'Notes from the Cornfield' provides insights from a Navajo community practitioner who partnered with multiple Navajo communities to increase access to healthy food. In the process, common themes emerged across the intervention sites that are noteworthy and recommended to employ when partnering with Indigenous communities. Inclusion of Navajo culture to ground and guild health promotion frameworks, revitalization of Navajo agroecological practices, restoration of traditional food, and alignment with policy to promote sustainability all became important for intervention success. Author shares experience so others can gain from his work in multiple cornfields across the Navajo Nation.
Background: The COVID-19 pandemic exacerbated existing inequalities and vulnerabilities among marginalized groups, particularly Indigenous Peoples in Canada. We assessed the influence of psychological antecedents of vaccine hesitancy on COVID-19 vaccine uptake among Métis in Ontario, Canada. Methods: The Métis Nation of Ontario (MNO) survey, a population-based online survey, was used to capture MNO citizens’ “5Cs” of psychological antecedents relating to vaccination intention (Confidence, Complacency, Constraint, Calculation, Collective Responsibility). Descriptive statistics and multivariable logistic regression models were used to model vaccination status to assess the influence of psychological antecedents of vaccination with vaccination behaviour, by linking survey data to the Ontario COVID-19 Vaccine Database (COVaxON), which captures all COVID-19 vaccinations administered in Ontario. Results: The study cohort size was 3,999, with 3,701 (92.5%) MNO citizens participating partially or fully vaccinated. Results from five separate logistic regression models suggested four variables/indicators from 5Cs – Confidence, Complacency, Calculation, and Collective Responsibility – were significantly associated with vaccination status, while Constraints was not. Conclusions: This study contributes valuable insight on the factors that may influence the decision to opt out of receiving a COVID-19 vaccination among Métis and can inform the development of targeted public health interventions and educational strategies aimed at dispelling misconceptions about vaccination.
nities to increase access to healthy food. In the process, common themes emerged across the intervention sites that are noteworthy and offer recommendations for partnering with Indigenous communities to improve access to healthy food. The inclusion of Navajo culture to ground and guide health promotion frame-works, revitalization of Navajo agro ecological practices, restoration of traditional food, and alignment with policy to promote sustainability all became important for intervention success. The author shares his experience so others can gain from his work in multiple cornfields across the Navajo Nation and beyond. "Notes from the Cornfield" provides insights from a Navajo community practitioner who partnered with multiple Navajo commu
Background: Indigenous Peoples in Canada have endured a significant history of colonization which has resulted in intergenerational disparities impacting individual and community wholistic health outcomes. This is complicated further for Indigenous Peoples who choose to access a complex mainstream, biomedical, colonial healthcare system. The role of the Indigenous Patient Navigator (IPN) has been identified as a strategy to address social determinants of health and provide a person-centered approach to empower individuals and families to establish a connection with appropriate health and social services. Purpose: The overall purpose of this study is to explore the role of the IPN across health care settings in the province of Ontario, Canada. More specifically, to understand the roles and activities IPNs undertake to address the health and social service barriers and enablers Indigenous community members experience when accessing the mainstream, biomedical healthcare system. Methods: This is a multi-site qualitative study guided by the methodological principles of Interpretive Description and the guidance of the Two-Eyed Seeing approach to ensure the inclusion of non-Indigenous and Indigenous worldviews. Results: Thirty-six participants (20 IPNs and 16 Indigenous community members who accessed IPN services in Ontario, Canada) participated in semi-structured one-to-one, virtual or telephone interviews. Additionally, ten IPN organizational documents were reviewed for this study. Eight IPN roles are presented with corresponding activities including: 1) health and social service navigation, 2) wholistic support of Indigenous Peoples, 3) education, 4) Indigenous Knowledge and Traditional healing, 5) advocacy and capacity building, 6) administrative navigation, 7) leadership, and 8) outreach. Conclusion: This research provides a deeper understanding of the role of the IPN across health care settings and how the role addressees barriers and enablers Indigenous community members experience when accessing health and social services.
