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Cultural orientation and safety app for new and short-term health care providers in Nunavut

Abstract

Setting

One of the greatest challenges of Nunavut’s health care system is its reliance on short-term professionals, many of whom are not oriented to the Inuit historical/cultural context and the organization of health care in the territory. Our objective was to develop a free iOS/Android app to address this knowledge gap.

Intervention

We reviewed existing literature and interviewed key stakeholders to develop the content of the app covering the following: Inuit ways of communicating and expectations in the health care setting; Inuit history, settlement, and societal values (including a bibliography and a list of Inuktitut language phrases and resources); health care model (including referral pathways for tertiary care and mental health referrals); maps and community information; and useful information to prepare for your arrival. The app, HealthNU, was launched in September 2017. We targeted new and short-term health care providers in Nunavut, and the app has also been circulated and used by social workers, educators, and health care providers outside of the territory.

Outcomes

By September 5, 2019, the app had been downloaded more than 700 times. To evaluate the app, we conducted interviews and a brief survey with key stakeholders (n = 18), who indicated that (1) the app was easy to use; (2) the content was highly relevant and would result in improved cultural competencies; and (3) they would recommend the app to colleagues and were already using it for recruitment/orientation. Challenges and limitations included: ensuring practitioners “completed” all modules while reading/using the app, and low response rate among providers who were solicited for feedback.

Implications

HealthNU is an example of how technology solutions developed in partnership with community members, health care providers, researchers, and government can improve the quality of care for Nunavummiut. We are currently working with the Nunavut Department of Health to develop similar apps in other contexts.

Résumé

Contexte

L’un des plus grands défis du système de santé du Nunavut réside dans sa dépendance à des professionnels temporaires, dont beaucoup ne sont pas formés au contexte historique/culturel inuit et à l’organisation des soins de santé dans le territoire. Notre objectif était de développer une application iOS/Android gratuite pour répondre à ce besoin.

Intervention

Nous avons examiné la littérature existante et nous avons consulté les principaux intervenants pour élaborer le contenu de l’application, qui couvre : les modes de communication et les attentes des Inuits en matière de soins de santé; histoire, établissement et valeurs sociétales des Inuits (incluant une bibliographie et une liste de ressources et phrases en Inuktitut); modèle de soins de santé (incluant le transfert de patients à des soins tertiaires et à des soins de santé mentale); cartes et informations sur les communautés; et informations utiles pour préparer le déménagement. L’application HealthNU a été lancée en septembre 2017. Nous avons ciblé de nouveaux prestataires de soins de santé et des professionnels temporaires au Nunavut. L’application a également été distribuée et utilisée par des travailleurs sociaux, des éducateurs et des prestataires de soins de santé à l’extérieur du territoire.

Résultats

Entre septembre 2017 et septembre 2019, l’application a été téléchargée plus de 700 fois. Pour évaluer l’application, nous avons mené des entretiens et un court sondage auprès des principaux intervenants (n = 18) qui ont indiqué que : 1) l’application est facile à utiliser; 2) le contenu est très pertinent et entraînerait une amélioration des compétences culturelles; et 3) ils recommanderaient l’application à des collègues et l’utilisent déjà pour le recrutement/l’orientation. Les défis et les limites principaux de l’évaluation ont été : 1) de s’assurer que les praticiens « terminaient » tous les modules en lisant/utilisant l’application, et 2) un faible taux de réponse des professionnels qui ont été sollicités pour participer aux entretiens et au sondage.

Conclusions

HealthNU est un exemple qui montre comment les solutions technologiques développées en partenariat avec des membres de la communauté, des prestataires de soins de santé, des chercheurs et le gouvernement peuvent améliorer la qualité des soins pour les Nunavummiut. Nous travaillons actuellement avec le Ministère de la Santé du Nunavut pour développer des applications similaires dans d’autres contextes.

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Fig. 1

Notes

  1. 1.

    Nunavummiut is the Inuktitut language term for “people of Nunavut”.

References

  1. Aitken, C., Power, R., & Dwyer, R. (2008). A very low response rate in an on-line survey of medical practitioners. Australian and New Zealand Journal of Public Health, 32(3), 288–289.

    Article  Google Scholar 

  2. Aylward, M. L. (2007). Discourses of cultural relevance in Nunavut schooling. Journal of Research in Rural Education, 22(7), 1–9.

    Google Scholar 

  3. Berger, P., & Epp, J. R. (2006). Practices against culture that “work” in Nunavut schools: problematizing two common practices. McGill Journal of Education/Revue des sciences de l’éducation de McGill, 41(1).

  4. Cater, T. (2015). ‘They should acknowledge the gap’: exploring contemporary mining encounters in Rankin Inlet, Nunavut. Northern Public Affairs, 4(1). Available at: http://www.northernpublicaffairs.ca/index/they-should-acknowledge-the-gap-exploring-contemporary-mining-encounters-in-rankin-inlet-nunavut/. Accessed 17 Oct 2019.

  5. Children’s Hospital of Eastern Ontario (2014). Qikiqtaaluk cultural competency modules. Available at: https://www.cheo.on.ca/en/Nunavut-Program-Modules. Accessed 17 Oct 2019.

