Addressing the realities of health care in northern aboriginal communities through participatory action research

Qualitative and quantitative methods used:
• Five-year retrospective study of oncology, diabetes, and mental health patient
• Data used from First Nations and Inuit Health Branch and Shibogama Health Program to develop program specific cost-analysis
• In-depth interviews with professional and paraprofessional health care providers serving each community, done so in Oji-Cree and English

This study involved interviews and a retrospective review of oncology, diabetes and mental health patient data from the First Nations and Inuit Health Branch and Shibogama Health Program in Northwestern Ontario. Findings point to the important and undervalued role that paraprofessionals play in delivering health care, as well as a need for improving mental health support. This article also describes and advocates for the use of community-based participatory action research.

Permission for research given by Shibogama First Nations Council
Oji-Cree interviews available to incorporate Native language speakers to share information
Results of study shared first with communities following First Nations protocol done so through a 2-day workshop with community members and care providers

Participatory research methods applied for projects with rural, Aboriginal and marginalized people:
• Argues for inherent value in participatory research to make policy changes
• Theorized as a way to equate power relationships
Strong calls to organize health program in communities
Utilize resources such as telehealth to create better communication strategies between communities
Highlighting the vital role that paraprofessional's place in health care support in the North
Researchers argue CBPR is an "ideal" way to engage with health disparities especially for northern Indigenous communities

Interviews and retrospective study within three First Nations communities
Findings report: relate to improving mental health support and diabetes prevention
2-day workshop to discuss findings

2-day workshop with community members and care providers to discuss research findings and make recommendations moving forward to solve issues identified
Established national aboriginal mental health strategy and furthermore track its progression
Final report created by Shibogama Health Council which includes recommendations and findings

"Staffing deficits—shortages, turnover, inadequate preparation—are the cause for much of the discontinuity that does occur. Because the care providers are short-term, the care horizon is also. Presenting symptoms are dealt with, follow-up is not. And patients, expected to tell and retell their stories to ever-changing faces, often give up and abandon treatment" (p. 364)

"A penultimate report was prepared by the research team for the Shibogama Health Council; however, it contained no recommendations. That task was entirely their responsibility—to translate the research findings into meaningful action" (p. 368)

Interprofessional Care
Indigenous Health
Health Policy