FormalPara Key Points

  • Decolonizing methodology and Indigenist research methods can challenge Western hegemony in research by asserting Indigenous ways of knowing, being, and doing.

  • Research with Indigenous peoples should use strengths-based and decolonizing approaches to highlight cultural strengths and resilience.

  • Co-designed research using one or more variations on Yarning methods is effective in empowering and privileging First Nations Australians’ voices.

  • Systematic use of reporting standards such as the CONSolIDated critERia for strengthening reporting of health research involving Indigenous peoples (CONSIDER statement) has the potential to increase the profile of, and enhance researcher accountability for, Indigenous research methods.

Ensuring that cancer research involving Indigenous communities fosters authentic collaboration and tangible benefit requires research methods that align with Indigenous ways of knowing, being, and doing. Given the enduring Western hegemony in research, this process must be grounded in Indigenist and decolonizing methodologies that prioritize Indigenous voices and worldviews [1]. This chapter provides a theoretical overview of Indigenist and decolonizing approaches in health research and provides some examples of research methods and reporting standards being used to prioritize Indigenous voices and paradigms.

Indigenist and Decolonizing Approaches

Indigenous communities have long been subjected to research practices that are ethically flawed, dismissive of Indigenous knowledge and expertise, and grounded in inequitable power structures [2]. This way of conducting research has historically been characterized by the acquisition of knowledge by Western researchers, the failure to compensate and/or acknowledge the community from which the knowledge was acquired, and, as such, a perpetuation of the systemic disparities and disadvantages of the very populations being researched [3]. To counter this, Indigenous researchers’ resistance has given rise to decolonizing and Indigenist methodologies, grounded in Indigenous worldviews and ways of knowledge creation and sharing [4], which are central in Indigenist epistemologies [1]. These methodologies are extensions of traditional Indigenous ways of knowing, being, and doing, and they are considered “living knowledges” that are relational in nature [5].

Two significant Indigenist epistemologies have emerged from the Indigenous resistance movements of the 1990s [2, 6]. The seminal work by Professor Linda Tuihwai Smith provided the first such specific decolonizing methodology for Māori in Aotearoa New Zealand: Kaupapa Māori research [2]. Tuihwai Smith defines the aims of Kaupapa Māori research as a reclamation of space within the research world by Māori, to:

… first, convince Māori people of the value of research for Māori; second, to convince the various, fragmented but powerful research communities of the need for greater Māori involvement in research; and third, to develop approaches and ways of carrying out research which take into account, without being limited by, the legacies of previous research, and the parameters of both previous and current approaches. [2, p. 183]

The second pioneering work, by Professor Lester-Irabinna Rigney, describes Indigenist research methodologies in Australia using three core principles: (1) notions of resistance as part of Indigenous peoples’ struggle for self-determination, (2) Indigenous research leadership in representing their communities to achieve self-determination, and (3) ensuring political integrity and privileging the voices of Indigenous peoples [1]. These provisions by Tuihwai Smith and Rigney encapsulate much of the aims and principles of Indigenist and decolonizing methodologies in the Indigenous communities of colonized nations, acknowledging that the interpretation and application of such methodologies is as unique and specific as the land and communities themselves. Indeed, diversity within Indigenous groups cannot be divorced from the process, acknowledging the imperative of embedding place-based approaches when using Indigenist and decolonizing methodologies.

Indigenous knowledges have been harnessed to assist understanding and provide practical tools that enable Western and Indigenous worldviews to co-exist and collaborate in practice. Two-Eyed Seeing (Etuaptmumk in Mi’kmaw) is an Indigenist and decolonizing concept originating from the Mi’kmaw First Nation in Canada [7]. As the name suggests, Two-Eyed Seeing constitutes an ability to approach circumstances with multiple perspectives, to learn:

… to see from one eye with the strengths of Indigenous knowledges and ways of knowing, and from the other eye with the strengths of Western knowledges and ways of knowing, and to [use] both these eyes together, for the benefit of all. [7, p. 335]

This concept has been paralleled by the idea of “working at the interface”—terminology developed by Māori academic Sir Mason Durie, where Indigenous and Western knowledge systems work together in tandem, with equal standing, contributing to the co-creation of innovative knowledge [8]. Similarly, Ganma, a Yolηu concept from Arnhem Land in the Northern Territory of Australia, references the meeting of freshwater (Yolηu knowledge) and saltwater (Western knowledge) in the river system, creating foam. This concept depicts two-way knowledge sharing and co-creation of new knowledge, endowed with mutual respect for both [9]. In Australia, research methods have emerged as extensions of Indigenous traditional ways to bring Indigenous ways of doing into predominantly Western research spaces.

