‘A new way of doing research’: Indigenous communities and U of A allies partner to support family, women and children’s well-being

Showing moms-to-be how to sew a moss bag, a pair of tiny beaver fur mitts or a ribbon blanket for their babies, Elder Beverly Tourangeau’s heart lifts.

As they journey into parenthood guided by traditional Indigenous knowledge, she sees how the young women in her northern Alberta community of Fort Chipewyan light up as they reconnect with their cultures.

“They are so proud that they sewed something for their baby. You can just see it in their faces, hear it in their voices, and I know it is something they are going to keep and pass on,” says Tourangeau, a member of the Athabasca Chipewyan First Nation.

That meaningful experience is just one way she and other elders have been guiding Indigenous families for the past five years, through a mentorship program co-designed by the Fort Chipewyan community and University of Alberta health researchers.

Called the Elders Mentoring Program, it also helps expecting families access support as they leave their remote communities in the Regional Municipality of Wood Buffalo to give birth at the nearest hospitals in Fort McMurray or Edmonton. And when the families return home and begin to care for their babies, the elders continue to offer cultural guidance on everything from bathing to feeding.

That support builds the young women’s confidence in who they are, Tourangeau says.

“We are bringing back the old culture of the way things used to be, and that helps them in their pride as First Nations ladies.”

Now, the work of Tourangeau and her fellow workers in the program will be expanded to support moms and their families from other communities in Wood Buffalo, as part of a new long-term project focused on improving health and wellness for Indigenous families, women and children.

Funded by a $16-million Canadian Institutes of Health Research (CIHR) grant, the six-year project brings together the Cree Nations of Maskwacîs and the Cree, Dene and Métis Nations of the Regional Municipality of Wood Buffalo Alberta, and the 14 Nuu-chah-nulth Nations of coastal British Columbia. The group represents a total of 23 communities leading the research, with partners from the Alberta First Nations Information Governance Centre (AFNIGC), and research partners from the University of Alberta and Simon Fraser University.

The Indigenous Healthy Life Trajectories Initiative is aimed at restoring traditional family systems, and will explore how to optimize child development in Indigenous communities by starting from pre-conception to early life.

“It’s a new way of doing research,” says Stephanie Montesanti, associate professor in the U of A School of Public Health and director of the CARE Research Lab.

“This work really supports families across the life cycle, it builds Indigenous communities’ capacity to be a part of this project, and is grounded in Indigenous worldviews on well-being,” says Montesanti, a co-principal investigator on the initiative along with researchers Richard Oster and Rhonda Bell from the Faculty of Agricultural, Life & Environmental Sciences.

With its deeply involved Indigenous-led cohort, the large-scale project empowers those communities to take the lead on their health and wellness research, adds Oster, who also serves as scientific director of Alberta Health Services’ Indigenous Wellness Core program.

“There is strength and hope and resilience in these communities. They have the answers; community members are the experts, they live there, they know. The solutions are already there, we just need to highlight and build from that strength and abundance.”

A healthy head start

Over the six years, partnering communities will collect community-derived health and well-being information from culturally appropriate programs to support healthy pregnancy, childbirth and child development.

The research will help assess long-term changes in health and well-being for people after being connected with the community-led programs, with the ultimate goal of restoring healthy family systems that will prevent diseases such as diabetes and obesity, and improve heart health and mental health.

“By supporting children’s development and well-being starting during pregnancy through strong connections to community, kinship and culture, as well as parental social and mental well-being, it reduces health risk and enhances wellness across generations,” says Montesanti, who is also thematic lead for the Supporting Healthy Indigenous Communities research program within the Centre for Healthy Communities.

The project will highlight the value of Indigenous perspectives on health and well-being, Oster believes.

“It’s much more holistic. It transcends the boundary of western biomedical measures and indicators of health, which only capture a very small piece of what it means for Indigenous people to be well.”

Carrying the light forward 

The U of A’s $6-million share of the funding will support and expand a variety of programs derived from the Indigenous communities, co-designed with researcher allies, and led by the community partners.

