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“And They Are Still the Guardians of These Sacred Waters …”: Land as a Process of Reconciliation.
Given that Indigenous Peoples in Canada continue to face health disparities as a result of ongoing colonial attempts at genocide, reconciliation requires using a decolonized health framework that identifies oppression and marginalization while seeking to improve Indigenous Peoples’ health and facilitates a shared understanding of well-being. Community and land-based interventions hold promise in providing insight into how the reconciliatory process can occur and have been shown to successfully address the health disparities experienced by Indigenous Peoples by connecting participants to their kin, culture, and identity. However, the impact of these interventions on facilitators, both Indigenous and non-Indigenous, is lesser known. This qualitative study explores the reconciliatory effects of a decolonized framework on 10 Indigenous and ally community-engaged facilitators during a land-based healing lodge using semistructured pre- and postinterviews. Findings indicate that engaging with the land as an equitable research partner while being reflective allows facilitators to develop a decolonized relationship with the place an intervention is being held, themselves, and effectively engage with the partner community. Furthermore, by implementing a decolonized approach to culturally centered interventions, several facilitators’ perspectives of healing transitioned from understanding healing as an outcome to a holistic process that engages place and the broader ecology. These findings signal a need for those working toward reconciliation (e.g., researchers, evaluators, health and health-allied professionals) to consider the influence of Indigenous ways of knowing and being on both Indigenous and non-Indigenous individuals involved in the healing process.
Read morePlanning for Your CANOE (Circumspect Awareness and Navigation of Outcomes and Expectations) Journey in Community-Engaged Research With Indigenous Communities
Community engagement has long been recognised as necessary for working with Indigenous communities. Although many researchers are excited to engage with communities and many articles describe the process of community engagement in research, almost none have addressed the foundational question of whether researchers should engage with Indigenous communities for research. In this Viewpoint, we will discuss the Circumspect Awareness and Navigation of Outcomes and Expectations (CANOE) approach, which describes what should be considered before embarking on a community-engaged research journey with Indigenous communities. We build on existing literature regarding understanding the need to recognise positionality, practise reflexivity, assess personal strengths and weaknesses, and consider abilities and skills that can be offered or promised to Indigenous partners. Our goal is to provide principles of being reflexive, intentional, and careful before launching into research with Indigenous communities. Drawing from our combined decades of experience as Indigenous, community-engaged scientists leading national and international community projects, we draw from the extant literature and lessons learned in the field to provide a guiding CANOE approach for community-engaged research. This Viewpoint provides researchers interested in community-engaged projects with the information they need to consider before embarking on their research journey. We provide a set of CANOE self-assessment questions designed to evaluate a researcher’s preparedness, suitability to invest in a research partnership, and adaptability to navigate a research journey with Indigenous communities. Not only should relationships be properly developed and nurtured, but researchers need to fundamentally understand their ability to develop research partnerships that prioritise Indigenous cultural worldviews and protocols in research design, development, testing, and implementation.
Read more“We don’t separate out these things. Everything is related”: Partnerships with Indigenous Communities to Design, Implement, and Evaluate Multilevel Interventions to Reduce Health Disparities
Figure 1. An overview of the partnerships in MLIs by building on the Indigenous Holistic Health and Wellness Multilevel Framework Multilevel interventions (MLIs) are appropriate to reduce health disparities among Indigenous peoples because of their ability to address these communities’ diverse histories, dynamics, cultures, politics, and environments. Intervention science has highlighted the importance of context-sensitive MLIs in Indigenous communities that can prioritize Indigenous and local knowledge systems and emphasize the collective versus the individual. This paradigm shift away from individual-level focus interventions to community-level focus interventions underscores the need for community engagement and diverse partnerships in MLI design, implementation, and evaluation. In this paper, we discuss three case studies addressing how Indigenous partners collaborated with researchers in each stage of the design, implementation, and evaluation of MLIs to reduce health disparities impacting their communities. We highlight the following: Collaborations with multiple, diverse tribal partners to carry out MLIs which require iterative, consistent conversations over time; Inclusion of qualitative and Indigenous research methods in MLIs as a way to honor Indigenous and local knowledge systems as well as a way to understand a health disparity phenomenon in a community; and Relationship building, maintenance, and mutual respect among MLI partners to reconcile past research abuses, prevent extractive research practices, decolonize research processes, and generate co-created knowledge between Indigenous and academic communities.
Read moreAll Systems are Interrelated: Multilevel Interventions with Indigenous Communities
Figure 1. Indigenous Holistic Health and Wellness Multilevel Framework. Colonial historical trauma and ongoing structural racism have impacted Indigenous peoples for generations and explain the ongoing health disparities. However, Indigenous peoples have been engaging in multilevel, clinical trial interventions with Indigenous and allied research scientists resulting in promising success. In this paper, National Institutes of Health funded scientists in the field of Indigenous health have sought to describe the utility and need for multilevel interventions across Indigenous communities (Jernigan et al., 2020). We posit limitations to the existing socioecological, multilevel frameworks and propose a dynamic, interrelated heuristic framework, which focuses on the inter-relationships of the collective within the environment and de-centers the individual. We conclude with identified calls for action within multilevel clinical trial research.