This narrative review explores the intersections of shame, identity, and well-being in Métis experiences, as depicted in autobiographical literature. Despite governmental recognition, Métis identity remains ambiguously defined, impacting their integration into federal health policies. This analysis underscores how racism and discrimination shape Métis identity and well-being and are influenced by socio-economic determinants. Central to Métis worldview is Wahkotowin which emphasizes relationality and interconnectedness. This paper considers Wahkotowin to understand the complex relationship between identity and well-being. Historical alliances like the Nehiyaw Pwat Confederacy exemplify kinship ties that have been disrupted by colonial policies, which further marginalize Métis connections with their Indigenous kin. This review of autobiographic works reveals the legacy of shame, both externally imposed and internally experienced by the Métis, which stems from colonial subjugation. These narratives provide profound insights into the impact of shame on Métis identity and kinship bonds. Acknowledging data limitations, this review advocates for further research into the nuanced effects of shame on Métis well-being. It calls for the adoption of distinction-based methodologies in healthcare and culturally sensitive interventions. Restoring historical kinship ties emerges as a central theme through this paper as essential for collective healing and the affirmation of Métis identity and well-being.
Yukon University and the Vuntut Gwitchin First Nation (VGFN) explored emerging issues during the COVID-19 pandemic within the community of Old Crow. This community-based participatory research project took place in Old Crow, Yukon and sought to hear the perspectives of citizens of the community during the pandemic. Using a strengths-based approach grounded in Indigenous ways of knowing and doing, participants described the impacts of COVID-19 in the northern Village of Old Crow on intergenerational trauma, mental wellness, social divisions created by vaccine uptake, and social isolation in an already isolated community. We also sought to learn how the health and wellness of the Vuntut Gwitchin citizens was impacted, including but not limited to, gender, the effects of COVID-19, vaccine confidence, social divisions generated through personal vaccine decisions, mental health and substance use, and the impact of long COVID. We heard how the community mobilized and reacted to the pandemic through policies and decisions, as well as programs and support offered to citizens. This project identified the lessons learned in the response to COVID-19 that could guide the response to subsequent pandemics or health emergencies that are culturally safe and strengthen the capacity of the community, as well as the health and wellness of the citizens. The participants’ perspectives reflected their resiliency, self-determination, strong sense of community, and traditional ways of knowing and being. The uniqueness of their experiences may provide insights that can support other communities that are Indigenous, rural and remote in dealing with future pandemics.
For over twenty years, the Network Environments for Indigenous Health Research (NEIHR) has been a key initiative of the Canadian Institutes of Health Research-Institute of Aboriginal Peoples’ Health, now the Institute of Indigenous Peoples’ Health (CIHR-IAPH-IIPH). The NEIHR Program is a national initiative of 9 networks with a national coordinating centre (NCC) across Canada focused on capacity development, research and knowledge translation centred on First Nations, Métis and Inuit Peoples (FNMI). These independent, Indigenous-led networks provide supportive research environments for Indigenous health research driven by, and grounded in, Indigenous communities across Canada (CIHR-IIPH, 2023).
Indigenous communities globally grapple with a high burden of human papillomavirus-related diseases like cancer of the cervix. Despite the availability of a highly protective vaccine for HPV, it is evident that immunization levels with this vaccine is still low among these communities. Compounded with socioeconomic marginalization and a history of colonial, racist, and underfunded health services, Indigenous communities in several countries continue to experience poor health outcomes due to HPV infections. HPV is administered to school-aged children in grades 6-10 depending on province or territory. Since HPV infections are delivered predominantly via schools, a study on how colonial history including residential schools; health services and health seeking behaviour may give a pointer as to the factors that affect school-based HPV immunizations. A scoping review was conducted on published literature in the US, Canada, and Australia to decipher how school-based HPV immunization was conducted and to delineate the causes of low HPV vaccine uptake. Results: Schools located in remote areas with a high proportion of Indigenous students, high absenteeism rate and in lower socioeconomic brackets had the lowest uptake of HPV vaccine. As compared to their non-Indigenous peers, Indigenous students had a lower initiation as well as lower completion rates for HPV vaccine. Countries that captured the Indigenous status of individuals at vaccination points had better quality data of the immunization status of Indigenous communities. For the US and Canada, immunization data on Indigenous communities is lacking.
