indigenous health conference - cpd.utoronto.ca · health outcomes. the panel format will encourage...

Indigenous Health ConferenceWalking Together

May 24-26, 2018

Workshop Abstracts

38 Indigenous Health Conference | May 24-26, 2018

Workshop Abstracts

W01IND-equity: moving from benevolence to rights-based healthcare approaches by/with Indigenous populations(Submission ID: 434404)

Downey Downey, Faculty of Health Science,McMaster University,

Background

Health equity is upheld as a way to assist people to reach their full potential and receive high quality healthcare that is fair and appropriate to them and their needs. Where they live, what they have and who they are is not supposed to matter. However, there remain significant gaps in health outcomes and access to service for different populations in Ontario. For Indigenous people, lower life expectancy and greater infant mortality paint the picture of ongoing health inequality.

There is a need to balance the implementation of universal mea-sures to improving population health with targeted approaches aimed at improving health outcomes for marginalized popu-lations. For Indigenous people, this requires inclusion of their own knowledge, practices and beliefs about well-being.

Instructional Method

As federal/provincial health system planners further engage in the development and implementation of strategies to improve health equity, how will the needs of Indigenous people be considered? This session will provide an opportunity to explore this question within the current reconciliation and rights - based environment.

Keyword(s): Health; equity; truth and reconciliation; Indige-nous knowledge; self-determination;

For more information, contact Submitting Author: Bernice Downey [email protected]

W02Jordan’s Principle and the Fetal Alcohol Spectrum Disorder (FASD) Continuum of Care(Submission ID: 432346)

Kathy Unsworth, Canada Fetal Alcohol Psecteun Disorder Research Network; Melanie Musgrove, Assembly of First Nations

Background

Research has shown that the legacy of Residential Schools and intergenerational trauma has resulted in indigenous women being at higher risk of having concurrent substance use, vio-lence and trauma experiences, mental health problems, and of

having children with FASD and in some cases, having FASD themselves. Research also demonstrates that early interventions are critical to improving outcomes. Navigating complex sys-tems to secure services can be difficult for all women, but First Nations women face challenges above and beyond those faced by other families in Canada.

Content

This presentation will describe the unique national partnership between the Assembly of First Nations (AFN) and the Canada FASD Research Network (CanFASD) to examine and under-stand the First Nations experience in the FASD continuum of care and identify gaps and challenges they may encounter to obtain proper services. The project’s framework, outcomes and relevant data from the Canadian Universal DataForm Project will be presented and discussed. AFN and CanFASD will describe the work they are doing together to strengthen the requirements under Jordan’s Principle in the pathway(s) of care for indigenous families seeking FASD screening, diagnosis and intervention services.

Conclusion

CanFASD and AFN are committed to creating dialogue, improving communications and providing immediate and lon-ger term recommendations to identify tangible systemic changes and strategies. In accordance with Jordan’s Principle, there is a need for an efficient, quality FASD continuum of care which includes prevention, screening, diagnosis and improved access to intervention services to ensure the best possible experience for indigenous women and families.


The interactive workshop will be presented using slides as well as other tools to engage the audience. Examples and case studies will be shared with participants to provide context and improve understanding of the issues, outcomes and proposed solutions.

Keyword(s): Indigenous women’s health, fetal alcohol spec-trum disorder, continuum of care

For more information, contact Submitting Author: Kathy Unsworth [email protected]

W03Wise Practices for Indigenous Cultural Safety Training: Addressing Anti-Indigenous Racial Discrimination and Implications for Provincial Implementation(Submission ID: 434106)

Michèle Parent-Bergeron, Southwest Ontario Aboriginal Health Access Centre; Diane Smylie; Leila Monib; Michelle Firestone, Well Living House, Centre for Urban Health Solutions, St. Michael’s Hospital

Indigenous Health Conference | May 24-26, 2018 39

Background

Addressing anti-Indigenous racial discrimination in health and social service settings is the central focus of the Ontario Indigenous Cultural Safety Program. In Ontario, there have been important commitments made to address anti-Indigenous racial discrimination in service settings. Our program approach is grounded in the principle of clinician critical self-reflection aimed at interrupting internalized and systemic colonial narra-tives and stereotypes that result in harm to Indigenous Peoples when they interface with health and social care. In recognition that good intentions are not enough, this workshop will sup-port and create opportunities for an anti-racist and decolonizing journey towards culturally safe service provision. Influenced by research conducted worldwide, the program is advancing ways to interrupt colonial narratives, biases and stereotypes, and improve the standard of care available to Indigenous Peoples. In the era of the Truth and Reconciliation Commission of Can-ada and related to cultural safety training, our goal is to con-tribute to the quality of knowledge that is informing training initiatives aimed at improving access to culturally safe care. As well as a focus on wise practices for Indigenous Cultural Safety Training, participants will learn about implicit bias through an interactive exercise.


This workshop is important, as it will provide an opportunity to broaden knowledge exchange and collaboration in the area of anti-Indigenous racial discrimination. The workshop is an excellent opportunity to further build capacity in Ontario for high quality, effective approaches to cultural safety training and equitable services for Indigenous Peoples.

Keyword(s): Anti-Indigenous Racial Discrimination

For more information, contact Submitting Author: Michèle Par-ent-Bergeron [email protected]

W04Ethical Considerations for Indigenous Evaluation in the Healthcare System(Submission ID: 434262)

Krystine Abel, Centre for Addiction and Mental Health; Julie Bull, Centre for Addiction and Mental Health

Background

As more programs and services are being developed in main-stream healthcare settings for Indigenous Peoples, the need to apply an Indigenous lens to evaluation has increased across the health sector. Aboriginal Engagement and Outreach (AEO) in the Provincial System Support Program (PSSP) at the Centre for Addiction and Mental Health (CAMH) has been actively engaged in the process of co-developing evaluation projects

with Indigenous and non-Indigenous partners across the prov-ince. While there many questions on how to embed Indige-nous perspectives, principles and values into the overall pro-cesses of evaluation, particularly in hospital and university set-tings, there is general agreement of some core concepts: it starts with engagement. This process of engagement has led AEO to understand some of the complexities of ethics and quality improvement within evaluation that can be helpful to others seeking to evaluate programs and projects with Indigenous Peo-ples. There are common queries and quandaries that arise which we will aim to address in this workshop under the general ques-tion: What are the challenges and considerations for ethics and quality improvement in Indigenous evaluation in the context of program delivery in healthcare settings?


We will use reflexive practice through dialogue by engaging participants to think through their own work and how they can promote Indigenous approaches to evaluation. We begin by sharing how we navigate evaluation practices followed by a world café style discussion aiming to address the question posed above.

Keyword(s): Indigenous Evaluation, Ethics, Engagement

For more information, contact Submitting Author: Krystine Abel [email protected]

W05Creating a Mentally-Healthy Workplace(Submission ID: 417010)

Susan Freeman, Canadian Centre for Occupational Health and Safety (CCOHS); Emma Nicolson, Canadian Centre for Occupational Health and Safety (CCOHS)

Background

It can be challenging to create and successfully maintain healthy workplaces that address both the psychological and physical well-being of your employees. In this session, the Canadian Centre for Occupational Health and Safety (CCOHS) will out-line how to implement a comprehensive workplace health and safety program that integrates both.

This session, Creating Mentally-Healthy Workplaces, will explore the workplace factors that can have a direct impact on worker well-being, including those in Indigenous Communi-ties. The session will include a methodology to address psy-chosocial hazards as well as strategies around the courageous conversations that need to take place when fostering a men-tally-healthy work environment. Participants will have the opportunity to take part in interactive discussions and focused exercises to help them recognize how to successfully apply these prevention practices in the workplace, and ultimately create a healthy workplace.



Interactive dialogue, facilitated conversations and workplace-fo-cused exercises will provide the ground from which participants can explore new ideas. Discussion relating to survey and assess-ment tools plus practical workplace resources will be derived from the facilitators and as participants in this co-created space, each other.

Keyword(s): Mental HealthHealthy WorkplaceHealth and SafetyHazard PreventionHealth

For more information, contact Submitting Author: Susan Freeman [email protected]

W06Defining service delivery models using the First Nation Mental Wellness Continuum Framework(Submission ID: 432680)

Brenda Restoule, First Peoples Wellness Circle; Carol Hopkins, Thunderbird Partnership Foundation; Patricia Wiebe, First Nation and Inuit Health Branch

Background

The First Nation Mental Wellness Continuum Framework (FNMWCF) is a framework designed and developed by and for First Nations. The Framework was launched in 2015 fol-lowing the collaborative efforts of the First Peoples Wellness Circle, Thunderbird Partnership Foundation, Assembly of First Nation), Indigenous mental wellness experts and Health Canada - First Nation and Inuit Health Branch to articulate a vision of mental wellness for First Nations. The highly successful launch of the Framework has resulted in uptake by federal, provincial and territorial partners to recognize and implement the key themes and concepts articulated in the FNMWCF in program planning, design, delivery and evaluation.

Content

This workshop will provide a short review of the FNMWCF and its key themes. It will then highlight the activities, ini-tiatives and opportunities that have been achieved during its 2 year implementation phase. The presenters will highlight how the use of Indigenous knowledge, evidence and practice as a foundational cornerstone to achieving mental wellness in First Nation communities has resulted in a shift in the land-scape for mental wellness services in First Nation communi-ties. Part of the achievements that will be described include the design of 2 service delivery models; land based programming and crisis prevention, response and planning, as well as projects and initiatives that foster greater community ownership and control in achieving wellness for their citizens. The workshop will also highlight shifts in systems that includes changes in policies and practices.


