INDIGENOUS HEALTH CONFERENCE - University of Toronto · 2017-03-20 · INDIGENOUS HEALTH CONFERENCE | NOVEMBER 20-21, 2014 6 Planning Committee Anna Banerji O.Ont MD MPH FRCPC DTM&H

INDIGENOUS HEALTH CONFERENCE | NOVEMBER 20-21, 2014 1

INDIGENOUS HEALTH CONFERENCECHALLENGING HEALTH INEQUITIES

Abstract Program

November 20 -21, 2014 University of Toronto Conference Centre

89 Chesnut Street | Toronto, Ontario

cpd.utoronto.ca/indigenoushealthFollow us on Twitter: #indigenousconf



A Message from the Conference Chair

Dear friends, colleagues, respected elders and community members,

I warmly welcome you to the inaugural Indigenous Health Conference: Challenging Health Inequities.

There is a change in the air… Do you feel it? It is the resolution that the poor health indicators on ev-ery measureable level among Indigenous populations in Canada are no longer acceptable. There is no choice but for things to change. It is a human rights issue.

It is important to learn about the past, to help us with the present and change the future. Learning about the history of Indigenous peoples in Canada, the centuries of abuse, neglect and the ongoing discrimination and inequity will help us advocate for change. Through dialogue we can learn how we can learn from each other to be more sensitive and effective health care providers.

We are privileged to have numerous outstanding speakers who can bridge the Indigenous world and non-Indigenous world such as Honourable Justice Murray Sinclair of the Truth and Reconciliation Commission, and Michèle Audette, President of the Native Women’s Association of Canada, who will talk about Missing and Murdered Aboriginal Women. We will also reflect in a discussion on Genocide: The Canadian Perspective, to see if, in fact, a genocide may have occurred.

You will hear of pain, suffering, discrimination….but more importantly you will hear of hope and de-termination and resolution to have a better future. You will hear of the new British Columbia Tripar-tite Framework Agreement on First Nation Health Governance, led by Dr. Evan Adams, and numerous successful programs. You will learn about the growing number of Indigenous health care providers who are determined to help their communities have a better future. The job fair opens up opportunities for both underserviced health centres and for providers looking for an opportunity to make a difference with Indigenous populations. There will be opportunities for promoting health education, advocacy and research with and for Indigenous peoples as equal partners.

We need to stand together, Indigenous and non-Indigenous brothers and sisters, and Challenge These Inequities. Let us share, listen, heal and grow and work towards health equity.

Thank you for being part of this change.

>>Add Signature

Anna Banerji, O.Ont MD MPH FRCPC DTM&H Chair, Indigenous Health Conference: Challenging Health Inequities


Table of Contents

Welcome Letter from the Conference Chair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Area Map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Planning Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Planning Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Speakers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Accreditation, Disclosure, Social Media Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Floor Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Program Agenda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Oral Abstracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Workshop Abstracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Poster Abstracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Sponsors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX

Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XX


Area MapInsert Map Showing 89 Chestnut and area attractions, e.g. Eaton Centre, ROM, etc.


Planning Committee

Anna Banerji O.Ont MD MPH FRCPC DTM&HConference DirectorDirector, Global and Indigenous Health Continuing Professional Development, Faculty of Medicine University of Toronto

Evan Adams MD Sliammon First Nation, Coast Salish Tribe Deputy Provincial Health Officer (DPHO) for Aboriginal health British Columbia

Vanessa Ambtman-Smith Métis-Cree Aboriginal Health Lead & Co-Chair, Provincial Aboriginal LHIN Network (PALN) South West Local Health Integration Network

Anna Claire Ryan MPH Senior Project Coordinator Inuit Tapiriit Kanatami

Darlene Kitty MD CCFP Chisasibi Cree First Nation President, Indigenous Physicians Association of Canada Director, Aboriginal Program, UOttawa, Faculty Of Medicine Family Physician, Chisasibi Hospital, Chisasibi QC

Melanie Morningstar Garden River First Nation – Ojibway Senior Policy Analyst Assembly of First Nations

Jason J. Pennington MD MSc FRCSC The Huron-Wendat Nation Curricular co-Lead in Indigenous Health Education Faculty of Medicine, University of Toronto General Surgeon, The Scarborough Hospital

Lisa Richardson MD FRCPC Anishnaabe/Scottish Clinician-Teacher, Division of General Internal Medicine, University of Toronto Curricular Co-Lead in Indigenous Health Education Faculty of Medicine, University of Toronto

Kent Saylor MD FRCPC Northern and Native Child Health Program General Pediatric Montreal’s General Hospital

Sara Wolfe Brunswick House First Nation Registered Midwife, Seventh Generation Midwives Toronto President and Project Leader, Toronto Birth Centre

Cathy Middleton Event Planner Continuing Professional Development Faculty of Medicine, University of Toronto


KEYNOTE SPEAKER: Justice Murray SinclairThe Honourable Justice Murray Sinclair was appointed Associate Chief Judge of the Provincial Court of Manitoba in March of 1988 and to the Court of Queen’s Bench of Manitoba in January 2001. He was Manitoba’s first Aboriginal Judge. Justice Sinclair was born and raised in the Selkirk area north of Winnipeg, graduating from his high school as class valedictorian and athlete of the year in 1968. After serving as Special Assistant to the Attorney General of Manitoba, Justice Sinclair attended the Univer-sities of Winnipeg and Manitoba and, in 1979, graduated from the Faculty of Law at the University of Manitoba.

He was called to the Manitoba Bar in 1980. In the course of his legal practice, Justice Sinclair practiced primarily in the fields of civil and criminal litigation and Aboriginal law. He represented a cross-section of clients but by the time of his appointment, was known for his representation of Aboriginal people and his knowledge of Aboriginal legal issues. He has been awarded a National Aboriginal Achievement award in addition to many other community service awards, as well as Honourary Degrees from the University of Manitoba, the University of Ottawa, and St. John’s College (University of Manitoba). He is an adjunct professor of Law and an adjunct professor in the Faculty of Graduate Studies at the University of Manitoba.


PLENARY SPEAKERS

Evan Adams MDSliammon First Nation, Coast Salish TribeDeputy Provincial Health Officer for Aboriginal HealthBritish Columbia

Aside from his career in the arts, Evan has completed 3 years of pre-med studies at the University of British Columbia (UBC), a Medical Doctorate from the University of Calgary in 2002, and a Family Practice residency (as Chief Resident) in the Ab-original Family Practice program at St. Paul’s Hospital in Van-couver, BC. He is the 2005 winner of the (provincial) Fami-ly Medicine Resident Leadership Award from the College of Family Physicians of Canada (CFPC), and the 2005 national winner of the Murray Stalker Award from the CFPC Research and Education Foundation. He is the past-President of the In-digenous Physicians Association of Canada, and is currently the Director of the Division of Aboriginal Peoples’ Health, UBC Department of Family Practice. He obtained his MPH in 2009 with the Johns Hopkins School of Public Health while working with the Office of the Provincial Health Officer.

In April 2012, Dr. Adams was appointed Deputy Provincial Health Officer (DPHO) with responsibility for Aboriginal health. In this role, he supports the work of the Provincial Health Officer (PHO), reports on the health of Aboriginal people in BC, and supports the development and operations of the First Nations Health Authority.

Michèle AudettePresident, Native Women’s Association of Canada

Hailing from the Innu community of Mani Utenam, next to the town of Sept-Îles on the North shore of the St. Lawrence River, Michèle Audette followed in the footsteps of her moth-er, respected Innu activist Evelyne St-Onge. Working with Quebec Native Women Inc. since 1990, Audette was elected President of this organization in November 1998.

Endorsing her predecessors’ equal rights commitments, Au-dette was also a strong advocate of women’s positions on a number of issues such as Bill C-7 (which dealt with First Na-tions governance) on the division of matrimonial real prop-erty. She raised decision-makers awareness of the importance of women’s health, safe houses for Aboriginal women, youth issues and international development during her term in office. Thanks to her efforts, four new coordinator positions were created at QNW, which increased the organization’s influence and profile. The Quebec Commission des droits de la personne et des droits de la jeunesse (Commission of Human Rights and Youth Rights) recognized the many accomplishments of Que-bec Native Women Inc. with an honourable mention in 2001.

Audette sat on a number of committees and boards of directors and served as acting president of the Native Women’s Associa-tion of Canada in 2001. She won a number of awards and dis-tinctions for her work on social issues, including the Quebec YWCA’s Femme de mérite award in the Community involve-ment category in 2004. She was also one of Montreal daily La Presse’s personalities of the week in 2003. Audette’s mandate with Quebec Native Women Inc. ended in March 2004 when she was appointed Associate Deputy Minister responsible for the Status of Women Secretariat in the Government of Que-bec.


Michael Dan MD PHD FRCSC MBA

Michael Dan is a neurosurgeon, philanthropist, and First Na-tions advocate. In 2002 he created The Paloma Foundation, which in turn, has donated over $8M to charities in the Great-er Toronto Area. Through his support of The University of Haifa, and the Michael and Amira Dan Professorship in Global Health at The University of Toronto, he has helped to build Jewish-Palestinian dialog and tolerance in Canada and around the world. In 2014 he donated $10M to The University of Toronto to create the first endowed institute for indigenous health research in the world at the Dalla Lana School of Public Health, University of Toronto. Michael is also a strong sup-porter of the Canadian Museum for Human Rights, The Scar-borough Hospital, and the Faculty of Pharmacy and Division of Neurosurgery at The University of Toronto.

Bernie M. FarberSenior Vice PresidentGovernment and External RelationsGemini Power CorporationHuman and Civil Rights Advocate

Bernie M. Farber is one of Canada’s leading experts on mi-nority and human rights, race relations and anti-Semitism. For more than a decade, Mr. Farber worked for the Youth Services Bureau, Ottawa’s Jewish Community Centre and the Children’s Aid Society of Ottawa-Carleton, specializing in as-sisting at-risk youth and battered women. After moving to To-ronto, he worked with Canadian Jewish Congress eventually becoming its CEO from 2006-2011.

Mr. Farber was appointed by the Attorney-General of Ontario to serve on the Hate Crimes Community Working Group. He also serves as Chair on the Board of the Jewish Humanitarian group Ve’ahavta where he recently initiated the Briut program. Briut is a community-driven health promotion program which places graduate level students studying public health or social work in partnership with First Nations “host” communities for four month placements. Briut’s goal is to improve the long term health of individuals and communities by strengthening local capacity for health promotion and the delivery of com-munity based health promotion programs. These programs are developed within the context of local knowledge and exper-tise.

Mr. Farber is a frequent writer for many National newspapers where he has authored thoughtful pieces on First Nations is-sues, human and civil rights matters. Today Mr. Farber works with Dr. Michael Dan as a Senior Vice President at Gemini Power Corp where he assists First Nations Reserves in devel-oping hydro projects and other initiatives encouraging sustain-able wealth development. He is also the CEO of the Paloma Foundation which helps develop skills of those who work on the frontlines with homeless youth in the GTA.

PLENARY SPEAKERS


Phil Fontaine OC OMSpecial Advisor of the Royal Bank of Canada

Phil Fontaine is a Special Advisor of the Royal Bank of Can-ada. He serves as a director for numerous private and public companies including Chieftain Metals and Avalon Rare Met-als. Mr. Fontaine served as National Chief of the Assembly of First Nations for an unprecedented three terms. He is a Member of Order of Manitoba and has received a National Aboriginal Achievement Award, the Equitas Human Rights Education Award, the Distinguished Leadership Award from the University of Ottawa, the Queen’s Diamond Jubilee, and most recently was appointed to the Order of Canada. Mr. Fon-taine also holds fifteen Honorary Doctorates from Canada and the United States.

Angeline Letendre RN PhDResearch Chair, Aboriginal Nurses Association of CanadaAdjunct Professor, Faculty of Nursing, University Of AlbertaLead Scientist. Communities, Alberta Cancer Prevention Legacy Fund-Alberta Heath Services

Angeline Letendre is the first person of Aboriginal descent to graduate from the University of Alberta with a doctoral de-gree in Nursing. Building on more than two decades of front-line nursing experience, the focus of Dr. Letendre’s career has been to contribute to the improved wellnes of First Nations, Inuit and Metis people. This has included work in cultural competency skills development in indigenous nursing, com-munity-based research and partnered activities at local, pro-vincial and national levels, as well as cancer care strategy and program planning. Currently Angeline is a primary co-Lead for two 3-year projects funded through the Canadian Partner-ship Against Cancer in partnership with First Nations, Inuit and Metis peoples of Alberta and Alberta Health Services. Re-cently, Dr. Letendre has joined forces with researchers from Australia, New Zealand and the United States to investigate the cancer research interests for Indigenous peoples from these countries. Outcomes of this work promise to include the de-velopment of international researcher-level partnerships for the exploration, strategy development and recommendations in cancer-related research with Indigenous populations in the associated countries.

PLENARY SPEAKERS


Natan Obed BADirector of Social and Cultural DevelopmentNunavut Tunngavik Incorporated

Natan Obed is a beneficiary of the Labrador Inuit Land Claim Agreement and originally from Nain, Nunatsiavut, but cur-rently lives in Iqaluit, Nunavut with his wife, Letia, and their sons Panigusiq and Jushua.

Natan is the director of social and cultural development for Nunavut Tunngavik Incorporated (NTI), the organization that represents the rights of Nunavut Inuit. NTI advocates on behalf of Inuit in such areas as health, education, language, justice, housing, social and cultural research, and suicide pre-vention.

Natan has a B.A. in both English and American Studies from Tufts University. Natan has worked his entire twelve year pro-fessional career with Inuit representational organizations.

Janet Smylie MD MPHScientist, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s HospitalResearch Scientist, Centre for Research on Inner City Health, St. Michael’s HospitalAssociate Professor, Dalla Lana School of Public Health, University of TorontoStaff Physician, Family and Community Medicine, St. Michael’s HospitalFull Member, School of Graduate Studies, University of TorontoAdjunct Scientist, Institute for Clinical Evaluative Sciences

Dr. Janet Smylie is a Métis family physician and researcher. Through her work with Well Living House, Dr. Smylie’s goal is to ensure that every child born in Canada has the opportu-nity to live a full and healthy life.

Dr. Smylie’s research bridges Indigenous knowledge systems and knowledge translation, public health knowledge, perinatal surveillance and Indigenous health information systems. She has forged and nurtured dozens of research partnerships with Indigenous communities and organizations around the world. Dr. Smylie holds a New Investigator Award from the Cana-dian Institutes of Health Research. In 2012, she was named a recipient of the prestigious National Aboriginal Achievement Award, which recognizes First Nations, Inuit and Métis indi-viduals across the country.

PLENARY SPEAKERS


AccreditationThe College of Family Physicians of Canada

This program meets the accreditation criteria of The College of Family Physicians of Canada and has been accredited by Con-tinuing Professional Development, Faculty of Medicine, Uni-versity of Toronto, for up to 13.5 Mainpro-M1 credits.

Royal College of Physicians and Surgeons of Canada

This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada, approved by Continuing Professional Development, Faculty of Medicine, University of Toronto, up to a maximum of (13.5 hours).

The American Medical Association

Through an agreement between the Royal College of Physi-cians and Surgeons of Canada and the American Medical Asso-ciation, physicians may convert Royal College MOC credits to AMA PRA Category 1 Credits™. Information on the process to convert Royal College MOC credit to AMA credit can be found at www.ama-assn.org/go/internationalcme

European Union for Medical Specialists (EUMS)

Live educational activities, occurring in Canada, recognized by the Royal College of Physicians and Surgeons of Canada as Ac-credited Group Learning Activities (Section 1) are deemed by the European Union of Medical Specialists (UEMS) eligible for ECMEC®.

Letters of accreditation/attendance will be available on-line following the course. Participants will be emailed informa-tion within two weeks specifying how to obtain their letter of accreditation/attendance online.

Faculty DisclosureIt is the policy of University of Toronto, Faculty of Medicine, Continuing Professional Development to ensure balance, inde-pendence, objectivity, and scientific rigor in all its individually accredited or jointly accredited educational programs. Speakers and/or planning committee members, participating in Univer-sity of Toronto accredited programs, are expected to disclose to the program audience any real or apparent conflict(s) of in-terest that may have a direct bearing on the subject matter of the continuing education program. This pertains to relation-ships within the last FIVE (5) years with pharmaceutical com-panies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the presentation topic. The intent of this policy is not to prevent a speaker with a potential conflict of interest from making a presentation. It is merely intended that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of facts. It remains for the audience to determine whether the speaker’s outside interests may reflect a possible bias in either the exposition or the conclusions presented.