Sport and physical activity have been mobilized as a vehicle for positive developmental outcomes of Indigenous youth . These experiences offer Indigenous youth the capacity to attain their full potential, accrue wholistic health benefits, and live in balance. Despite this knowledge, there is still limited research to understand Indigenous perspectives in extant literature. The purpose of this research was to explore and better understand how the wholistic health of First Nations youth is impacted through participation in sport and physical activity. Using purposeful sampling, eight First Nations youth (5 males, 3 females) between the age of 14 and 18 years (Mage = 16.75 years) were recruited to participate in one of two virtual sharing circles. Results highlighted that sport and physical activity are associated with positive outcomes related to physical adaptations, mental health, mental skills, and interconnectedness for First Nations youth. However, to balance findings, this research also demonstrates room for growth in sport and physical activity participation (e.g., racism). Findings from this research add important context and nuance to the overarching belief that sport and physical activity participation is beneficial to the wholistic health of Indigenous youth.
The response to the COVID-19 pandemic limited socializing and connecting, impacting the ability of Elders to pass on guidance and leadership through culturally specific ways. Community-level supports are vital for older adults living in First Nation communities, particularly supports that are inclusive, accessible, private, and confidential, and those that promote visiting, connecting, and culture, offer opportunities for outings, and use many avenues for awareness. Using an Anishinabek research methodology to inform decision-making among the Health and Community Wellness Committee, this community-based participatory action research study used the Gaataa’aabing visual research method to answer the research question: what are the perceptions of “community” adults over 50 years of age who have multiple chronic conditions about community-level supports during the COVID-19 pandemic? We recruited two participants who participated in three learning circles and contributed seven photos. We followed an adapted version of the collective consensual data analytic procedure to analyze over 400 coded segments, resulting in 15 themes organized into barriers to, thoughts and perceptions about, and strengths of community-level supports. We found that the importance of connecting through various means was heightened during the COVID-19 pandemic and community-level support aided in socialization through digital platforms. Although Elders enjoyed connecting with others through modern technology, they also felt that there is a need to return to the old ways, bringing back an Anishinabek way of life. Moving forward, service providers can use these findings to support the coordination of ‘friendly visiting’ via community-level volunteer programs to reduce the impacts of social isolation.
Using methodological approaches rooted in Indigenous ways of knowing and being can help to ensure that research findings are relevant and useful to Indigenous communities, while providing evidence for more responsive public health policy and practice. This article explores a practical application of a Two-Eyed Seeing approach in knowledge synthesis as part of Phase I of the First Nation Health Authority’s Indigenizing Harm Reduction Study. The Study aims to develop a First Nations harm reduction framework rooted in community knowledges in response to the disproportionate harms of the toxic drug emergency on First Nations people in British Columbia (BC). Our approach prioritized Indigenist research methods, centering relationality and storytelling in knowledge gathering, analyses, and validation activities, while weaving in a Western scoping review methodology. The literature review explored harm reduction among Indigenous communities globally. Conversational interviews and questionnaires gathered knowledge from individuals who identified as First Nations people who access harm reduction services or individuals who provide harm reduction services to First Nations people in BC. Weaving together these knowledge systems helped our team to develop a more wholistic understanding of existing harm reduction approaches and current needs of First Nations communities in BC, grounded in Indigenous values and lived experiences. This culturally relevant approach to knowledge synthesis contributes to the knowledge base on Indigenous research methodologies and presents a practical Two-Eyed Seeing framework for weaving together both academic and community-based evidence within healthcare contexts. We share this methodology as an offering for both Indigenous and settler scholars, care providers, and decision makers working in health to privilege Indigenous knowledges in developing evidence-informed policies and practices.