A lecture style method will be employed to highlight key learning. Participants will learn about and review implemen-tation opportunities through descriptions, videos and written material. Participants will also have the opportunity to access electronic and written resources on the FNMWCF including implementation guides, assessment tools and toolkits.

Keyword(s): Mental WellnessIndigenous knowledge and evi-denceSystems changeImplementation opportunities

For more information, contact Submitting Author: Brenda Restoule [email protected]

W07Mamow Ahyamowen: A Partnership Model for Measuring Gaps in Health Outcomes(Submission ID: 433639)

Fern Assinewe, Sagamok Anishnawbek First Nation; Robert Gibbens-Tenneriello, Weeneebayko Area Health Authority; Penny Carpenter, Keewaytinook Okimakanak; Jennifer Walker, Institute for Clinical Evaluative Sciences; Stephen Moore, Mamow Ahyamowen

Background

Truth and Reconciliation Commission Call to Action #19 calls for the creation of goals with indicators and regular report-ing to close the gap in health outcomes between Aboriginal and non-Aboriginal people. Mamow Ahyamowen (meaning Everyone’s Voices) is an epidemiology partnership of nine First Nations health service organizations serving 74 First Nations from across Northern Ontario. Mamow Ahyamowen aims to be a trusted Northern voice providing First Nations with the health information they need to achieve health equity.

This workshop explores challenges and opportunities encoun-tered when First Nations want to use their data to improve health outcomes. The panel format will encourage interaction with participants and present a range of perspectives that will help workshop attendees better understand how to successfully implement Call to Action #19. By the end of the workshop participants will be able to:

• Summarize why it is important for First Nations to have access to their health data

• Describe key challenges faced when First Nations measure health status

• List several ways that First Nations are successfully access-ing their health data

• Describe how organizations can respectfully support First Nations data needs



A panel format will be used to provide different perspectives on a variety of audience driven questions related to population health data. The session will bring together the lived experience of a Community Wellness Director, a regional First Nations Council Director, a Health Authority Manager, and a provin-cial data custodian.

Keyword(s): Epidemiology, Data, Health Status, Partnership

For more information, contact Submitting Author: Stephen Moore [email protected]

W08Critical Discourse on the use of Indigenous methodologies to Improve Culturaly Safe care for Women with Perinatal Substance-use(Submission ID: 440707)

Sheona Mitchell-Foster, University of British Columbia; Tarissa Alec, University of British Columbia; Lucille Duncan, Central Interior Native Health Society; Maria Brouwer, Harmony House; Deena Latta, Pheonix Transition Society; Karen Underhill, Phoenix Transition Society

Background

Existing research structures and health systems in Canada are inherently colonial in nature and this limits genuine engage-ment from Indigenous and marginalized people in clinical and community health research, bringing unique challenges in patient-oriented research. Using an example from approaches to engaging Indigenous women struggling with substance-use during pregnancy in northern BC, the session will include a short didactic and narrative portion followed by small group discussions on incorporating Indigenous methodologies in strategies for patient-oriented research. Questions of the appro-priateness of using Indigenous methodologies to evaluate con-ventional healthy service interventions will be addressed.


The session will begin with narrative by a Tl’azt’en Nation Elder on the journey to the creation of Harmony House, a culturally safe housing program for women struggling with substance-use during pregnancy and post-partum in northern British Columbia. Guided discussion will follow on the use of Indigenous methodologies.

Keyword(s): Indigenous methodologies, cultural safety, perina-tal addictions, pregnancy, patient-oriented research

For more information, contact Submitting Author: Sheona Mitch-ell-Foster [email protected]

W09A Gentle Approach to Diabetes Programming(Submission ID: 438016)

Autumn Watson, Indigenous Diabetes Health Circle; Kathleen LaForme, Indigenous Diabetes Health Circle

Background

The Indigenous Diabetes Health Circle delivers culturally based health and wellness programs for diabetes prevention. More recently, IDHC has been delivering the following workshops to both front line and community members: Wellness Shak-ers; Quills to Cessation; Wellness Quills; Healthy Journeys; and Black Ash basket making.

In addition to the knowledge and skills acquired to complete a: black ash basket; shaker; quilled canoe; or piece, participations gain a tremendous amount of patience, respect, appreciation and understanding, for both self and the art.

Content

The workshop aims to interconnect creative art, traditional teachings and culture with the goal of increasing awareness of: diabetes; prevention techniques and management options. This gentle approach, increases community participation in health and wellness workshops, while also restoring culture and tra-dition. Individuals walk away with: a new skill; a positive per-ception of self; and, some tools necessary to take care of oneself physically, mentally, emotionally and spiritually.

It’s a program that connects community back with the LAWs of the earth (Land, Air, Water and Sun); revitalizes culture and traditions; and strengthens the relationships between commu-nity members, local organizations and service providers.

Conclusion

Through their creative energies and perseverance, participants gain a stronger sense of identity, confidence and belonging. By gaining knowledge (both informationaly and through art) par-ticipants learn a method that can: reduce anxiety; foster creativ-ity; take self-control; and, encourage a proactive approach to problem solving.


Participants will be provided with an overview of the cultural workshops available, how they can implement them within their community/organization and a hands on activity from one of the workshops.

Keyword(s): Culture, Diabetes Awareness, Prevention, Tradi-tional teachings, Community

For more information, contact Submitting Author: Amanda Lipinski [email protected]


W10Indigenous health/socio-economic determinants of healthStrategic Research and Statistics Directorate, Crown Indigenous and Relations and Northern Affairs Canada, Indigenous Services Canada; First Nations and Inuit Health Branch, Indigenous Services Canada; Health Analysis Division, Statistics Canada; First Nations Information Governance Centre

Background

Indigenous Services Canada and Crown-Indigenous Relations and Northern Affairs Canada in partnership with the First Nations Information Governance Centre and Statistics Canada, has supported a variety of research, surveys, and statistical initia-tives on demographic and socio-economic outcomes for Indig-enous peoples. Much of the collaborative work has focused on topics related to health and social-determinants of health such as, education, youth, language and culture employment, housing, infrastructure, and governance of Indigenous information.

Purpose

To transfer knowledge and disseminate selected results of col-laborative research projects that address aspects of health, and socio-economic determinants of health in order to help inform health care professionals, researchers and policy makers for pro-gram, planning and policy development purposes.

Content

There have been a number of national collaborations in recent years designed to expand and enhance Indigenous data hold-ings. Indigenous Services Canada and Crown-Indigenous Relations and Northern Affairs Canada have partnered with the First Nations Information Governance Centre on a num-ber of First-Nations led surveys on health and education that also respect First Nation principles of OCAP® (Ownership, Control, Access, and Possession). The federal government has also funded the Aboriginal Peoples Survey by Statistics Can-ada, covering Indigenous peoples living off reserve and in the north. In addition, data linkages between the Census and the Discharge Abstract Database have provided unique insights into Indigenous hospitalization.

This session showcases some of these collaborative research presentations, focusing on Indigenous health/socio-economic determinants of health, which will also highlight the impor-tance of partnerships that incorporate Indigenous perspectives and optimize new and existing data sources.


Didactic presentation, panel discussion and Q&A/ group discussion.

Keyword(s): socio-economic determinants of health, statistics, collaboration

For more information, contact Submitting Author: Jeannette Steffler [email protected]

W11Our Health Counts Inuit Adult Community Report (Submission ID: 440501)

Michelle Firestone, Well Living House, Centre for Urban Health Solutions, St. Michael’s Hospital; Janet Smylie, St. Michael`s Hospital University of Toronto; Jason LeBlanc, Tungasuvvingat Inuit; Paani Zizman, Tungasuvvingat Inuit

Background

Purpose of Our Health counts was to create a population health database for Inuit in Ottawa and to provide for future longi-tudinal studies for Inuit in Ontario specifically. Project was in partnership with OFIFC, MNO, TI, ONWA, MOHLTC, and SMH. This is the first baseline data for Inuit outside of our land claim areas (Inuit Nunangat) The group used community based participatory action research and allowed for community capacity and growth as the lead in this first respectful health sur-vey. Methods used were Respondent Driven Sampling which proved very effective for our community, Community Concept Mapping which allowed us to determine the top priorities for our community which generated more than 44 statements of importance. The report has since been published and released back to Community January 18, 2018 in English and Inuktitut. Results showed that in comparative release with Census 2016 our population projection is much higher than what Census shows us. Six sections show our Inuit statistics in the following areas: Sociodemographics, Keeping Warm and Safe, Physical Health, Past Experience: Abuse and Trauma, Mental Health and Addiction Illnesses, Access to Health Services.


TBD

Keyword(s): Inuit Community Based Research, Respondent Driven Sampling, Inuit Community Implementation.