Strengths-Based Approaches

Deficit discourse is a pervasive narrative within the First Nations academic and policy arena, which focuses on problems and pathology. It frames First Nations individuals in terms of negativity and failure [10], rather than interrogating the structures, systems, and policies that create and maintain disparities in health and wellbeing. Worryingly, deficit discourse can lead to self-internalization of deficit narratives among First Nations peoples [11]. Deficit narratives can negatively frame the research questions that are asked and affect how that research is operationalized, evaluated, and transformed into policy and practice, ultimately perpetuating cycles of injustice and further entrenching notions of disadvantage [11].

Alternatively, strengths-based approaches to research highlight and integrate the strengths and cultural knowledge of First Nations people. These approaches counteract the harms of deficit narratives by disrupting and challenging their underlying assumptions of problem and pathology [12]. Importantly, they do not detract from the very real challenges facing First Nations communities, instead reframing how these issues may be addressed using community-identified strengths and assets. A growing body of research has demonstrated the benefits of incorporating strengths-based approaches in conjunction with decolonizing research methods.

Examples of Strengths-Based, Decolonizing Research Methods

There are mounting examples of research methods being used to engage Indigenous peoples in research via empowering and respectful ways. Some useful examples are detailed below.

Co-design

Culturally appropriate and effective methodological approaches are required to ensure that First Nations Australians’ voices are central in directing and guiding the design and implementation of strategies to address issues affecting their communities. Co-design is one such method that is increasingly being used with both First Nations people and other marginalized groups. Co-design refers to processes and approaches whereby multiple parties, importantly including consumers or end-users, work together to find solutions to complex and persistent problems [13]. Co-design can give power to marginalized communities by prioritizing their voices and experiences, ensuring that they lead the way in finding solutions to the issues they find important. However, for co-design to work optimally, it must align with First Nations cultural values and perspectives and privilege First Nations ways of knowing, being, and doing [14, 15].

Recently, a set of key principles and best practices of co-design in health policy, practice, and research with First Nations Australians was collaboratively developed in an Australian study commissioned by Cancer Australia [14, 15]. The final set of key principles and best practices was developed through a systematic literature review [15] and rigorous stakeholder consultation [14]. Six key principles alongside numerous best practices were identified. These were First Nations leadership, culturally grounded approach, respect, benefit to community, inclusive partnerships, and transparency and evaluation [14]. Together, these principles and practices provide an essential framework for culturally safe research that favors the use of Indigenous research methods.

Social, Research, and Collaborative Yarning

Yarning is a recognized culturally appropriate style of communication among First Nations peoples in Australia and has been shown to be a powerful decolonizing research method. As a qualitative research method, Yarning centers on First Nations peoples’ ways of knowing, being, and doing and respects traditional oral customs and values. Yarning builds trust and connection between researchers and participants and it is grounded in cultural connection to one another and relationality. Yarns can be conducted on a one-on-one basis or in small groups as Yarning Circles (Fig. 62.1).

Fig. 62.1
A group of people sitting in a circle on a rug, engaged in a yarning circle, a culturally appropriate communication method among First Nations peoples in Australia.

Yarning circle. (Photo: Matt Williams)

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Bessarab and Ng’andu describe several types of Yarning [16]. Social Yarning involves both the researcher and participant introducing themselves, their mob (e.g., family, kin, and/or language groups), and Country. The Social Yarn allows participants to situate themselves and define how they are connected to each other and the researcher, and this is key to building comfort, connection, and trust. Often refreshments are shared during the Social Yarn as an important part of cultural protocol. The Research Yarn invites participants to share their lived experiences on the topic of interest. Unlike conventional qualitative methods, Research Yarns are non-linear and may take the form of stories. The researcher’s role is to listen to parts of the stories that are relevant to the research topic [17].

Collaborative Yarning Methodology is an iterative and flexible process of analysis that builds upon the concept of Collaborative Yarning identified by Bessarab and Ng’andu [16]. It brings together multiple perspectives from different First Nations individuals and groups to review, discuss, and refine data. The goal is to work collaboratively toward a shared understanding and co-analysis of data and results, ensuring that First Nations peoples are involved in all aspects and stages of the analysis and interpretation. The groups involved in Collaborative Yarning vary, depending on the specific needs and context of the project. The groups may include research participants, First Nations project advisory and working groups, First Nations researchers and investigators, and other stakeholders involved in the project. The process of Collaborative Yarning involves several recursive and iterative steps of analysis, checking, discussion, and re-checking between multiple parties and perspectives to gain feedback and guidance. An example of this process being used to develop the key principles and best practices for co-design with First Nations Australians is illustrated in Fig. 62.2 [14, 15].