This conceptual article addresses several critical gaps in Indigenous health literature by exploring the ethical, spiritual, and cultural dimensions of assisted dying through the lens of Māori cosmology and pūrākau (ancestral narratives). While existing end-of-life policy frameworks often prioritise Western bioethical principles, this article argues for the inclusion of Kaupapa Māori principles—such as whakapapa, wairua, mana motuhake, and tapu/noa—as essential components of culturally resonant care. Drawing upon foundational narratives including the separation of Ranginui and Papatūānuku, the creation of Hineahuone, the transformation of Hinetītama into Hinenuitepō, and the fatal attempt of Māui to conquer death, we position pūrākau as dynamic ethical texts that guide decision-making. This article contributes to Indigenous health discourse by offering a whānau-centred, tikanga-informed critique of the End-of-Life Choice Act 2019 and calls for broader recognition of spiritual and relational dimensions in end-of-life care. We contend that assisted dying, when undertaken with whānau engagement, spiritual awareness, and cultural integrity, may be ethically compatible with tikanga Māori (Māori cultural practices).
The COVID-19 pandemic exacerbated existing inequalities and vulnerabilities among marginalized groups, particularly Indigenous Peoples in Canada. We assessed the influence of psychological antecedents of vaccine hesitancy on COVID-19 vaccine uptake among Metis in Ontario, Canada. The Metis Nation of Ontario (MNO) survey, a population-based online survey, was used to cap-ture MNO citizens' "5Cs"-psychological antecedents relating to vaccination intention (confidence, complacency, constraint, calculation, and collective responsibility). Descriptive statistics and multivariable logistic regression models were used to model vaccination status to assess the influence of psychological antecedents of vaccination on vaccination behaviour, by linking survey data to the Ontario COVID-19 Vaccine Database (COVaxON), which captures all COVID-19 vaccinations administered in Ontario. The study cohort size was 3,999, with 3,701 (92.5%) of participating MNO citizens partially or fully vaccinated. Results from five separate logistic regression models suggested four variables/indicators from the 5Cs-confidence, complacency, calculation, and collective responsibility-were significantly associated with vaccination status, while constraints was not. This study contributes valuable insight on the factors that may influence the decision to opt out of receiving a COVID-19 vaccination among Metis and can inform the development of targeted public health interventions and educational strategies aimed at dispelling misconceptions about vaccination.
Globally, it is essential that Indigenous-specific patient healthcare experience metrics are developed, to ensure that the distinct expe-riences of Indigenous Peoples in healthcare are captured appropri-ately. In this study, we sought to understand Indigenous Elders' perspectives on storytelling as a way to measure and respond to Indigenous patients' healthcare experiences. This study is led by a team of Indigenous and non-Indigenous researchers committed to using culturally safe approaches throughout all stages of research. Four individual interviews were conducted with Indigenous El-ders who serve patients in the healthcare system in Vancouver, British Columbia, Canada, and thematic and narrative analyses were used to identify themes pertaining to the use of storytelling in the Elders' work, and as an approach to measuring Indigenous patients' experiences. Four BC First Nations Elders participated in one-on-one in-depth interviews between March and August 2023. Elders shared that an important element of storytelling is the ability to centre positive conversation to help with a patients' healing journey. Storytelling, which represents a traditional prac-tice of knowledge translation for many First Nations, M & eacute;tis, and Inuit communities, was found to connect Indigenous Peoples to cultural teachings and supports, which allowed for the building and strengthening of relationships between patients, families, and healthcare providers. Findings illustrate that storytelling is an important and effective strategy for measuring and responding to Indigenous patients' healthcare experiences. Study results sup-port the use of storytelling as a method for measuring Indigenous patients' healthcare experiences, and future research should focus on understanding community perspectives and logistics of imple-menting a storytelling-based, Indigenous-specific patient experi-ence measurement tool.
