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Can the democratic ideal of participatory research be achieved? An inside look at an academic-indigenous community partnership.

https://arctichealth.org/en/permalink/ahliterature159393
Source
Health Educ Res. 2008 Oct;23(5):904-14
Publication Type
Article
Date
Oct-2008
Author
Margaret Cargo
Treena Delormier
Lucie Lévesque
Kahente Horn-Miller
Alex McComber
Ann C Macaulay
Author Affiliation
Psychosocial Research Division, Douglas Hospital Research Centre-McGill University, Verdun, Québec, Canada H4H 1R3. margaret.cargo@unisa.edu.au
Source
Health Educ Res. 2008 Oct;23(5):904-14
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Adult
Canada
Community-Institutional Relations
Consumer Participation
Diabetes Mellitus, Type 2 - ethnology - prevention & control
Female
Health Services, Indigenous - organization & administration
Humans
Indians, North American
Male
Middle Aged
Abstract
Democratic or equal participation in decision making is an ideal that community and academic stakeholders engaged in participatory research strive to achieve. This ideal, however, may compete with indigenous peoples' right to self-determination. Study objectives were to assess the perceived influence of multiple community (indigenous) and academic stakeholders engaged in the Kahnawake Schools Diabetes Prevention Project (KSDPP) across six domains of project decision making and to test the hypothesis that KSDPP would be directed by community stakeholders. Self-report surveys were completed by 51 stakeholders comprising the KSDPP Community Advisory Board (CAB), KSDPP staff, academic researchers and supervisory board members. KSDPP staff were perceived to share similar levels of influence with (i) CAB on maintaining partnership ethics and CAB activities and (ii) academic researchers on research and dissemination activities. KSDPP staff were perceived to carry significantly more influence than other stakeholders on decisions related to annual activities, program operations and intervention activities. CAB and staff were the perceived owners of KSDPP. The strong community leadership aligns KSDPP with a model of community-directed research and suggests that equitable participation-distinct from democratic or equal participation-is reflected by indigenous community partners exerting greater influence than academic partners in decision making.
PubMed ID
18187491 View in PubMed
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Community governance of the Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Mohawk Nation, Canada.

https://arctichealth.org/en/permalink/ahliterature184076
Source
Health Promot Int. 2003 Sep;18(3):177-87
Publication Type
Article
Date
Sep-2003
Author
Margaret Cargo
Lucie Lévesque
Ann C Macaulay
Alex McComber
Serge Desrosiers
Treena Delormier
Louise Potvin
Author Affiliation
KSDPP, Kahnawake Territory, Kanien'keh (Mohawk Nation), Québec, Canada. mcargo@total.net
Source
Health Promot Int. 2003 Sep;18(3):177-87
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Adult
Advisory Committees
Canada
Community Health Planning - organization & administration
Community Health Services - organization & administration
Consumer Participation
Cooperative Behavior
Decision Making
Diabetes Mellitus, Type 2 - ethnology - prevention & control
Diet
Exercise
Female
Health Promotion - organization & administration
Health Services, Indigenous - organization & administration
Humans
Indians, North American
Male
Middle Aged
Questionnaires
School Health Services - organization & administration
Abstract
Health promotion emphasizes the importance of community ownership in the governance of community-based programmes, yet little research has been conducted in this area. This study examined perceptions of community ownership among project partners taking responsibility for decision-making related to the Kahnawake Schools Diabetes Prevention Project (KSDPP). Project partners were surveyed cross-sectionally at 18 months (T1) and 60 months (T2) into the project. The perceived influence of each project partner was assessed at T1 and T2 for three domains: (i) KSDPP activities; (ii) KSDPP operations; and (iii) Community Advisory Board (CAB) activities. Project staff were perceived to have the greatest influence on KSDPP activities, KSDPP operations and CAB activities at both T1 and T2. High mean scores of perceived influence for CAB members and community researchers, however, suggests that project decision-making was a shared responsibility among multiple community partners. Although academic researcher influence was consistently low, they were satisfied with their level of influence. This was unlike community affiliates, who were less satisfied with their lower level of influence. In keeping with Kanien'kehaka (Mohawk) culture, the findings suggest a participatory democracy or shared decision-making as the primary mode of governance of KSDPP.
PubMed ID
12920138 View in PubMed
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Critical cultural perspectives and health care involving Aboriginal peoples.

