be attentive to existing informal and formal emergency response systems. These lessons may be instructive for the development of other programs in similar settings.

Drowning in the Social Determinants of Health: Understanding Policy’s Role in High Rates of Drowning in Aboriginal Communities in Canada

Within Canada, Aboriginal peoples drown at much higher rates than non-Aboriginal peoples (Health Canada, 2001). Drowning is commonly understood as a that has its roots in individuals' failure to learn to swim, a failure of adults to supervise children properly, or a failure to engage with safety practices (such as wearing a lifejacket or boating only when sober). This understanding of aquatic-related injury reflects the neo- liberal tendency to assign individual blame for poor health, rather than viewing health as being produced within particular socio-historico-politico environments. In this paper we use Bacchi's (2007) What's the problem approach to policy analysis to argue that it is misguided to understand high rates of drowning in Aboriginal communities as being caused primarily by the aforementioned factors, as they fail to account for the ways in which social determinants influence Aboriginal peoples' health. Language: en

Promoting resilience and wellbeing through an outdoor intervention designed for Aboriginal adolescents

Aboriginal people in Canada (First Nations, Inuit and Métis) have a lower health status compared to the Canadian population. There is a particular concern about the mental health and wellbeing of First Nations adolescents living on reserves. Interventions following principles of outdoor education and adventure therapy appear to be an appropriate fit for this population. These approaches have proven effective in non-Aboriginal populations, yet there is very little evidence on the efficacy of these types of program for Aboriginal adolescents. The primary purpose of this study was to evaluate the impact of an outdoor adventure leadership experience (OALE) on the resilience and wellbeing of First Nations adolescents from one reserve community. The secondary purposes were to explore whether this impact was sustainable, and whether there were any intervening factors that may have influenced the impact. The collaborative research team used a mixed-method design to evaluate the 10-day OALE for adolescents from Wikwemikong Unceded Indian Reserve in northern Ontario, Canada. The main outcome assessed was resilience, measured by self-report, using the 14-Item Resilience Scale (RS-14). Several other exploratory measures assessed other aspects of health and well-being. The questionnaire package was administered at three different time periods: (T1) one day before the OALE; (T2) one month after the OALE; and (T3) one year after the OALE. The Mental Component Score (MCS) of the SF-12v2 was used to confirm any changes in resilience. Open-ended questions were appended to the questionnaire at the 1-year point to identify any intervening factors that may have impacted any changes in resilience and wellbeing. The primary analysis compared mean RS-14 scores at T1 with those at T2. Responses to the open-ended questions were analyzed using content analysis. Over two summers (2009 and 2010), 73 youth 12-18 years of age from Wikwemikong participated in a standardized 10-day OALE program. This represented 15% of the on-reserve population of adolescents in this age range. Survey responses from 59 (80.8%) participants were available for analysis at T1, compared to 47 (64.4%) at T2 and 33 (45.2%) at T3. The mean RS-14 score was 73.65 at baseline, and this improved 3.40 points (p=0.011) between T1 and T2. However, the resilience scores at T3 (1 year post-OALE) had a mean of 74.19, indicating a return back to pre-OALE levels. The mean MCS score at T1 was 48.23 and it improved over the subsequent two time periods. Several intervening factors reported at T3 may have influenced the decrease in resilience scores from T2 to T3. These included changes in family living situation, death in the family, and other life stressors that occurred over the course of the year. Outcome scores from this study provide a unique glimpse into the self-reported health and wellbeing for adolescents within one First Nations community in Canada. The OALE program was beneficial in promoting resilience for adolescents in Wikwemikong over the short-term. Future studies are necessary to assess whether the OALE (or similar outdoor type interventions) are effective within other communities.

Drowning in the Social Determinants of Health: Understanding Policy’s Role in High Rates of Drowning in Aboriginal Communities in Canada

Drowning in the Social Determinants of Health: Understanding Policy’s Role in High Rates of Drowning in Aboriginal Communities in Canada

A framework for building research partnerships with first nations communities.