ational disparities impacting individual and community wholistic health outcomes. This is complicated further for Indigenous Peoples who choose to access a complex mainstream, biomedical, colonial healthcare system. The role of the Indigenous Patient Navigator (IPN) has been identified as a strategy to address social determinants of health and provide a person-centered approach to empower individuals and families to establish a connection with appropriate health and social services. The overall purpose of this study is to explore the role of the IPN across healthcare settings in the province of Ontario, Canada. More specifically, it aims to understand the roles and activities IPNs undertake to address the health and social service barriers and enablers that Indigenous community members experience when accessing the mainstream, biomedical healthcare system. This is a multi-site qualitative study guided by the methodological principles of Interpretive Description and the guidance of the Two-Eyed Seeing approach to ensure the inclusion of non-Indigenous and Indigenous worldviews. Thirty-six participants (20 IPNs and 16 Indigenous community members) who accessed IPN services in Ontario, Canada participated in semi-structured one-to-one, virtual or telephone interviews. Additionally, 10 IPN organizational documents were reviewed. This article presents eight IPN roles, with corresponding activities including: (1) health and social service navigation; (2) wholistic support of Indigenous Peoples; (3) education; (4) Indigenous Knowledge and Traditional Healing; (5) advocacy and capacity building; (6) administrative navigation; (7) leadership; and (8) outreach. The research provides a deeper understanding of the role of the IPN across healthcare settings, and how this role addresses barriers and enablers that Indigenous community members experience when accessing health and social services. Indigenous Peoples in Canada have and continue to endure a significant history of colonization, which has resulted in intergener
The Yetwánaý Project is a community-led, land-based case study from the Skwxwú7mesh (Squamish) Nation that explores how reconnection with culturally important plants can support Indigenous health and wellness, particularly in relation to the prevention and management of Type 2 Diabetes (T2D). Rooted in Community-Based Participatory Action Research (CBPAR) and Insurgent Research methodologies, the project engaged over 200 participants through seasonal community gatherings, land-based harvesting sessions, and interactive activities grounded in Skwxwú7mesh culture. Data sources included harvest surveys, community feedback, planning committee meeting notes, and facilitation materials. A thematic analysis was employed to identify key themes emerging from this diverse dataset. The analysis revealed six interrelated themes, including the role of Indigenous plants in wellness, ancestral continuity, cultural implications of T2D, colonial barriers to land access, and the importance of Indigenous researchers. The Yetwánaý Project is an example of what respectful research with Indigenous community partners can look like and demonstrates the value of participatory, decolonial, and culturally grounded approaches to ethnobotanical research. The paper concludes with “wise practices” to guide ethical and reciprocal research partnerships in Indigenous health contexts.
Indigenous knowledge is at the heart of identity, culture, and wellbeing for Indigenous Peoples, and knowledge transmission is fundamental to sustaining a sense of belonging, connection to community, and upholding Indigenous Peoples inherent rights and sovereignties. However, colonial and Eurocentric ideologies have long disrupted this knowledge transmission, impeding self-determination and aiming to assimilate and control Indigenous Peoples, cultures, and identities. The inaugural Indigenous Wellbeing Gathering Conference hosted by the Urban Indigenous Wellbeing Collective on the traditional territory of the Syilx Okanagan Nation, sought to create a responsive and inclusive space for the sharing and revitalization of Indigenous knowledge systems. Grounded in reciprocity and relationality, the conference centred Indigenous-led pathways of wellbeing, with the aim of bringing together academic and Indigenous community-led wellbeing research and practices. This paper describes the journey of organizing the conference, offering insights into Indigenous approaches to knowledge translation within health research contexts. Emerging from the experience of organizing the gathering, we share an Indigenous Wellbeing Research Knowledge Translation Framework, which emphasizes iterative, community-engaged processes, valuing Indigenous knowledge systems alongside research and wellbeing practitioner knowledges. This framework aims to advance health equity, Indigenous human rights, and self-determination by centering Indigenous knowledge systems and practices. The conference's success highlights the importance of culturally relevant, community-led initiatives in promoting Indigenous wellbeing.