https://arctichealth.org/en/permalink/ahliterature167148
Source
Contemp Nurse. 2006 Sep;22(2):155-67
Publication Type
Article
Date
Sep-2006
Author
Annette J Browne
Colleen Varcoe
Author Affiliation
School of Nursing, University of British Columbia, Canadian Institutes of Health Research, Vancouver BC, Canada.
Source
Contemp Nurse. 2006 Sep;22(2):155-67
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Cultural Characteristics
Health Services, Indigenous - organization & administration
Humans
Population Groups
Abstract
Despite a growing body of critical scholarship in nursing, the concept of culture continues to be applied in ways that diminish the significance of power relations and structural constraints on health and health care. In this paper, we take a critical look at how assumptions and ideas underpinning conceptualizations of culture and cultural sensitivity can influence nurses' perceptions of Aboriginal peoples and Aboriginal health. Drawing on examples from our research, we examine how popularized assumptions about culture can shape nurses' views of Aboriginal patients. These assumptions and perceptions require closer scrutiny because of their potential to influence nurses' practice with Aboriginal patients. Our specific aims are to: (a) consider some of the limitations of cultural sensitivity in relation to health care involving Aboriginal peoples; (b) explore how ideas about culture have the potential to become problematic in nursing practice with Aboriginal peoples; and (c) explore the relevance of a 'critical cultural approach' in extending our understanding of culture in relation to Aboriginal peoples' health. We discuss a critical cultural perspective as one way of broadening nurses' understandings about the complexities of culture and the many facets of culture that require critical consideration. In relation to Aboriginal health, this will require nurses to develop greater critical awareness of culture as a relational process, and as necessarily influenced by issues of racism, colonialism, historical circumstances, and the current political climate in which we live.
PubMed ID
17026422 View in PubMed
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Legitimizing diabetes as a community health issue: a case analysis of an Aboriginal community in Canada.

https://arctichealth.org/en/permalink/ahliterature178873
Source
Health Promot Int. 2004 Sep;19(3):317-26
Publication Type
Article
Date
Sep-2004
Author
Sherri Bisset
Margaret Cargo
Treena Delormier
Ann C Macaulay
Louise Potvin
Author Affiliation
Groupe de Recherche Interdisciplinarie en Santé, Université de Montréal, C.P. 6128, Succ. Centre-ville, Montréal, Québec, Canada H3C 3J7. sherri.l.bisset@umontreal.ca
Source
Health Promot Int. 2004 Sep;19(3):317-26
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Community Health Planning - organization & administration
Diabetes Mellitus, Type 2 - ethnology - prevention & control
Female
Health Education - organization & administration
Health Services, Indigenous - organization & administration
Humans
Indians, North American
Male
Primary Prevention - organization & administration
Program Evaluation
Risk factors
Abstract
The Kahnawake Schools Diabetes Prevention Project (KSDPP) is an ongoing participatory research and intervention project aimed at the primary prevention of type 2 diabetes. Formally initiated in 1994 with strong community support, KSDPP provides a fertile opportunity to learn about how a community came to identify the need for preventive action on a health problem such as diabetes. The purpose of our study was to describe the various conditions in the community of Kahnawake, which gave rise to its mobilization for the prevention of type 2 diabetes. Qualitative data consisted of 12 individual interviews and one focus group with key community members and health professionals living and/or working in the community of Kahnawake, along with historically relevant documents. The data collection and analysis procedures of the grounded theory method were applied. Results describe a preceding phase to formal KSDPP implementation, triggered by returning research results on the community prevalence of type 2 diabetes. This phase of 'legitimizing diabetes as a community health issue' is characterized by a shift in the perceived preventability of diabetes among community members; from a problem that was to be lived with to a problem that was to be prevented. The shift in perceptions was facilitated by the context in the community, described by structural developments, cognitive and relational elements. In addition to reaffirming the critical importance of utilizing lay knowledge during the planning of a health promotion intervention, our study has uncovered some of the key conditions through which individuals in the community came to participate in the identification and planning of a diabetes prevention project.
PubMed ID
15306616 View in PubMed
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The relevance of indigenous knowledge for nursing curriculum.

https://arctichealth.org/en/permalink/ahliterature112602
Source
Int J Nurs Educ Scholarsh. 2013;10
Publication Type
Article
Date
2013
Author
Della Stansfield
Annette J Browne
Author Affiliation
Vancouver Island University, 900 Fifth St., Nanaimo, BC V9R 5S5, Canada. Della.Stansfield@viu.ca
Source
Int J Nurs Educ Scholarsh. 2013;10
Date
2013
Language
English
Publication Type
Article
Keywords
Canada
Cultural Characteristics
Curriculum
Education, Nursing - organization & administration
Faculty, Nursing - organization & administration
Female
Health Services, Indigenous - organization & administration
Humans
Male
Professional Competence
Rural Nursing - education
Abstract
Indigenous knowledge (IK) has the potential to complement the dominant epistemologies central to nursing curricula. Acknowledging IK as a thriving set of worldviews, we discuss how nursing educators might access and integrate IK in ways that are respectful and sustainable. IK is highlighted as an entry point for understanding concepts such as cultural safety, ethical space, and relational practice and as a strength-based approach to learning about Aboriginal people's health. As with any use of knowledge, consideration must be given to issues of ownership, misappropriation, institutional responsibility, Indigenous protocol, and the creation of partnerships. Recommendations are provided for educators wishing to explore how to incorporate IK into nursing curriculum. With appropriate partnerships, protocols, and processes in place, the incorporation of IK may provide educators and students an opportunity to explore divergent epistemologies, philosophies, and worldviews, thereby encouraging broader perspectives about the world, ways of being, various types of knowledge, and nursing care.
PubMed ID
23813335 View in PubMed
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