Social MediaFollow us on Twitter #indigenousconf


Floor Plan

2nd Floor Plenary Room, Workshop Rooms, Posters, Refreshments, Exhibits

3rd Floor Workshop Rooms, Crafts, Job Fair

COLONY BALLROOMCENTER

COLONY BALLROOMEAST

2ND FLOOR

GIOVANNI ROOM

ELM

SUIT

E

ARMOURYSUITE

CARL

TON

LOM

BARD

SUIT

E

COLONY BALLROOMWEST

STAGE

CATERINGOFFICE

3RD FLOOR

TERRACEEAST

ST.LAWRENCE

ST.ANDREW

ST. GEORGEEAST

ST. GEORGEWEST

ST. DAVIDNORTH

ST. DAVIDSOUTH

ST. PATRICKNORTH

ST. PATRICKSOUTH

TERRACENORTH

TERRACEWEST


Program Agenda Thursday, November 20, 20147:15 Registration and Continental Breakfast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom and Foyer

8:00 Opening Ceremony and Welcome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom

Dr. Anna Banerji, Dr. Darlene Kitty, Terry Audia- President Inuit Tapiriit Kanatami

Chief Phil Fontaine, Assembly of First Nations (TBC), Elder Cat Crigger, University of Toronto

8:30 Justice Murray Sinclair: Truth and Reconciliation Commission. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom

9:30 Dr. Evan Adams: Transforming Systems, Transforming Ourselves – an Update on the First Nations Health Authority in BC . . . . . . .Colony Ballroom

10:15 Refreshment Break with Posters and Exhibits

10:30 Workshop Session #1 Room

Mental Health W01 Honouring our Strengths: A Renewed Framework to Address Substance Use Issues among First Nations People in Canada

Carol Hopkins

National Native Addictions Partnership Foundation, Canadian Centre on Substance Abuse

Lombard

2nd Floor

Mental Health W02 Connecting the Dots: An Innovative Urban Aboriginal Mental Health Project

Jessa Williams, Johanna Denduyf

Canadian Mental Health Association British Columbia Division, British Columbia Association of Aboriginal Friendship Centres

St. David North

3rd Floor

Women’s Health W03 Supporting First Nations, Métis and Inuit Women to Engage in Shared Decision Making: A Skill Building Workshop

Janet Elizabeth Jull, Minwaashin Lodge, Dawn Stacey

University of Ottawa, Institute of Population Health, Minwaashin Lodge - The Aboriginal Women’s Support Centre, University of Ottawa

St. David South

3rd Floor

Traditional W05 Atikowisi miýw-ay¯awin, Ascribed Health and Wellness, to Kaskitamasowin miýw-ay¯awin¯, Achieved Health and Wellness: Shifting the Paradigm

Madeleine Dion Stout, Elder

Elm

2nd Floor

Food security / nutrition

W06 Evaluation of “Community-Led Food Assessment for Inuit Communities” model aimed at assessing and addressing Food Security in Inuit Communities

Kristeen McTavish, Chris Furgal, Shantel Popp, Vinay Rajdev, Kristie Jameson

Trent University, Nasivvik Centre for Inuit Health and Changing Environments, Trent University, Food Security Network of Newfoundland and Labrador

St. Patrick South

3rd Floor

Cultural Safety WO7 “Don’t bother him, he’s probably just drunk”: Advancing Indigenous Cultural Competency training in Ontario

Vanessa Ambtman-Smith, Guy Hagar

Provincial Aboriginal LHIN Network (PALN) South West Local Health Integration Network, Southwest Ontario Aboriginal Health Access Centre (SOAHAC)

Colony Ballroom

2nd Floor



Health Systems W08 There Are Good Things Done Under the Midnight Sun

Julie Lys, NP, Laura Lee Evoy, RN, Bandy Thompson, RN

Fort Smith Health & Social Services Authority / Aboriginal Nurses Association of Canada, Fort Smith Health & Social Services Authority

Armoury

2nd Floor

Nursing W09 Collaborating for Cultural Safety in Nursing Education

Vivian Recollet, Pamela Walker

Native Men’s Residence, Lawrence S. Bloomberg Faculty of Nursing University of Toronto

St. Patrick North

3rd Floor

Respiratory / cardio / chronic disease

W10 Heart and Stroke Foundation’s Indigenous Health Strategy

Lesley James, Ratsamy Norman Pathammavong

Heart and Stroke Foundation

St. George

3rd Floor

11:30 Speaker TBA: National Aboriginal Women’s Association Missing and Murdered Indigenous Women. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom

12:30 Lunch and Posters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom / Documentary Civilized to Death will be shown over lunch in the ballroom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Giovanni Room

* courtesy of Ms. Kimlee Wong, Researcher Writer, APTN

1:30 Oral Presentations Room

Women’s Health (including Reproductive and Violence)

O01 Gettin’ F.O.X.Y.: Exploring the Development of Self-Efficacy among Young Women in the Northwest Territories Using an Arts-based Sexual Health Intervention

Candice Lys

Institute for Circumpolar Health Research

O02 Missing and Murdered Aboriginal Women

Nicole Johnstone

Sherbourne Health Centre

O04 Internal and External “Risk” Constructions as Barriers to Birthing Choices for Indigenous Women: Findings from a Comparative Study in Northwestern Ontario

Pamela Wakewich, Kristin Burnett, Martha Dowsley, Helle Moeller

Departments of Indigenous Learning, Anthropology & Geography, Health Sciences, Sociology, Women’s Studies, and Centre for Rural and Northern Health Research, Lakehead University

Lombard

2nd Floor


Women’s Health (including Reproductive and Violence)

and

Children’s Health

O05 Adapting HOME VISITING PROGRAMS in Aboriginal communities -Lessons learned from implementation

Faisca Richer, Michèle Boileau-Falardeau

Institut national de santé publique du Québec, Agence canadienne de santépublique

O06 Spirit Runner: An activity app for Aboriginal youth

Don Patterson

Every Kid Deserves a Chance Inc.

O07 Bridging the Knowledge Gap: A North-South Collaboration

Marika Bellerose, Vera Nenadovic

Health Canada - First Nations and Inuit Health Branch, Hospital for Sick Children

O08 Healthy Teeth, Healthy Lives: Steps to Improve Inuit Children’s Oral Health

Tanya Nancarrow, Anna-Claire Ryan

Inuit Tapiriit Kanatami

St. Patrick North

3rd Floor

Mental Health (including Substance Abuse)

O09 Methadone overdose death: Case study of a 52 year old Métis woman

Lynn F. Lavallee, Kelly A. Fairney

Ryerson University

O10 ITS TIME: Indigenous Tools and Strategies on Tobacco Interventions

Peter L. Selby, Rosa C. Dragonetti

CAMH, CAMG

O11 Getting something out of (close to) nothing: self-designed Indigenous mental health learning experiences

Alex Drossos

McMaster University, Department of Psychiatry and Behavioural Neurosciences

O12 Building Virtual Communities to End Isolation

Peggy A. Shaugnnessy

Whitepath Consulting

St. David North

3rd Floor

Oral Presentations Room


Infectious Disease

and

Determinants of Health (housing, poverty, etc.)

O14 Root Cause Analysis of Premature Deaths in the Aboriginal Population in Toronto

Chandrakant Shah, Rajbir Klair, Allison Reeves

Anishnawbe Health Toronto, Private Practitioner

O16 Determinants of Sexual Health in a Northern Cree Community

Dionne Gesink, Lana Whiskeyjack, Terri Suntjens, Alanna Mihic, Sherri Chisan

University of Toronto, Dalla Lana School of Public Health, Blue Quills First Nations College

O13 The Outreach Planning & Exchange Network for HIV/STBBI Prevention Programs: An Overview

Rick Harp

National Collaborating Centre for Infectious Diseases (NCCID)

O15 Supporting Aboriginal Health Care Needs Through an Aboriginal Employment Program

Steve Sxwithul’txw, Rod O’Connell

Island Health (Vancouver Island Health Authority)

Colony Ballroom

2nd Floor

Determinants of Health (housing, poverty, etc.)

and

Environmental Health

O19 Exposure to methylmercury by consumption of fish and the risk for neurotoxicity in the developing fetus at Walpole Island First Nation - changes from 1975 to 2014

Judy Peters, Gideon Koren, Michael J. Rieder, Mary Jane Tucker, Rosemary Williams, Dean Jacobs, Phaedra Henley, Katherine Schoeman, Regna Darnell, Christianne V. Stephens, Carol P. Herbert, Chandan Chakraborty, Bradley A. Corbett, Charles G. Trick, John R. Bend

Chatham-Kent Community Health Centre, Walpole Island Office, Walpole Island Health Centre, Walpole Island Heritage Centre, Departments of Medicine, Paediatrics, Pathology, Physiology, Pharmacology, Anthropology, Social Sciences, Pathology, Family Medicine, Biology, and Science, Interfaculty Program in Public Health, Siebens-Drake Medical Research Institute, Schulich Medicine & Dentistry, Western University; Ivey School of Business, Western University; Department of Anthropology, McMaster University

O18 Enhancing Traditional, Healthy Food Skills in an Urban Aboriginal Community

Jaime Cidro, Tabitha Martens

University of Winnipeg, University of Manitoba

O20 Provision of Sleep Apnea Care in Saskatchewan: Policy Complexities Related to Registered Indian Status

Tarun Katapally, Caroline Beck, Gregory P. Marchildon, Jo-Ann Episkenew, Sylvia Abonyi , Punam Pahwa, Mark Fenton, James Dosman

Department of Community Health and Epidemiology, University of Saskatchewan, Johnson-Shoyama Graduate School of Public Policy, University of Regina, Indigenous Peoples’ Health Research Centre, University of Regina, College of Medicine, University of Saskatchewan, Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan

St. David South

3rd Floor



Health Care Systems

and

Cultural Competency and Safety

O21 Reducing the Gap: Robotics technology increases access for patients in Northern Saskatchewan

Ivar Mendez, Veronica McKinney

University of Saskatchewan - also a presenter, University of Saskatchewan

O22 Institutional incompleteness in the urban Aboriginal health service infrastructure

Kian Madjedi, Kevin FitzMaurice

Laurentian University

O26 Wellness in our own words: Understanding the interconnected elements of Indigenous health through partnerships

Kian Madjedi

Laurentian University of Sudbury

O23 Aboriginal Cultural Safety Initiative

Chandrakant Shah, Allison Reeves

Anishnawbe Health Toronto

St. Lawrence

3rd Floor

Cultural Competency and Safety

and

Traditional Ways and Self- determination

O24 Talking About Change: Understanding Colonial Rhetoric

Pamela Walker

Lawrence S Bloomberg Faculty of Nursing, University of Toronto

O25 Enhancing Supportive Decision Making For Aboriginal Patients and Family Members

Jenny Lynn Morgan, Anita Ho, Kim Taylor

University of British Columbia

O27 Cultural continuity is protective against diabetes in Alberta First Nations

Richard Thomas Oster, Angela Grier, Rick Lightning, Mari Mayan, Ellen Toth

University of Alberta, Piikani Blackfoot Nation, Ermineskin Cree Nation

O28 Self-Determination in First Nations Communities

Angela Mashford-Pringle

University of Toronto

St. George

3rd Floor



Traditional Ways and Self- determination

O29 Mino-bimaadiziwin: Re-honoring the relational roots of Indigenous food sovereignty

Michelle Daigle

University of Washington

O30 The Toronto Aboriginal Health Advisory Circle: The Development of An Innovative Model of Self Determination

Ellen M. Blais

Toronto Central Local Health Integration Network , Toronto Central Lhins

O32 Nehiyaw Pimatisiwin: Sharings from Onihcikiskowapowin - Cultural interventions from a community-based research partnership with the University of Toronto

James Makokis, Alsena White

Saddle Lake Health Care Centre, Saddle Lake Cree Nation

O31 wahkomakanak: Relationships and Language as Medicine

Lana Whiskeyjack, Dionne Gesink, Alanna Mihic, Priscilla McGilvery

Saddle Lake Cree Nation, University of Toronto, Blue Quills First Nations College

Armoury

2nd Floor

Indigenous Research and Population Health Data

O34 Community Based Participatory Research as a Path to Build Resilience

Kevin Donald Willison

Lakehead University

O36 Telling Our Stories: Population Health Surveillance in Unama’ki

Elaine Allison, Darlene Anganis, Stacey Lewis, Jennifer MacDonald, Sharon Rudderham, Laurie Touesnard

Wagmatcook Health Centre, Membertou Wellness Home, Tui’kn Partnership, Waycobah Health Centre, Eskasoni Health Centre, Potlotek Health Centre

O35 Letting the Body Tell Its Story: Using Body Mapping and Hazard Mapping as Visual Representations of Community Well-Being in Indigenous Health Research

Christianne V. Stephens, Linda Lou Classens

York University, Walpole Island First Nation

Elm

2nd Floor

2:30 Break

2:45 Dr. Janet Smylie Resisting Exclusion – Understanding and Supporting Métis Growth and Empowerment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom





Mental Health W12 Homeless and Hopeless: An examination of Toronto’s Health and Addiction Services for Indigenous homeless peoples and what can be done to improve them

Suzanne Lea Stewart, Nicole Estella Elliott

Ontario Institute for Studies in Education/ University of Toronto

St. David North

3rd Floor

Determinants of Health

W13 The Work of Frontiers Foundation of Toronto

Jim Bacque, Lawrence Gladue, Marco Guzmana, Don Irving

Frontiers Foundation of Toronto

Elm

2nd Floor

Traditional W14 Wii Kwan De Taa (Bringing People Together for a Sacred Purpose

Lori Flinders

Fort Frances Tribal Area Health Services

St. David South

3rd Floor

Inuit W15 More than medicine: on being an ally and a physician advocate in Nunavut

Madeleine Cole

Qikiqtani General Hospital

St. Patrick North

3rd Floor

Respiratory/ cardio/ chronic disease

W17 A History of Dying at Home From Pre-European Times to the Present Palliative and End of Life Care Era

Dean Walters

Central East Community Care Access Centre

St. George

3rd Floor

Equity W18 Jurisdiction as a Determinant of First Nations Health Care

Stephanie Ann Sinclair, Amanda Meawasige

Assembly of Manitoba Chiefs

Lombard

2rd Floor

Education W19 I honestly don’t think I learned anything about Indigenous peoples: Understanding medical school preceptors’ and students’ current knowledge and attitudes towards Indigenous peoples and Indigenous health

Heather Castleden, Debbie Martin, Jeff Denis, Paul Sylvestre

Queen’s University, Dalhousie University, McMaster University

St. Patrick South

3rd Floor

Research W20 Respondent driven sampling (RDS) as a tool for urban Aboriginal health assessment and community engagement in Ontario, Canada

Michelle Firestone, Janet Smylie, Sara Wolfe, Constance McKnight

Well Living House, Centre for Research on Inner City Health, St. Michael’s Hospital, Seventh Genera-tion Midwives Toronto , De dwa da dehs nye>s Aboriginal Health Centre

Armoury

2nd Floor

Children’s Health W60 The Atii! Health living intervention improves knowledge, builds cultural skills and strengthens intergenerational bonds among Inuit children, youth and families in the Nunavut

Gwen Healey, Shirley Tagalik, Tracey Galloway

Qaujigiartlit Health Research Centre (AHRNNU), Arviat Health committee, University of Manitoba

Lawrence

3rd Floor


4:30 Break . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Health Systems W21 Community health worker models: International best practices and their application to remote First Nations communities

Ben Chan, Janet Gordon, Sumeet Sodhi

University of Toronto, Sioux Lookout First Nations Health Authority, Dignitas International

Elm

2nd Floor

Mental Health W22 An Indigenous Model of Effective Community Mental Health Services

Germaine Frances Elliott, John Rice

Enaahtig Healing Lodge, Simcoe County Canadian Mental Health Association

Lombard

2nd Floor

Children’s Health W23 Lower Respiratory Tract Infections in Inuit Children

Dr. Anna Banerji

Department of Paediatrics and Dalla Lana School of Public Health, University of Toronto

St. Patrick North

3rd Floor

Traditional W24 Understanding Tobacco Use Amongst Youth in Four First Nations

Sheila Cote-Meek, Sonia Isaac-Mann

Laurentian University, Assembly of First Nations

Armoury

2nd Floor

Inuit W25 Social Determinants of Inuit Health

Anna Fowler

Inuit Tapiriit Kanatami (ITK)

St. David North

3rd Floor

Cancer W26 Reducing inequalities in cancer for Ontario First Nations: From surveillance to action

Loraine Marrett, Diane Nishri, Amanda Sheppard, Anna Chiarelli, Alethea Kewayosh

Cancer Care Ontario, Hospital for Sick Children

St. Lawrence

3rd Floor

Cultural Safety W27 Is cultural safety enough? Confronting racism to address inequities in Indigenous health

Barry Lavallee, Linda Diffey, Thomas Dignan, Paul Tomascik

University of Manitoba, First Nations and Inuit Health Branch, Health Canada, Royal College of Physi-cians and Surgeons of Canada

St. George

3rd Floor

Equity W28 Manitoba First Nations Indicators of Wellbeing

Leona Star, Kathi Avery Kinew


St. Patrick South

3rd Floor

Education W29 Come walk in our mocassins: Strategies in Recruitment, Admissions and Curriculum at the Aboriginal Program at the University of Ottawa

Darlene Janet Kitty

Aboriginal Program, Faculty of Medicine, University of Ottawa

St. David South

3rd Floor


Workshop Session #3 Room

Research W30 Creating a First Nations health data repository in Ontario by linking the Indian Register to ICES health administrative data: a collaborative governance process that protects the interests of First Nations

David Henry, Tracy Antone, Carmen Jones, Saba Khan

Institute for Clinical Evaluative Sciences, Chiefs of Ontario

Carlton

2nd Floor

5:30 Reception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom

7:00 Adjourn


Program Agenda Friday, November 21, 2014

8:00 Communities to Researchers Advocacy Breakfast Discussion Chaired by Vanessa Ambtman-Smith and Dr. Lisa Richardson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom

9:00 Natan Obed: Improving Inuit Nunangat health outcomes - A call to action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom

9:45 Dr. Angeline Letendre: Indigenous Nursing and Nursing Knowledge as Practice toward Improved Health and Wellness in First Nation, Inuit and Metis Communities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom



Children’s Health W31 The Status of Oral Health among Canada’s First Nations Peoples and Inuit

Amir Azarpazhooh, Dick Ito, Martin Chartier, Tracey Guitard, Hannah Tait Neufeld

Faculty of Dentistry-University of Toronto, Faculty of Medicine-University of Toronto, Mount Sinai Hospital, Public Health Agency of Canada, Thunder Bay District Health Unit and Simcoe Muskoka District Health Unit

Colony Ballroom

2nd Floor

Women’s Health W32 Trafficked: Why are Aboriginal Women at Increased Risk?