For more information, contact Submitting Author: Paani Zizman [email protected]

W12Asthma in Children(Submission ID: 433967)

Dr. Tom Kovesi, Professor of Pediatrics, University of Ottawa

Background

This one hour workshop provide health care professionals with the appropriate information in order to make a well-informed


decision in the care of the young asthmatic. The workshop highlights current research, health promotion and management of pediatric asthma in accordance with evidence-based clinical practice guidelines. The recently published 2015 CTS Position Paper, Diagnosis and Management of Asthma in Preschoolers, as well as 2012 Canadian Thoracic Society’s Pediatric Asthma Guidelines, will guide the health care provider with the neces-sary tools and information in order to accurately address man-agement and treatment of asthma in the preschool population. By the end of this workshop, the participant will be able to:

• Identify the burden of underappreciated asthma in children

• Identify the hallmarks of controlled and uncontrolled asthma in pediatric populations

• Diagnose asthma in children by listing the criteria, symp-toms and risk factors

• Develop a pediatric asthma action plan

• Escalate therapy within an action plan applying the Cana-dian Asthma Consensus Guidelines (CACG)


The Asthma in Children workshop provides the necessary resources and fundamental tools to identify, diagnose and man-age asthma in pediatric population in accordance with evi-dence-based clinical practice guidelines. It includes a didactic presentation delivered by a specialist in the field, followed by the opportunity to work through a case study.

Keyword(s): Asthma, Pediatric, Evidence, Guidelines, Symp-toms, Diagnosis, Management, Action Plan, Resources

For more information, contact Submitting Author: Lana Biro [email protected]

W13Sharing Lessons Learned From Community-Driven Research Supporting Urban Aboriginal Children their families and Caregivers(Submission ID: 436770)

Verle Harrop; Pamela Griffin

Background

The purpose of the workshop is to share lessons learned and promising practices identified in a 2017 project involving the Urban Aboriginal Knowledge Network (UAKN) Atlantic, the Public Health Agency of Canada (PHAC), Friendship Centres in the Atlantic region and the Aboriginal Head Start in Urban & Northern Communities projects. The project consisted of hosting two national webinars, and five follow-up in-person workshops in five cities throughout the region.

Content

The Objective of the workshop is to deepen our collective understanding of and support for urban Aboriginal children, their families and caregivers in order to help prevent Aborigi-nal children from being taken into care, and to help strengthen families that have been separated.

Many findings and conclusions will be presented including:

• Urban and northern aboriginal community groups are best positioned to offer wrap-around services in a culturally safe environment.

• Non-aboriginal groups, organizations, and governments need training from aboriginal groups and Elders on how to translate cultural safety into practice.


A panel of 3-5 project participants will present the knowledge shared in the webinars and follow-up workshops which took place in Moncton Halifax, Happy Valley–Goose Bay, St. John’s, and Charlottetown. Panelists will present on how the various stakeholders identified a number of ways they could contribute to a better life for northern and urban Aboriginal children and families. They will also discuss knowledge gaps and ongoing community-driven research identified in this project.

Keyword(s): Support for urban Aboriginal Children, their families and caregivers

For more information, contact Submitting Author: Teresa Palliser [email protected]

W14Indigenous Trans Intersectionality: Lack of Support, Resources, and Inclusion. Shifting the Dialogue from “Don’t Worry”(Submission ID: 434202)

Megan Lewis; Tori Cress; Julie James; Sanne Kaas-Mason; Susan Preston

Background

Service delivery often reinforces white, eurocentric, settler, cis-gender privilege. Health care and community service provid-ers can benefit from working collaboratively across professional boundaries to challenge these processes.

Content

Storytelling based on personal experiences of an Indigenous par-ent of an Indigenous trans youth will help engage participants in reflection and discussion about interprofessional collaboration within a system of service delivery. Stories about the challenges Indigenous 2-Spirit trans youth face in accessing services will be addressed including: safe housing and/or shelter space, access


to culturally appropriate trans-related health care, and experi-ences of oppression within service delivery system. Participants will simulate an interprofessional service coordination meet-ing in a community agency, each participant reflecting on their own professional role and how it applies to the shared delivery of care/service to the clients.

Issues explored will include: the importance of cultural humil-ity, critically assessing the power/privilege involved in service relationships, identifying barriers to service, the entrenchment of white settler colonial oppression within service practices, an orientation towards a desired-based versus a damaged-based framework, centering the client voices, client participation in service delivery creation, and youth-led models of care.

Conclusion

Interprofessional engagement allows us to interact with and become exposed to the perspectives of our professional col-leagues in order to develop an appreciation for the different professions and professional lenses. We may then be better equipped to reflect on how to engage with Indigenous trans youth in service need identification, service delivery creation, and program development.


Storytelling based on personal experiences of an Indigenous parent of an Indigenous trans youth is a powerful tool for the engagement of multiple disciplines applying professional com-petencies in an interprofessional context. Interactive, facilitated discussion allows participants to challenge biases, attitudes; explore of issues of power, hierarchy, role and boundary clarity.

Keyword(s): interprofessional simulation, power/privilege, 2-Spirit trans youth, person-centered care

For more information, contact Submitting Author: Sanne Kaas-Mason

W15Walking together & learning from each other: Eabametoong First Nation, Matawa First Nation Management & NOSM’s postgraduate education partnership(Submission ID: 432873)

Jennifer Fawcett, Northern Ontario School of Medicine; Claudette Chase, Northern Ontario School of Medicine; Kristy Côté, Northern Ontario School of Medicine; Paul Capon, Matawa First Nations Management; Robert Baxter, Eabametoong First Nation; Margaret (Molly) Boyce, Eabametoong First Nation; Deepak Murthy, Northern Ontario School of Medicine; Ghislaine Pilot-Attema, Northern Ontario School of Medicine

Background

The Northern Ontario School of Medicine, Matawa First Nations Management and Eabametoong First Nation collabo-ratively lead a residency stream. The stream is built on founda-tional principles of equal partnership including respect for the immemorial, constitutional, Treaty and international rights of Indigenous Peoples. This workshop will focus on our collec-tive tri-party learning from varying perspectives as we walk this journey together. The goal is to share knowledge and experiences to help inform other respectful and culturally safe partnerships and relationships. This will be an open workshop with a smudge and Elder blessing, followed by a collaborative presentation reflecting voices of all parties/presenters describing the stream, how we each approached the partnership, how we applied principles of effective Nation to Nation relationships and what we have all learned along the way about working together and our future plans. After that, workshop participants will engage in one large group-sharing circle facilitated by the Elder. Participants will be asked to introduce themselves in the Indigenous way and share one thing that surprised them, one thing they learned professionally, and one thing that touched their heart.


We will be using a sharing circle method, with partici-pation from both presenters and participants. This work-shop will focus on interwoven individual stories, which will be brought together.

Keyword(s): Partnership, Resident Medical Education, Build-ing Community Capacity, Collective Learning

For more information, contact Submitting Author: Ghislaine Pilot-At-tema [email protected]

W16Western Psychiatry in the North: Clinical Conundrums(Submission ID: 424799)

Kathryn Jean Macdonald, OPOP, Six Nations Mental Health

Background

Modern psychiatry works primarily on the basis of diagnosis by DSM/ICD and treatment according to best practice guidelines, which usually outline medication management and specific psy-chotherapeutic approaches. We are trained both academically and clinically according to this model, and, for the most part, we work within these constraints for most of our careers in hospitals, health care teams and private practices. We use well researched and standardized labels for clusters of symptoms, and we recommend well-researched and standardized approaches to treatment of these disorders. Our colleagues, and our Colleges, typically expect compliance with this method of practice. What happens, however, when these recommendations are not fully


applicable to the population we are treating? What do we do when the approaches we have spent years of our lives learning and practicing are not available to our patients? In the context of single-consult assessments, often done remotely through tech-nological means, how do we recommend appropriate treatment and provide adequate consultation? I do not have answers to these questions. I hope, however, to promote discussion about ways in which we can adapt our approaches, and continue to explore manageable solutions, for mental health care in the north. It will start with a presentation focusing on some of the difficulties with and barriers to using standard approaches to psychiatric care in Northern communities, and what compli-cates the provision of care to communities. This will be fol-lowed by small group and then large group discussion.


Following the presentation, there will be focused small group discussions on a variety of topics, followed by a review of the resulting ideas with the full group. The discussion can be flexible based on the background, knowledge and interest of the participants.

Keyword(s): Mental health, Psychiatry, Family Medicine, Treatment, Diagnosis, Counselling, Community health

For more information, contact Submitting Author: Kathryn Macdon-ald [email protected]

W17An Anishinabe Approach to Recovery from the Opioid Crisis(Submission ID: 434090)

Tim Ominika; Marion Mar, Medical Anthropology, Northern Ontario School of Medicine; Darrel Manitowabi, Laurentian University

Background

High rates of prescription opioids as a treatment for pain have led to the current crisis of opioid addiction in Canada. Sophis-ticated black markets supply opioids to those who are no lon-ger prescribed opioids by their physicians. The consequences include rising health and social problems, including chronic drug-related illnesses, mental health issues, family violence, children in foster care, trafficking of women, crime, vandal-ism, and breakdown of the social fabric of the community. Opioid replacement therapy uses medications to treat addic-tions to drugs such as heroin, morphine, and OxyContin. Patients who are prescribed methadone or buprenorphine are under the supervision of an addictions specialist physician and should “be carefully monitored within a framework of medi-cal, social, and psychosocial support as part of a comprehensive opioid dependence treatment program.” However, our collab-orative research at a First Nations owned Methadone Clinic in

Wiikwemikoong, shows that many more supports are needed for patients to be able to return to Mino Mbaadiziwin (the healthy life). Mainstream models do not provide the necessary supports to Indigenous patients. In this workshop, we facili-tate a dialogue about culturally safe approaches to Indigenous opioid addictions therapy based on the result of our communi-ty-based research in Wiikemkoong. We discuss the components of supportive cultural services such as traditional counseling and land-based activities as well as reasons why these are necessary for opioid replacement therapy. Concrete examples of types of traditional and land-based services and their role in recovery particularly with Indigenous survivors of adverse experiences and trauma will be provided.