Solutions to complex health and environmental issues experienced by First Nations communities in Canada require the adoption of collaborative modes of research. The traditional “helicopter” approach to research applied in communities has led to disenchantment on the part of First Nations people and has impeded their willingness to participate in research. University researchers have tended to develop projects without community input and to adopt short term approaches to the entire process, perhaps a reflection of granting and publication cycles and other realities of academia. Researchers often enter communities, collect data without respect for local culture, and then exit, having had little or no community interaction or consideration of how results generated could benefit communities or lead to sustainable solutions. Community-based participatory research (CBPR) has emerged as an alternative to the helicopter approach and is promoted here as a method to research that will meet the objectives of both First Nations and research communities. CBPR is a collaborative approach that equitably involves all partners in the research process. Although the benefits of CBPR have been recognized by segments of the University research community, there exists a need for comprehensive changes in approaches to First Nations centered research, and additional guidance to researchers on how to establish respectful and productive partnerships with First Nations communities beyond a single funded research project. This article provides a brief overview of ethical guidelines developed for researchers planning studies involving Aboriginal people as well as the historical context and principles of CBPR. A framework for building research partnerships with First Nations communities that incorporates and builds upon the guidelines and principles of CBPR is then presented. The framework was based on 10 years’ experience working with First Nations communities in Saskatchewan. The framework for research partnership is composed of five phases. They are categorized as the pre-research, community consultation, community entry, research and research dissemination phases. These phases are cyclical, non-linear and interconnected. Elements of, and opportunities for, exploration, discussion, engagement, consultation, relationship building, partnership development, community involvement, and information sharing are key components of the five phases within the framework. The phases and elements within this proposed framework have been utilized to build and implement sustainable collaborative environmental health research projects with Saskatchewan First Nations communities.

Disparities in Canadian Indigenous Health Research on Neurodevelopmental Disorders

To map the landscape of research on autism (ASD), cerebral palsy (CP), and fetal alcohol spectrum disorder (FASD) in Canadian Aboriginal children. The authors used a detailed search strategy to identify and access publications on ASD, CP, and FASD involving Canadian Aboriginal children, families, and communities from online databases. They analyzed these materials for the type of research, stated objectives, methodologies, and the level of engagement of Aboriginal Peoples. The authors found a total of 52 reports published since 1981 relevant to Aboriginal children. Of these, 51 focused exclusively on FASD. They also found a near-complete failure to acknowledge community involvement in research decisions or dissemination of results in any of the publications. The focus on FASD in Aboriginal children and the absence of research on the other 2 major childhood disorders are at odds with rates of these disorders across Canadian children. The authors argue that this trend violates fundamental principles ensuring equitable representation of all children regardless of background in research and access to benefits of research in health care and perpetuates stigma in an already marginalized population.

Private and Moral Authority, Self-Determination, and the Domestic Transfer Objective: Foundations for Understanding Sport for Development and Peace in Aboriginal Communities in Canada

Sport for development and peace (SDP) is a contemporary term for practices that have a long history, particularly in Canada’s provincial and territorial north, and especially with Aboriginal peoples for whom the region is home. Using a postcolonial international relations feminist approach, theories of global governance and private authority, and by exploring recent literature on self-determination in the context of Aboriginal peoples, we investigate 1) the assumptions at work in attempts to “transfer” SDP programming models in the Two-Thirds World to Aboriginal communities across Canada; 2) how the retreat of the welfare state and neo-liberal policies have produced the “need” for SDP in Aboriginal communities; and 3) how efforts toward Aboriginal self-determination can be made through SDP. We argue that, taken together, these concepts build a useful foundation better understanding for the historical and sociopolitical processes involved in deploying SDP interventions in Aboriginal communities.

Aboriginal populations and youth suicide

We agree with Orkin and colleagues[1][1] that addressing suicidal behaviour within Aboriginal communities in Canada should be an urgent priority for research and public health action. We support all actions to work with these communities to better understand this complex phenomenon, and to intervene