The most long-standing project to be supported by the funding is an Elders Mentoring Program which was started in 2016 in the Maskwacîs communities; the idea behind it was later adapted by the Wood Buffalo communities to create their own unique program.

Through the Maskwacîs program, elders like Muriel Lee share culturally based teachings with expectant mothers in the Maskwacîs communities, to help provide emotional, mental, spiritual and physical support “so the child within her can grow,” says Lee, a member of the Ermineskin First Nation.

The teachings help the young women stay strong as they journey through pregnancy, she adds.

“We tell the mom stories about parenting; that long ago, as soon as a mother announced she was with child, the elders, the grandmothers would come together and begin to take care of that little spirit that has arrived to the mother, and the mother was instructed in what enhances the child’s development and what doesn’t. In attitude she is encouraged and empowered to be as positive as she can be, because those beliefs carry themselves into the baby’s spirit.”

In turn, passing along those teachings to young parents provides role models for the children to come, Lee says.

“It’s my hope that instead of passing along intergenerational trauma of anger, of unworthiness, we do exactly the opposite, and when a person is viewed in that light, they will carry that light forward — it will take care of itself.” 

Today’s learners, tomorrow’s elders

The ongoing mentorship provided to families through culturally based programs also contributes to their wellness by helping create the elders of tomorrow, Tourangeau says.

“In the future, the young mothers we are helping now are going to help other young mothers, and are going to teach them and bring them into the program. That will be keeping our culture and traditional knowledge alive in a positive way.”

Also included in the Wood Buffalo project is Aunties Within Reach, a program started in spring of 2022, co-designed in partnership with Ihkapaskwa Indigenous Wellness Collective and Montesanti’s CARE Research Lab team, and delivered by Indigenous birth workers like Sheena Bradley.

Offered within the Cree, Dene and Métis Nations in the Regional Municipality of Wood Buffalo, the program helps participants reclaim traditional family or kinship care systems in their communities.

“We provide a wraparound approach to caring for our families, a traditional kinship model where we are like aunties, and kin that lifts families up,” says Bradley, who is Cree Métis and a member of McMurray Métis Local 1935.

Aunties Within Reach offers a phone hotline to get Indigenous families immediate assistance in a wide range of ways, from helping navigate the health-care system and access resources to providing cultural support and providing full-spectrum birthwork to support new families.

“New families are often looking to learn more about cultural birth and postpartum practices, or would like to connect with an elder, so we can help with these connections and share our knowledge in a good way,” says Bradley.

The new CIHR funding will support an additional birth worker to serve the First Nations and Métis communities in the Wood Buffalo region.

The hope for the program is to ultimately improve perinatal health outcomes for families, and “to restore healthy family systems in Indigenous communities and have traditional birth worker roles in each community,” Bradley says.

“Colonization has removed many of our traditional child-rearing practices, so going back to our traditional ways helps with our identity as Indigenous people, which positively impacts a child.”

Support for dads, too

Along with mothers and babies, the funding will also support a program for Indigenous fathers.

Deadly Dads, a program begun two years ago by the communities of Maskwacîs, offers dads a break from their busy lives through ceremony such as sweats and feasts, as well as group talks, social events like round dances, or even just going for supper.

“It’s an outlet for us, a place to come and share and hang out,” says Dylan Lightning, a father of four who helped shape the program as its first participant and is now a group leader.

Deadly Dads helped him get back on track after his marriage ended and he became a single dad, Lightning says. “I was broken and didn’t know how to fix myself; I had to start as a whole new person, somebody I didn’t know.”

But through the group, he was able to open up and tell his story, “and because I talked and didn’t keep it in, I changed,” he recalls. “This program is something that gets us back to the person we were before the things that troubled us.”

Today, he adds, “I’m ‘me’ again. ‘Me’ is a happy, healthy dad who takes care of my kids day in and day out and loves to do things with them: hockey in the winter and golf in the summer. We are always on the go.”

The program also supports the whole family, Lightning adds. “It brings the idea that when a husband comes home [from Deadly Dads], he’s going home to give his wife and kids the best of him.”

Allies in community-based research

The communities and researchers will work closely with the I-HeLTI Collaborating Centre, established at the AFNIGC. Funded by $2 million of the CIHR grant, the centre will support the research teams in developing a shared collaborative model for working together, and a process for sharing data and knowledge across communities and teams over the six years.

The centre’s involvement ensures that the processes used will “respect First Nation jurisdiction over research and data to own, protect and control how their information is collected, used and disclosed,” says Lea Bill, executive director of the AFNIGC and co-principal investigator on the project.

The centre’s partnership with the U of A researcher allies “assures the First Nations of Alberta and the communities participating in this project that there will be accountability of the researchers to work in a way that is beneficial to the communities and Nations,” she adds.

“We bring the Indigenous lens and approaches to the research, providing key concepts within the research area that have never been included in the past.”

The U of A researchers also seek to ensure capacity-building within communities, including by hiring community-based research assistants to lead the work, such as Faculty of Science graduate Denise Young.

A member of Ermineskin Cree Nation in Maskwacîs, the mother of three also took part in the Elders Mentoring Program offered there.

Having an elder to talk with helped fill a void left by the too-early loss of her own grandparents, Young says. “The program reminded me of how important it is to have our Kokums and Mosoms.”

As a research assistant with the Maskwacîs Maternal, Child & Family Wellbeing research group, Young works with elders and an advisory committee of community members to “guide which direction our research goes in,” tapping into the strength of traditional knowledge and wisdom.

“We know what is best for our families,” she says. “We’re the experts in our own communities, and a lot of what has come out of research shows that what we need for healthy families is our language and our culture. We thrive in community.”

So far, four themes have emerged from the feedback by program participants: culture, language, resilience and community, Young adds.

“These are the things needed to be healthy parents, so we are using those themes to figure out how to serve mothers and families.”

Young’s involvement in the project builds the U of A’s capacity to mentor the next generation of community-based researchers to work in Indigenous health, Montesanti notes. 

“We want to be able to train in dedicated practices when they are working with research communities.” 

Young hopes the programming happening at Maskwacîs eventually becomes part of her community’s fabric.

“Ultimately my biggest hope is that when I have grandchildren and when they have grandchildren, that there will be an Elders Mentoring Program, our own birthing centre, our own healing centre — and that it’s not a research project, but led by community.”

Kaylen Duke, community engagement co-ordinator and research assistant with the Aunties Within Reach program in Wood Buffalo, is optimistic that the beneficial work being done by such programs will be more widely felt.

“I hope the research we are doing will help bring better community resources for families in Wood Buffalo and to other Indigenous communities across Alberta,” says Duke, a lifelong resident of the area whose family roots stem from Chipewyan Prairie Dene First Nation.

The Aunties Within Reach program “has already revealed the gaps in healthcare for our Indigenous communities,” with their main goal being to help bridge those shortfalls, she adds.

“We all deserve to have access to the resources needed to live a happy and healthy lifestyle.”

Aunties Within Reach has helped her both professionally and personally, through mentorship and support on the impending birth of her child, as well as through conferences and workshops arranged through the CARE Research Lab, she adds.

“I’ll now have a midwife from our team to help provide care for myself and my little one.”

Grateful for the opportunity to grow professionally through her involvement with Aunties Within Reach, Duke hopes positions like hers show the way forward for the generations of today and tomorrow in Indigenous-led, community-based health care.

“It’s important to be able to show other young Indigenous peoples that we can take up space within these organizations to provide more support for our people and our communities.”

Restoring cultural learning

Keeping and strengthening community-led programs helps restore the cultural learning that was broken by the residential school system, Tourangeau says.

“Now this allows us to go ahead and bring back what has been forgotten over the generations. Every human being has DNA, and this traditional knowledge is part of their DNA; they are going to remember deep down inside, it’s part of them.”

Along with the CIHR funding, the project is supported through funding and in-kind support from Stollery Children's Hospital Foundation through the Women and Children's Health Research Institute. Montesanti, Oster and Bell are also supported by WCHRI in their ongoing research.

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