Presentation of the Wiikwemikoong methadone clinic model and discussion of qualitative research on the role of cultural ser-vices in treatment, based on interviews with patients and pro-viders. This will be followed by small group discussions on par-ticipants’ experience with Indigenous patients with addictions. A facilitated discussion focuses on common solutions.

Keyword(s): opioid crisis; replacement therapy; land-based activities; traditional counseling; community-based services;

For more information, contact Submitting Author: Marion Mar [email protected]

W18Burden of Drowning in Indigenous People in Canada (Submission ID: 434305)

Steve Beerman, MD; Tessa Clemens, PhD; Lisa Hanson Ouellette, MA

Background

Indigenous peoples in Canada have a tragic preventable drown-ing mortality burden that is substantially larger than that of non-Indigenous Canadians. Work is needed to address and eliminate this disparity.

Indigenous communities are growing as a percentage of the Canadian population, and there is a high proportion of young community members under the age of 30. Indigenous commu-nities dominate the population in the Northwest Territories, Nunavut, and the Yukon, which have the highest drowning rates in Canada.

The Canadian Drowning Prevention Coalition seeks to better understand and improve health outcomes for Indigenous peo-ples through a reduction in drowning. We acknowledge that this can only be achieved through a commitment to maintain-ing and respecting relationships with Indigenous peoples; there-fore, we wish to understand how to best collaboratively engage Indigenous community members in drowning risk reduction


solution finding. Indigenous peoples and Indigenous health leaders are needed for the Canadian Drowning Prevention Coalition Technical Working Group on Indigenous Drowning Reduction in Canada.

Content

Objectives of the Workshop

• To better understand the burden of drowning mortality for Indigenous peoples in Canada.

• To review options for drowning risk reduction and cultur-ally acceptable approaches within the high risk Indigenous people in Canada.

• To identify individuals and or organizations who can engage with the Canadian Drowning Prevention Coali-tion to reduce drowning risk in Indigenous populations in Canada.


Small group interactive discussion to share knowledge and experience to explore community based interventions, policy/regulation and research for solutions; and, information gathered from the workshop will be shared with the Canadian Drowning Prevention Coalition.

Keyword(s): Indigenous drowning prevention

For more information, contact Submitting Author: Lisa Hanson Ouel-lette [email protected]

W19Indigenous Approaches to Smoking Cessation(Submission ID: 434339)

Lisa Beedie, Cancer Care Ontario; Chantel Antone, South West Regional Cancer Program

Background

Cancer Care Ontario’s Aboriginal Tobacco Program in part-nership with the South West Regional Cancer Program work to provide culturally safe and sensitive smoking cessation support services for Indigenous communities in the South West region. These services provide a holistic approach to raising awareness about the effects of commercial tobacco use, and focus on par-ticipatory ways of knowledge exchange and sharing. The goal of this work is to promote self-determination and empower Indigenous people to take control of their health and well-be-ing. Adopting culturally appropriate approaches in health care can benefit individuals, providers and healthcare systems; thus underscoring the importance of serving and supporting Indige-nous people throughout their health and wellness journey.

Content

Learning objectives for this presentation:

• Demonstrate ways to engage in culturally safe methods for teaching and learning through a reciprocal relationship uti-lizing the lexicon and pedagogy that resonates with Indig-enous people

• Describe the importance of trust building and acknowledg-ing community protocols as a means to building productive relationships while working towards and improving health outcomes for Indigenous people

• Promote a better understanding of cultural approaches and needs of First Nations people


Lisa Beedie, Cancer Care Ontario’s Aboriginal Tobacco Lead and Chantel Antone, Aboriginal Patient Navigator will present using visual, auditory, verbal and kinesthetic ways of teaching to aide participants in learning. Additional tools include a slide deck presentation and face-to-face interactions with participants.

Keyword(s): Traditional ways of Knowing, Culturally appro-priate approaches to careholistic

For more information, contact Submitting Author: Lisa Beedie [email protected]

W20Decolonizing Indigenous health reporting: holistic approaches to an Indigenous Women’s Health Report (IWHR) at the First Nations Health Authority (FNHA)(Submission ID: 434538)

Nikisha Khare, First Nations Health Authority; Krista Stelkia, First Nations Health Authority; Shannon McDonald, First Nations Health Authority

Background

Indigenous women in Canada face various inequities as a result of well-documented historical injustices and ongoing colonial legacies, leading to poorer health outcomes compared with other Canadians. Public health reporting has typically focused on dis-parities that portray a deficit-based view of Indigenous people and that may serve to perpetuate health inequities amongst the Indigenous population rather than ameliorate them. Reporting on Indigenous women’s health from a holistic perspective is an essential first step in addressing these inequities. The FNHA, a first of its kind in Canada, is working to transform the way Indigenous people’s health is reported in BC.


Content

The objectives of the workshop will be to develop a greater awareness of the positive impact of using a holistic perspective in reporting on health and wellness outcomes, along with shar-ing innovative approaches to public health reporting that con-textualize health issues, champion a wellness-based model, and address the intersections of oppressions Indigenous women face. Key points include using qualitative and Indigenous research methodologies to raise Indigenous women’s voices and stories and draw connections across individual and generational life courses. The unique partnership between the FNHA Office of the Chief Medical Officer and the Office of the Provincial Health Officer in developing the IWHR will also be discussed.

Conclusion

Presenters will share summary findings from the 2017 IWHR. The workshop will conclude with a group exchange to stimu-late ideas and interest in applying Indigenous and anti-oppres-sive approaches to decolonize reporting on Indigenous health.


Theoretical approaches and specific examples of their appli-cation will be highlighted, including intersectional, life course, and structural approaches. In this interactive session, participants will break into groups to discuss how they can apply novel approaches in their work. We will conclude with a group discussion.

Keyword(s): Indigenous Women’s Health; Population Health Reporting; Indigenous Ways of Knowing

For more information, contact Submitting Author: Nikisha Khare [email protected]

W21Indigenous Residency Training: Looking to the Future in Indigenous Cultural Safety and Anti-Racism EducationAnna Banerji, University of Toronto; Lisa Richardson, University of Toronto; Jason Pennington, University of Toronto; Darlene Kitty, University of Ottawa; Lindsey Fechtig, University of Toronto

Background

It is recognized that many Indigenous peoples in Canada often encounter barriers when trying to access health services includ-ing systematic biases and racism. The Truth and Reconcilia-tion Commission Report recommendation includes providing cultural competency training for all healthcare professionals. In October 2017, the Royal College of Physicians and Surgeons of Canada indicated that cultural safety and anti-racism train-ing would be required for all post graduate medical education (residency) programs across Canada. Similarly, the College of

Family Physicians of Canada is reviewing and making changes to its residency objectives to include Indigenous health and its Indigenous Health Working Group are writing an Indigenous version of the 2017 CanMEDS competencies for medical train-ees and family physicians.


Currently medical schools across Canada are reflecting on how to implement such programs. While some schools are in the early planning stages, others are well advanced or have resi-dency Indigenous cultural safety programs in place. Through this workshop, we plan to have a discussion with education leaders on how to move forward on implementing Indigenous PGME programs. This forum will provide an opportunity for programs to discuss what content should be in the training pro-grams, and to discuss if there maybe the opportunity to share and collaborate on resources. In addition, we will discuss how the training programs could be implemented as we move to wards competency-based education.

Keyword(s): Indigenous Cultural Safety, Education, Racism

For more information, contact Submitting Author: Anna Banerji [email protected]

W22Virtual Care: Modernizing the Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder in Indigenous CommunitiesBrenda Stade, Think Research; Brett Cacamo, Think Research; Rushabh Gudka, Think Research; Alexandra Milgrom, Think Research; Salma Walji, Think Research; Kirsten Lewis, Think Research

Background

In Canada, the incidence of Fetal Alcohol Spectrum Disorder (FASD) is estimated to be 1 in 100 live births. Caused by pre-natal exposure to alcohol, FASD is the leading cause of cogni-tive and developmental disabilities in Canadian children. While there is ongoing research and resources targeting this issue, these initiatives often fail to reach populations who may benefit most. Currently, there are few solutions that enable remote Indige-nous communities to receive FASD diagnosis and treatment.

Content

Think Research’s Virtual Care is a new and emerging health care technology accessed through a downloadable app that can connect underserviced populations with clinicians to provide a platform for assessment, diagnosis, and treatment. Virtual care can be established in communities without access to specialized FASD diagnosis and treatment to provide Indigenous commu-nities with high quality care.



This workshop will demonstrate Think Research’s virtual care model in respect to it’s application on the diagnosis and assessment of FASD. An oral presentation and a live demon-stration will be used to display the potential immediate and lasting impact of Virtual Care on the health and wellbeing of Indigenous children.