Oral health care is just one example of the pervasive impacts of Anti-Indigenous Racism (AIR) on various facets of Indigenous health, with Indigenous Peoples in Canada experiencing poorer oral health than their non-Indigenous counterparts. However, there is limited investigation into the specific oral health experiences of Indigenous Women, Two-Spirit, Transgender, and Gender Diverse (IW2STGD+) Peoples. To address this gap, a mixed-methods research study was conducted. The study engaged IW2STGD+ Peoples in exploring their oral health care experiences, focusing on racism and discrimination. Surveys, along with virtual and in-person Sharing Circles, were conducted with IW2STGD+ individuals and oral healthcare providers across Turtle Island and Inuit Nunangat. Engagements with IW2STGD+ Peoples and oral healthcare providers yielded insights into shortcomings, accessibility issues, and service needs related to oral health care. The research study resulted in the development of recommendations and potential metrics for success aimed at enhancing the overall experience of IW2STGD+ individuals with oral health care needs. Aligned with the Calls to Action outlined by the Truth and Reconciliation Commission of Canada, addressing AIR in oral health care education, access, and delivery remains a crucial component of advancing reconciliation with Indigenous Peoples.
Indigenous health research. While capacities are required at political, organizational, and individual levels, individual capacity is critical to unpack, as it is related to capacity at all levels. In the Alberta NEIHR, the Indigenous Primary Health Care and Policy Research (IPHCPR) network, our evaluation team has been working to identify the knowledge, skills, abilities, and other characteristics (KSAOs) required for competency and readiness to practice Indigenous health research. Utilizing competency modeling techniques, we brought together IPHCPR members to participate in an idea generation session regarding Indigenous health research competencies. Competencies were grouped using a qualitative cut-and-sort technique and juxtaposed with readiness to practice in healthcare domains from non-Indigenous and Indigenous literatures in a co-occurrence matrix. The idea generation session produced 151 statements about Indigenous health research competencies, from which 42 non-redundant KSAOs were derived. Frequently occurring competencies included knowledge of Indigenous methodologies, skills in alignment with relational approaches, characteristics such as humility and openness to learn new approaches, and social abilities. These KSAOs supported cognitions, decolonized practice, personal attributes, research, and relational dispositions associated with perceived readiness to practice. Research capacity for Indigenous health research is a complicated construct often left undefined or uninterrogated. This study helped to unpack research capacity for Indigenous health research for individuals to support evaluation, training, and selection. Network Environments for Indigenous Health Research (NEIHR) are funded across Canadian provinces to enhance capacities for
Colonial legacies have left Indigenous older adults in remote communities vulnerable to health challenges that impede healthy ageing in place. Access to culturally safe health programming and support for using ageing technology remains a significant challenge for these older adults. Our previous research projects within the Star Blanket Cree Nation introduced older adults to new technologies, including blood glucose monitors, blood pressure monitors, smart scales, tablets, and Fitbits. The Community Knowledge Council, which directs this research, has identified a significant gap in further support and health programming around these technologies that must be addressed. Consequently, the Community Knowledge Council has recommended engaging older adults through culturally safe health programming focused on technology use. Using an Indigenist theoretical framework and a community-based participatory research approach, this research project aims to support Indigenous older adults in maximizing existing technologies through culturally safe health programming. Sharing circles involving ten older adults from the community are employed to gather knowledge and explore culturally appropriate health programs that facilitate technology usage among Indigenous older adults. Our findings underscore the importance of grounding Indigenous culture in designing ageing technology support programs for remote Indigenous communities. For instance, we found that intergenerational support, a critical component of Indigenous culture, plays a vital role in adopting ageing technology. Therefore, designing age-tech support programs without incorporating younger family members poses significant challenges within these communities.