Eileen McMahon

Mount Sinai Hospital

St. David North

3rd Floor

Children’s Health W33 No Jordan’s Principle Cases in Canada? The Truth and Politics of Disparities in Access to Health and Social Services for First Nations Children Living On-Reserve

Vandna Sinha, Anne Blumenthal, Molly Churchill, Lucyna Lach, Nico Trocme

McGill University, University of Michigan

Armoury

2nd Floor

Traditional W34 An Investigation into some Contemporary Self-Regulatory Dynamics that Operate in and around First Nations Traditional Healing Systems

Julian Robbins

Independent Community Based Researcher

St. Patrick South

3rd Floor

Environmental W35 The potential contribution of exposure to persistent organic pollutants (POPs) and of psychosocial stress to enhanced risk for Type 2 diabetes (T2D) at Walpole Island First Nation (WIFN)

John R. Bend, Rosemary Williams, Gideon Koren, Michael J Rieder, Mary Jane Tucker, Naomi Williams, Phaedra Henley, Julie Hill, Zahra Jahedmotlagh, Regna Darnell, Christianne V. Stephens, Stan Van Uum, Carol P Herbert, Chandan Chakraborty, Dean Jacobs, Judy Peters, Charles G Trick

Walpole Island Health Centre, Departments of Medicine and Paediatrics, Schulich Medicine & Den-tistry, Western University, Walpole Island Heritage Centre, Department of Pathology, Department of Physiology & Pharmacology, Departments of Anthropology, Social Sciences and Pathology, McMaster University, Departments of Family Medicine and Pathology, Chatham-Kent Community Health Centre, Walpole Island Office, Department of Biology, Science and Interfaculty Program in Public Health, Siebens-Drake Medical Research Institute

Lombard

2nd Floor



Cancer W36 Addressing gaps in the continuity of cancer care with and for First Nations, Inuit and Métis living in rural and remote communities in Canada.

Colleen Patterson, Pam Tobin

Canadian Partnership Against Cancer

St. Patrick North

3rd Floor

Cultural Safety W37 Clinical tips for culturally-safe care: A new Consensus Guide for Health Professionals working with First Nations, Inuit and Métis

Alisha Nicole Apale

SOGC

St. George

3rd Floor

Social work W39 Rahskwahseron:nis – Building bridges with Indigenous communities through decolonizing social work education

Michael Loft, Nicole Ives, Courtney Montour

McGill University, School of Social Work

Elm

2nd Floor

Research W40 Storytellers as Public Health Facilitators

Joahnna Kathleen Berti, Jeanette Levall, David Osawabine

Debajehmujig Storytellers

St. Patrick South

3rd Floor

11:45 Lunch and Posters Documentary Rivers of Hope: “Bringing health to indigenous communities in the Orinoco and the Amazon in Colombia” will be shown over lunch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Colony Ballroom / Giovanni Room

*courtesy of Pan American Health Organization (PAHO/WHO), funded by the Canada- Foreign Affairs, Trade and Development Department.

1:00 Genocide: The Canadian Perspective Panel Dr. Michael Dan, Chief Phil Fontaine, Mr. Bernie M. Farber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom


Substance Abuse W41 Prescription Drug Misuse - Looking at Prevention in Indigenous Communities through a Population Health Lens

Cheryl Currie

University of Lethbridge

Armoury

2nd Floor

Women’s Health W42 Beyond The Womb: Encouraging healthy pregnancies through cultural reconnection

Ashley Lamothe, Roslynn Baird

Southern Ontario Aboriginal Diabetes Initiative

St. Lawrence

3rd Floor


Workshop Session #5 Room

Children’s Health W43 Issues in service delivery to Canadian First Nations, Métis, and Inuit children with speech and language difficulties

Alice A. Eriks-Brophy, Francis Lori-Anne Davis-Hill, Jacqueline Dawn Smith, Laura Todd Hunter Leah Rae Radziwon

University of Toronto, Six Nations Health Services

St. George

3rd Floor

Traditional W44 Teaching cultural competence in the federal government - the Indigenous Community Development course

Rose LeMay

First Nations and Inuit Health Branch, Health Canada, FNIHB or Aboriginal Affairs and Northern Development Canada

St. David North

3rd Floor

Environmental W45 Uranium Mining and Health: Facts, Figures and Questions

Dale M. Dewar

Society of Rural Physicians of Canada

St. Lawrence

3rd Floor


W46 Respiratory health in First Nations, Inuit and Métis communities: Raising awareness through community outreach and engagement

Jennifer Dawn Walker, Oxana Latycheva, Wayne Warry

Nipissing University, Ontario Lung Association, Centre for Rural and Northern Health Research

Colony Ballroom

2nd Floor

Cultural Safety W47 A new way of looking at good practices in Aboriginal communities: The Canadian Best Practice Initiative’s Aboriginal Ways Tried and True Methodological Framework

Nina Jetha, Lori Meckelborg, Andrea L.K. Johnston, Steve Jreige

Public Health Agency of Canada, Johnston Research Inc.

St. David South

3rd Floor

Health Systems W48 Back to Moss: Developing and Integrating Public Health Services for Northern Ontario First Nations Communities

Janet Gordon, Emily Paterson

Sioux Lookout First Nations Health Authority

St. Patrick North

3rd Floor

Midwifery W49 Aboriginal Midwifery: Aboriginal Midwives working in Every Aboriginal Community

Ellen M. Blais

Association of Ontario Midwives

St. Patrick South

3rd Floor

Research W50 Addressing health inequalities by Indigenizing health services and research

Julie Bull

University of New Brunswick

Lombard

3rd Floor





W51 Embedding First Nations approaches into the prevention and management of chronic disease

Shannon Tania Waters

First Nations Health Authority

Armoury

2nd Floor

Substance Abuse W52 Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment

Colleen Dell, Carol Hopkins, Peter Menzies

University of Saskatchewan, National Native Addictions Partnership Foundation (NNAPF), CAMH

Colony Ballroom

2nd Floor

Women’s Health Shared Workshop

W53 The Aboriginal Women’s Health Intervention: What is the potential for contributing to social change?

Colleen Varcoe, Jane Inyallie, Linda Day, Madeleine Dion Stout, Holly MacKenzie, Annette Browne, Marilyn Ford-Gilboe

University of British Columbia, Central Interior Native Health, Vancouver Native Health Society, University of Western Ontario

W59 Solidarity not appropriation: How non-Indigenous healthcare providers and organizations can support Indigenous women’s reproductive justice and sovereignty

Holly A. McKenzie


Lombard

2nd Floor

Food security / nutrition

W54 Use-and-Occupancy Mapping: A tool to support food security in aboriginal communities

Daniel Tobias

D. Tobias Consulting Inc.

St. Lawrence

3rd Floor

Cultural Safety W55 A Journey to Cultural Competency and Safety: Highlights of IPAC-AFMC Collaborative Activities

Darlene Janet Kitty

Indigenous Physicians Association of Canada

St. David North

3rd Floor

Midwifery W56 Revolutionary Care: Indigenous Midwifery

Cheryllee Bourgeois, Billie Allan

Seventh Generation Midwives Toronto, Well Living House

St. Patrick North

3rd Floor

Research W57 Using record linkage to study chronic diseases in the Métis population in Ontario

David Henry, Storm J Russell, Wenda Watteyne, Saba Khan

Institute for Clinical Evaluative Sciences and University of Toronto, Métis Nation of Ontario , Institute for Clinical Evaluative Sciences

St. Patrick South

3rd Floor


Social work W58 One Canoe, One Oar: Navigating mental health with our Indigenous youth, a wholistic approach.

Ela Smith

Wholistic Child and Youth

Elm

2nd Floor

4:00 Break

4:15 Conclusion and Next Steps Dr. Anna Banerji . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Colony Ballroom

4:30 Adjourn


Oral AbstractsO01(Abstract ID: 25)

THURS. NOV. 20 - 1:30PM-1:45PM

Gettin’ F.O.X.Y.: Exploring the Development of Self-Efficacy among Young Women in the Northwest Territories Using an Arts-based Sexual Health Intervention

Candice Lys


The sexual health of Northwest Territories (NWT) youth is a serious public health concern; thus, a social arts-based inter-vention that uses body mapping and drama techniques, named FOXY (Fostering Open eXpression among Youth) was devel-oped to address the sexual health needs of young NWT women. This doctoral research is grounded in social cognitive theory and social ecological theory and uses a community-based research approach, developmental evaluation methodology, and the grounded theory method to develop a theory of how FOXY influences sexual behavior expectations among young women in the NWT, considering determinants that contextu-alize sexual health outcomes. The first aim explores the intra-personal and interpersonal contexts that influence the efficacy and outcome expectations of female youth in the NWT. The second aim determines if and how a social arts-based interven-tion influences individual efficacy expectations regarding sex-ual behaviors among female youth in the NWT. The third aim determines if and how a social arts-based intervention influ-ences individual outcome expectations regarding sexual behav-iors among female youth in the NWT. In Phase I, pilot test-ing occurred with 6 female youth to improve interview guide design. Phase II entailed semi-structured interviews with 41 female youth aged 13-18 years selected via purposive sampling 3 days post-workshop. Data collection occurred until saturation of new themes was reached at 6 study locations. A multi-stage thematic analysis is in progress using memoing and coding via the grounded theory method. Front-line workers and research-ers can use the results to inform arts-based intervention pro-grams and research among other rural Arctic populations.

O02(Abstract ID: 188)

THURS. NOV. 20 - 1:45PM-2:00PM

Missing and Murdered Aboriginal Women

Nicole Johnstone


In 2001, Canada was named the best country to live in based on health, education, life expectancy, and standard of living.

Although many of Canada’s citizens rank high in these mea-sures, the aboriginal population does not; they continue to fare poorly in indicators of health, education, and income. Aborigi-nal women deal with this harsh reality on a daily basis, in addi-tion to higher rates of violence victimization than aboriginal males and non-aboriginal women. Historically, most of the research focused on domestic violence for aboriginal women; however in 2013, a different situation came to light and the RCMP totalled 1,181 missing and murdered aboriginal women in the past thirty years. Aboriginal female homicides were almost seven times higher than non-aboriginal females from 1997 to 2000.Inquests into the missing and murdered aboriginal women have been demanded by aboriginal leaders, families of the missing and murdered women, Amnesty International, and as a recommendation of the United Nations. Aboriginal women remain at high risk of violence as a result of colonization, resi-dential schools, systemic racism, and past and present issues with the justice system and police; yet the government maintains that they are proud of their human rights record. There is hope; the RCMP have made changes to policies and are focusing on programs for at risk communities. Knowledge is power; as indi-viduals we can educate our young aboriginal men and women until further action is taken by the government to ensure the safety of aboriginal women.

O03WITHDRAWN


THURS. NOV. 20 – 2:15PM-2:30PM

Internal and External “Risk” Constructions as Barriers to Birthing Choices for Indigenous Women: Findings from a Comparative Study in Northwestern Ontario

Pamela Wakewich, Kristin Burnett, Martha Dowsley, Helle Moeller

Lakehead University, Dept. of Indigenous Learning, Lakehead University, Depts. of Anthropology & Geography, Lakehead University, Dept. of Health Sciences, Lakehead University, Depts. of Sociology & Women’s Studies; and Centre for Rural and Northern Health Research

In recent years there has been a growing recognition of the importance of repatriating birth to rural and northern Indige-nous communities (Couchie and Sanderson 2007) and increas-ing childbirth choices for both urban and rural Indigenous women (NAHO 2004). An ongoing challenge for Indigenous women regarding care options and birth locations has been what Kornelsen and Mackie (2013, p.1) have described as “the clash of clinical and social risk [constructions]” in the determination of safety in pregnancy and childbirth. Racism and colonialism in Canada have produced a picture of Indigenous women that


typically constructs them as high risk as a function of racial and ethnic identity rather than the social, economic, political, and historical factors that shape their lives. This construction has been internalized by many women and begun to inform their personal choices and self-identification about risk. The moral risk of being labelled an “irresponsible” mother impacts the ability of many women to resist “authoritative’ biomedical knowledge (Hall et al. 2012) even when it may compromise their sense of integrity and cultural values.

Here we report on a comparative qualitative study exploring birthing choices and experiences of Indigenous,migrant and Euro-Canadian women in Northwestern Ontario. We discuss the ways in which both clinical and social constructions of “risk” positioned many of our Indigenous participants as high risk limiting their perceived and actual choices of caregiver. Negotiating a low risk status and a wider range of childbirth choices was enhanced by peer and family supports and support-ive care providers.



Adapting HOME VISITING PROGRAMS in Aboriginal communities -Lessons learned from implementation

Faisca Richer, Michèle Boileau-Falardeau

Institut national de santé publique du Québec, Agence canadienne de santépublique

Awash (AMA) is a home visiting program aimed at pro-moting early childhood development, implemented by the Cree Health Board (CHB) in three pilot communities. It includes local paraprofessionals as home visitors, as this has been shown to be key to ensuring the continuity and cul-tural safety of family support services. A process evaluation was conducted to understand the successes and challenges faced by the paraprofessionals in implementing home visits in this context.

Methods: We used a multiple case study design with qual-itative analysis of staff interviews in all pilot communities. Individual in-depth interviews were conducted in English, French or Cree with a total of 44 staff members. Data was analyzed through thematic analysis with NVivo10 soft-ware. A participatory approach was used for data collec-tion and analysis.

Results: Paraprofessional workers face challenges when implementing home visiting programs at the personal and organizational levels (see figures 1 and 2)

Discussion and implications for practice: Employing local Indigenous staff in an early childhood development pro-gram can have a positive impact on the cultural safety of

services provided, but it can come with challenges. Pro-viding flexible work patterns, ongoing training / mento-ring as well as psychological support may help to improve staff retention and prevent compassion fatigue. The sup-port provided should respect Aboriginal learning styles, as well as provide local workers with opportunities to thrive within the organization.



Spirit Runner: An activity app for Aboriginal youth

Don Patterson

Every Kid Deserves a Chance Inc.

Spirit Runner was designed to encourage physical activity amongst Aboriginal youth, to help them maintain a healthy lifestyle and to honour Aboriginal culture. The app is FREE to download on iTunes, FREE of advertisements and there is no collection of data.

The creation of Spirit Runner was based on extensive feed-back from Aboriginal youth and leaders. The youth also shared the importance of developing an app to reflect their culture. In essence, they wanted the app to feel like it “belonged” to them. The stunning artwork was created by Aboriginal artist, Jessica Desmoulin.

Four user-friendly components

Activity log: Records the activity with 32 to choose from. Can also be tracked with GPS, Step Counter and Timer. Email/text/tweet completed activities. A great tool for remote coaching.

Reminders: Set daily, weekly reminders. Pop-up box tells the user it’s time to get active!

Motivations: Hundreds of inspirational quotes by athletes and world leaders including many Aboriginal spokespeople (e.g. Chief Dan George, Billy Mills, Sun Bear). Favorites can be starred and emailed/texted/tweeted.

Achievements: As more activities are completed, achievements pop up to reward the user.

Engaging youth through technology: The Spirit Runner app is accessible, useful and fun to use. Youth today are bombarded with distractions that are increasingly non-active. Spirit Run-ner’s technology engages young minds and encourages them to continue an active lifestyle.

Website: www.spiritrunnerapp.com

Twitter: @spiritrunnerapp




Bridging the Knowledge Gap: A North-South Collaboration

Marika Bellerose, Vera Nenadovic

Health Canada - First Nations and Inuit Health Branch, The Hospital for Sick Children

Changes in treatment in subspecialties such as Paediatric Neu-rology are not quickly disseminated to community-based health care providers creating a disparity between children with easy access to quaternary care teaching hospitals and those without. In remote parts of Northwestern Ontario, health care profes-sionals working in isolated First Nations communities are gen-eralists by necessity. Maintaining currency of the generalist’s broad based knowledge in such settings is burdensome. In 2013, the Sioux Lookout First Nations Health Authority and nurses from Health Canada, First Nations and Inuit Health Branch in the Sioux Lookout Zone partnered with the Division of Neurology at Sick Kids to create a pilot series of lectures based on learning needs. Education delivery by powerpoint, fax and teleconference was tailored for wide community access. Edu-cational content was tailored in context of availability of diag-nostic resources. An iterative process of education delivery, feedback and revision of content is envisioned to make a sus-tainable outreach education program. This workshop presents the experience of this partnership with paediatric neurology as a template model of outreach education for subspecialty services.



Healthy Teeth, Healthy Lives: Steps to Improve Inuit Children’s Oral Health

Tanya Nancarrow, Anna-Claire Ryan


For Inuit children in Canada, access to regular dental care is inconsistent, including for both treatment and prevention. Inadequate funding arrangements, jurisdictional issues, poor nutrition, and difficulty in recruiting and retaining oral health service providers mean ongoing challenges in achieving an acceptable oral health standard. The 2008-2009 Inuit Oral Health Survey highlighted the need for urgent and compre-hensive measures to overcome the unacceptably high rate of oral disease among Inuit. In response, Inuit Tapiriit Kanatami (ITK) and the Inuit Land Claim Organizations created Healthy Teeth, Healthy Lives: Inuit Oral Health Action Plan to share with the Canadian oral health community, including all lev-els of government, the Inuit perspective on what is needed to

improve oral health among Inuit. This presentation will out-line child-focused solutions to improve oral health and will aim to promote understanding around the scope of the oral health issue for Inuit children in Canada; the key factors impacting the issue; and the current and potential models of collaboration among key stakeholders and the collective actions that aim to address the issues, including Inuit-specific oral health promo-tional materials and initiatives from Inuit regions.