Keyword(s): Indigenous women’s health, fetal alcohol spec-trum disorder

For more information, contact Submitting Author: Brenda Stade

W23Nurturing the Seed: Supporting Infant and Early Childhood Mental Health in Indigenous Families(Submission ID: 429645)

Donna Hill, Infant Mental Health Promotion (IMHP)

Background

Many people play a role in supporting Indigenous infants, chil-dren and families in their life journeys. In order for western ori-ented practitioners to engage with, and develop meaningful and effective infant and early childhood mental health support, pre-vention and intervention planning, and service delivery when working with Indigenous families, they must first understand Indigenous experiences, worldviews and values, and incorpo-rate these understandings into relationship building approaches. Infant Mental Health Promotion (IMHP) has had the opportu-nity to meet with Indigenous partners across Canada to discuss how we can engage to support Indigenous infants, young chil-dren, and families. The model presented – Nurturing the Seed: A Developmental Support Planning Model for Working with Indigenous Infants, Children and Families - is intended to help non-indigenous practitioners recognize and honor these differ-ing experiences and use culturally safe approaches specifically relating to promoting early mental health and wellness.

Over the next two years, supported by Public Health Agency of Canada (PHAC), this model will be implemented and evaluated through Aboriginal Head Start in Urban and Northern Com-munities (AHSUNC) programs across Canada.

Goals and Objectives:

• Participants will learn how the Nurturing the Seed resource can be utilized to support families and the early mental health and development of Indigenous children.

• Participants will understand the rationale behind creating the Nurturing the Seed model.

• Participants will explore key themes learned from discus-sions with knowledge keepers and Indigenous communi-ties in Canada.


The presentation format will include a discussion based format and some small group role playing case study simulations.

Keyword(s): mental health, parenting, family-centred care

For more information, contact Submitting Author: Donna Hill [email protected]

W24Making Space for Indigenous Practice Approaches(Submission ID: 423698)

Jane Rousseau, California State University Stanislaus

Background

This workshop will focus on the unique challenges faced by Indigenous professionals, who attempt to engage in Indige-nous practice approaches, while working within a government child welfare system responsible for the ongoing oppression of Aboriginal children, families and communities. The workshop facilitator, a non-Indigenous organizational insider researcher, shares the results of an Indigenous/ethnographic research study that examined these issues with Indigenous professionals within the British Columbia Ministry of Children and Family Devel-opment (MCFD). We will explore the history, identity, values, motivations, and practice approaches of Indigenous profes-sionals as well as how organizational structural and environ-ment variables support or impede their efforts toward critically needed service improvements for Indigenous children, youth, families and communities.

The workshop is intended to support health and social welfare professionals to better understand individual (micro level) and organizational (mezzo level) behaviors/ factors that may support or impede Indigenous professionals’ efforts to engage in cultur-ally consistent and safe practices. Organizational variables, such as low Indigenous practice support, racism, cultural incompe-tence, hierarchical structure and decision making, risk-averse practice norms, poorly implemented or rhetorical change ini-tiatives, and institutional physical environments are found to impede Indigenous practice approaches. Some significant miti-gating factors found to be helpful will be shared. These include the recognition and support for Indigenous professionals who occupy conflicting dual accountabilities when working with mainstream organizations within Indigenous communities. Ensuring meaningful organizational support at the worksite level through dedicated culturally competent Indigenous man-agement and practice teams is critically important. Non-Indig-enous allies have an important role to play.



Presentation - Interaction/Dialogue

Keyword(s): Indigenous practice, organizational support, dual accountabilities, culturally safe practice, allies

For more information, contact Submitting Author: Jane Rousseau [email protected]

W25Our Learning Journey Together - public health engagement with First Nations communities: applying engagement principles throughout a collaborative research project(Submission ID: 440443)

Suzanne Lemieux, Public Health Sudbury & Districts; Caroline Lidstone-Jones, Weeneebayko Area Health Authority (WAHA); Marion Maar, Medical Anthropology, Northern Ontario School of Medicine, Sudbury, ON, Canada; Mareiette Sutherland, Public Health Sudbury & Districts; Rebecca Mador, Public Health Ontario

Background

In April 2017, a group of northeastern Ontario public health units, academic partners, and Indigenous community partners embarked on a research project entitled “Relationship build-ing with First Nations and public health: Exploring principles and practices for engagement to improve community health”. The project team’s learning about its own engagement journey began right from the early stages of development, and continued throughout the course of the project. Throughout the process of developing and implementing this project, numerous opportu-nities for sharing and reciprocal learning emerged. Additionally, key principles emerging from the study, namely trust, respect, self-determination and commitment have shaped our approach to the research actviities. These approaches include:

• Having an Indigenous Circle guiding every phase

• Employing Participatory Action Research principles

• Respectful consideration and inclusion of OCAP© principles

• Reciprocal sharing of western based research approaches and and Indigenous research methods

• Using a strengths-based approach

• Building on existing relationships

Content Objectives

(1) Reflect on practices that foster public health engagement with First Nations communities. (2) Reflect on collaborative practices with Indigenous people in the context of a research project. (3) Explore how relationship principles form the foun-

dation in supporting and strengthening respectful relationships with Indigenous people.


1. Situating ourselves – 5 minutes

2. Project design and context, how research activities were shaped by emerging principles – 15 minutes. Discussion/reflective activities – 15 minutes

3. Reconciliation – applying relationship principles and practices learned from project – 15 minutes. Discussion & closing reflections – 10 minutes

Keyword(s): - Mutually beneficial relationships- Research project principles towards reconciliation

For more information, contact Submitting Author: Mareiette Suther-land [email protected]

W26Collaborating for Person-Centred Improvement - Working Together for Better Quality Outcomes in Primary Care (Submission ID: 433353)

Jeremy Rezmovitz; Patricia O’Brien

Background

Setting the anchor for improvement by reflecting on the personal experience of individuals is critical for a successful improve-ment journey. Primary care healthcare teams have an oppor-tunity to partner with, and listen to, the voice of individuals as quality improvement topics are selected and improvement journeys are undertaken.

Content

Designed as an interactive workshop, this session will describe an approach to collaborating for person-centered improvement by supporting participants to:

• Employ a systems approach in the identification of improve-ment opportunities

• Assess improvement opportunities for feasibility and impact

• Design improvement opportunities to be respectful and congruent with the experience of individuals through the application of person-centered approaches, tools and actions

The process of collaborating for person-centered improvement will highlight the value of ‘team’ in quality improvement efforts; the concept of ‘better’ and continuity in achieving improve-ment; the critical importance of engaging individuals and their story; and the power of measurement in describing the impact of positive change in primary care.



This interactive workshop will include elements of guided reflection, sharing and in-session design work on the part of the participants. Quality improvement concepts will be presented with relevant primary care examples and augmented with application time to enable an introductory experience with the methodology and approaches.

Keyword(s): quality improvement, personal experience, improvement journey, primary care, healthcare teams

For more information, contact Submitting Author: Marisa Schwartz [email protected]

W27Harmonious Healing Traditions: First Nations Healing Practices and Acceptance and Commitment Therapy(Submission ID: 436793)

Alison Benedict, Centre for Addiction and Mental Health; Kenneth Fung, Toronto Western Hospital

Background

Indigenous healing practices, or wise practices have existed long before European contact or the development of the field of psy-chology. Traditional Indigenous practices are reflected in many of the evidence based practices in existence today. Acceptance and Commitment Therapy (ACT) shares many of the same founda-tional understandings as Indigenous ways of being and helping as evidenced by mindfulness based practice, relational frame theory and each aspect of the ACT hexaflex. Unfortunately, traditional Indigenous practices were outlawed, as assimilation policies, such as the residential school systems, the 60s Scoop and other poli-cies disrupted the natural transmission of knowledge, induced trauma and suffering, and contributed to health disparities. High rates of depression, substance use, and suicide are reported in many communities as a result of these policies.

Content

There is congruence between traditional Indigenous healing methodologies and ACT. ACT may facilitate individual and community healing. Workshop participants will be interac-tively engaged to learn the historical context of the First Peoples of Canada; make connections between ACT processes and First Nations teachings; and integrate both for clinical work.


The workshop approach includes both Western and Traditional perspectives on healing and helping. Utilizing an experiential approach, participants are invited to learn through exercises, role plays and sharing their strengths and voice. It recognizes the wisdom, knowledge and experience of all participants.

Keyword(s): Mental Health, Evidence Based Intervention, Two-eyed seeing

For more information, contact Submitting Author: Alison Benedict [email protected]

W28Using Sport and Physical Activity to Improve Indigenous Health and Well-Being: A Holistic Approach(Submission ID: 440509)

Emily Rand, Sport for Life Society; Greg Henhawk

Background

In the Truth and Reconciliation Commission report, sport and recreation are identified as tools for social development to improve the health and well-being of individuals and commu-nities. Involvement and enjoyment at a young age can create healthy habits for life. However, Indigenous participation in sport at all levels has been under-represented and mainstream programs do not necessarily align with Indigenous needs or experiences.

Content

This workshop will provide health leaders and community champions with information and practical tips on how to bet-ter include and support Indigenous participants, especially chil-dren, in physical activity and sport programs as a way to encour-age healthy lifestyles. It will outline the key elements that need to be considered when planning and implementing programs, including a holistic focus on supporting the physical, mental (intellectual and emotional), spiritual and cultural needs of the individual to maximize their experience in physical activity and sport. Key resources will be shared, including the Aboriginal Long-Term Participant Development Pathway and Aboriginal Communities: Active for Life. These resources have been devel-oped in collaboration with Indigenous leaders across the coun-try to help Indigenous champions, and non-Indigenous leaders working with Indigenous communities, as they seek to develop quality activity programs, and create collaborative relation-ships across community members in a journey towards building active, healthy and engaged communities.

Conclusion

Participants will come away with tools, resources and ideas to create action plans to help support and promote Indigenous par-ticipation in physical activity and sport with the overall goal of enhanced health and well-being.


