Giishpin Nonagzwaat Binoojiinyik Kanim Na Majiishkaami: determinants of obesity among indigenous children in six First Nations Communities in Northeastern Ontario

Background: Worldwide, childhood obesity rates are high and even higher among Indigenous children. Childhood obesity is of concern as it can result in metabolic conditions. Much has been written about the causes of obesity, usually focusing on individual behaviours, but a gap exists in understanding the social determinants of obesity in Indigenous populations. Methods: Survey data was collected from First Nations students in grades 6 to 8 through a diet and health behavior survey. Measurements including height, weight and waist circumference were taken. Focus groups with 33 caregivers were conducted to explore the determinants of physical activity and nutrition. Results: The prevalence of overweight/obesity in children was 65.8%. The prevalence central obesity was 37.7%. There was a strong positive correlation between waist circumference (cm) and BMI z scores (rs = 0.84, p>0). Daily physical activity (DPA) of 60 minutes per day was associated with a BMI ≤85th percentile and a waist circumference ≤90th percentile. Girls consumed 3.5 servings of fruits and vegetables and boys consumed 2.5 servings. Consuming fruit juice was directly associated with central obesity. Normal weight was associated with participation in at least four types of cultural activities. Caregivers identified impediments to physical activity as financial, recreational technology, safety concerns, and community activation. Changes in lifestyles, influenced by the consequences of colonization, have resulted in reduced physical activity. Colonial policies result in funding challenges for children’s recreation programs and a reliance on government develops. Safety concerns stem from intergenerational trauma created by colonial policies. Dietary decisions were influenced by the availability of fish and game, hunting and fishing regulations, food insecurity and the proliferation of processed foods. Dietary decisions are influenced by the contamination of traditional territories, the marginalization of culture, participation in the economy and issues of poverty. Conclusions: Waist circumference is an effective indicator of obesity along with BMI and should be used in public health screening of Indigenous children. Low fruit and vegetable consumption is of concern as is the consumption of fruit juice. Protective factors against obesity are 60 minutes of DPA and participation in at least four types of cultural activities. Colonialism is a determinant of physical activity, nutrition, and obesity in this population.Doctor of Philosophy (PhD) in Interdisciplinary Rural and Northern Healt

Towards meaningful research and engagement: Indigenous knowledge systems and Great Lakes governance

For thousands of years, Indigenous peoples governed their relations in the Great Lakes region, guided by distinct political, legal, governance, and knowledge systems. Despite historic and ongoing exclusion of Indigenous peoples from Great Lakes governance in the Canadian context and other assaults on Indigenous sovereignty, authority, jurisdiction and responsibilities, Indigenous peoples have maintained their relationships with the Great Lakes. In recent years, Indigenous knowledge systems (IKS) have made inroads in Great Lakes governance, thanks primarily to First Nation political advocacy. However, it remains a challenge to include Indigenous knowledge and implement approaches that bridge Indigenous and Western ways of knowing. Instead of asking, ‘‘What needs to be done to support research into Indigenous knowledge systems?”, more appropriate questions addressed in this paper are: ‘‘What needs to be done to support Indigenous peoples to uphold, strengthen, revitalize Indigenous knowledge systems so they are able to share knowledge if they wish?” and ‘‘How can external institutions, agencies, and people engaged in sustainable management of Great Lakes ecosystems better prepare to engage with IKS respectfully and in the manner required by First Nations?”. In this paper, we demonstrate a First Nations-led knowledge sharing approach to research. In addition to making important contributions to Great Lakes governance and to the scientific research landscape in Canada, this paper points to the requirement to support Indigenous research capacity by building the necessary infrastructure and funding to ensure Indigenous people can lead their own research