Fig. 62.2
A circular diagram of collaborative yarning methodology. It includes the Research Team, Cancer Australia, and Indigenous co design working group.

Schematic representing collaborative yarning methodology. (Adapted from Ref. Butler et al. [15])

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Online Yarning Circles

The rapid uptake of virtual meeting platforms such as Zoom and Teams, alongside the social distancing and travel restrictions arising from the COVID-19 pandemic, has led to researchers investigating how Yarning can be conducted online. An Australian study showed that First Nations youth found Online Yarning Circles (OYCs) to be a feasible and acceptable way to both participate in and facilitate research [18]. Although there are technical and logistical challenges to overcome, OYCs can facilitate high levels of accessibility and engagement in research for First Nations peoples [18].

PhotoYarning

PhotoYarning provides another Indigenous research method that facilitates engagement and accessibility for the participant and builds on approaches based on words alone. It privileges the knowledge of community members by having them photograph their lived experience relevant to the topic of the project [19] and uses these images as the basis for Yarning about the topic. PhotoYarning acknowledges that a person possesses the expertise to Yarn about their life experiences and it facilitates that expression through photographs they have chosen to take that help describe what they see as significant themes, events, and phenomena [20]. The photographs may reveal similar or diverse images that may, in turn, be discussed with community members and researchers as part of the Research Yarn. The process moves toward a co-constructed understanding of the topic, informed by the words and images of the PhotoYarn participants. The entire process may include several stages that move the research through preparation and orientation of the task and equipment, data generation, and analyses of the photographs and Yarn transcripts.

PhotoYarning is effective as a method to explore the lived experiences of First Nations individuals and groups of people. For example, Dickson employed PhotoYarning to examine the strategies Aboriginal and Torres Strait Islander health professionals use to empower themselves within the challenging and sometimes conflicting contexts of their communities and healthcare settings [20]. Participants were able to depict and describe the challenges involved in navigating extremely complex networks of interactions at home and at work and how these challenges specifically affected the presentation of oneself seamlessly across these contexts. PhotoYarning has also recently been used to examine what young First Nations people (aged 12–17) view as important for their wellbeing. A range of images of people, places, pets, events, and objects of personal significance were shared in the context of group Yarns with peers. Researchers helped facilitate Yarns about the images, seeking input from the person who took the photo and inviting further comments from other members of the group to see if the image resonated with them and their wellbeing. Additionally, the young people participating in PhotoYarning described the process as “fun,” “easy” to do, and said they “enjoyed taking the photos.” Although some participants reported challenges in capturing the desired picture, they also expressed appreciation for the researchers’ interest in their lives, photos, and thoughts.

PhotoYarning can be an appropriate and innovative way of gaining a visual insight into the lived realities of First Nations people, serving as a springboard for meaningful and rich yarns about complex lived experiences.

Ensuring Accountability and Transparency in the Reporting of Indigenous Research Methods

It is imperative that researchers accurately and comprehensively report on the Indigenist and decolonizing research approaches and methods used in their research projects. This will lead to greater visibility of these approaches and their value, as well as greater understanding and awareness of the diverse ways these methods can be operationalized. The CONSolIDated critERia for strengthening reporting of health research involving Indigenous peoples (CONSIDER) statement provides a systematic checklist for reporting health research involving Indigenous peoples [21]. To develop the checklist, a working group of experts in Indigenous health and health equity examined Indigenous research ethics and research guidelines globally and then conducted an iterative process of discussion, review, and consensus-finding. The final checklist includes 17 items relating to eight domains for reporting research involving Indigenous peoples. The domains are governance, prioritization, relationships, methodologies, participation, capacity, analysis and interpretation, and dissemination. The checklist is designed to apply to the reporting of any health research that includes a significant focus on Indigenous peoples [21].

Although intended as a reporting checklist, researchers should also use the CONSIDER statement to better inform research design and methodology and to prompt close consideration of the various aspects of decolonizing research. Furthermore, journals, their editorial teams, and other publication outlets should require authors to complete the checklist as part of the article submission process, including justifying statements for any criteria that are not met. Systematic use of the CONSIDER statement and similar tools will improve accountability, transparency, and integrity in reporting and using Indigenous research methods.

Conclusions

These methods provide actionable tools for Indigenous and non-Indigenous researchers to conduct research in culturally appropriate ways. The application of Indigenist and decolonizing methodologies must be grounded in an overarching Indigenist epistemology (way of understanding and interpreting the world) [4] as well as appropriate approaches to research and design [14, 15]. Doing so will ensure that First Nations people are empowered to use research as a tool for justice and health equity.