Abstract
The research described in this chapter offers a promising example of how health promotion research can contribute to meaningfully transforming health services and promoting culturally safe healthcare, through respectful, equitable and reciprocal partnerships with Indigenous communities. The objective of this research is to co-develop, based on a Two-Eyed Seeing approach, a new intervention model to ensure cultural safety for Atikamekw patients in the health system of the province of Québec (Canada). The project builds on the premise that for Indigenous needs, rights and identities to be fully taken into consideration in Western-based healthcare, we need research approaches that support the decolonization of Western science. In keeping with this premise, this research has been developed in full partnership with Indigenous partners on the basis of a Two-Eyed Seeing approach, with the aims of defending the political, moral and ethical principles that fight oppression and of repositioning Indigenous peoples’ unique knowledge, beliefs and values within research and the various social institutions of society. One of the major contributions of this research is to operationalize – and thereby inform the evolution of – the concepts of cultural safety and the Two-Eyed Seeing approach, which currently lack coherent application guidelines in the healthcare system.
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References
Allan, B., & Smylie, J. (2015). First peoples, second class treatment: The role of racism in the health and well-being of indigenous peoples in Canada. The Wellesley Institute: Toronto. 17 pages.
Assemblée des Premières Nations du Québec et du Labrador. (2014). Protocole de recherche des Premières Nations au Québec et au Labrador. APNQL, Wendake, 98 pages.
Aboriginal Nurses Association of Canada & Canadian Association of Schools of Nursing. (2009). Cultural competency and cultural safety in nursing education. A framework for First Nations, Inuit and Métis nursing. ANAC, Ottawa, 15 pages.
Indigenous Physicians Association of Canada, & Association of Faculties of Medicine of Canada. (2009). First Nations, Inuit, Métis Health Core Competencies. IPAC and AFMC, Ottawa, 7 pages.
Atikamekw Sipi. (2019). Atikamekw Sipi. https://www.atikamekwsipi.com/
Bartlett, C., Marshall, M., & Marshall, A. (2012). Two-eyed seeing and other lessons learned within a co-learning journey of bringing together indigenous and mainstream knowledges and ways of knowing. Journal of Environmental Studies and Sciences, 2(4), 331–340. https://doi.org/10.1007/s13412-012-0086-8
Bartlett, C., Marshall, M., Marshall, A., & Iwama, A. (2015). Integrative science and two-eyed seeing: Enriching the discussion framework for healthy communities. In Ecosystems, society and health: Pathways through diversity, convergence and integration (pp. 280–326). McGill-Queen’s University Press.
Baum, F., MacDougall, C., & Smith, D. (2006). Participatory action research. Journal of Epidemiology and Community Health, 60(10), 854–857. https://doi.org/10.1136/jech.2004.028662
Beagan, B. L., & Kumas-Tan, Z. (2009). Approaches to diversity in family medicine: "I have always tried to be colour blind". Canadian family physician Medecin de famille canadien, 55(8), 21–28.
Brascoupé, S., & Waters, C. (2009). Cultural safety exploring the applicability of the concept of cultural safety to aboriginal health and community wellness. Journal of Aboriginal Health, 5(2), 6–41.
Buller, M., Audette, M., Robinson, Q., & Eyolfson, B. (2019). Réclamer notre pouvoir et notre place: le rapport final de l’Enquête nationale sur les femmes et les filles autochtones disparues et assassinées. Bureau du Conseil privé.
Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council. (2018) Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans. TCPS, Ottawa, 23 pages.