Maternal and Newborn Health Profile in a First Nations Community in Canada

ObjectiveWe sought to characterize maternal health profiles and birth outcomes among First Nations people living in Southern Ontario. MethodsWe performed a retrospective chart review of all 453 women from the Six Nations Reserve, Ontario, who were pregnant between 2005 and 2010. Maternal health behaviours, past medical history, physical measurements, birth outcomes, and newborn characteristics were abstracted. Key maternal and newborn characteristics were compared with those of a cohort of non-First Nations women recruited from nearby Hamilton, Ontario. ResultsThe average age of women in the study cohort was 25.1 ± 6.2 (mean ± SD) years, and 75.8% were multiparous. The mean pre-pregnancy BMI was 28.3 ± 6.6kg/m2, and the average weight gain in pregnancy was 14.9 ± 8.3kg. Mean weight gain during pregnancy was inversely associated with pre-pregnancy BMI, and 57.1% of women gained more than the recommended weight. The prevalence of type 2 diabetes or gestational diabetes was 4.7%, hypertension was present before or during pregnancy in 5.6%, and 35% used tobacco during pregnancy. The mean gestational age at delivery was 39.5 ± 1.7 weeks and the mean crude birth weight was 3619 ± 557g. The main determinants of newborn weight included sex of the newborn, pre-pregnancy BMI, and weight gain during pregnancy. Compared with a contemporary cohort of 622 non-First Nations mothers and newborns, First Nations mothers were, on average, younger (25.1 vs. 32.1 years; P< 0.001), had a higher mean pre-pregnancy BMI (28.3 vs. 26.8kg/m2; P< 0.001), and were more likely to use tobacco during pregnancy (35.0% vs. 14.4%; P< 0.001). First Nations newborns had significantly higher mean birth weight (+176 grams) and length (+2.3cm) than non-First Nations newborns. ConclusionFirst Nations mothers from the Six Nations Reserve tended to have a high pre-pregnancy BMI, tended to gain more than the recommended weight during pregnancy, and commonly used tobacco during pregnancy. Programs to prevent overweight/ obesity and excess weight gain during pregnancy and to minimize smoking are required among women of child-bearing age in this community.

Hair Cortisol as a Biomarker of Stress Among a First Nation in Canada

Cortisol level in hair is increasingly being used as a biomarker of chronic stress. Members of First Nation communities in Canada are experiencing stress related to a higher incidence of chronic diseases, socioeconomic factors, the state of their environment, and cultural oppression. This study aimed to investigate hair cortisol as a biomarker of stress in this population. Hair samples were collected from the posterior vertex of 55 Walpole Island First Nation (WIFN) volunteers and compared with white volunteers living in and around London, ON, Canada. An enzyme-linked immunosorbent assay technique was used to measure cortisol content in 1 cm of hair, considered to represent 1 month of growth. In parallel, the Perceived Stress Scale (PSS), which measures short-term stress, was also completed. Median hair cortisol level (range) in WIFN volunteers was 177 (93-273) ng/g, significantly higher than the median hair cortisol in the healthy white controls of 116 (26-204) ng/g (P < 0.0001, Mann-Whitney U test). Hair cortisol correlated positively with gender, smoking status, and self-reported diabetes. Unlike hair cortisol, the Perceived Stress Scale did not differentiate between the First Nation and control population. The increased hair cortisol concentrations among WIFN volunteers compared with volunteers from a non-First Nation community suggests higher levels of chronic stress. The causes for this apparent increased stress are likely due to factors such as socioeconomic and poorer health and are worthy of further evaluation. The results highlight the difference between acute stress measured for short periods of time compared with chronic stress, measured by hair analysis.

Northern Food Networks: Building Collaborative Efforts for Food Security in Remote Canadian Aboriginal Communities

Canada's northern and remote regions experience high rates of food insecurity, exceptionally high food costs, environmental concerns related to contamination and climate change, and a diversity of other uniquely northern challenges related to food production, acquisition, and consumption. As such, there is a need to understand and develop strategies to address food-related concerns in the North. The diversity of communities across the North demands the tailoring of specific, local-level responses to meet diverse needs. Over the past decade, local networks have emerged as a powerful method for developing localized responses, promoting food security and the development of more sustainable food systems across Canada and North America. Despite this, there is a paucity of research examining challenges and effective approaches utilized by these local networks or their potential applicability for building food security in rural, remote, and northern communities. This research utilized participant observation as a method to examine the experiences of a Northern Canadian food security network. The experience of this network points to strategies that can lead to successful collaborative approaches aimed at implementing programs to address food security in northern and remote communities.

Assessment of Tuberculosis Outbreak Definitions for a First Nations On-Reserve Context

Improving the prevention and control of tuberculosis (TB) in Aboriginal communities in Canada is a matter of great urgency. Canadian-born Aboriginal people account for 21% of TB cases in the country even though they represent only 3.8% of the overall population. Moreover, age standardized rates of TB in Aboriginal people reveal an incidence almost six fold greater than the national rate. There are unique challenges in the prevention and control of TB in First Nations populations. We sought to investigate whether the Canadian Tuberculosis Standards definition being used Canada wide to address TB is appropriate in a First Nations on-reserve context or whether alternate definitions should be considered. In this study, we spoke to health care workers, scientists, and administrators involved in TB programs and care across the country to assess the suitability of the definition used to classify an outbreak. Our data showed that the majority of study participants did not support a First Nations-specific TB outbreak definition. Participants felt that a response protocol would be useful, along with a preamble to the definition detailing unique circumstances that may pertain to an outbreak on-reserve.