  6. Creswell, J. W. (2013). Qualitative inquiry and research design (3rd ed.). Thousand Oaks: Sage.

    Google Scholar 

  7. Crouch, S., Robinson, P., & Pitts, M. (2011). A comparison of general practitioner response rates to electronic and postal surveys in the setting of the National STI Prevention Program. Australian and New Zealand Journal of Public Health, 35(2), 187–189.

    Article  Google Scholar 

  8. Healey, G. K. (2006). Report on health research ethics workshop and community consultation in Iqaluit, Nunavut. Iqaluit: Qaujigiartiit/Arctic Health Research Network.

    Google Scholar 

  9. Healey, G. K. (2007). Report on health research ethics workshop and community consultation in Rankin Inlet, Nunavut. Iqaluit: Qaujigiartiit/Arctic Health Research Network.

    Google Scholar 

  10. Jenness, S. E. (1991). Arctic odyssey: the diary of Diamond Jenness 1913–1916. Ottawa: Canadian Museum of Civilization.

    Google Scholar 

  11. Kabloona, K. A. (2016). Note to my clinician 2016. Internal publication of the Department of Health. Iqaluit: Government of Nunavut.

    Google Scholar 

  12. Kirmayer, L. J. (2013). Embracing uncertainty as a path to competence: cultural safety, empathy, and alterity in clinical training. Culture, Medicine and Psychiatry, 37(2), 365–372.

    Article  Google Scholar 

  13. McDonnell, L., & Healey, G. (2017). Perspectives of primary care providers on the topic of medevac communication and rural practice in Northwest Territories and Nunavut: a report on survey findings. Iqaluit: Qaujigiartiit Health Research Centre.

    Google Scholar 

  14. Moffitt, M., Chetwynd, C., & Todd, Z. (2015). Interrupting the northern research industry: why northern research should be in northern hands. Northern Public Affairs, 4(1) Available at: http://www.northernpublicaffairs.ca/index/interrupting-the-northern-research-industry-why-northern-research-should-be-in-northern-hands/. Accessed 17 Oct 2019.

  15. Nunavut Tunngavik Inc. (2008). Nunavut’s health system: a report delivered as part of Inuit obligations under Article 32 of the Nunavut Land Claims Agreement, 1993 — Annual report on the state of Inuit culture and society. Iqaluit, NU. Available at: www.tunngavik.com/documents/publications/2007-2008%20Annual%20Report%20on%20the%20State%20of%20Inuit%20Culture%20and%20Society%20(English).pdf. Accessed 17 Oct 2019.

  16. Office of the Auditor General of Canada. (2017). Health care services — Nunavut. Available at: www.oag-bvg.gc.ca/internet/English/nun_201703_e_41998.html. Accessed 17 Oct 2019.

  17. Power, P. (2014). How we misunderstand the Canadian North. The Globe and Mail. Available at: https://www.theglobeandmail.com/news/national/the-north/arctic-circle-panel-how-we-misunderstand-the-canadian-north/article16404201/. Accessed 17 Oct 2019.

  18. Public Health Agency of Canada. (2019). Core competencies for public health in Canada. Ottawa: Government of Canada Available at: https://www.canada.ca/en/public-health/services/public-health-practice/skills-online/core-competencies-public-health-canada.html. Accessed 17 Oct 2019.

    Google Scholar 

  19. Redvers, N., Marianayagam, J., & Blondin, B. S. (2019). Improving access to Indigenous medicine for patients in hospital-based settings: a challenge for health systems in northern Canada. International Journal of Circumpolar Health, 78(2), 1589208.

    Article  Google Scholar 

  20. Truth and Reconciliation Commission of Canada. (2015). Calls to action. Winnipeg: Truth and Reconciliation Commission of Canada Available at: http://trc.ca/assets/pdf/Calls_to_Action_English2.pdf. Accessed 17 Oct 2019.

    Google Scholar 

  21. Wihak, C., & Merali, N. (2007). Racial/cultural identity: transformation among school-based mental health professionals working in Nunavut. Canadian Journal of Education, 30(1), 291–322.

    Article  Google Scholar 

  22. Young, T. K., Tabish, T., Young, S. K., & Healey, G. (2019). Patient transportation in Canada’s northern territories: patterns, costs and providers’ perspectives. Rural and Remote Health, 19(2), 5113–5113.

    CAS  PubMed  Google Scholar 

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Funding

This project builds on the work of the CIHR-funded Circumpolar Health Systems Innovation Team (2013–2018), which has been working to address health care system challenges in the circumpolar region using innovative policy, design, and technology-based solutions. Much of the research time and content development was provided in kind from the Circumpolar Health Systems Innovation Team research project. The First Nations and Inuit Health Branch of Canada provided the funding for the coding and piloting phase of the app.

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Authors

Contributions

Gwen Healey Akearok: Content design and collecting community member perspectives and experiences for inclusion in the development of the intervention

Taha Tabish: App design, development, and testing

Maria Cherba: Knowledge translation

Corresponding author

Correspondence to Maria Cherba.

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The authors declare that they have no conflict of interest.

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Healey Akearok, G., Tabish, T. & Cherba, M. Cultural orientation and safety app for new and short-term health care providers in Nunavut. Can J Public Health 111, 694–700 (2020). https://doi.org/10.17269/s41997-020-00311-8

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Keywords

  • Health care provider orientation
  • Cultural competency
  • Mobile app development
  • Nunavut

Mots-clés

  • Orientation des prestataires de soins de santé
  • Compétences culturelles
  • Développement d’applications mobiles
  • Nunavut