Research Methodology and Community Participation: A Decade of Indigenous Social Science Research in Canada.

Those engaged in community-based participatory research often comment on tensions between social scientific and community values, yet little systematic evidence exists about the relationship between social science research methodologies and community participation. We analyze nearly 500 peer-reviewed articles published between 2005 and 2015 on Indigenous issues in Canada, where policies encourage participatory research methods with disempowered groups. We find that research that includes Indigenous participation is more likely to include Indigenous epistemologies and participatory evidence sources and analysis methods. We also find that peer-reviewed research involving Indigenous participants often fails to go beyond minimum levels of consultation required by policies.

Les personnes qui prennent part à la recherche participative communautaire (RPC) font souvent des commentaires sur les tensions entre les valeurs sociales scientifiques et communautaires, bien qu'il y ait fort peu d'évidence systémique au sujet des relations entre les méthodologies de recherche en sciences sociales et la participation de la collectivité. Nous analysons près de 500 articles revus par des pairs publiés entre 2005 et 2015 sur des questions autochtones au Canada, lorsque les politiques ont favorisé les méthodes de recherche participative auprès de groupes privés de pouvoir. Nous avons découvert que la recherche qui avait recours à la participation autochtone tend davantage à inclure les épistémologies autochtones, les sources de preuve participative et les méthodes d'analyse. Nous avons également constaté que souvent, la recherche revue par les pairs faisant intervenir des participants autochtones n'allait pas au-delà des degrés minimaux de consultation qu'exigent les politiques.

The Perinatal Mental Health of Indigenous Women: A Systematic Review and Meta-Analysis.

OBJECTIVE: Although Indigenous women are exposed to high rates of risk factors for perinatal mental health problems, the magnitude of their risk is not known. This lack of data impedes the development of appropriate screening and treatment protocols, as well as the proper allocation of resources for Indigenous women. The objective of this systematic review and meta-analysis was to compare rates of perinatal mental health problems among Indigenous and non-Indigenous women. METHODS: We searched Medline, EMBASE, PsycINFO, CINAHL, and Web of Science from their inceptions until February 2019. Studies were included if they assessed mental health in Indigenous women during pregnancy and/or up to 12 months postpartum. RESULTS: Twenty-six articles met study inclusion criteria and 21 were eligible for meta-analysis. Indigenous identity was associated with higher odds of mental health problems (odds ratio [OR] 1.62; 95% confidence interval [CI], 1.25 to 2.11). Odds were higher still when analyses were restricted to problems of greater severity (OR 1.95; 95% CI, 1.21 to 3.16) and young Indigenous women (OR 1.86; 95% CI, 1.51 to 2.28). CONCLUSION: Indigenous women are at increased risk of mental health problems during the perinatal period, particularly depression, anxiety, and substance misuse. However, resiliency among Indigenous women, cultural teachings, and methodological issues may be affecting estimates. Future research should utilize more representative samples, adapt and validate diagnostic and symptom measures for Indigenous groups, and engage Indigenous actors, leaders, and related allies to help improve the accuracy of estimates, as well as the well-being of Indigenous mothers, their families, and future generations. TRIAL REGISTRATION: PROSPERO-CRD42018108638.

Indigenous mothers' experiences of using acute care health services for their infants.

AIMS AND OBJECTIVES: To develop an understanding of how Indigenous mothers experience selecting and using health services for their infants can assist nurses in improving their access to care. This understanding may ultimately lead to improved health outcomes for Indigenous infants and their families. BACKGROUND: Access to acute care services is important to minimise morbidity and mortality from urgent health issues; however, Indigenous people describe difficulties accessing care. Indigenous infants are known to use the emergency department frequently, yet little is known about the facilitators and barriers their mothers experience when accessing these services. DESIGN: This study undertook a qualitative, interpretive description design. METHODS: This article adheres to the reporting guidelines of COREQ. Data collection methods included interviews and a discussion group with Indigenous mothers (n = 19). Data analysis was collaborative and incorporated both Indigenous and Western ways of knowing, through the application of Two-Eyed Seeing. RESULTS: A thematic summary resulted in six themes: (a) problematic wait times; (b) the hidden costs of acute care; (c) paediatric care; (d) trusting relationships; (e) racism and discrimination; and (f) holistic care. CONCLUSIONS: The experiences of Indigenous mothers using acute care services for their infants suggest a role for culturally safe and trauma and violence-informed care by health providers in the acute care context. RELEVANCE TO CLINICAL PRACTICE: Nurses can improve access to acute care services for Indigenous mothers and infants through the provision of culturally safe and trauma and violence-informed approaches care, by building rapport with families, providing care that is respectful and nonjudgemental, eliminating fees associated with using acute care services and linking families with cultural resources both in hospital and within the community.

Indigenous mothers' experiences of using primary care in Hamilton, Ontario, for their infants.

PURPOSE: Access to primary care can help mitigate the negative impacts of social inequity that disproportionately affect Indigenous people in Canada. Despite this, however, Indigenous people cite difficulties accessing care. This study seeks to understand how Indigenous mothers-typically responsible for the health of their infants-living in urban areas, experience selecting and using health services to meet the health needs of their infants. Results provide strategies to improve access to care, which may lead to improved health outcomes for Indigenous infants and their families. METHODS: This qualitative interpretive description study is guided by the Two-Eyed Seeing framework. Interviews were conducted with 19 Indigenous mothers and 5 primary care providers. RESULTS: The experiences of Indigenous mothers using primary care for their infants resulted in eight themes. Themes were organized according to three domains of primary care: structural, organizational and personnel. CONCLUSIONS: Primary care providers can develop contextual-awareness to better recognize and respond to the health and well-being of Indigenous families. Applying culturally safe, trauma and violence-informed and family-centred approaches to care can promote equitable access and positive health care interactions which may lead to improved health outcomes for Indigenous infants and their families.

How Indigenous mothers experience selecting and using early childhood development services to care for their infants.

Purpose: Promoting a child's healthy growth and development in the first six years of life is critical to their later health and well-being. Indigenous infants experience poorer health outcomes than non-Indigenous infants, yet little is understood about how parents access and use health services to optimize their infants' growth and development. Exploring the experiences of Indigenous mothers who select and use early childhood development (ECD) services provides important lessons into how best to promote their access and use of health services. Methods: This qualitative interpretive description study was guided by the Two-Eyed Seeing framework and included interviews with 19 Indigenous mothers of infants less than two years of age and 7 providers of ECD services. Results: Mainstream (public) and Indigenous-led health promotion programs both promoted the access and use of services while Indigenous-led programs further demonstrated an ability to provide culturally safe and trauma and violence-informed care. Conclusions: Providers of Indigenous-led services are best suited to deliver culturally safe care for Indigenous mothers and infants. Providers of mainstream services, however, supported by government policies and funding, can better meet the needs of Indigenous mothers and infants by providing cultural safe and trauma and violence-informed care.