Methadone overdose death: Case study of a 52 year old Métis woman

Lynn F. Lavallee, Kelly A. Fairney

Ryerson University

Methadone maintenance treatment programs (MMT) were designed as a harm reduction strategy to address the harms of heroin injection. Currently, many people on MMT are not injecting street level heroin. Rather, many have found them-selves addicted to opioids after prescription use of narcotics. Although there are federal and provincial regulations about MMT, there are still instances of methadone overdose and death. Unfortunately, these overdoes and deaths are occurring in Aboriginal communities at an alarming rate. Some of these overdoses and deaths have been the result of individuals taking someone else’s methadone (carry) but others occur during the first two weeks of attending a methadone clinic. This presen-tation will explore the case of a 52 year old Mètis woman who passed on to the spirit world after attending a methadone clinic for 10 days and receiving a lethal dose of methadone. The pre-sentation will highlight the statistics related opioid addiction and methadone overdose within Mètis, Inuit and First Nations communities and provide an overview of the Health Canada- Best Practices for MMT and the Ontario Standards and Clin-ical Guidelines. The unfortunate circumstances of this Mètis woman’s life will inform how further measures can be put in place to ensure harm reduction strategies are actually reducing harm versus causing death. The presentation will be of interest to a wide range of practitioners and advocates working with the Aboriginal community.



ITS TIME: Indigenous Tools and Strategies on Tobacco Interventions

Peter L. Selby, Rosa C. Dragonetti

CAMH, CAMG


There is a growing recognition of the need for culturally com-petent health services, including smoking cessation treatment. Frontline workers are concerned about high smoking rates in their communities and requested more culturally safe materials that would resonate with Aboriginal colleagues and clients. A network of Aboriginal frontline workers, health care profes-sionals, educators and Elders formed an Engagement Circle to create content that is owned, controlled, and fully possessed and accessible by Aboriginal peoples. ITS TIME has retooled evi-dence-based approaches to reflect Aboriginal ways of learning, knowing, healing and recovery.

ITS TIME TOOLKIT is a resource that can be used by health care professionals and frontline workers to help their clients address their commercial tobacco use. Some of the components and strategies included in the toolkit include:

Making tobacco ties and other craft-making activities. Tradi-tional tobacco teachings from an Elder and fact sheet. Narra-tive healing through sharing and quit journey stories (testimo-nial recordings from community members and Elders). Group activities, trivia cards and facilitation summary sheets. This workshop will engage participants by practicing various com-ponents of the toolkit. We will demonstrate how the toolkit can be used in both group and individual settings. Participants will be able to: (1) Discuss the various strategies for smoking cessa-tion (2) Use the toolkit to deliver smoking cessation to their clients.



Getting something out of (close to) nothing: self-de-signed Indigenous mental health learning experiences

Alex Drossos

McMaster University, Department of Psychiatry and Behavioural Neurosciences

Even in a large University Psychiatry program in southwestern Ontario there are few formal opportunities for clinical rotations in Indigenous Mental Health. However, when one is resource-ful and motivated, there are many ways to create a variety of learning experiences. For me personally, these began as a clini-cal clerk when I completed Family Medicine electives in Iqaluit, Nunavut and Churchill, Manitoba and in Suicide Prevention in Ottawa, which included policy and prevention work through the National Aboriginal Health Organization and Inuit Tapi-riit Kanatami. Once in residency, I began to seek out further opportunities within psychiatry. These have included spend-ing time at an urban Aboriginal health centre with psychiatry staff and traditional healers; working in the Aboriginal services program at a tertiary care psychiatric facility; longitudinally spending 1-2 days per week at an outpatient mental health clinic in a large reserve; conducting telepsychiatry assessments

to northern Ontario remote First Nations; and another rota-tion in Iqaluit this time specifically in psychiatry. In addition, I have also included policy and research activities related to Indigenous mental health whenever possible, which have been numerous and have expanded my learning beyond the role of Medical Expert, to include Advocate, Collaborator, Manager and Scholar. Finally, ongoing reading of published journal arti-cles, clinical books, ethnocultural books and literature (includ-ing film) have been an important part of my education. Though my experiences have focused on mental health, these kinds of opportunities could be easily applied to any other area of medi-cine or the health sciences.



Building Virtual Communities to End Isolation

Peggy A. Shaugnnessy

Whitepath Consulting

The Aboriginal population is the youngest and fastest growing segment of Canada’s population, yet the children are among the most disadvantaged of all children in the country and struggle for rights that come more easily to non-Aboriginal children. Almost all of the “air access” only First Nation communities in Ontario are located in the north. Isolation is a challenge for remote communities, as is access to quality health care

National rates of suicide among Aboriginal youth are estimated to be five to seven times higher than among non-aboriginal youth. There is a lack of consistent mental health services for those living in remote communities. Where drug and alcohol dependencies continue to be problematic.

Redpath is launching the first social network for those strug-gling with mental illness and addiction. Building on our highly successful offline model, the online social platform delivers real-time access to those in need. Redpath enables participants to develop the skills they need to face their own daily challenges via a series of assignments and interactions with other online participants. The network is designed to be a flexible option for anyone who is struggling in their life, and is entirely anon-ymous, ensuring that users feel safe enough to remove their masks and approach the process truthfully. Redpath is a vir-tual community that aims to end isolation. The program allows people in similar situations to share their experiences and build awareness that others are working through the same issues.




The Outreach Planning &Exchange Network for HIV/STBBI Prevention Programs: An Overview

Rick Harp

National Collaborating Centre for Infectious Diseases (NCCID)

A project of the National Collaborating Centre for Infectious Diseases (NCCID), the Outreach Planning & Exchange Network (OPEN) is a set of free on-line tools primarily aimed at frontline HIV/STBBIoutreach programmers.

These tools include i)a public database of outreach programs, ii) a public database of program evaluation indicators, plus iii)a confidential knowledge exchange forum for programmers interested in further communication/collaboration.

This workshop will offer a basic overview of OPEN, including how to use the Network to locate other outreach programs and their indicators, plus sign up and post a program profile of your own.



Root Cause Analysis of Premature Deaths in the Aboriginal Population in Toronto

Chandrakant Shah, Rajbir Klair, Allison Reeves

Anishnawbe Health Toronto, Private Practitioner

This study on premature deaths in the Aboriginal community combines a quantitative chart review, and qualitative narrative analysis conducted at Anishnawbe Health Toronto (AHT). By providing insight in to the social issues among the urban Aboriginal community from a personal, interview-based per-spective, the study aims to identify the root causes of the com-munity’s premature death rates.

Data collection occurred between 2008-2011 by review of medical charts of the deceased at AHT along with data provided by three other social services. Interviews with those familiar with the deceased were conducted. The numbers of deceased totaled 109 and twenty interviews were conducted. Interview-ees contributed details into the personal and social tragedies indicated by the data.

The results of our data show the average age at time of death to be 38 years of age among this group of Aboriginals. The interviews conducted demonstrate the inequality in many social determinants of health such as poverty, unemployment, discrimination, lack of access to adequate resources and hous-ing. The qualitative research shows us that Aboriginal people moving to cities face many challenges - challenges of social and

economic integration, as well as securing access to public ser-vices. The data review over this period corroborates this analy-sis and demonstrates its fatal consequence: a significantly lower life expectancy for Aboriginal Canadians. The root causes of which can be traced back to the forced assimilation of Aborigi-nal peoples through the residential school system. The intergen-erational health impact of Canada’s colonial legacy perpetuates conditions impacting the health of Aboriginal Canadians.



Supporting Aboriginal Health Care Needs Through an Aboriginal Employment Program

Steve Sxwithul’txw, Rod O’Connell

Island Health (Vancouver Island Health Authority)

Employment has long been known to be a social determinant of health. Island Health (Vancouver Island Health Authority)has embarked on a long term Aboriginal employment strategy with a view to achieving a representative workforce by the year 2020.Island Health sees the current and future Aboriginal workforce as an untapped resource that will help meet our workforce needs as well as assist in providing quality, culturally appropriate care to our Aboriginal clients. Through our 4 person Aboriginal employment team Island Health is building relationships of trust with Aboriginal communities, attracting Aboriginal youth to the full spectrum of health care careers, enhancing job seeker skills and increasing Aboriginal organizational awareness, as we move towards our representative workforce goal.

In this session participants will learn about Island Health’s award winning (Canada’s Best Diversity Employers award - 2013, 2014 and Simon Fraser University Exemplary Initiative Diversity Award - 2013) Aboriginal Employment Program and the”5 Pillars” that guide the organization’s journey to becom-ing an Aboriginal employer of choice on Vancouver Island and in the healthcare labor sector.

Since June 2011 Island Health has hired approximately 260 new Aboriginal employees and currently has nearly 500 employees who have self identified as being of Aboriginal descent. For the last 2 year our Aboriginal employee turnover rate is lower than the organizational turnover rate.

Island Health is the 4th largest health care employer in B.C. and the largest employer on Vancouver Island with ~19,000 staff.”




Determinants of Sexual Health in a Northern Cree Community

Dionne Gesink, Lana Whiskeyjack, Terri Suntjens, Alanna Mihic, Sherri Chisan

University of Toronto, Dalla Lana School of Public Health, Blue Quills First Nations College

The Saddle Lake Cree community is a large First Nations community in northern Alberta reporting sexually transmit-ted infection (STI) rates three to six times higher than neigh-bouring Aspen regional health authority (non-First Nations) in 2009. Our intention was to learn about sexual health at the community level to inform restoration activities at the individ-ual and community levels.

We used the Whiskeyjack method of interviewing, an indig-enous relational research method. Participants were identified and recruited through a network of relationships. Consenting participants were invited to participate in an activity (e.g. cook-ing together) while being interviewed using an unstructured, visiting interview style. STI data was shared with participants and they were then asked why they thought STI rates were high in the community. Interviews were recorded and transcripts analyzed for core and related concepts.

We interviewed 25 community members in the fall of 2010. The core concept identified is that HIV and other STIs are a physical manifestation of widespread mental, emotional, and spiritual trauma experienced through misuse and abuse of power in relationships. Related concepts included that the med-icine wheel is out of order because historic trauma resulting in loss of knowledge, practice, roles, responsibilities and mentor-ing; disconnect and detachment, whether externally or inter-nally imposed, leads to relationship, blame, responsibility and addiction shifting; an environment of fear, abandonment and isolation has led to inadequate support for change; drugs, alco-hol and sex co-occur but are not necessarily causally associated - rather being symptoms of poverty and trauma and perceived as medicine.



Addressing the “need’ for sustainable food security initiatives: Evaluating the role of a community freezer in Hopedale, Nunatsiavut in supporting Inuit food security

Emily Willson, Chris Furgal

Trent University

Rooted in Inuit culture are preferences for wild foods that come from their local environments. These food preferences are criti-cal for providing Inuit with nutritious food, and for connecting Inuit to their environment, which supports their cultural iden-tity, and health. However, changes in their social and physical environments are challenging the use and availability of these foods, and in part, accounting for the higher rates of food inse-curity Northern populations, such as those in the region of Nun-atsiavut (Labrador) are experiencing. To address food insecurity, food support initiatives need to address individual requirements for food while supporting a sustainable and culturally preferred food system. This requires developing an understanding of both the food security needs within a community, and the ability of services and environment to support them. Objective measures of the physiological needs (nutrient and caloric intakes) for food are commonly understood, but there is limited information regarding the preferred social and cultural requirements that are also key components of food security status, as recognized needs surrounding rights to food in many conceptualizations of food security, and also as elements recognized in Land Claims agree-ments, such as Nunasiavuts’. Using mixed-methods of one-on-one interviews, and a community-wide survey, data on the nature and diversity of food “needs” and the use of food support programs within Hopedale will be collected. By adding to our understanding of the different needs for food, results from this study will help inform the process of developing or improving community level solutions to food security issues.



Enhancing Traditional, Healthy Food Skills in an Urban Aboriginal Community

Jaime Cidro, Tabitha Martens

University of Winnipeg, University of Manitoba

Purpose: Urban Indigenous people face food insecurity from limited quantities of healthy and affordable food, to limited access to traditional food. Food security, while a separate con-cept from food sovereignty, is certainly aligned. Within an Indigenous context, IFS is contextualized in remote, rural communities. Food insecurity also exists for urban Indigenous


communities. This research explores how to operationalize IFS principles and practice with urban Indigenous people in Winni-peg through traditional, healthy food skill building.

Methods: An initial series of focus groups and interviews were held identifying how urban Indigenous people worked towards IFS. From this, a series of workshops were held in partnership with an inner city organization to build skills and awareness around traditional foods. Focus groups were throughout the workshop series to identify consciousness shifts around grow-ing, consuming and eating traditional, healthy food and the lived experience of IFS.

Results: Urban Indigenous people experienced food insecurity, but also were working towards larger goals of IFS with regards to cultural food specifically. Urban Aboriginal people can indeed participate in growing, harvesting and eating healthy, nutritious traditional Aboriginal food in the city. When Indig-enous people have the skills to practice IFS then a whole range of positive benefits to their health and wellbeing will unfold.

Conclusion: Organizations and public health providers in the city that serve Indigenous communities have an important role to play in supporting Indigenous communities as they work towards food sovereignty which enabling them to improve their health status.



Exposure to methylmercury by consumption of fish and the risk for neurotoxicity in the developing fetus at Walpole Island First Nation - changes from 1975 to 2014

Judy Peters, Gideon Koren, Michael J. Rieder, Mary Jane Tucker, Rosemary Williams, Dean Jacobs, Phaedra Henley, Katherine Schoeman, Regna Darnell, Christianne V. Stephens, Carol P. Herbert, Chandan Chakraborty, Bradley A. Corbett, Charles G. Trick, John R. Bend

Chatham-Kent Community Health Centre, Walpole Island Office, Departments of Medicine and Paediatrics, Schulich Medicine & Den-tistry, Western University, Departments of Paediatrics and Medicine, Schulich Medicine & Dentistry, Western University, Department of Medicine, Schulich Medicine & Dentistry, Western University, Wal-pole Island Health Centre, Walpole Island Heritage Centre, Depart-ment of Pathology, Schulich Medicine & Dentistry, Western Univer-sity, Department of Physiology & Pharmacology, Schulich Medicine & Dentistry, Western University, Departments of Anthropology, Social Sciences and Pathology, Schulich Medicine & Dentistry, West-ern University, Department of Anthropology, McMaster University, Departments of Family Medicine and Pathology, Schulich Medicine & Dentistry, Western University, Ivey School of Business, Western University, Department of Biology, Science and Interfaculty Program in Public Health, Schulich Medicine & Dentistry, Western University,

Department of Pathology, Siebens-Drake Medical Research Institute, Schulich Medicine & Dentistry, Western University

An estimated 400 tonnes of mercury were released into the St. Clair River, upstream from the Walpole Island First Nation (WIFN).High methylmercury levels in fish caught at WIFN resulted in the closing of the fishing enterprise at WIFN in the 1970’s. Anxiety about the health effects of exposures to mercury and other pollutants released from Chemical Valley remains an issue at WIFN today. A research partnership between WIFN and Western University has completed a fish consumption study; analyzed mercury in many Traditional Food species and in hair and blood of volunteers; conducted a survey of health status; and reviewed health records at the Walpole Island Health Centre. Our systematic review of the world’s relevant epidemiological data derived a conservative no observable adverse effect level (NOAEL) of 0.3 ppm for mercury in maternal hair for mild neurotoxicity during fetal exposure (Schoeman et al, 2009). From comparison of our recent (2008) biomonitoring data in several volunteers to values for the same individuals in 1975 and 1976, we found that hair mercury content had decreased by 85%. By voluntary restriction of fish consumption, community members had dramatically reduced their risk of impaired fetal neurodevelopment over this time. However, mercury poisoning remains an issue of concern because 7 women of reproductive age analyzed during our study had hair mercury concentrations of 0.3 ppm or higher. These individuals were counselled to eat less fish in any subsequent pregnancy, an action that would reduce mercury exposures to amounts of no concern (Koren and Bend, 2010).



Provision of Sleep Apnea Care in Saskatchewan: Policy Complexities Related to Registered Indian Status

Tarun Katapally, Caroline Beck, Gregory P. Marchildon, Jo-Ann Episkenew, Sylvia Abonyi , Punam Pahwa, Mark Fenton, James Dosman

Department of Community Health and Epidemiology, University of Saskatchewan, Johnson-Shoyama Graduate School of Public Policy, University of Regina, Indigenous Peoples’ Health Research Centre, University of Regina, College of Medicine, University of Saskatchewan, Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan

Obstructive sleep apnea (OSA) is a pervasive and largely undi-agnosed chronic condition in Canada. However, eligibility and coverage for treatment varies significantly depending on status as defined under the Indian Act. For example, in Saskatche-wan, Registered Indian patients’ access OSA treatment through federal Non-Insured Health Benefits (NIHB) rather than the relevant provincial program. Coverage and eligibility require-ments have profound implications on access to diagnostic and


treatment services. This research identifies the variations in coverage between these programs to highlight challenges for patients and to inform provincial and federal policy. Effective diagnosis of OSA can occur through sophisticated, laborato-ry-based Level 1 tests as well as through lower-level, home-based Level 3 tests. In Saskatchewan, two public sleep laborato-ries conduct publicly-funded Level 1 testing, one of which also offers Level 3 tests. Several private providers also offer Level 3 for a fee. Residents of Saskatchewan who are not Registered Indians can access treatment based on Level 3 tests. However, based on NIHB requirements, registered Indians in Saskatch-ewan must undergo a Level 1 public test in order to obtain treatment by continuous positive pressure (CPAP) therapy. High demand and low availability for Level 1 testing results in significantly longer wait periods, and distance to travel, than does Level 3 testing through public or private clinics. Inequi-ties result, including longer waits, greater travel, and reduced availability of treatment for Registered Indians versus other Sas-katchewan residents. These findings suggest areas for significant policy redress to remedy issues of access and to improve Indige-nous population health outcomes.