Read moreLand as a Process of Reconciliation: Transforming Health Narratives Among Land-Based Healing Camp Facilitators
Colonialism has resulted in isolation, lack of services, and health disparities experienced by Indigenous peoples (IPs)1 which increased risk for COVID-19. Despite this, IPs have found ways to thrive. For example, they have implemented land-based healing (LBH) interventions2, 3, 4. Increasing cultural continuity through reconnecting to the land has broad implications for the health and wellbeing of IPs. As such, CIEDAR (CoVaRR-Net’s Indigenous Engagement, Development, and Research Pillar 7) partnered with Taché Waters Healing Society (TWHS) to achieve the following objectives. To co-develop a LBH camp grounded in culture to facilitate healing from the ongoing impacts of settler-colonialism, exacerbated by the pandemic. To evaluate the LBH camp pilot by asking the following question: How does being guided upon the land influence facilitators perspectives of health and wellbeing?
Read more“Being on the Walk put it Somewhere in my Body”: The Meaning of Place in Health for Indigenous Women
Relationship to place is integral to Indigenous health. A qualitative, secondary phenomenological analysis of in-depth interviews with four non-Choctaw Indigenous women participating in an outdoor, experiential tribally-specific Choctaw health leadership study uncovered culturally grounded narratives using thematic analysis as an analytic approach. Results revealed that physically being in historical trauma sites of other Indigenous groups involved a multi-faceted process that facilitated embodied stress by connecting participants with their own historical and contemporary traumas. Participants also experienced embodied resilience through connectedness to place and collective resistance. Implications point to the role of place in developing collective resistance and resilience through culturally and methodologically innovative approaches.
Read moreOde’imin Giizis: Proposing and Piloting Gardening as an Indigenous Childhood Health Intervention
Figure 1. Gardening by the moons as digitally interpreted by RICH Postdoctoral Fellow, Dr. LaPensee, who worked with local tribal members. The Research for Indigenous Community Health Center and the American Indian Housing Organization sought to reduce obesity among Indigenous children and families in a Northern Midwestern urban community who are at risk for homelessness by piloting a gardening health intervention. This community-based participatory research, mixed-methods study examined the feasibility of gardening as an obesity intervention among a school-aged Indigenous population at risk for homelessness through using focus groups, key informant interviews, and valid health measures. The program was found highly feasible and fulfilled a critical need among Indigenous youth and their families, who reportedly suffered from food insecurity and access. This intervention increased healthy food awareness and perceptions, cultural resources, and ancestral food knowledge skills through activities, mentorship, and multigenerational engagement. This study augments the literature on the feasibility of using tribal ecological knowledge and the environment in designing culturally appropriate health interventions.
Read moreReturning to our Roots: Tribal Health and Wellness Through Land-Based Healing
Background Settler colonialism has severely disrupted Indigenous ancestral ways of healing and being, contributing to an onslaught of health disparities. In particular, the United Houma Nation (UHN) has faced large land loss and trauma, dispossession, and marginalization. Given the paucity of research addressing health for Indigenous individuals living in Louisiana, this study sought to co-identify a United Houma Nation health framework, by co-developing a community land-based healing approach in order to inform future community-based health prevention programs. Methods This pilot tested, co-designed and implemented a land-based healing pilot study among Houma women utilizing a health promotion leadership approach and utilized semi-structured interviews among 20 UHN women to identify a UHN health framework to guide future results. Results The findings indicated that RTOR was a feasible pilot project. The initial themes were Place Environmental/land trauma Ancestors Spirituality/mindfulness Cultural continuity Environment and health The reconnection to land was deemed feasible and seen as central to renewing relationships with ancestors (aihalia asanochi taha), others, and body. This mindful, re-engagement with the land contributed to subthemes of developing stronger tribal identities, recreating ceremonies, and increased cultural continuity, and transforming narratives of trauma into hope and resilience. Based on these findings a Houma Health (Uma Hochokma) Framework was developed and presented. Conclusions Overall, this study found that land can serve as a feasible therapeutic site for healing through reconnecting Houma tribal citizens to both ancestral knowledges and stories of resilience, as well as viewing self as part of a larger collective. These findings also imply that revisiting historically traumatic places encouraged renewed commitment to cultural continuity and health behaviors—particularly when these places are approached relationally, with ceremony, and traumatic events tied to these places, including climate change and environmental/land trauma, are acknowledged along with the love the ancestors held for future generations.
Read more“I’m Stronger than I Thought”: Native Women Reconnecting to Body, Health, and Place
This community-based research applied principles of wilderness experience programming and Indigenous knowledges in an exploratory intervention designed to address health disparities in a tribal community. Drawing on historical trauma frameworks, tribal members rewalked the Trail of Tears to consider its effect on contemporary tribal health. Qualitative data from tribal members suggest that engagement with place and experiential learning, particularly the physical and emotional challenge of the Trail, facilitated changes in health beliefs, attitudes, and behaviors. Deep engagement outside of traditional health service settings should be considered in interventions and may be particularly effective in promoting positive health behaviors in Native communities.
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