This didactic workshop will provide information and include interactive activities, participant-driven discussions,


thought-provoking questions and reflections to help partici-pants understand and relate to the material.

Keyword(s): Holistic approach, physical activity, sport

For more information, contact Submitting Author: Emily Rand [email protected]

W29Indigenous Research & Population Health Data Workshop - Protecting Our Knowledge, Telling Our Stories, Strengthening Our Communities(Submission ID: 440722)

Darcy Jagodzinsky, AFNIGC; Andy Alook, Alberta First Nations Information Governance Centre / GOA - Ministry of Health

Background

First Nations need to govern the creation, use, and disclosure of data to support their articulation of improved health outcomes from their own worldview perspective. For data to make a dif-ference, clearly articulated partnerships must be established that are built on a foundation of mutual respect. For too long have the prescribed solutions for First Nations health disparities been defined by white settler culture, creating issues of “informa-tion poverty” for First Nation communities, whereby they are poorly equipped to articulate their data stories as a direct result of 150 years of paternalistic administrative government systems.Supporting First Nation community research and data repatri-ation is a way in which each First Nation can articulate their needs, successes, and challenges. In this workshop, we want to provide an overview of the Alberta First Nation communities working towards self-determination in information governance through data sovereignty.The outcome of this workshop is to provide an “Ethical Space” in which participants can work in partnership to discuss and facilitate partnerships and actions to improve the health and wellbeing of all First Peoples. Respect-ful collaboration amongst the world’s indigenous population is work that supports all our communities to action.


Through open dialogue and small group discussions the reali-zation of First Nations data sovereignty can begin. Participants will work together in providing examples of existing data sys-tems and develop example community data profiles for the use in First Nation communities they come from by using examples of surveillance, evaluation, planning.

Keyword(s): Sovereignty, Repatriation, Collaboration

For more information, contact Submitting Author: Andy Alook [email protected]

W30Seven Generations ~ Replacing Our Gifts of Peace and Wellness(Submission ID: 433149)

Renee Thomas Hill, Indigenous Diabetes Health Circle; Amanda L. Lipinski, Indigenous Diabetes Health Circle

Background

The Indigenous Diabetes Health Circle is a holistic diabetes education and prevention program that incorporates Traditional teachings as a best practice in the development and delivery of educational programs and culturally appropriate resources to Indigenous communities across Ontario. As diabetes is affect-ing Indigenous Peoples all over the world, its essential that we begin restoring our traditions that work to balance our body, mind and spirit.

Content

Indigenous Peoples were given gifts to maintain peace and wellness in their lives and communities. Through the process of assimilation these gifts have been taken away, resulting in a variety of complications, diabetes being one of them. This interactive workshop will examine the effects of colonization within 7 generations and how we can return to those original gifts to help prevent type 2 diabetes and renew wellness within our communities.


Amanda Lipinski will open with a brief overview of diabetes within Indigenous communities and the culturally appropri-ate programs and resources available through the Indigenous Diabetes Health Circle.Grandmother Renee Thomas Hill will lead participants through a interactive activity demonstrating Indigenous Original Teachings in peace and Wellness through 7 generations.

Keyword(s): Traditional, Culture, Holistic, Diabetes, Wellness

For more information, contact Submitting Author: Amanda Lipinski [email protected]

W31Doing good research ethics with First Nations, Inuit and Métis PeoplesGeneviève Dubois-Flynn, Canadian Institutes of Health Research (CIHR) Ethics Office; Earl Nowgesic, CIHR Institute of Indigenous Peoples’ Health; Catherine Paquet, Canadian Association of Research Ethics Boards (CAREB); Anita Benoit, University of Toronto; Julie Bull, Centre for Addiction and Mental Health (CAMH); Lynn Lavallee, University of Manitoba; Dawn Martin-Hill, McMaster University; Fred Wien, Dalhousie University; Susan Zimmerman, Secretariat on the Responsible Conduct of ResearchBackground


1. To consider research ethics from various perspectives, includ-ing the 2007 United Nations Declaration on the Rights of Indigenous Peoples; the 2015 Final Report of the Truth and Reconciliation Commission of Canada; and the 2017 Final Report of Canada’s Fundamental Science Review

2. To understand the Tri-Council Policy Statement – Ethical Conduct for Research Involving Humans (2nd edition) Chapter 9: Research Involving the First Nations, Inuit and Métis Peoples of Canada, and discuss challenges to imple-menting Chapter 9

3. To identify best and wise practices in ethical research with Indigenous communities


This workshop will begin with a panel presentation and will be followed by a group discussion. Workshop delegates should have some familiarity with Chapter 9 (Research Involv-ing the First Nations, Inuit and Métis Peoples of Canada) of the Tri-Council Policy Statement – Ethical Conduct for Research Involving Humans (2nd edition) http://www.pre.ethics.gc.ca/eng/policy-politique/initiatives/tcps2-eptc2/chap-ter9-chapitre9/#toc09-1. A report on the proceedings of this workshop will be developed for publication on the CIHR web-site. A draft will be sent to workshop delegates for their review before being uploaded on the CIHR website.

Keyword(s): Indigenous, Research, Ethics

For more information, contact Submitting Author: Earl Nowgesic [email protected]

W32Cultural Competancy

WITHDRAWN

Background

W33Colorectal Cancer in First Nations people in Ontario: The Truth and How the Social Determinants Impact the Aboriginal Cancer Journey(Submission ID: )

Jason J. Pennington, MD MSc FRCSC, Scarborough and Rouge Hospital

Background

This session examines Colorectal Cancer and how its impact on the First Nations population in Ontario. It will begin with a brief overview of Colorectal Cancer and the Cancer Journey

from risk factors to survivorship and palliation. We will then review the latest statistics and trends around incidence and out-comes in the First Nation versus general Ontario population. This data will then be compared to historical numbers and data from other Indigenous groups and jurisdictions. The impact of pathophysiology and social determinants of Indigenous health, both individually and in combination, on these findings will then be explored. Recommendations and discussion around how to use this information to improve the Aboriginal Col-orectal Cancer Journey will conclude the workshop.

Keyword(s): Cancer journey, social determinants of health

For more information, contact Submitting Author: Jason Pennington [email protected]

W34Using Indigenous Art and Photography to Develop Cultural Understanding in Health Care Providers(Submission ID: 440034)

Randy Trudeau; Marion Maar, Medical Anthropology, Northern Ontario School of Medicine; Mariette Sutherland; Erin Cameron, Northern Ontario School of Medicine

Background

Research shows that art in healthcare provider education can support the development of professionals who are compassion-ate, patient-centered, and collaborative. In this workshop, we invite participants to reflect on visual art and photography cre-ated by Indigenous artists and community members to foster an understanding of the lived experience of Indigenous peoples. We will use Visual Thinking Strategies (VTS) to explore art created in the context of community-based Indigenous health initiatives and consider how this art invites new learnings that might enhance the provision of culturally safe care. The visual art will be selected from two exhibits that the presenters have collaborated on as researchers and Indigenous artists. First, the Noojamadaa (Let’s Heal) Exhibit is the result of a visual arts research method intended to stimulate discussion among Indig-enous women from three Manitoulin Island First Nations com-munities on the strengths they see in their communities regard-ing healthy relationships and families. Photographer Mariette Sutherland will be present to reflect with the audience on select pieces of this exhibit. Second, the Shkagamik Kwe Nandwego-nah (Mother Earth Healing Us) Exhibit currently under devel-opment explores the healing relationship between Indigenous people, the earth, and land-based activities. Artist and hunter/trapper Randy Trudeau will share this work and lead the discus-sion.This art-based workshop will use an experiential learning approach to foster and promote healing and reconciliation. The workshop will provide a space for Indigenous and non-Indige-nous peoples to reflect on our shared journey towards wellness,


through contemplation of our relationships with one another and our surroundings.


We will provide a brief background description of the signif-icance of the art in healthcare education, and specifically the method called Virtual Thinking Strategies. The majority of the time will be spent viewing and reflecting on various pieces of Indigenous art and photography in a reflection guided by the presenters.

Keyword(s): Indigenous art; cultural safety; land-based activities

For more information, contact Submitting Author: Marion Maar [email protected]

W35Aboriginal Head Start - Making a Difference - In the lives of Indigenous children and families in Canada(Submission ID: 421563)

Joan Gignac, Aboriginal Head Start Association of BC; Alanaise Onizhichin Goodwill

Background

Aboriginal Head Start in Urban and Northern Communities (AHSUNC) participated in the National Indigenous Early Learning and Child Care Engagement (IELCC) in 2017. This presentation shares with participants the unique voice of 1845 Parents, Families, Staff and Elders in our programs. Aboriginal Head Start Association of BC (AHSABC) in partnership with the Public Health Agency of Canada (PHAC) provided support and funding to our AHSUNC programs across Canada to host community engagement sessions. The purpose of the Engage-ment process was to share back with the Government of Canada ‘what is working’ and ‘what is not working in AHS’ in order to make positive change. We wanted to learn: What are the strengths and challenges of AHS? What are the greatest needs of children, parents, staff and community? What would give more value to the children and families? While these findings are commensurate with ELCC research, they are viewed and shared through the ELCC principles of:

• co-development and partnership;

• comprehensive and inclusive dialogue;

• reconciliation (acknowledge the past, act now, look to the future);

• responsive and outcome driven practices and;

• Family-centered methodology.