Ethics of Biological Sampling Research with Aboriginal Communities in Canada

The objective of this paper is to identify key ethical issues associated with biological sampling in Aboriginal populations in Canada and to recommend approaches that can be taken to address these issues. Our work included the review of notable biological sampling cases and issues. We examined several significant cases (Nuu-chah-nult people of British Columbia, Hagahai peoples of Papua New Guinea and the Havasupai tribe of Arizona) on the inappropriate use of biological samples and secondary research in Aboriginal populations by researchers. Considerations for biological sampling in Aboriginal communities with a focus on community-based participatory research involving Aboriginal communities and partners are discussed. Recommendations are provided on issues of researcher reflexivity, ethical considerations, establishing authentic research relationships, ownership of biological material and the use of community-based participatory research involving Aboriginal communities. Despite specific guidelines for Aboriginal research, there remains a need for biological sampling protocols in Aboriginal communities. This will help protect Aboriginal communities from unethical use of their biological materials while advancing biomedical research that could improve health outcomes

Innovations on a shoestring: a study of a collaborative community-based Aboriginal mental health service model in rural Canada

<p>Abstract</p> <p>Background</p> <p>Collaborative, culturally safe services that integrate clinical approaches with traditional Aboriginal healing have been hailed as promising approaches to ameliorate the high rates of mental health problems in Aboriginal communities in Canada. Overcoming significant financial and human resources barriers, a mental health team in northern Ontario is beginning to realize this ideal. We studied the strategies, strengths and challenges related to collaborative Aboriginal mental health care.</p> <p>Methods</p> <p>A participatory action research approach was employed to evaluate the Knaw Chi Ge Win services and their place in the broader mental health system. Qualitative methods were used as the primary source of data collection and included document review, ethnographic interviews with 15 providers and 23 clients; and 3 focus groups with community workers and managers.</p> <p>Results</p> <p>The Knaw Chi Ge Win model is an innovative, community-based Aboriginal mental health care model that has led to various improvements in care in a challenging rural, high needs environment. Formal opportunities to share information, shared protocols and ongoing education support this model of collaborative care. Positive outcomes associated with this model include improved quality of care, cultural safety, and integration of traditional Aboriginal healing with clinical approaches. Ongoing challenges include chronic lack of resources, health information and the still cursory understanding of Aboriginal healing and outcomes.</p> <p>Conclusions</p> <p>This model can serve to inform collaborative care in other rural and Indigenous mental health systems. Further research into traditional Aboriginal approaches to mental health is needed to continue advances in collaborative practice in a clinical setting.</p

Community-based screening and triage connecting First Nations children and youth to local supports: a cross-sectional study

BACKGROUND: First Nations children in Canada experience health inequities. We aimed to determine whether a self-report health app identified children's needs for support earlier in their illness than would typically occur. METHODS: Children (aged 8 to 18 yr) were recruited from a rural First Nation community. Children completed the Aaniish Naa Gegii: the Children's Health and Well-being Measure (ACHWM) and then met with a local mental health worker who determined their risk status. ACHWM Emotional Quadrant Scores (EQS) were compared between 3 groups of children: healthy peers (HP) who were not at risk, those with newly identified needs (NIN) who were at risk and not previously identified, and a typical treatment (TT) group who were at risk and already receiving support. RESULTS: We included 227 children (57.1% girls), and the mean age was 12.9 (standard deviation [SD] 2.9) years. The 134 children in the HP group had a mean EQS of 80.1 (SD 11.25), the 35 children in the NIN group had a mean EQS of 67.2 (SD 13.27) and the 58 children in the TT group had a mean EQS of 66.2 (SD 16.30). The HP group had significantly better EQS than the NIN and TT groups (p < 0.001). The EQS did not differ between the NIN and TT groups (p = 0.8). INTERPRETATION: The ACHWM screening process identified needs for support among 35 children, and the associated triage process connected them to local services; the similarity of EQS in the NIN and TT groups highlights the value of community screening to optimize access to services. Future research will examine the impact of this process over the subsequent year in these groups

Caregivers’ Perspectives on the Determinants of Dietary Decisions in Six First Nation Communities