Reducing the Gap: Robotics technology increases access for patients in Northern Saskatchewan

Ivar Mendez, Veronica McKinney

University of Saskatchewan - also a presenter, University of Saskatchewan

In Canada, we pride ourselves on having universal medicare, equal access for all. However, in reality, this “equal access’ does not exist. Many of our First Nations communities face several challenges in accessing health care. The use of autonomous robotic and mobile devices enable physicians or other health care providers the opportunity to control the device remotely, allowing for assess-ment of patients by speaking with them directly, using periph-eral devices such as a digital stethoscope or ultrasound to make a more informed decision on patient management. This reduces travel costs as well as providing more rapid initiation of appro-priate care as needed. Having expert support readily available supports the community and providers alike which translates to increased recruitment and retention as well as improved relation-ships between communities and tertiary care centres. Additionally, the patient and their family has the ability to speak to care provid-ers directly improving communication and opportunity for col-laborative care. It is important to note that this technology does not replace human beings. Rather it is the medium that allows health professionals the opportunity to come to where the patient is, make a diagnosis and recommend what needs to be done. The possibilities with this technology are endless and enables access to care that rivals or succeeds that available in any major centre.



Institutional incompleteness in the urban Aboriginal health service infrastructure

Kian Madjedi, Kevin FitzMaurice

Laurentian University

The purpose of this research is to examine the role of institu-tional completeness as it relates to the urban Aboriginal health service infrastructure for persons increasingly coming to be known as the “Urban Aboriginal Professional Class”. Institu-tional completeness refers to the number, variety and nature of institutions that serve as communal reference points for indi-viduals to meet, interact and receive services. The term “Urban Aboriginal Professional Class” represents Indigenous peoples living in cities who earn a certain income, who have attained postsecondary education, and who hold professional / manage-rial roles.

The Toronto Aboriginal Research Project reports that the major-ity of the urban Aboriginal service “infrastructure’ is strongly social service oriented; in the city, nearly 80% of the Aboriginal organizations are dedicated to providing social services such as housing and employment assistance. For some members of the Urban Aboriginal Professional Class this strong social service orientation may create a sense of disconnection from the greater urban Aboriginal community and this is termed “Institutional incompleteness”.

One key Social Determinants of Health is a strong Social Sup-port Network (PHAC, 2013). This research makes the case for the creation of space, place and programming for Urban Aboriginal Professional people within the already-existing urban Aboriginal service infrastructure, such as Aboriginal Health Access Centres and Friendship Centres. By embedding health-related networking programs within the established ser-vice organizations, the urban Aboriginal health service infra-structure can move towards increased institutional complete-ness and contribute to the health and wellbeing of all members of the urban Aboriginal community.



Aboriginal Cultural Safety Initiative

Chandrakant Shah, Allison Reeves

Anishnawbe Health Toronto

There are approximately 57,000 students enrolled in post-sec-ondary health sciences programs across Ontario. At present, the majority of the health sciences programs in colleges and uni-versities that are training front line health care workers across


Ontario have very little to no curriculum content on Aborigi-nal Cultural Safety. The Aboriginal Cultural Safety Initiative created by Anishnawbe Health Toronto sought to train students so that they will be better prepared to serve their Aboriginal clients and work with them in a culturally sensitive manner in order to improve health outcomes.

In order to carry out this mandate, approximately 32 volun-teer Aboriginal instructors across Ontario were recruited and trained to deliver relevant education materials to students in the health sciences disciplines in Ontario colleges and univer-sities. Between the fall of 2011 and the fall of 2013, thirty-four Cultural Safety training sessions were delivered across eight post-secondary institutions in Ontario. Student evaluations indicate that the Aboriginal Cultural Safety Initiative was suc-cessful in increasing student knowledge in the following topic areas: the Indian Act, government policies affecting Aboriginal Peoples; residential schools; determinants of health for Aborigi-nal Peoples; health outcomes for Aboriginal Peoples; Aboriginal concepts of health and healing practices; knowledge of Aborig-inal cultures generally; and concepts of Cultural Safety. Evalua-tions also indicate that the initiative was successful in increasing student interest in the following areas: Interest in Aboriginal Peoples’ culture and well-being; interest in cultural compe-tence/cultural safety for Aboriginal Peoples in Canada; and interest in advocacy and/or empowerment work in this area.



Talking About Change: Understanding Colonial Rhetoric

Pamela Walker

Lawrence S Bloomberg Faculty of Nursing, University of Toronto

In the Canadian context, it is the responsibility of all non-In-digenous people to learn about the history of colonialism in Canada. One element of this responsibility is learning to rec-ognize the stereotypes and oppressive attitudes towards Indig-enous peoples that are embedded in popular and health care discourses, and reproduced in health care interactions. In this workshop, the presenter unpacks colonial rhetoric through an exploration of settler colonialism, Eurocentrism, anthropology and positivism, and examines the powerful influence these dis-ciplines and ideologies continue to exert on western thought and speech. Responding to oppressive remarks in the workplace can be very challenging, and the presenter will lead an interac-tive discussion with participants to share and develop strategies that can help us speak up for change in health care.



Enhancing Supportive Decision Making For Aboriginal Patients and Family Members

Jenny Lynn Morgan, Anita Ho, Kim Taylor


Background: In Canada, Aboriginal peoples have higher mor-tality and morbidity rates than their non-Aboriginal coun-terparts. Aboriginal peoples’ voices are often dismissed, with little known in the mainstream medical or bioethics literature regarding their experiences in healthcare decision making.

Purpose: Via stories from Aboriginal patients, supportive deci-sion makers (SDMs include formal surrogates and loved ones who make joint decisions alongside a competent patient), and patient navigators/liaisons, this presentation examines factors affecting Aboriginal patients’/families’ ability to make complex healthcare decisions that uphold their priorities and values.

Methods: Twenty-four in-depth semi-structured interviews (14 patients, 10 SDMs, and 3 patient navigators/liaisons of Aboriginal ancestry) were conducted in a Canadian city. Tran-scribed data were coded and thematic analysis was informed by grounded theory.

Results: Participants identified three intersecting themes regard-ing challenges in healthcare decision making. First, patients/SDMs consistently encounter relational obstacles including dis-trust, stereotypes, or dismissal of Aboriginal stories by HCPs as irrelevant to care. These barriers perpetuate the lack of cul-tural safety in clinical encounters. Second, some patients/SDMs face informational barriers due to their low literacy regarding western and institutional medicine and lack of accessible infor-mation. Third, participants highlighted systemic factors includ-ing their distrust of institutional care, HCPs’ ignorance of tra-ditional healing practices, and lack of coordination between healthcare and other social services.

Discussion: Participants highlighted the importance of promot-ing socio-historical understanding, dismantling stereotypes, fostering relationships, coordinating various aspects of care, and attending to indigenous ways of knowing in strengthen-ing therapeutic alliances. Professional and systemic strategies to promote Aboriginal-centered care will be discussed.




Wellness in our own words: Understanding the interconnected elements of Indigenous health through partnerships

Kian Madjedi


Respectful partnerships are critical to the development of effec-tive, sustainable and meaningful community health service delivery, as they allow a better understanding of the individual and collective goals, aspirations, perspectives and narratives of a community. It is critical to first understand the needs and desires of a community, as defined by the community itself as a pre-liminary step in conducting community-based health research. One way of building these partnerships is through knowledge sharing, and understanding the ways in which the community itself outlines and defines its own health goals.

The purpose of this research was to establish a baseline for future community-engaged health research with the urban Aboriginal community in Sudbury, Ontario by first exploring the ways in which Anishnaabe peoples define health and wellbeing “in our own words”. Semi-structured interviews were conducted with 16 participants, who were asked, “how do you define health and wellbeing?”

There were eight emergent themes in the way health and well-being was understood:

• Strengthening community relationships;

• Building supportive family relationships;

• Practicing tradition / culture;

• Self-determination

• Respecting and being respected;

• (Re)connecting with the land; and

• Revitalizing Indigenous languages.

Defining health and wellness “in our own words” may help improve the accountability of future health research with Indig-enous communities by providing a contextualized, communi-ty-engaged shared knowledge base to inform research agendas that understand more fully the aspirations, identities and val-ues of Indigenous peoples. Ultimately, this research highlights the importance of developing ethical, respectful and engaged partnerships when conducting health research with Indigenous communities.



Cultural continuity is protective against diabetes in Alberta First Nations

Richard Thomas Oster, Angela Grier, Rick Lightning, Mari Mayan, Ellen Toth

University of Alberta, Piikani Blackfoot Nation, Ermineskin Cree Nation

Background: We sought to examine the association between cultural continuity, self-determination, and diabetes prevalence in First Nations in Alberta, Canada.

Methods: We used an exploratory sequential mixed methods approach. First we conducted a qualitative descriptive study with 10 Cree and Blackfoot leaders (members of Chief and Council) from across the province to understand cultural continuity and self-determination in the Alberta First Nations context. Inter-views recorded, transcribed, and subject to qualitative content analysis. We shared the findings with interested participants for feedback, interpretation, clarity, validity, and other concerns. Participants also had the opportunity to be involved in data analysis and dissemination. We then conducted a cross-sectional quantitative study using provincial administrative data and pub-lically available data for 31 First Nations to examine any rela-tionship with diabetes prevalence.

Results: Qualitative: Cultural continuity, or “being who we are”, is foundational to healthy and successful First Nations. Self-determination, or “being a self-sufficient Nation”, stems from cultural continuity and is seriously compromised in today’s Alberta Cree and Blackfoot Nations. Sadly, First Nations are in a continuous battle against government policy and the intergen-erational effects of colonization to rehabilitate their culture and achieve self-determination. Quantitative: Crude diabetes prev-alence varied dramatically among Nations with values as low as 1.2% and as high as 18.3%. Those Nations that appeared to have more cultural continuity (measured by traditional Indigenous language knowledge) had significantly lower diabetes preva-lence after adjustment for socio-economic factors (p = 0.007).

Conclusions: We conclude that cultural continuity is protective against diabetes in Alberta First Nations.



Self-Determination in First Nations Communities

Angela Mashford-Pringle


The perceived level of self-determination in health care in four First Nations communities in Canada was examined through a


multiple case study approach. Twenty-three participants from federal, provincial and First Nations governments as well as health care professionals in four First Nations communities to provide insight into the diversity of perception of self-determi-nation in First Nations health care. The difference in definition between Aboriginal and the federal and provincial governments is a factor in the varying perceptions of the level of control First Nations communities have over their health care system. Par-ticipants from the four First Nations communities perceived their level of self-determination over their health care system to be much lower than the level perceived by provincial and fed-eral government participants. The organization and delivery of health care is based on the location of the community, the avail-ability of the human resources, the level of communication, the amount of community resources, and the ability to self-manage. The socio-political history including impact of contact, residen-tial schools, and integration of Aboriginal worldview are factors in the organization and delivery of health care as well as the per-ceived level of self-determination that the community sees. The duration and intensity of contact influences how health care is organized as the communities become more familiarized with the biomedical model that most Canadians use.



Mino-bimaadiziwin: Re-honoring the relational roots of Indigenous food sovereignty

Michelle Daigle

University of Washington

Food sovereignty has become a popular discourse guiding alter-native food movements since it was first coined at the World Food Summit in 1996.Meanwhile, on-going colonial inter-vention on Indigenous lands have resulted in alarming rates of malnutrition, health problems, environmental degradation and severed relationships with the land and kinship networks. These various facets of oppression have led some Indigenous people, including some communities in Canada, to politically mobilize around concerns for food sovereignty. Yet current research on food sovereignty in Canada has largely focused on low-income neighborhoods, racial minorities and small farmers while the examination of Indigenous experiences remain, for the most part, somewhat depthless. This begs the question of how food sovereignty is abused by various groups continuing to encroach on Indigenous lands and how sovereignty is understood accord-ing to Indigenous worldviews. My PhD research examines Anishinaabe people’s place-based experiences and knowledge of food sovereignty and how this contributes to the social, eco-nomic and political goals of self-determination as defined by Anishinaabe people themselves. Through in-depth qualitative interviews with Anishinaabe people of the treaty #3 territory, this research looks at the relational aspects of Indigenous food

sovereignty. Specifically, I am interested in the spiritual aspect of Indigenous food practices and the importance of re-building relationships with the land and kinships networks and how this contributes to the (re)formation of Indigenous nationhood and self-determination. For Anishinaabe people, local food prac-tices and the popularized discourse of food sovereignty are more accurately reflected through the teaching of mino-bimaadiz-iwin, living the good life.



The Toronto Aboriginal Health Advisory Circle: The Development of An Innovative Model of Self Determination

Ellen M. Blais

Toronto Central Local Health Integration Network, Toronto Central Lhins

The Toronto Central Local Health Integration Network ( TCLHINS) has been working on many aspects of Aboriginal health, including supporting the development and implemen-tation of the Toronto Aboriginal Health Advisory Circle. This workshop will outline the history and development of the cir-cle, methods of community engagement and the goals which the circle is planning to achieve. This model is innovative as it is a collaborative effort with Toronto Public Health Toronto Central Lhins, and the Aboriginal community of Toronto. Self determination in all aspects of health is the one of the core val-ues of the circle. Cultural safety will also be discussed.



wahkomakanak: Relationships and Language as Medicine

Lana Whiskeyjack, Dionne Gesink, Alanna Mihic, Priscilla McGilvery

Saddle Lake Cree Nation, University of Toronto, Blue Quills First Nations College

Research on restoring health in Saddle Lake Cree Nation lead researchers from the community and the University of Toronto into a paradigm shift, evolving from an academic way of think-ing into a collective cree way of being with one another. What began as information gathering also became foundational work on how to conduct ourselves, not only as researchers, but as community helpers. One of the solutions from the research was the importance of connecting with one another through exam-ining relational ideas through the Cree language. Consulting and acknowledging community Cree speakers and knowledge keepers through interviews was an excellent start of addressing


health issues. By asking them how can the community restore health, we learned about wahkomakanak, our multifaceted relationships, and how it is linked to health. We learned that the importance of being interconnected is about knowing who you are, where you come from and the roles and meaning of your life, which has a great impact on how we serve the collective work within First Nations communities. Through learning tra-ditional knowledge one cree word at a time, First Nations com-munity researchers/members working and learning together with non-First Nations academics became more knowledgable in Cree epistemology, culturally aware of the community and deep connected relationships were built. In learning that words are medicine, researchers as community helpers became bet-ter equipped in addressing and promoting health interventions, solutions and community development.



Nehiyaw Pimatisiwin: Sharings from Onihcikiskowapowin - Cultural interventions from a community-based research partnership with the University of Toronto

James Makokis, Alsena White

Saddle Lake Health Care Centre, Saddle Lake Cree Nation

In 2009, the University of Toronto and the Saddle Lake Cree Nation engaged in a community based research partnership pri-marily looking at sexual health in the community. The results and process of this research will be examined in another work-shop (Gesink, Whiskeyjack, Suntjens, Mihic, Chisan), while this will focus on culturally based interventions aimed at restor-ing balance within our Nation. Specifically we will share about:

1) Transforming the current federally delivered prenatal pro-gram to be more reflective of opikinâwasowin (“the way of child-rearing) based on the Cree stages of life. This helps in preparing nehiyawak awasisak to be healthy, whole, human beings.

2) Incorporating nehiyaw muskikiya (Cree medicines) into the Saddle Lake Medical Clinic by having a traditional medicine person/knowledge holder work alongside the community Cree medical doctor.

3) Addressing food insecurity and community development by initiating a community garden in the “town-site” area of the Saddle Lake Cree Nation. Future plans include the development of a community medicine teaching garden.

4) The development of a youth outreach based clinic within the community at the local youth Boys and Girls Club.

These “interventions” are based and founded in nehiyaw mam-itoneyicikan (Cree thought), and form the foundation of all our activities related to these research findings.



Human papillomavirus within Inuit women from Nunavik, Quebec

Barbara Gauthier, Paul Brassard

Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Division of Clinical Epidemiology, McGill University

This research consists of examining the Pap smear results of a group of Inuit women from the Nunavik region in northern Quebec to better understand the role of human papillomavi-rus (HPV) in their community. This involves describing which different variants of several high-risk HPV types (16, 18, 31, 33, 35, 52, and 58) are present. These different strains may vary in the time it takes to be cleared from the individual. They may also vary in risk of developing cellular abnormalities found with a Pap smear. Assessment of these differences will allow for characterization of HPV in this Indigenous community and help predict which strains may be more harmful and related to cervical cancer. This is important because the rates of cervi-cal cancer among Inuit communities are higher as compared to the general Canadian population. As there are sometimes diffi-culties ensuring proper follow-up and healthcare within these Northern communities, this assessment of the most threatening strains will mean that in the future it will be easier to determine which women are at the highest risk and ensure they receive the proper care.



Community Based Participatory Research as a Path to Build Resilience

Kevin Donald Willison

Lakehead University

Background: To facilitate the translation and dissemination of knowledge and improve cultural sensitivity about Indigenous health in Canada it is important to involve Indigenous Peo-ples in health care planning and decision making. A potential way to do so is through community based participatory research (CBPR).