What we learned from the 1845 responses will be shared and discussed in this presentation and will focus on AHS as an

early intervention program in Canada since 1995 and how it has evolved into strong models of Family Wellness programs. We’ll share what we heard are the priorities for present and future growth of AHS and Indigenous Early Learning and Child Care in Canada.


Presenters will use power point presentation to guide talking points and provide key visual of Engagement reach and signifi-cant messages learned.Opportunities for dialogue, questions and discussion will follow and be included through presentation.

Keyword(s): ChildrenParentsFamiliesCommunityAboriginal CultureWellnessEngagement BenefitsConnected

For more information, contact Submitting Author: Joan Gignac [email protected]

W36Addressing Indigenous Inequity in Health Care: Using Role-Play for Reconciliation(Submission ID: 433991)

Lloy Wylie, Western University; Stephanie McConkey, Western University; Danielle Robinson, Western University

Background

There is a need to improve knowledge and practice through tar-geted educational initiatives that give providers concrete recom-mendations to ensure culturally safe care. Such actions include understanding and correcting their own biases, improving their knowledge, and ensuring system-wide supports for culturally safe care. The presenters will illustrate a range of challenges fac-ing Indigenous people, both within the health care system and in the social determinants of health, based on an Ontario study on health care services and care providers attitudes that shape experiences within the health care system.

Following a brief introduction to key themes, the workshop will use a series of short case vignette videos that demonstrate gaps in knowledge and practice that compromise culturally safe, quality health care for Indigenous patients, families and communities. The exercises will demonstrate ways to recognize culturally unsafe behaviours, and how to ensure interactions between care providers and Indigenous patients and families are respectful and culturally safe. Participants will develop strate-gies to address these issues through experiential learning exer-cises that explore challenges and collectively develop solutions that build concrete skills. This workshop will provide expe-riential learning opportunities for health educators and prac-titioners to improve their ability to offer culturally safe care for Indigenous people. In addition, the workshop will support participants to develop theatre-based training activities in their own health service settings.


The aim of this workshop is to advance the recommendations from Canada’s Truth and Reconciliation Commission, as well as the goals of reconciliation more broadly within health care.


Video cases on challenges Indigenous people face will be pre-sented. Participants will work in teams to discuss the cases, and will then present a theatrical sketch that re-writes the scenario in a culturally safe way. Workshop facilitators will guide a reflective discussion and explore ways participants can use this approach.

Keyword(s): racism, cultural safety, health care providers, experiential learning, role play

For more information, contact Submitting Author: Lloy Wylie [email protected]

W37Strong Medicine: Educating on HIV treatment through Indigenous worldviews(Submission ID: 433916)

Laurie Edmiston, CATIE; Christie Johnston, CATIE; Trevor Stratton, Canadian Aboriginal AIDS Network (CAAN); The Group that Shared their Journey with HIV Treatment

Background

In Canada, Indigenous people are disproportionately affected by HIV. Indigenous people make up approximately 12.2% of new HIV infections and 8.9% of those living with HIV. Only 37% of Indigenous people in Canada have been tested. Because of antiretroviral medication, HIV is now a chronic, manageable illness. However, many Indigenous people with HIV (PLHIV) face significant barriers to accessing and staying on treatment over the long-term, two things critical to health and to achiev-ing prevention benefits of effective treatment.

There is urgent need to support accurate HIV treatment infor-mation among Indigenous communities to encourage those at risk to access testing and those living with HIV to start and stay on treatment. One strategy includes combining Indigenous knowledge with Western therapies in a holistic approach to health management.

To this end, CAAN and CATIE produced an educational video with Indigenous-PLHIV that talks about HIV treatment and the benefits of getting on treatment early and staying on treatment. Embracing the contributions of Western and Indigenous ways of knowing, the story weaves together the two worldviews, connecting how HIV treatment can be a part of a more holistic approach to health and efforts to achieve a balance among the physical, emotional, mental and spiritual realms.

This session will screen the 23-minute video and engage in dia-logue on how practitioners can use the video to engage in useful

discussion about HIV and treatment with their clients and com-munities. The video is also a way to learn more about HIV and Indigenous peoples in Canada.


Introduction to HIV among Indigenous people and the impor-tance of HIV treatment for health and prevention and video screening; followed by facilitated, large-group discussion focused on: reactions to the film; current challenges and solu-tions to supporting people with testing and treatment; how the film can be used in diverse settings.

Keyword(s): HIV, Treatment, Two-Eyed Seeing,

For more information, contact Submitting Author: Christie Johnson [email protected]

W38Addressing Trauma from an Inidgenous Lens(Submission ID: 432954)

Brenda Restoule, First Peoples Wellness Circle; Carol Hopkins, Thunderbird Partnership Foundation

Background

Colonization and assimilationist acts have perpetuated a his-tory of trauma for Indigenous people in Canada. This his-tory of trauma has resulted in a myraid of health problems for Indigenous people that spans from high rates of chronic and infectious diseases to significantly higher social health concerns in the areas of justice, housing, employment and education to alarming rates of mental health/illness and addictions issues. Indigenous people in current society are faced with addressing the legacy of intergenerational trauma while present day trau-mas may be a ongoing reality for many. Clinical practices have adopted a trauma informed care philosophy that recognizes and offers support to those impacted by trauma. Defining trauma informed care from an Indigenous lens will allow for improved cultural competency and ensure that Indigenous people are able to address the unique traumas inflicted as part of colonialism.

Content

This workshop will examine Indigenous understanding of trauma and wellness to define culturally defined trauma informed care for Indigenous people. Comprehending the negative outcomes and risk factors to intergenerational trauma through current research will highlight the risk factors asso-ciated with concomitant mental health issues. Indigenous evi-dence and practices will be discussed as strategies to address trauma. Parts of the workshop will also explore various assess-ment tools that can support work on achieving wellness for var-ious populations and emphasize a strengths based approach to care including strategies to foster resilience.



This workshop will use a lecture style with interactive dialogue to support the learning of participants.

Keyword(s): Culturally defined trauma informed careIndige-nous wellness and resiliency

For more information, contact Submitting Author: Brenda Restoule [email protected]

W39Connecting Clinical and Cultural Competencies: The Creation of a Practice Charter for Health Professionals Working with Indigenous Communities(Submission ID: 428325)

Melanie MacKinnon; Ian Whetter; Sara Goulet

Background

Rationale/BackgroundThe current health comorbidities and social complexities lived by Indigenous clients and there adverse health outcomes not only require highly competent clinicians but culturally safe ones. Cultural competency is a CanMED standard and other health associations are adopting these concepts as well but what does that look and feel like in practice for learners and professionals? What attitudes, beliefs and behaviours need to be reflected and reconciled between providers and patients? Furthermore, how do institutions and organizations realign with Indigenous ways of knowing and being to become culturally safe themselves?The Rady Faculty of Health Sciences at the University of Manitoba has been ask-ing and responding to these questions with real action through the guidance of physician leaders, Indigenous health experts and elders. One such example is the Ongomiizwin Health Services (OHS) Physician Charter.

Content/Objectives

• Discuss critical success factors for operationalizing cultural competencies in practice.

• Understand the history of OHS in northern and remote communities; its vision, scope, administrative structure, service commitments and opportunities for other health and academic organizations.

• Expand efforts for culturally safe, effective and integrated service delivery models.


A seminar format, involving two presentations related to the stated objectives (15 min each). The remainder 30 min will be a facilitated discussion, participants will be encouraged to discuss how these examples relate to their own context, and identify ways they can apply learnings to their own practice.

Keyword(s): cultural safety, indigenous ways of being, inte-grated services delivery models

For more information, contact Submitting Author: Melanie MacKin-non [email protected]

W40Juddah’s Place-An Indigenous Evaluation Project: Traditional and Western Medicine in Primary Care

WITHDRAWN

W41“Re-membering who we are; Decolonizing Health Practices”(Submission ID: 404187)

Lori Flinders

Background

This workshop is both a ‘give away’ ceremony of inherent knowledge and opportunity to generate discussion on building a ‘knowledge bundle’ of best practice for Cultural Competency in person centered health care. We are moving towards nor-malization of traditional practices by the building of a practice ‘bundle’ for person centered care. This is a recognized and pub-lished leading practice with Accreditation Canada.

This presentation will describe, identify, and indicate how the translation and dissemination of our ‘traditional knowledge bundles’ improved cultural safety within our Agency and spe-cifically within our mental health and addictions Behavioural Health Unit. Through our bundles (personal, professional, and agency) we play a critical role in advocating for our clients, fam-ilies, and communities and create best practices that are com-munity driven.

Participants will be brought through the ‘story telling’ of how we came to understand that culture belongs to the people and as such the workshop increases, adds, and expands their cul-tural competency in terms of traditional practices. This ‘story’ of creating a shift in paradigm or transformation from cultural inexperience to cultural awareness and ultimately cultural nor-malization through the building of culturally based personal and Agency practice bundle (feather, medicines, methodologies, traditional drum, eagle staff, pipes).

This workshop empowers the TRC recommendation to pro-vide an opportunity to start to initiate and establish the ideol-ogy that the people have a right to health initiatives that respond to their social, cultural, linguistic, gender and spiritual and/or religious diversity and promote their health and wellbeing in this context.



Lecture/Discussion methodology. Workshop will include inductive learning traditional opening with tobacco offer-ing and hand drum song (smudging if allowed). Lecture will include power point presentation and closing will include a ‘give away’ ceremony. Please have room set up in a CIRCLE for relationship building

Keyword(s): DecolonizingTraditional MethodologiesCultur-al-Identity, Safety, Competency

For more information, contact Submitting Author: Lori Flinders [email protected]

W42Decolonizing Death and DyingMichael Anderson, Dalla Lana School of Public Health, University of Toronto

Background

First Nations, Inuit and Métis people are a very heterogeneous group and this diversity is apparent in the care and practices around the last stages of life. Indigenous communities have a long history of practicing palliative care – caring for and sup-porting each other. While the final walk of one’s journey to the spirit world presents challenges, it remains an auspicious oppor-tunity for healing. To realize the opportunities for healing, Indigenous culture, knowledges, and constructs of community need to be respected and valued. This is not simply about heal-ing the individual but also encompasses healing families, com-munities, and ancestral relations. In other words - it is about healing “all my relations.”


The path to decolonizing palliative care can be approached by building meaningful relationships which support harmony and understanding between Indigenous and biomedical worldviews. Improving palliative care for Indigenous people must begin with an effort to appreciate that Indigenous worldviews are rela-tional and thus differ fundamentally from that of the dominant biomedical system. Death and dying are strongly linked with community, cultural practices, and spiritual significance. Only when cultural beliefs, values, practices, and spiritual ceremonies are respected and valued will culturally safe care be realized. Death is not a medical event. It is about culture and community.

Keyword(s): Death and Dying, Palliative care, Relationships

For more information, contact Submitting Author: Michael Anderson [email protected]

W43From Dog Teams to the Internet: A Focus on Inuit HealthQauyisaq Etitiq, Sunburst Consulting

Background

Inuit come to the South for treatments of all sorts. Often these can result in long term stays in cities across Canada for cancer treatment, heart surgeries or even birthing etc. Some prac-titioners have not had an Inuit patient before, and naturally miscommunications can happen due to language barriers and a lack of understanding due to interpretations on both sides of the conversation. This workshop will provide a snapshot of history on Inuit health statistics and then provide time for discussion on examples of the current system of care and the journey Inuit go through to seek medical attention.

Content

Workshop will review health statistics that are available for Inuit in Canada from multitude of sources to inform audience of real-ities of Inuit health status across Canada. Reviews how this can help shape policy development and inform future health research with communities in the North and South. New health care practitioners will learn basic concepts of communicating with Inuit and discussion on the health care system of working between the territory and province. Experiences and stories will be shared to demonstrate the current system and the jour-ney Inuit go through to better their health before they enter your examination room. Resources will be shared of what organizations in Ottawa work together that are a part of the system of health for Inuit.


Narrative format, stories of lived experience, powerpoint pre-sentation, involved discussion and questions.

Keyword(s): Cultural competency, Inuit, health systems, com-munication

For more information, contact Submitting Author: Qauyisaq Etitiq [email protected]

W44Shkagamik Kwe Nandwegonah (Mother Earth Healing Us)(Submission ID: 434195)

Randy Trudeau; Marion Maar, Medical Anthropology, Northern Ontario School of Medicine

Background

The Anishinabe conceptualization of good health, known as mino-bimaadiziwin, goes beyond the Western individualistic,


physically-focused model of health. Colonial approaches and structures such as mainstream health and social services and justice systems have a long history of impacting negatively on Indigenous mino-bimaadiziwin (holistic health and wellness). Therefore to restore Indigenous health and wellness, it is nec-essary to explore how approaches to improve Indigenous health can support the restoration of mino-bimaadiziwin.

Content

While the literature of the benefits of land-based activities, in general, is growing, the relationship between cultural activities, the land, and Indigenous health is complex. We seek to improve participants understanding of how Anishinabe mino-bimaadiz-iwin is experienced through healthy relationships with Indig-enous culture, the land, and land-based activities. We will dis-cuss a range of land-based and traditional activities that have been shown to be beneficial to people recovering from adverse childhood experiences, trauma, and addictions. We will also facilitate a discussion how these activities can be incorporated into health and social services and programs of interest to the participants.We will present video clips of traditional land-based activities such as hunting, trapping, and medicine picking from our recent video ethnographic research. Discussion of these activities and benefits to Anishinabe wellness will be led by an Indigenous presenter with lived experience of hunting, trap-ping, harvesting of medicines and other traditional activities.


Participants will have time to explore the relevance of these activities to their patient or clients in small groups, with the support of facilitators. An interactive group dialogue on how activities can be incorporated into services and policies in a variety of settings will conclude the session.

Keyword(s): land-based activities; hunting, trapping, culturally safe services, healing, traditional medicines

For more information, contact Submitting Author: Marion Maar [email protected]

W45Mercury Contamination

WITHDRAWN

W46Advocacy - Government Relations

WITHDRAWN

W47Elders WorkshopJan Kahehti:io Longboat (First Nations), Larry McDermott (First Nations), Karen Cederwall (Métis Senator) and Meeka Kakudluk (Inuit Elder)

Description

Join the conference elders for a continued discussion based on the Elder’s Circle earlier in the day. There may be an opportu-nity for smaller discussions within the larger group.

W48Using Participatory Action Research (PAR) in the development of community-based mentorship program for First Nations boys and men(Submission ID: 433672)

Julie George, Centre for Addiction and Mental Health; Samantha Wells; Kathryn Graham; Jordan Williams

Background

With funding from Movember, men from Kettle & Stony Point First Nation are developing interventions for mental health and addiction challenges. Working with men and a team of clini-cians and Spiritual Advisors, we are examining the causes of health challenges and the role of protective and resilience factors in supporting well-being through difficult life experiences.

This workshop will highlight the use of PAR and Photovoice as a method for exploring difficult life experiences, engaging men in critical reflection and advocating for change. We will highlight the development of a comprehensive, well-integrated and culturally-appropriate program of prevention and interven-tion, including cultural and spiritual supports and a range of clinical services. This will include a discussion of a theoretical framework for understanding mental health and addiction chal-lenges and developing appropriate community-based solutions.

Photographs and narratives point to the relationships that underlie health challenges in First Nations communities, the role of colonization and the central role of decolonization in addressing factors that perpetuate ill health. In supporting men to identify and reflect on challenges and strengths, preliminary results point to the importance of five factors: Spiritual Devel-opment; Spiritual Balance; Community and Cultural Connect-edness; an Ethic of Responsibility; and Children/Hope for the Future. These findings highlight the role of decolonization in overcoming health challenges and promoting whole health, and will form the basis of our discussion on why and how the com-munity is building a clinical framework for the incorporation of THPs.



This interactive workshop will include group discussions and incorporate a mix of prepared media, including a PowerPoint presentation of Photovoice photographs and narratives, as well as a series of short video clips. It will incorporate a Pipe Cere-mony, Smudging and a Welcoming and Travelling song.

Keyword(s): First Nations; Health; Mental Health and Addic-tions; Traditional Healing Practices

For more information, contact Submitting Author: Julie George [email protected]

W49Kiviuq and the Fifth RegionJoshua Stribbell, National Urban Inuit Youth Council

Background

Inuit Nunangat refers to the four arctic regions in Canada. They are, from west to east, Inuvialuit, Nunavut, Nunavik, and Nun-atsiavut. They make up the Inuit homeland in Canada. Today, approximately thirty percent of Inuit live outside of Inuit Nun-angat in urban and rural centres across Canada. This presenta-tion will provide a brief history of colonization and its impacts on Inuit communities, and will examine present realities and barriers to self - determination and well - being that effect Inuit today. It will recognize the importance of identifying, address-ing and supporting the needs of Inuit living outside of the arctic, as well as exploring ways to strengthen the relationship between northern and southern Inuit communities, and the rest of Can-ada as a whole. Participants will leave with a stronger under-standing of the intergenerational trauma that is experienced by all Inuit as a result of the legacy of colonization.


Kiviuq and the Fifth Region will be in lecture format with time for Q and A given at the end. This presentation is ideal for healthcare providers, government ministries, and educational professionals as a foundation for working with Inuit clients.

Keyword(s): Decolonization, Inuit, Self-Determination, Reconciliation

For more information, contact Submitting Author: Joshua Stribbell [email protected]

W50How Air Ambulance Services Might Improve Access to Emergency Health Care for Remote Indigenous CommunitiesHomer Tien, Ornge

Background

Air ambulance services have the clinical, educational, logisti-cal and technological expertise to improve access to emergency health care for remote Indigenous communities. As well, air ambulance services often already have bases within or close to these communities.

Content

Presentation of a five-part strategy that Ornge Air Ambulance is implementing in conjunction with stakeholders to improve access to emergency health care in Northern Ontario.

Table 1: Strategies to Improve Access to Care for Remote Indigenous Communities

Strategy Projects

Clinical 1. Telemedicine Support

Logistical 2. Provisioning of Point of Care Lab Tests

Education 3. Educational programs to Nurses Delivering Care in Communities

4. Educational programs to develop First Responders within the Communities

Outreach 5. First Aid/CPR Training for Indigenous Youth

6. “Stop the Bleed “ Courses for Indigenous Youth

7. PARTY program for Indigenous Youth

8. “Opioid Dependence” Training for Indigenous Youth

Data 9. Data analysis for Quality Improvement


1. Presentation (20 min) 2. Question and Answers (10 min) 3. Discussion (30 min)

Keyword(s): Air Ambulance, Access to Care, Emergency Medicine

For more information, contact Submitting Author: Homer Tien [email protected]

indigenous health conference - cpd.utoronto.ca · health outcomes. the panel format will encourage...

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