Colonialism is a fundamental determinant of Indigenous people’s health in Canada, yet little is known about its effects on food systems and dietary decisions in First Nation communities. A socioecological approach was used to explore the determinants of dietary decisions made by Indigenous caregivers. Conclusions are drawn from a narrative analysis of eight focus groups involving 33 caregivers in six First Nation communities. Caregivers identified the changes that they have observed in how food is procured, distributed, processed and prepared, along with the nutritional consequences and the sociocultural meanings of these changes. Determinants such as participation in the wage economy, low income, hunting and fishing regulations, availability of fish and game, and the proliferation of inexpensive, processed foods have altered the food systems and influenced dietary decisions made by caregivers in six First Nation communities. Initiatives such as community gardens, community freezers and community hunting camps are ways that these communities are seeking to regain food sovereignty

Examining Informed Consent Processes for Indigenous families in Research: A Scoping Review Protocol

Introduction: Though numerous research pursuits in Indigenous communities have been undertaken, very few have consistently addressed community priorities, or collaborated with Indigenous peoples throughout the research process. This scoping review protocol proposes to explore the existing wise consent processes that respect the rights of Indigenous families (parents, children), and Indigenous community protocols. Methods and analysis: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting scoping reviews will be followed closely. All primary and theoretical studies of any design written in English from January 1st 2000 to March 31st 2022 examining Indigenous approaches to obtaining informed consent among parents or families and/or children and youth, will be included. Two reviewers will independently review the literature in order to apply the inclusion and exclusion criteria. Data from studies will be extracted and charted in NVivo, following the Arksey and O’Malley’s (2005) framework. The Critical Appraisal Skills Programme (CASP) checklists, depending on the study design of each included study, and the original and modified Aboriginal and Torres Strait Islander Quality Appraisal Tool (ATSI) versions, will be used to assess study quality. A narrative synthesis of the informed consent literature will be reported. Dissemination: This scoping review will evaluate the existing informed consent processes, barriers to consent, and alternative consent processes in the literature. Results will be shared via conferences, reports and social media with our Indigenous communities, and disseminated through a peer-reviewed publication. This scoping review may prove useful to others who are investigating informed consent processes among Indigenous families in research

Intimate Partner Violence Against Indigenous Men in Heterosexual Relationships: Toward a Culturally Safe Response in Primary Health Care Settings

Most Indigenous intimate partner violence (IPV) research and interventions are geared toward women, while the experiences of Indigenous men as survivors of IPV are not well investigated or understood. Indigenous men are typically portrayed as perpetrators of violence yet very seldom as survivors of violence, although they experience disproportionately high rates of violence, including IPV, when compared to non-Indigenous men. Our community-based participatory research, conducted in partnership with First Nations communities in Northern Ontario, Canada, completed in 2019, identified this bias as a major barrier for Indigenous men to disclose IPV in a health service setting, where a safe space and support should be available. The primary health care providers involved in this study reported awareness of serious abuse perpetrated against First Nations men in heterosexual relationships. However, they also cited insufficient preparedness within the primary care system to respond to the needs of these men, including significant gaps in culturally safe services. These findings warrant attention and action. We offer recommendations for health and social services and community organizations to help address, in culturally safe ways, IPV experienced by Indigenous men and its effects on families and communities

Ethics of Biological Sampling Research with Aboriginal Communities in Canada

The objective of this paper is to identify key ethical issues associated with biological sampling in Aboriginal populations in Canada and to recommend approaches that can be taken to address these issues. Our work included the review of notable biological sampling cases and issues. We examined several significant cases (Nuu-chah-nult people of British Columbia, Hagahai peoples of Papua New Guinea and the Havasupai tribe of Arizona) on the inappropriate use of biological samples and secondary research in Aboriginal populations by researchers. Considerations for biological sampling in Aboriginal communities with a focus on community-based participatory research involving Aboriginal communities and partners are discussed. Recommendations are provided on issues of researcher reflexivity, ethical considerations, establishing authentic research relationships, ownership of biological material and the use of community-based participatory research involving Aboriginal communities. Despite specific guidelines for Aboriginal research, there remains a need for biological sampling protocols in Aboriginal communities. This will help protect Aboriginal communities from unethical use of their biological materials while advancing biomedical research that could improve health outcomes