Methodology: Using a retrospective approach and the key words “Indigenous health” and “community based participatory research” a review of the social as well as health science/public health literature was conducted. Relevant publications reviewed were in English only and dated back no more than twelve years. Specific databases accessed included Goggle Scholar, Pubmed, Medline, Ageline, Sociofile, PsychLit, and CINHL.


Results: Canadian publications denoting active engaged Indig-enous populations / communities in the research process are sparse. Of the literature that was found it appears that, when a given community or chosen community representative actively participates in planning and/or decision making there is poten-tial for that person and/or community to build resilience. In general, there appears to be support for the idea that, when people are actively engaged their self-worth and self-esteem improves, which can help build resilience.

Conclusion: Deploying a CBPR approach appears to have potential in building resilience both at the individual (micro) as well as community (meso) level. Current evidence in the liter-ature points out that resilience is an important determinant of health. Finding ways to build resilience within Indigenous pop-ulations may aide in improving overall health related quality of life. To this end, further research on the potential of CBPR is needed.



Letting the Body Tell Its Story: Using Body Mapping and Hazard Mapping as Visual Representations of Community Well-Being in Indigenous Health Research

Christianne Victoria Stephens, Linda Lou Classens

York University, Walpole Island First Nation

Research has shown that Indigenous populations in Canada experience elevated rates of chronic and infectious diseases compared to their non-Native counterparts. They are also more vulnerable to toxic exposure and have less access to qual-ity health care than the population as a whole. Attention has been directed to the study of historical and systemic processes. However, a key issue that continues to be overlooked is the lack of basic information on the overall health of individual Native communities. Data collection and linkages are problematic as many national and regional surveys overlook Aboriginal health concerns and health care needs. Moreover, these surveys often provide a homogenized view of indigenous health that lacks specificity regarding local ecological threats and stressors. Our collaborative project strives to answer the following questions: Can community-devised models that expand the conventional theoretical and methodological boundaries of traditional health research frameworks shed new light on spaces of vulnerabil-ity, the social determinants of health and the impacts of diverse forms of structural violence on ‘local biologies’? Can these methods improve the quality of health data gathered on First Nations reserves? Our health project based at the Walpole Island First Nation applies theories and methods from the fields of occupational health, medical anthropology and health geogra-phy. We will present the findings of our pilot study and explore the utility of innovative models like body mapping and hazard

mapping for studying and representing the cumulative impacts of social inequalities, historical trauma and ‘syndemic suffering’ (Mendenhall 2012) on Indigenous health.



Telling Our Stories: Population Health Surveillance in Unama’ki

Elaine Allison, Darlene Anganis, Stacey Lewis, Jennifer Mac-Donald, Sharon Rudderham, Laurie Touesnard

Wagmatcook Health Centre, Membertou Wellness Home, Tui’kn Partnership, Waycobah Health Centre, Eskasoni Health Centre, Pot-lotek Health Centre

It is widely recognized that there are significant gaps in infor-mation about the health of First Nations populations. This limits the ability of communities, health agencies, and governments to respond affectively to the health needs of First Nations. A wide variety of information about the health of First Nations people resides in provincial and territorial health data systems. How-ever, using this readily available data source to support First Nations population health surveillance efforts is difficult due to a myriad of privacy, governance and technical challenges. This presentation will describe how the five First Nations in Una-ma’ki (Cape Breton Island, NS) worked with provincial, federal and academic partners to overcome these challenges and create the Unama’ki Client Linkage Registry - a unique population registry that has been linked with provincial health data sources in order to provide the Unama’ki First Nations with better population health surveillance data. With the development of the registry and the establishment of a data sharing agreement between the Unama’ki First Nations and the Province of Nova Scotia, the Bands now have unprecedented access to critical population health data. This presentation will describe how the registry was created. It will discuss the registry data governance model which is based on OCAPª principles and adheres to rel-evant privacy legislation. The presentation will include high-lights from health indicator reports that have been developed as a result of this data linkage partnership, and the presenta-tion will discuss how the Unama’ki First Nations are using this information to improve health.


Workshop AbstractsW01SESSION 1

(Abstract ID: 19)

Mental Health

THURS. NOV. 20 – 10:30AM-11:15AM

Honouring our Strengths: A Renewed Framework to Address Substance Use Issues among First Nations Peo-ple in Canada

Carol Hopkins

National Native Addictions Partnership Foundation, Canadian Cen-tre on Substance Abuse

A national framework that champions a First Nations voice and the importance of Indigenous Knowledge as an evidence base for addressing substance use issues. The workshop will highlight the importance of partnership and process to engage First Nations people in a meaningful policy development. The workshop will also discuss the flexibility of the framework for its use in policy development, strategic planning, system and program design, and service delivery.

W02SESSION 1

(Abstract ID: 53)

Mental Health

THURS. NOV. 20 – 10:30AM-11:15AM

Connecting the Dots: An Innovative Urban Aboriginal Mental Health Project

Jessa Williams, Johanna Denduyf

Canadian Mental Health Association British Columbia Division, British Columbia Association of Aboriginal Friendship Centres

Aboriginal people are the youngest and fastest growing segment of the Canadian population and experience disproportionally high rates of mental health challenges and are underrepresented in mainstream community mental health services. This presen-tation will describe an innovative, multi-partner, communi-ty-led mental health promotion project in BC which is based on an adapted evidence based Communities that Care model.

The objectives of the Connecting the Dots (CTD) project are to promote the mental health of urban, off-reserve Aboriginal youth and families by mobilizing the community to address risk and protective factors influencing mental health, to build cross sector partnerships and to adapt the Communities that Care model to ensure cultural relevancy in urban Aboriginal communities.

Key elements for discussion will be on CTD program develop-ment, implementation and evaluation, Aboriginal concepts of

health and wellness, community engagement and partnership, cultural competencies and safety, cultural adaptations and les-sons learned during this five year project.

Successful mental health programs in Aboriginal communities must address key elements such as community engagement and ownership, cultural relevance and competencies and the effects of colonization and intergenerational trauma on risk and protec-tive factors. Sharing experiences and knowledge offers a unique opportunity for participants to gain a deeper understanding of mental health initiatives in urban Aboriginal communities in BC.

W03SESSION 1

(Abstract ID: 95)

Women’s Health

THURS. NOV. 20 – 10:30AM-11:15AM

Supporting First Nations, Métis and Inuit Women to Engage in Shared Decision Making: A Skill Building Workshop

Janet Elizabeth Jull, Minwaashin Lodge, Dawn Stacey

University of Ottawa, Institute of Population Health, Minwaashin Lodge - The Aboriginal Women’s Support Centre, University of Ottawa

Introduction: When compared with general populations in Canada, Aboriginal women are more likely to experience health inequity. Shared decision-making (SDM) may narrow health equity gaps by engaging clients with their health care providers in making health decisions; however, little is known about SDM interventions with Aboriginal Peoples. This workshop intro-duces participants to the use of an SDM approach developed in collaboration with a community partner (Minwaashin Lodge), to support Aboriginal women in making health decisions.

Objectives: Define SDM and interventions to support SDM: what it is, how it is done, why it is important, patient decision aids, coaching. Describe how a population of women defined the SDM process: Findings from work with the women of Minwaashin Lodge. Practice providing decision support during a simulated clinical encounter using coaching guided by the adapted Ottawa Personal Decision Guide (OPDG). Discuss practical features of implementing decision support for/with Aboriginal people.

Overview of SDM and Interventions.

Adaptations for Aboriginal women.

Skills building exercise: Use of the adapted OPDG. Break into groups and choose a decision (provided by workshop facilitator) and roles to play. Role play using the adapted OPDG. Large group debriefing on the encounter.


Implementation Key messages: In general populations, patient decision aids help clients to participate with their health care providers in health decision making. This workshop introduces a patient decision aid, the adapted OPDG with decision coach-ing, developed by and with a population of Aboriginal women.

W04WITHDRAWN

W05SESSION 1

(Abstract ID: 253)

Traditional

THURS. NOV. 20 – 10:30AM-11:15AM

Atikowisi miýw-āyāwin, Ascribed Health and Wellness, to Kaskitamasowin miýw-āyāwin, Achieved Health and Wellness: Shifting the Paradigm

Madeleine Dion-Stout, Elder

I use the Cree language to describe our experiences, realities and aspirations because it provides a ready and relevant window into our social, health and health care inequities. I focus on an important transformation that is taking place in our lives as we move from atikowisi miýw-āyāwin, ascribed health and well-ness, to kaskitamasowin miýw-āyāwin, achieved health and well-ness. This is not a linear or a straightforward process, and it is not happening in isolation from our mainstream health systems, which, with the proper understanding of our perspectives and experiences, can help to bring favorable change. Still, atten-tion does have to be paid to the location and flow of significant markers on this journey. If atikowisi miýw-āyāwin is at one end of a spectrum (where we are coming from) and kaskitamasowin miýw-āyāwin is at the other end of the spectrum (where we are going to), then nātamakéwin miýw-āyāwin, or assisted health and wellness, has to be located in the middle, where a supportive system goes hand in hand with a growing sense of the helping “self.”

W06SESSION 1

(Abstract ID: 238)

Food Security/Nutrition

THURS. NOV. 20 – 10:30AM-11:15AM

Evaluation of “Community-Led Food Assessment for Inuit Communities” model aimed at assessing and addressing Food Security in Inuit Communities

Kristeen McTavish, Chris Furgal, Shantel Popp, Vinay Rajdev, Kristie Jameson

Trent University, Nasivvik Centre for Inuit Health and Chang-ing Environments, Trent University, Food Security Network of

Newfoundland and Labrador

This project aims to develop an appropriate model for building community competency in addressing food security in remote Inuit Communities. The first phase of the project focused on the Northern Inuit communities of Nunatsiavut, Labrador _ a population that face some of the most extreme health inequal-ities in Canada. In 2010, the community of Hopedale, Nunat-siavut successfully completed a community-led food assessment (CLFA) project entitled NiKigijavut Hopedalimi (“Our Food in Hopedale”), using the BC Provincial Health Services Author-ity’s “Community Food Assessment Guide” (2008). The proj-ect began by evaluating the process of implementing a CLFA with the 2008 tool in Hopedale, in order to identify its use and applicability in Inuit communities. Using recommendations resulting from this evaluation, the tool was adapted in order to develop a culturally appropriate CLFA as the central aspect of a more broadly transferable CLFA to be used by other remote, northern, Inuit communities. Adaptations included expanding the tool’s content into a toolkit of five learning guides, changes to the format, language, and examples, as well as creating a more detailed process and inclusion of practice activities and additional resources. The project has developed a model for engaging communities in addressing risk factors influencing their food supply (threats to country food harvesting, access to healthy foods, food sharing networks), the activity environment (programs, food competency building), as well as individual and family factors of individual food consumption. An Inuit spe-cific CLFA guide and resource materials are now available, and undergoing evaluation in three Inuit communities.

WO7SESSION 1

(Abstract ID: 280)

Cultural Safety

THURS. NOV. 20 – 10:30AM-11:15AM

“Don’t bother him, he’s probably just drunk”: Advanc-ing Indigenous Cultural Competency training in Ontario

Vanessa Ambtman-Smith, Guy Hagar

Provincial Aboriginal LHIN Network (PALN) South West Local Health Integration Network, Southwest Ontario Aboriginal Health Access Centre (SOAHAC)

• Cultural Safety and healthcare

• Supporting the journey towards cultural safety

• Indigenous Cultural Competency (ICC) Training as a best practice

• Advancing ICC in Ontario’s healthcare system


W08SESSION 1

(Abstract ID: 226)

Health Systems

THURS. NOV. 20 – 10:30AM-11:15AM

There Are Good Things Done Under the Midnight Sun

Julie Lys, NP, Laura Lee Evoy, RN, Bandy Thompson, RN

Fort Smith Health & Social Services Authority / Aboriginal Nurses Association of Canada, Fort Smith Health & Social Services Authority

Explore the good things done under the midnight sun. Many Aboriginal communities in rural and remote areas of Canada have high turnover rates of nursing staff. When nurses have a sense of belonging and professional satisfaction they are more likely to stay in the community. One solution to high turnover rates is to promote and support community members to become health care professionals. In the Land of the Midnight Sun (the NWT) this includes recruiting Aboriginal people into the nurs-ing profession. However, some believe it is too difficult as an Aboriginal nurse to work in their home community.

Nurses play a pivotal role in the health care system in the NWT. The scope of practice for nurses and nurse practitioners sets the stage for true primary health care. The work is challenging, rewarding and truly satisfying. The sense of belonging and pur-pose in the community also increases job satisfaction.

In this northern community many of the nursing staff are Aboriginal and are from the community. Learn how the inter-active practice environments of this northern health centre, employer and community support increases job satisfaction. Learn why these Aboriginal nurses enter the nursing profession and how the NWT healthcare system supports them through grad mentorship, bursaries and continuing education. Learn how these nurses and nurse practitioner draw on the sense of belonging to work successfully in their home community of Fort Smith, NWT.

W09SESSION 1

(Abstract ID: 120)

Nursing

THURS. NOV. 20 – 10:30AM-11:15AM

Collaborating for Cultural Safety in Nursing Education

Vivian Recollet, Pamela Walker

Native Men’s Residence, Lawrence S Bloomberg Faculty of Nursing University of Toronto

It is well documented that Aboriginal people experience dis-crimination and racism in the Canadian health care sys-tem. In response, mainstream and Aboriginal organizations

recommend that undergraduate nursing students receive cul-tural safety education during their nursing programs. However, in order to provide quality cultural safety education, collabora-tion between nursing faculties and Aboriginal communities is essential. Vivian Recollet is an Aboriginal nurse whose lineage stems from the traditional territories of the Wikwemikong First Nation. Vivian has been an advocate for aboriginal health issues since 1996 and currently works towards bringing a holistic care model to her work in a Men’s shelter Mental Health Program. Vivian is knowledgeable about western and traditional philos-ophies and combines the two worlds to bring the best possible care to her community. Pam Walker has been a nurse educator at the University of Toronto for five years. Before coming to U of T, she worked for many years as a community health nurse with Haida, Coast Salish and Carrier First Nations peoples in western Canada. As a non-Aboriginal woman and nurse, Pam is committed to integrating cultural safety into nursing education at U of T. Together, Vivian and Pam provide classroom and clinical education in urban Aboriginal health and co-facilitate seminars for nursing students preparing for practicums in north-ern communities. In this presentation, Vivian and Pam describe their collaboration, how it influences the cultural safety educa-tion they provide, and the importance of combining Indigenous knowledge with contemporary nursing knowledge in order to provide holistic nursing care.

W10SESSION 1

(Abstract ID: 130)

Respiratory/Cardio/Chronic Disease

THURS. NOV. 20 – 10:30AM – 11:15AM

Heart and Stroke Foundation’s Indigenous Health Strategy

Lesley James, Ratsamy Norman Pathammavong

Heart and Stroke Foundation

The Heart and Stroke Foundation (HSF), Canada’s largest char-ity dedicated to reducing the burden of heart disease and stroke recognizes that the cerebral-cardiovascular health of aboriginal peoples in Canada is very poor. The prevalence of cardiovas-cular (heart disease and stroke) disease among the First Nations people is 2 to 3 times higher than the rate among the general Canadian population. While cardiovascular disease (CVD) rates are declining in Canada, data suggest they are increasing among Canada’s Indigenous Peoples. Indigenous Peoples in Canada have a higher prevalence of CVD risk factors including physical inactivity, smoking, obesity, hypertension, diabetes, and food insecurity. Income security is low among Aboriginal commu-nities and forty percent of Aboriginal children live in poverty, which is a risk factor that makes healthy choices inaccessible. With over 1.4 million people self-identifying as aboriginal in Canada and a high growth rate among this population, these CVD stats are alarming and require action.


To change the poor health associated with Canada’s Indigenous Peoples, HSF will invest in ensuring health equity for Indig-enous People from coast to coast to coast. HSF aims to be a model national health organization in working with Aborig-inal, First Nations, Inuit and Métis (AFNIM) by developing an evidence-informed aboriginal health strategy. Incorporating the Aboriginal Medicine Wheel as a framework, the strategy will explore partnerships with Indigenous leadership and com-munities throughout Canada and with potential funders and partners such as other health charities/organizations. Elements of the strategy include food, children in schools, pathways to health, and promoting recovery.

W11WITHDRAWN

W12SESSION 2

(Abstract ID: 68)

Mental Health

THURS. NOV. 20 3:45PM-4:30PM

Homeless and Hopeless: An examination of Toronto’s Health and Addiction Services for Indigenous homeless peoples and what can be done to improve them.

Suzanne Lea Stewart, Nicole Estella Elliott

Ontario Institute for Studies in Education/University of Toronto

Indigenous homelessness is at a current state of crisis within the urban area of Toronto, where 15.4% of people living on the streets are of Indigenous ancestry and is disproportionate to the 0.5-1.5% Indigenous Toronto residents. Current literature demonstrates that Indigenous peoples in Canada have less access and under use psychological services, including psychotherapy, despite a crisis of mental health disorders within their commu-nities. Further, Indigenous homeless individuals show higher than average rates of mental health symptoms, disorders, and hospitalizations. This is an alarming issue as a study conducted by the City of Toronto (2009) found that 51.8% of Toronto’s homeless identified that access to appropriate addiction, health and mental health services were inadequate and served as a major barrier in terms of finding housing and getting off the streets. Community based qualitative research with Indigenous homeless individuals and with service providers of Indigenous homeless people was conducted to identify the barriers and suc-cess in mental health and social services, with an emphasis on harm reductions services in the treatment of concurrent disor-ders. Results revealed metathemes of racism and stigmatization, difficulty in healing with concurrent disorders, the need for harm reduction strategies in social services and tensions between traditional cultural/spiritual healing and western psychological interventions. Guidelines for practitioners and implications for service and research will be discussed.