Policy (Mis)Alignment: Addressing Type 2 Diabetes in Aboriginal Communities in Canada

In this article, we employ Bacchi’s (1999) What’s the Problem approach to policy analysis to examine Health Canada’s Aboriginal Diabetes Initiative (ADI) and the ways in which it articulates with existing federal policies that relate to three Aboriginal social determinants of health: colonialism, education, and health care. Focusing our analysis on the Aboriginal population with the highest prevalence of type 2 diabetes, First Nations, we argue that the ADI produces type 2 diabetes as a problem related to First Nations peoples’ apparently poor health decision making and lifestyle choices. Such a framing of the problem ignores the ways in which current federal policies are aligned in a way that undermines attempts, like the ADI, to improve First Nations peoples’ health. We argue that for rates of type 2 diabetes to decrease in First Nations communities, the federal government needs to re-align policies that affect all of the Aboriginal social determinants of health so that the startling inequities in health that exist between First Nations peoples and non-First Nations peoples, particularly those related to type 2 diabetes, can be addressed in a more effective fashion.

The Experience of HIV Diagnosis Among Aboriginal People Living With HIV/AIDS and Depression

In this article, we consider how the broad context of Aboriginal people's lives can shape their experience and understanding of their HIV diagnosis. We conducted interviews across Canada with 72 Aboriginal people living with HIV who also reported feelings of depression. Consistent with what has been found in previous studies, participants responded to their HIV diagnosis with shock, disbelief, and often anger. Prior depression, drug and alcohol use, multiple losses, stigma, and social isolation also shaped how participants experienced their diagnosis. We consider how the history of colonization of Aboriginal communities in Canada relates to the experience of HIV diagnosis, and end with a discussion of the service implications of our findings.

Bourdieu in the North: Practical Understanding in Natural Resource Governance

Natural resource management (NRM) analyses often avoid understanding environmental governance as arising from and shaped by social practices and power relations in resource conflicts, contested property rights, and political-economic strategies. I examine a northern Canadian Aboriginal community’s experience of a structured yet dynamic socio-cultural response to a period of social and political change. Drawing from Pierre Bourdieu’s conception of social practice I suggest that a diffuse, or less-determinist, theory of practice may help explain how power relations are interwoven throughout yet applied differentially in NRM governance. Drawing on ethnographic research on northern watershed management and protection of Aboriginal cultural landscapes, I propose the notion of practical understanding to explain the ways government resource managers and community leaders challenge and negotiate one another’s conceptions of environmental governance in a duel process of cooperation-conflict.

Returning birth: The politics of midwifery implementation on First Nations reserves in Canada

Objectiveto explore the role of midwives in the implementation of an elective birthing programme in one remote First Nation community in Canada, and to identify current barriers and challenges to the practice of midwifery in these settings Designthe study is a multisited ethnography based on 15 months of fieldwork in Manitoba, Canada. Thirty-nine individual qualitative, semi-structured interviews were completed. The data from the interviews were coded into themes and presented in the paper. Settingthe study focuses on one First Nation community and their process of implementation of midwifery services. This case study is used to address broader themes of midwifery and policy at a national level. Participantsparticipants included Aboriginal midwives from across Canada, policy makers from provincial and federal jurisdictions, medical professionals involved in Aboriginal health care, Aboriginal political leadership, and Aboriginal women and their families. Findingsnational policy and issues of jurisdiction among levels of government were shown to be a barrier to midwifery implementation. Key conclusionsthe current policy of evacuation in most Aboriginal communities does not effectively address the Millennium Development Goal of having a skilled birth attendant at every birth. The role of midwifery is central to the process of returning birth to Aboriginal communities, and steps must be taken at both the policy and clinical level to ensure that midwifery implementation and education can become an option for all Aboriginal communities in Canada. Implications for practicewhen considering midwifery implementation in communities, midwives must engage in both political and clinical negotiations to ensure their ability to practice effectively. Understanding the complexity of the policy discourse, along with the place of midwifery within the existing clinical guidelines is integral to the success of this process.