Cargo, M., & Mercer, S. L. (2008). The value and challenges of participatory research: Strengthening its practice. Annual Review of Public Health, 29, 325–350. https://doi.org/10.1146/annurev.publhealth.29.091307.083824
Conseil des Atikamekw de Manawan, & Conseil de la Nation Atikamekw. (2020). Principe de Joyce: Mémoire présenté par le Conseil des Atikamekw de Manawan et le Conseil de la Nation Atikamekw. https://www.atikamekwsipi.com/public/images/wbr/uploads/telechargement/Doc_Principe-de-Joyce.pdf
Duru, O. K., Harawa, N. T., Kermah, D., & Norris, K. C. (2012). Allostatic load burden and racial disparities in mortality. Journal of the National Medical Association, 104(1–2), 89–95. https://doi.org/10.1016/s0027-9684(15)30120-6
Gao, S., Manns, B. J., Culleton, B. F., Tonelli, M., Quan, H., Crowshoe, L., et al. (2008). Access to health care among status aboriginal people with chronic kidney disease. Canadian Medical Association Journal, 179(10), 1007–1012. https://doi.org/10.1503/cmaj.080063
Gerlach, A. J. (2012). A critical reflection on the concept of cultural safety. Canadian Journal of Occupational Therapy, 79(3), 151–158. https://doi.org/10.2182/cjot.2012.79.3.4
Gouvernement du Canada. (2021, February 10). Le gouvernement du Canada accorde deux millions de dollars au Conseil des Atikamekw de Manawan et au Conseil de la Nation Atikamekw pour soutenir le Principe de Joyce. Gouvernement du Canada [Press release]. https://www.canada.ca/fr/services-autochtones-canada/nouvelles/2021/02/le-gouvernement-du-canada-accorde-deux-millions-de-dollars-au-conseil-des-atikamekw-de-manawan-et-au-conseil-de-la-nation-atikamekw-pour-soutenir-l.html
Gouvernement du Québec. (2019). Commission d’enquête sur les relations entre les Autochtones et certains services publics: écoute, réconciliation et progrès (Rapport final). Commission d’enquête sur les relations entre les Autochtones et certains services publics. https://www.cerp.gouv.qc.ca/fileadmin/Fichiers_clients/Rapport/Rapport_final.pdf
Gouvernement du Québec. (2020, November 6). Investissement de 15 M$ pour la sécurisation culturelle auprès des membres des Premières Nations et des Inuits dans le réseau de la santé et des services sociaux Québec [Press release]. https://www.msss.gouv.qc.ca/ministere/salle-de-presse/communique-2427/
Hackett, F. J., Abonyi, S., & Dyck, R. F. (2016). Anthropometric indices of First Nations children and youth on first entry to Manitoba/Saskatchewan residential schools-1919 to 1953. International Journal of Circumpolar Health, 75, 30734. https://doi.org/10.3402/ijch.v75.30734
Iwama, M., Marshall, M., Marshall, A., & Bartlett, C. (2009). Two-eyed seeing and the language of healing in community-based research. Canadian Journal of Native Education, 32, 3–23.
Jacklin, K. M., Henderson, R. I., Green, M. E., Walker, L. M., Calam, B., & Crowshoe, L. J. (2017). Health care experiences of Indigenous people living with type 2 diabetes in Canada. Canadian Medical Association Journal, 189(3), E106–E112. https://doi.org/10.1503/cmaj.161098
Janzen, B., Karunanayake, C., Rennie, D., Katapally, T., Dyck, R., McMullin, K., et al. (2018). Racial discrimination and depression among on-reserve First Nations people in rural Saskatchewan. Canadian Journal of Public Health, 108(5–6), e482–e487. https://doi.org/10.17269/cjph.108.6151
Kolahdooz, F., Nader, F., Kyoung, J. Y., & Sharma, S. (2015). Understanding the social determinants of health among Indigenous Canadians: Priorities for health promotion policies and actions. Global Health Action, 8(0), 1–16. https://doi.org/10.3402/gha.v8.27968
Lavis, J. (2010). Organizing and evaluating deliberative dialogues in Canada and elsewhere. 13es Journées annuelles de santé publique, Montreal. https://www.ncchpp.ca/docs/DeliberationJASP2010_LAVIS_EN.pdf
Kamel, G. (2021). Rapport d’enquête concernant le décès de Joyce Echaquan. Québec, CA: Bureau du coroner. https://www.coroner.gouv.qc.ca/fileadmin/Enquetes_publiques/2020-EP00275-9.pdf
Loppie Reading, C., & Wien, F. (2009). Inégalités en matière de santé et déterminants sociaux de la santé des peuples autochtones (Centre de collaboration national de la santé autochtone (Ed.)). Prince George
Marrone, S. (2007). Understanding barriers to health care: A review of disparities in health care services among indigenous populations. International Journal of Circumpolar Health, 66(3), 188–198. https://doi.org/10.3402/ijch.v66i3.18254
Martin, D. H. (2012). Two-eyed seeing: A framework for understanding indigenous and non-indigenous approaches to indigenous health research. The Canadian Journal of Nursing Research, 44(2), 20–42.