W13SESSION 2

(Abstract ID: 251)

Determinants of Health


The Work of Frontiers Foundation of Toronto

Jim Bacque, Lawrence Gladue, Marco Guzmana, Don Irving

Frontiers Foundation of Toronto

Are you fed up with stories of people dying in fiery shacks on Canadian reserves?

Do you hate hearing about despairing children forming gangs to commit group suicide, young women murdered in the streets, band chiefs jailed for protesting against the theft of their lands by companies and governments, corrupt reserve councils steal-ing tax money, wild waste in government spending?

Do you want something done about these horrors right away?

Then Frontiers Foundation is for you. Our Canadian and inter-national volunteers have built over 3,000 houses in Canada for and with aboriginals and Métis. On some reserves our volun-teers have eliminated child suicide. Our buildings are first-class construction, affordable and durable. Our houses on reserves cost half what private builders charge governments for giveaway houses.

Cooperating in construction of the house which is mandatory for Frontiers beneficiaries instills pride and a sense of accom-plishment in every head of family. More than eight thousand Frontiers volunteers trained many thousands of aboriginals in useful trades as they built houses and happiness together.

Every year, thousands of indigenous children especially in northern Canada are taught in schools by our volunteers coop-erating with local authorities. In every case, our volunteers have been invited to come. They have inspired people to better their own lives through courage, fun and hard work.

The founder, the late Charles Catto, was awarded the Order of Canada for his inspiring work. Frontiers is now staffed and run mainly by aboriginals helped by whites. Our president is Law-rence Gladue, OC and our offices are in Toronto. Our western branch run by Don Irving, is headquartered in Surrey BC.


W14SESSION 2

(Abstract ID: 27)

Traditional


Wii Kwan De Taa (Bringing People Together for a Sacred Purpose

Lori Flinders

Fort Frances Tribal Area Health Services

Through our traditional cultural knowledge, we breathe spirit into our practice. This is the leadership principle that we have adopted at the Behavioural Health Services Unit of FFTAHS. The BHSU is an adult mental health and addictions service that works for/with ten First Nations communities in southern Treaty #3 in NW Ontario. This presentation will take the participant through the presenters “story’ of creating a shift in paradigm from cultural inexperience to cultural awareness through the build-ing of culturally based personal and Agency practice bundles (feather, medicines, methodologies, traditional drum, eagle staff, pipes).The opportunities for staff “knowledge bundle” acquisi-tion (inductive traditional learning/training through teachings/ceremony), and incorporation of culturally based practice bundles will be highlighted along with staff testimonials. The presentation will include a traditional opening with smudging ceremony, hand drum song, and brief sharing/introduction circle. The presenta-tion will utilize a traditional oratory “story telling’ along with power point presentation to describe how inherent knowledge and scared sanctioning were utilized throughout the process. This presentation will describe how the traditional “code of ethics’, embedded within the seven sacred teachings of the Anishinaabe, were harmonized into a model of contemporary best practices within a mental health and addictions curriculum for our con-tinuum for holistic wellness. Time will be given to participants for question and answer on the barriers, support, and tangible outcomes from the creation of cultural bundles. The presentation is for those wishing to begin to create cultural safety and an First Nation foundation of practice.

W15SESSION 2

(Abstract ID: 47)

Inuit


More than medicine: on being an ally and a physician advocate in Nunavut

Madeleine Cole

Qikiqtani General Hospital

Health Advocacy can take many forms and has many defini-tions. As a family doctor, it means helping people to improve

their health by using our knowledge and power as physicians to create change on behalf patients or communities who have less power. To be an effective and caring health care provider, or policy maker for that matter, keeping in mind three C’s can help: Context, Curiosity and Conversation. These factors are indeed necessary for good advocacy as well as for cultural safety.

Following decades of hardwork and advocacy by Inuit leaders, the territory of Nunavut was created in 1999. Nunavut, which means “our land” in Inuktitut, is a vast and beautiful place and though it makes up a fifth of Canada’s land mass, the territory has just over 30,000 residents. About 85% of Nunavummiut are Inuit and Inuktitut remains one of the strongest indigenous languages in Canada, and a first language to most.

This presentation will review the historical context of health care in Nunavut (TB care, E numbers, the dog slaughter, high arctic relocations and residential schools) and contemporary health challenges that Inuit face today. The role that physi-cians can and must play to improve social determinants will be emphasized by examples from the field and efforts for small scale improvement in advocacy education in Family Medicine training will be shared.

W16WITHDRAWN

W17SESSION 2

(Abstract ID: 181)

Respiratory/cardio/chronic disease


A History of Dying at Home From Pre-European Times to the Present Palliative and End of Life Care Era

Dean Walters

Central East Community Care Access Centre

In Scarborough, Ontario, Canada there exists a testament to the care of the dying for all who wish to see it. There lay an ossuary located at Bellamy Road and Lawrence Avenue that serves as a prominent reminder of an indigenous understanding of dying . Immigration and colonization brought a different art of dying through the introduction of new religions but a sea change in health care in the past 150 years firmly placed dying in the hands of medical practitioners inside a technologically-based health care system. Presently, those receiving palliative and end of life health care often find they cannot be pointed to a way of dying of their choosing and find themselves unable to conceive of how to die. This workshop is an historical review of how dying in present-day Scarborough has changed from pre-European con-tact to the current palliative and end of life health care era and offers a glimpse of what might be needed to approach dying in a manner that nourishes our birthright.


W18SESSION 2

(Abstract ID: 131)

Equity


Jurisdiction as a Determinant of First Nations Health Care

Stephanie Ann Sinclair, Amanda Meawasige


Manitoba has one of the highest First Nation populations in Canada, with a large concentration of residents living in remote and isolated communities. This geographical context presents an impediment for First Nations in seeking equitable access to health care, which numerous studies have demonstrated results in poorer health standards and outcomes for First Nations when compared to that of the general Manitoba population. Further compounding this disadvantage is the jurisdictional ambiguity between the Federal and Provincial governments with respect to determining who is responsible for First Nation Health in Manitoba. The presentation will outline the political context of the division of powers over First Nations by the Provincial and Federal governments in relation to health service provi-sion. Case studies will be used to demonstrate the inequities of services and resourcing across the health care spectrum due to the system(s) and policies being focused on divesting itself of responsibility versus a focus on improving health outcomes. Issues to be discussed will include; Jordan’s Principle, Social Determinants of Health, Historical Legacies, Disability Services and Cancer Care.

W19SESSION 2

(Abstract ID: 103)

Education


I honestly don’t think I learned anything about Indig-enous peoples: Understanding medical school precep-tors’ and students’ current knowledge and attitudes towards Indigenous peoples and Indigenous health

Heather Castleden, Debbie Martin, Jeff Denis, Paul Sylvestre

Queen’s University, Dalhousie University, McMaster University

In Canada, Indigenous peoples’ experiences with health care are shaped by the “double burden’ of racism and colonialism. Given this, our research documented medical school precep-tors’ and students’ knowledge and attitudes towards Indigenous peoples, their health and their interactions with the health care system. To do this, we conducted online surveys of first-year medical school students as well as face-to-face interviews with

medical school preceptors at a Canadian University (Spring 2014). Our thematic analysis revealed five key themes. First, there is a lack of education and training about Indigenous health and related issues. Second, opinions between students and pre-ceptors diverge with respect to the adequacy and efficacy of the existing curriculum. Third, a tension exists between medical school norms and training and the recognition that cultural and historical contexts inevitably influence health care encounters. Fourth, due to a lack of awareness, understanding, and experi-ence, preceptors tended to convey analogies to other margin-alized populations, failing to address the nuances of both the diverse and unique aspects of Indigenous peoples’ lived experi-ences. Fifth, while many of the participants expressed common stereotypes, they were less likely than the general Canadian population to endorse victim-blaming explanations for Indig-enous peoples’ poor health and social issues. The next step in our research is to design an intervention with medical students and preceptors aimed at positively influencing their perceptions towards Indigenous peoples’ health issues through transforma-tive experiential learning with the goal of ensuring future med-ical professionals are informed of Indigenous peoples’ cultures, histories, and health issues.

W60SESSION 2

(Abstract ID: 164)

Children’s Health


The Atii! healthy living intervention improves knowl-edge, builds cultural skills and strengthens intergener-ational bonds among Inuit children, youth and families in Nunavut

Gwen Healey, Shirley Tagalik, Tracey Galloway

Qaujigiartiit Health Research Centre (AHRN-NU), Arviat Health Committee, University of Manitoba

Atii! Let’s do it! is a comprehensive healthy living intervention that uses Inuit creativity and culture to improve diet and physi-cal activity patterns among Inuit children and youth. Supported by the Public Health Agency of Canada’s “Achieving Health Weights” Innovation Strategy, the project was piloted in 3 com-munities in Kivalliq and Qikiqtaaluk in 2011-12 and expanded to 3 communities in Kitikmeot in 2013. In June 2014 the Nun-avut Department of Education adopted the program for imple-mentation in every school in the territory. The success of the program has exceeded its initial goals of improving health liter-acy and promoting healthy diet and physical activity behaviours. The school-based component, which focuses on positive nutri-tion and active living messages delivered through youth leaders, improves health knowledge in an exciting format that engages families, mobilizes and expands social networks, and builds social cohesion in communities. The after-school component,


a Young Harvesters’ Program, emphasizes traditional outdoor hunting and fishing activities through a process that promotes intergenerational transmission of knowledge, a process that not only engages young people in traditional Inuit cultural activities but actually builds empowerment and self-esteem by enhancing children’s role as knowledge carriers in families and communi-ties. Atii! is a powerful example of the ability of Nunavummiut to address the unique public health challenges facing northern communities in creative and effective ways. Building on tradi-tional Inuit knowledge and implemented by inter-generational teams of Inuit Elders and youth, this healthy living intervention is making positive and lasting changes in Nunavut communities

W20SESSION 2

(Abstract ID: 129)

Research


Respondent driven sampling (RDS) as a tool for urban Aboriginal health assessment and community engage-ment in Ontario, Canada

Michelle Firestone, Janet Smylie, Sara Wolfe, Constance McKnight

Well Living House, Centre for Research on Inner City Health, St. Michael’s Hospital, Seventh Generation Midwives Toronto, De dwa da dehs nye>s Aboriginal Health Centre

The majority of Aboriginal people in Canada now live in urban areas, however Aboriginal specific health needs assessment is virtually absent and only a minority of Aboriginal health ser-vice funding is directed towards urban populations. Respon-dent Driven Sampling (RDS), a modified chain-referral sam-pling technique, can generate representative, population-based data and effectively address this knowledge gap. The Well Living House (WLH) in Toronto is an action research centre focused on building and sharing evidence to support Indige-nous infant, child and family health and is co-governed by St. Michael’s Hospital and a Council of Indigenous Grandparents. The WLH upholds the dual criteria of Indigenous community relevance and scientific rigour which embodies the principle of “two-eyed seeing.” The WLH has led two successful RDS pri-mary data collections with First Nations in Hamilton and Inuit in Ottawa and will generate the first inclusive population based Aboriginal database in Toronto. In this interactive workshop, representatives from the WLH, De dwa da dehs ney>s Aborig-inal Health Access Centre in Hamilton, Ontario and Seventh Generation Midwives Toronto will discuss how RDS can be used as a tool to: 1) facilitate local Aboriginal community lead-ership; 2) emphasize the active participation of diverse urban Aboriginal communities in developing, gathering, sharing and applying their own health information and health data; and 3) be used effectively to drive policy change and action.

W21SESSION 3

(Abstract ID: 216)

Health Systems


Community health worker models: International best practices and their application to remote First Nations communities

Ben Chan, Janet Gordon, Sumeet Sodhi

University of Toronto, Sioux Lookout First Nations Health Authority, Dignitas International

The community health worker (CHW) model has been estab-lished in many low-resource environments world-wide. CHWs have successfully delivered essential primary care in areas such as maternal and child health, HIV/AIDS treatment, acute infec-tious diseases, health promotion and increasingly, chronic dis-ease management. Such individuals are typically high-school educated recruits from the communities being served. Tasks are shifted from other providers such as physicians, who are difficult to retain in small communities.

The community health representative (CHR) model, a variant of CHWs, was first established by Health Canada in 1962 to serve First Nations communities. Responsibilities were broad, including emergency treatment, preventive health, mental health counselling and housecalls. Since that time, responsibili-ties evolved as more trained nurses were brought into commu-nities and as Health Canada devolved responsibility for manag-ing staff to individual tribal organizations.

The first part of this session explores the past successes of the CHR model and current challenges, such as selection of can-didates, difficulties in ensuring common standards and mentor-ship, and integration of the CHR with the rest of the health care team. The session will draw on story-telling from First Nations veterans of the CHR program. The second part will present a review of current global best practices in CHW program design and case studies from Africa and Asia, using a framework which examines practices around recruitment, retention, training, supervision, clinical protocols and quality measurement. The third part will feature perspectives from First Nations leaders on the applicability of these global examples to Canada.


W22SESSION 3

(Abstract ID: 215)

Mental Health


An Indigenous Model of Effective Community Mental Health Services

Germaine Frances Elliott, John Rice

Enaahtig Healing Lodge, Simcoe County Canadian Mental Health Association

Our presentation will describe the positive impact of using cul-ture and traditional teachings in designing mental health ser-vices that restore balance and harmony to First Nation, Métis and Inuit individuals and families in need of healing, based on the concept of B’imaadziwin (The Good Life).It will demon-strate the value of using a wholistic approach in healing prac-tices which combine Indigenous approaches with clinical prac-tices. The wholistic approach includes: reconnecting to a nat-ural environment, use of ceremony in healing, use of alterna-tive therapies, and promoting client self-determination. These approaches use an inclusive approach that respects the regional diverse Indigenous populations, and is based on traditional teachings of natural law.

Our workshop will be in a story-telling format. We will share the growth and development of an Aboriginal community mental health service that includes case management and com-munity outreach. Our co-presenter is Mr. John Rice, who is a traditional teacher, knowledgeable in Indigenous approaches to mental health and well being. It will describe an Indigenous understanding of mental balance and mental illness.

This workshop will challenge the stereo-types of Indigenous people and mental illness. It will use a strengths based approach to describe how a community service model can impact pos-itive change in individuals. Outcomes will be shared. It will describe the work that our agencies have done in LHIN 12 to promote system change that accommodates traditional healing approaches. We will share our strategies for successfully devel-oping a regional healing model by linking mainstream partners with Indigenous communities and services.

W23SESSION 3

(Abstract ID: 252)

Children’s Health


Lower Respiratory Tract Infections in Inuit Children

Dr. Anna Banerji

Department of Paediatrics and Dalla Lana School of Public Health, University of Toronto

Dr. Anna Banerji will be profiling her 2 decades of research on lower respiratory tract infections (LRTI) in Inuit children. After Dr. Banerji’s first few trips to the Canadian Arctic in 1995, she documented that Inuit infants on Baffin Island had the high-est rates of LRTI globally, and that an Inuit infant less than 6 months of age has a 50% chance of being admitted to the hospital with an LRTI. Subsequently she conducted a case-control study which demonstrated that the risks for LRTI admission included: overcrowding, lack of breastfeeding, living in remote commu-nities, smoking in pregnancy, overcrowded and associated with being Inuit versus non-Inuit. Analysis of the viruses identi-fied respiratory syncytial virus (RSV) as being the common-est infection associated with LRTI admissions, with extremely elevated rates of admission in young Inuit infants in the rural communities. An economic analysis demonstrated that it was cheaper to use an antibody to prevent RSV (palivizumab) than to pay for hospitalizations. Consequently the Canadian Paedi-atric Society agreed, and revised their guidelines to include the Inuit. Her current study across the Canadian Arctic for infants less than 1 year of age demonstrates major difference in the rates of RSV admissions, where in certain regions there would be tremendous costs savings for preventing RSV with the antibody for infants born at term. Despite the growing evidence the CPS guidelines continue to be ignored which she will argue reflects a larger systematic problem for Indigenous populations in Can-ada from an equity and human rights framework.

W24SESSION 3

(Abstract ID: 169)

Traditional


Understanding Tobacco Use Amongst Youth in Four First Nations

Sheila Cote-Meek, Sonia Isaac-Mann

Laurentian University, Assembly of First Nations

Our community research partnership explored how traditional knowledge about tobacco could be used in prevention and intervention of tobacco misuse amongst First Nations Youth.


Preliminary findings inform us that understanding tobacco as a sacred medicine is important in addressing cessation efforts and tobacco misuse among First Nations Youth. Of particular interest were the needs of First Nations women in addressing tobacco misuse during pregnancy. In our presentation, we will review findings of our First Nations-led five year project that involved 4 First Nations communities from across Canada. Our research methods applied a decolonizing methodology in work-ing with four First Nations communities. Community research coordinators were involved in every aspect of research, includ-ing development of research tools, data collection, data analysis, report writing, and community feedback sessions. Each com-munity team included a Research team lead (usually the Health Director in the community), a Community Based Research Assistant, an Elder, and a Youth representative. The commu-nity-based team were supported by a Research Project Coor-dinator and researchers from the larger team. We surveyed 559 First Nations Youth, aged 12-24, living on-reserve. Preliminary results indicate that just under half of the Youth self-reported that they are current smokers. As well, 89% of Youth surveyed found that it would be fairly easy to obtain cigarettes, which speaks to a need to better understand access to non-traditional tobacco from First Nations’ perspectives.

W25SESSION 3

(Abstract ID: 142)

Inuit


Social Determinants of Inuit Health

Anna Fowler

Inuit Tapiriit Kanatami (ITK)

Inuit continue to face significant health disparities compared to non-Inuit Canadians including comparatively lower life expec-tancies, high rates of infant mortality and the highest suicide rates of any population group in the country. Effective solu-tions will involve addressing the underlying determinants and focusing on a wholistic view of health. In 2014 Inuit Tapiriit Kanatami (ITK) developed a report on the Social Determinants of Inuit Health in Canada. Drawing from current data sources and consultation with Inuit organizations, agencies and gov-ernments, this paper highlights the key social determinants of health that are relevant to Inuit in Canada including: quality of early childhood development, culture and language, liveli-hoods, income distribution, housing, personal safety and secu-rity, education, food security, availability of health services, mental wellness and the environment. While summarizing the key challenges that exist for each of these areas, the report also highlights practices that have resulted in positive outcomes. This Social Determinants of Inuit Health in Canada Report is an Inuit-specific resource designed to support public health

activities across the Inuit regions in Canada and to function as a reference for organizations and governments working within the Canadian health and social services sector. While progress is being made, substantial work is still required to address the conditions that lead to poor health outcomes for Inuit.

W26SESSION 3

(Abstract ID: 61)

Cancer


Reducing inequalities in cancer for Ontario First Nations: From surveillance to action

Loraine Marrett, Diane Nishri, Amanda Sheppard, Anna Chi-arelli, Alethea Kewayosh

Cancer Care Ontario, Hospital for Sick Children

Background: First Nations people (FN) suffer from many health and socioeconomic inequalities, including in cancer: while incidence was historically low, it is rising to approach that in the non-Aboriginal population. Little is known about cancer survival disparities.

Objectives: To describe research on cancer disparities between FN and other Ontarians, and resulting action strategies.

Methods: Cancer diagnoses in Ontario FN for 1968-2001 were identified through linkage of the Indian Registry System and the Ontario Cancer Registry, and followed up through 2006. Incidence rates and survival in FN and other Ontarians were compared. Potential prognostic factors were abstracted from charts for women with breast cancer to examine reasons for survival disparities.

Results: Cancer incidence was lower overall in FN, especially for breast and prostate cancer. Rates for major cancers are increasing; colorectal cancer incidence in particular has risen dramatically in FN. For most cancers survival was significantly poorer in FN (e.g., the risk of death from breast cancer was 1.6 times higher in FN women). FN women with breast cancer were 1.5 times more likely to be diagnosed at stages II+. Stage I (but not higher stage) survival was significantly worse in FN; greater comorbidity is the main explanatory factor.

Conclusions: Work is needed to decrease cancer disparities and to monitor progress towards equity. Cancer Care Ontar-io’s second Aboriginal Cancer Strategy (ACSII, 2012) includes initiatives designed to reduce cancer disparities through, e.g., creation of educational resources, enhanced prevention and screening, and adding Aboriginal Patient Navigators.


W27SESSION 3

(Abstract ID: 88)

Cultural Safety


Is cultural safety enough? Confronting racism to address inequities in Indigenous health

Barry Lavallee, Linda Diffey, Thomas Dignan, Paul Tomascik

University of Manitoba, First Nations and Inuit Health Branch, Health Canada, Royal College of Physicians and Surgeons of Canada

Rooted in a violent colonial past and masked by our national identity as a multicultural, benevolent society, the racism expe-rienced by Indigenous people in Canada’s health care system is both pervasive and largely unacknowledged. Incidents such as the 2008 death of Brian Sinclair in a Winnipeg emergency room highlight the dire outcomes that racism can have for Indigenous patients. The Health Council of Canada (2012) notes that many Indigenous people do not trust mainstream health care services due to lack of safety related to stereotyping and racism, leading to delays and diagnosis at later stages of disease. Yet discourse around interventions to improve health outcomes for Indige-nous patients tends to focus on culture or barriers to access and avoid the examination of racism and oppression that are foun-dational to the problem.

This workshop will outline the work of two Canadian institu-tions in addressing racism in the context of Indigenous health: The new Indigenous Health course in undergraduate medicine at the University of Manitoba employs an anti-racism peda-gogical framework, an approach that poses challenges to both learners and instructors. Strategies for facilitating the “difficult dialogues’ about racism with students will be explored in this presentation. The Royal College’s CanMEDS Physician Com-petency Framework coupled with its Indigenous health values and principles statement provides a platform to promote cul-turally safe care. Cultural safety dismantles power structures between the Indigenous patient and the provider; it facilitates critical thinking and self-reflection in medical education and practice to confront racism.

W28SESSION 3

(Abstract ID: 163)

Equity


Manitoba First Nations Indicators of Wellbeing

Leona Star, Kathi Avery Kinew


Historically First Nations well-being has been measured against urban, Non-First Nations and Canadian standards. Manitoba First Nations (MFNs)are redefining the focus of research, moving away from a deficit orientated western model of defining wellbeing and health. As First Nations we have been defined through research as failing to achieve the same standards of middle class, non-First Nation Canadians. During a workshop called “Counting for Nationhood” in February 2007, 50 representatives from MFNs worked together to develop practical, community-based indica-tors of change which MFNs could use to track trends and pro-mote positive change. Through discussion MFNs participants set the goal of community based, positive, goal-oriented, culturally rooted/relevant indicators that made sense to First Nations. These indicators of change included many social determinants of health, but also the MFNs insistence that the indicators be grounded in a cultural foundation. Such indicators would empower First Nations to track their efforts in working from First Nations strengths and identity, toward closing the gap between First Nations state of social-economic-cultural-health status as compared with the rest of Canada. These indicators of wellbeing are currently being tested in the Manitoba regional survey component of the national First Nations led survey called the, First Nations Early Childhood, Education and Employment Survey (FNREEES). The FNREEES is a national survey that is based on the successful framework and methodology of the First Nations Regional Health Survey that is governed by the First Nations principles of OCAP.

W29SESSION 3

(Abstract ID: 234)

Education


Come walk in our moccasins: Strategies in Recruit-ment, Admissions and Curriculum at the Aboriginal Program at the University of Ottawa

Darlene Janet Kitty

Aboriginal Program, Faculty of Medicine, University of Ottawa

Since its inception in 2005, the Aboriginal Program at the Faculty of Medicine, University of Ottawa has endeavoured to address cultural competency and cultural safety of medical


students as part of the social accountability mandate and con-tribute to improved health and social issues of Indigenous pop-ulations. The Aboriginal Program has been successful in admit-ting and training Indigenous students to become physicians and supporting them through medical school. Several recruitment strategies will be described, which have helped to promote the program and inspire Indigenous youth, post-secondary and mature students to prepare and become physicians. For example, Mini-Medical Schools (MMS) sessions are organized and led by our Aboriginal medical students, portraying to the partici-pants what a day in medical school is like. This MMS simulate lectures, physical exam skills and diagnostic imaging sessions, and teach medical procedures, such as casting and suturing. Our medical students share their stories and advice on getting into medical school, inspiring participants that they too can become a physician. Their successful admission and progress through the medical program demonstrates to potential applicants that they too can “walk in their moccasins” in this supportive set-ting at the Ottawa Faculty of Medicine’s Aboriginal Program. Also, curriculum activities, such as the Aboriginal Celebra-tion,are done to sensitize all medical students on the health and social issues,complemented by engaging Indigenous commu-nity members and organizations. The Director and Program Co-ordinator of the Aboriginal Program work together with our students and faculty, so that all medical students become knowlegeable and practice with cultural competency and cul-tural safety in their residency and practice, with urban, rural and remote Indigenous communities.

W30SESSION 3

(Abstract ID: 172)

Research


Creating a First Nations health data repository in Ontario by linking the Indian Register to ICES health administrative data: a collaborative governance process that protects the interests of First Nations

David Henry, Tracy Antone, Carmen Jones, Saba Khan

Institute for Clinical Evaluative Sciences, Chiefs of Ontario

The Chiefs of Ontario, the Institute for Clinical Evaluative Sciences (ICES) and Cancer Care Ontario have established data-sharing and data-governance agreements that enabled transfer of the Indian Register (IR) from the Department of Aboriginal and Northern Affairs Canada to ICES. ICES as a prescribed entity under the Personal Health Information Pro-tection Act was able to receive the file with personal identifiers that enabled probabilistic matching of the records to the many health administrative files already held at ICES. After linkage, all files were anonymised and can now be used for disease sur-veillance, evaluation of quality of healthcare and for research into the health of First Nations people living on and off reserve.

The data governance agreements determine how and when the linked data-sets can be used. Data governance is currently over-seen by the Chiefs of Ontario and separate agreements are being discussed with other representative organisations and some communities. The agreements establish mutually beneficial and ethical partnerships to enable timely and relevant research studies using linked health administrative data. The agreements work in an open and collaborative manner that respects the First Nations principles of OCAPª (Ownership, Control, Access and Possession). At the workshop the history of these agreements will be presented by staff from The Chiefs of Ontario and ICES. The governance arrangements that protect the interests of First Nations people and communities will be discussed, along with the plans to use the linked data to support efforts to improve the health of First Nations in Ontario.

W31SESSION 4

(Abstract ID: 250)

Children’s Health

FRI. NOV. 21 – 11:00AM-11:45AM

The Status of Oral Health among Canada’s First Nations Peoples and Inuit

Amir Azarpazhooh, Dick Ito, Martin Chartier, Tracey Guitard, Hannah Tait Neufeld

Faculty of Dentistry-University of Toronto, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Public Health Agency of Canada, Thunder Bay District Health Unit and Simcoe Muskoka District Health Unit

Young children of First Nations and Inuit ancestry are 8.6 times more likely to have early childhood tooth decay treated under general anaesthesia in hospital than other Canadian chil-dren. More than 85% of Aboriginal children 3 to 5 years of age have experienced tooth decay with an average of 7 to 8 teeth affected. Not only young children, but First Nations peoples and Inuit across all age groups have poorer oral health compared to other Canadians. Clinical examination undertaken for oral health surveys indicated that higher percentages of First Nations peoples and Inuit required dental services in virtually all the categories assessed - fillings, extractions, root canals, dentures and periodontal treatments. As with dental decay, the need for treating gum disease, was more than eight times higher in the Aboriginal than for the non-Aboriginal population. In addi-tion to clinical examinations, as part of the oral health surveys, in self-reported questionnaires more First Nations participants reported having fair to poor oral health, avoiding particular foods due to oral problems, and having persistent pain in the mouth in the past 12 months, than the non-Aboriginal popula-tion. This workshop aims to bring a panel together to examine the data on the oral health status of First Nations Peoples and Inuit and their difficulties in access to dental care.


Oral diseases in children are an important public health issue. They are a public health problem because of their high prev-alence, their effects on the functional, psychological and social dimensions of a child’s well-being, and their high cost of treat-ment. Despite the gains in Canada in reducing the burden of oral disease, Canadian children continue to have a high rate of dental disease, and this burden of illness is disproportionately repre-sented by children in Aboriginal communities. In fact, young children of First Nations and Inuit ancestry are 8.6 times more likely to have early childhood tooth decay treated under general anaesthesia in hospital than other Canadian children. Also, more than 85% of Aboriginal children 3 to 5 years of age have experi-enced tooth decay with an average of 7 to 8 teeth affected.

High prevalence and severity of oral diseases in indigenous populations further compromises their nutrition, overall health, quality of life, and educational and work potential, exacerbating socioeconomic and health disparities. This workshop brings a panel of academic researchers, policy makers, and field clinicians to examine the data on the oral health status of First Nations Peoples and Inuit, to identify the barriers to access care, and to elaborate on potential solutions in addressing these inequalities.

W32SESSION 4

(Abstract Id: 58)

Women’s Health

FRI. NOV. 21 – 11:00AM-11:45AM

Trafficked: Why are Aboriginal Women at Increased Risk?

Eileen McMahon

Mount Sinai Hospital

Aim: Human trafficking is the “recruitment, transportation, transfer, harbouring or receipt of persons by means of threat or use of force or other forms of coercion, of abduction, of fraud, of deception”. The sexual exploitation of persons through human trafficking is a crime that disproportionately affects women and girls. Marginalized and exploited populations of women, and in particular Aboriginal women, are most vulnerable to being targeted. Understanding the historical background and mechanisms through which Aboriginal women and girls are at increased risk for being trafficked will assist service providers in responding to and caring for these victims.

Methods: Review relevant literature on human trafficking and Aboriginal women and girls including MEDLINE, CINAHL, the Joanna Briggs database, and Diane Redsky’s research through the Canadian Women’s Foundation National Task Force on Sex Trafficking of Girls and Young Women in Canada.

Results: There is a paucity of literature available on human traf-ficking as it relates to Aboriginal women and girls. However, the Canadian Women’s Foundation National Task Force on Sex

Trafficking of Girls and Young Women in Canada, a multi-site, cross country project, does provide crucial information regard-ing human trafficking in this marginalized group.

Conclusions: Human trafficking especially for the purpose of sexual exploitation, is happening in Canada and it is dispropor-tionately affecting Aboriginal women and girls. Understanding the mechanisms through which Aboriginal women and girls are disproportionately targeted will assist service providers. This workshop will provide the historical context as well as clinical tips for responding to and caring for victims.

W33SESSION 4

(Abstract ID: 107)

Children’s Health

FRI. NOV. 21 – 11:00AM-11:45AM

No Jordan’s Principle Cases in Canada? The Truth and Politics of Disparities in Access to Health and Social Services for First Nations Children Living On-Reserve

Vandna Sinha, Anne Blumenthal, Molly Churchill, Lucyna Lach, Nico Trocme

McGill University, University of Michigan

Jordan’s Principle is a child-first principle designed to ensure that First Nations children do not experience delays, denials or disruptions of services due to jurisdictional disputes. First Nations children are particularly vulnerable to jurisdictional disputes over payment for services because of a structural framework in which the federal government funds on-reserve health and social services for Status First Nations people, while provincial governments are responsible for funding and pro-viding these services to most other people. Accordingly, Jor-dan’s Principle is key to ensuring equitable services for First Nations children. Disparities in on-reserve health and social services are well documented, and anecdotal evidence suggests Jordan’s Principle cases may be prevalent. Yet, the federal gov-ernment has proclaimed that there are no known Jordan’s Prin-ciple cases in Canada. This workshop will present findings of research exploring the basis for this federal government claim and describing factors which contribute to delays, denials and disruptions of health and child welfare services for First Nations children. Research findings are based on a content analysis of Jordan’s Principle related documents and exploratory interviews with health service and child welfare workers. Research was conducted in partnership with the Assembly of First Nations, UNICEF Canada, the Canadian Paediatric Society, and the Canadian Association of Paediatric Health Centres. We draw on a human rights framework to asses the implications of cur-rent approaches to implementing Jordan’s Principle, and to addressing disparities in services, for First Nations children.


W34SESSION 4

(Abstract ID: 177)

Traditional

An Investigation into some Contemporary Self-Reg-ulatory Dynamics that Operate in and around First Nations Traditional Healing Systems

Julian Robbins

Independent Community Based Researcher

The evolution of health regulation processes in Canada has focused on the development of standards of practice premised upon the principle of “do no harm’ and the approval of these by government regulatory agencies. This principle of ‘do no harm’ are also present in other non-western systems of health-care and healing but their healing methodologies can often be misunderstood in the context of modern western medicine. This workshop will illicit discussion based on 4 communities of practice, examined by the author during his PhD thesis, that bring traditional indigenous knowledge and indigenous healers forward into health care and their approaches to regulation. The results of this exporatory study indicated that surrounding con-texts of meaning influence understandings about self-regulation and that these understandings are dynamic because contempo-rary practices of First Nations traditional healing can occur in different contexts. The study cautioned that unless we remain close to these “healer centred’ contexts, there is no guarantee that the self-regulatory value systems stemming from modern Western medical communities of practice will not be applied by default or that the emerging “integrative’ models of self-regula-tion developed between governments and First Nations will be an accurate representation of the true understandings that exist and are practiced in traditional Indigenous health systems.

W35SESSION 4

(Abstract ID: 49)

Environmental

FRI. NOV. 21 – 11:00AM-11:45AM

The potential contribution of exposure to persistent organic pollutants (POPs) and of psychosocial stress to enhanced risk for Type 2 diabetes (T2D) at Walpole Island First Nation (WIFN)

John R. Bend, Rosemary Williams, Gideon Koren, Michael J Rieder, Mary Jane Tucker, Naomi Williams, Phaedra Henley, Julie Hill, Zahra Jahedmotlagh, Regna Darnell, Christianne V Stephens, Stan Van Uum, Carol P Herbert, Chandan Chakraborty, Dean Jacobs, Judy Peters, Charles G Trick, John R. Bend

Walpole Island Health Centre, Departments of Medicine and Paedi-atrics, Schulich Medicine & Dentistry, Western University, Walpole

Island Heritage Centre, Department of Pathology, Department of Physiology & Pharmacology, Departments of Anthropology, Social Sciences and Pathology, McMaster University, Departments of Family Medicine and Pathology, Chatham-Kent Community Health Centre, Walpole Island Office, Department of Biology, Science and Interfaculty Program in Public Health, Siebens-Drake Medical Research Institute

Our systematic review (Henley et al, 2012) confirms the enhanced risk for T2D from environmental exposures to many different POPs including pesticides such as DDE and nonachlor, and several PCB congeners. