U of A Elders, faculty and students contribute to research network aimed at improving health outcomes for Indigenous peoples in Alberta

University of Alberta Elders, faculty and students are contributing to a new research network aimed at improving the health of Indigenous people across the province.

For Elder Bert Auger, making the health-care system more responsive to Indigenous needs is a key part of fulfilling Canada’s Truth and Reconciliation calls to action. A member of the Whitefish Lake First Nation #459, Auger advises the new Indigenous Primary Health Care and Policy Research (IPHCPR) Network in Alberta. 

“Acknowledging Indigenous ways of knowing means that we’ve had our own medicines that work for a long time, for thousands of years, like diamond willow is a painkiller and different kinds of teas help nausea,” said Auger, who is part of the U of A School of Public Health’s Elders and Knowledge Keepers Program. 

“But it also means that when we access the public health system, services should be delivered in a culturally appropriate way.”

For example, Auger said services in northern Alberta communities should be available in Cree and Indigenous guides should be hired to help patients navigate the health system, especially for people from remote communities who must go to the cities for specialized care. 

The Atikameg Health Centre, which was built in Whitefish Lake three years ago, is a success story Auger plans to share through the new network. “We educated and hired some of our own people so there’s no need for translators, and Elders can access health care in their language,” he said.

Auger also spent time on East Prairie Métis Settlement when he was growing up and worked for 35 years as a social worker. He now lives in Edmonton and works to build understanding of Indigenous perspectives amongst non-Indigenous Albertans. 

“I had a traditional upbringing—hunting, fishing, living off the land and being part of the land as Cree people,” Auger said. “Now, I travel in two worlds and my philosophy has always been to bring our story to mainstream society.”

Collaborating with communities

“This is an opportunity to really shift our mindset and systems towards achieving health equity, and foster inclusion of Indigenous people in policy decisions,” said Stephanie Montesanti, one of 10 principal investigators and associate professor in the School of Public Health. 

“For far too long policies and decisions have been made without the inclusion of Indigenous ways of knowing.”

The network’s vision emerged from a two-day workshop in 2015 that brought together 65 First Nations and Métis community leaders, primary health-care providers, government health policy officials and academic researchers. They explored three innovative initiatives for delivering primary health-care services to Indigenous communities from across Canada. One model includes Elders working alongside health-care professionals at a clinic in Vancouver’s downtown eastside. 

“We really wanted to understand what was unique about that model, what made it successful, how were they able to implement an innovative model within the primary health-care setting that is based on a western biomedical approach to care,” Montesanti said.

“What the innovations all had in common was that they were community-led and were driven by a vision of bringing in traditional ways of knowing and healing practices to improve Indigenous health outcomes,” Montesanti said.

Sharing knowledge, changing policy

The new network brings together researchers from the University of Calgary, Mount Royal University, the University of Alberta and Queen’s University, and is led by U of C associate professor of family medicine Lindsay Crowshoe, a U of A medical grad and Alumni Award winner. The network has received $3.5 million over five years from the Canadian Institutes of Health Research (CIHR) through the Network Environments for Indigenous Health Research (NEIHR) program. U of A MD grad Cara Bablitz and Esther Tailfeathers, both assistant clinical professors in family medicine at U of A, are also principal investigators. Tailfeathers is a recent winner of the Royal College of Physicians’ Dr. Thomas Dignan Indigenous Health Award. 

“The network will promote a renewed and transformed primary health-care system in Alberta to achieve Indigenous health equity,” said Montesanti, who is also a scientist with the Centre for Healthy Communities and a member of the Women & Children's Health Research Institute. She was recognized as one of Edify magazine’s Top 40 under 40 this year and received a School of Public Health Diversity Champion Award in 2018.

Danika Goveas is a non-Indigenous School of Public Health student who hopes to one day train as a doctor. As a graduate research assistant for the network, she is currently supporting evidence reviews, searching for Indigenous-focused best practices around the world that might be explored in Alberta. Soon she will begin her thesis project for her master’s in epidemiology under the supervision of Montesanti. She has received one of five 2020 IPHCPR Network annual seed grants to support her work evaluating primary health care strategies in Alberta communities through community-led sharing circles and interviews. 

“We want to listen to personal experiences and collaborate to highlight priorities for policy change,” Goveas said. “We need a deeper understanding of what works and what doesn’t work for communities.”

That knowledge will then be shared back with communities through conferences and workshops. Indigenous leaders will guide the scientific and community-based research, and will also provide mentoring opportunities for students. The goal is to foster relationships and collaborations, and to advocate for change. What is learned will also be shared with government health officials. 

“We can't innovate without engaging policy and decision-makers, so they can understand what the needs and gaps are, what we know, where are the opportunities for change,” Montesanti said. “Together we are building capacity and generating knowledge.”

“Communities already know the solutions, they know what needs to happen and it’s really about supporting and actualizing those strengths in those communities and working with them to identify the best possible solutions and ways of delivering care or services,” she said.

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