McKinstry, S. (2017). Indigenous oral health inequity: An indigenous provider perspective. Canadian Journal of Public Health, 108(3), e221–e223. https://doi.org/10.17269/CJPH.108.6243
Peiris, D., Brown, A., & Cass, A. (2008). Addressing inequities in access to quality health care for indigenous people. CMAJ, 179(10), 985–986. https://doi.org/10.1503/cmaj.081445
Ramsden, I. (1990). Cultural safety. The New Zealand Nursing Journal Kai Tiaki, 83(11), 18–19.
Ramsden, I. (1992). Teaching cultural safety. The New Zealand Nursing Journal, 85(5), 21–23.
Reading, J. (2009). Les déterminants sociaux de la santé chez les Autochtones : Approche fondée sur le parcours de vie. Ottawa: Sous-comité sénatorial sur la santé de la population. 164 pages.
Smye, V., Josewski, V., & Kendall, E. (2010). Cultural safety: An overview. Mental Health Commission of Canada Canada, First Nations, Inuit and Métis Advisory Committee. https://www.troubleshumeur.ca/documents/Publications/CULTURAL%20SAFETY%20AN%20OVERVIEW%20(draft%20mar%202010).pdf
Tang, S. Y., & Browne, A. J. (2008). ‘Race’ matters: Racialization and egalitarian discourses involving aboriginal people in the Canadian health care context. Ethnicity & Health, 13(2), 109–127. https://doi.org/10.1080/13557850701830307
Tremblay, M. C., & Richard, L. (2014). Complexity: A potential paradigm for a health promotion discipline. Health Promotion International, 29(2), 378–388. https://doi.org/10.1093/heapro/dar054
Tremblay, M. C., Bradette-Laplante, M., Witteman, H. O., Dogba, M. J., Breault, P., Paquette, J. S., et al. (2020). Providing culturally safe care to indigenous people living with diabetes: Identifying barriers and enablers from different perspectives. Health Expectations. https://doi.org/10.1111/hex.13168
Truth and Reconciliation Commission of Canada. (2015). Truth and Reconciliation Commission of Canada: Calls to action. https://www2.gov.bc.ca/assets/gov/british-columbians-our-governments/indigenous-people/aboriginal-peoples-documents/calls_to_action_english2.pdf
Wood, P. J., & Schwass, M. (1993). Cultural safety: A framework for changing attitudes. Nursing Praxis in New Zealand, 8(1), 4–15.
Zambas, S. I., & Wright, J. (2016). Impact of colonialism on Maori and aboriginal healthcare access: A discussion paper. Contemporary Nurse, 52(4), 398–409. https://doi.org/10.1080/10376178.2016.1195238
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Tremblay, MC., Echaquan, S. (2022). Fostering Cultural Safety in Health Care Through a Decolonizing Approach to Research with, for and by Indigenous Communities. In: Potvin, L., Jourdan, D. (eds) Global Handbook of Health Promotion Research, Vol. 1. Springer, Cham. https://doi.org/10.1007/978-3-030-97212-7_9
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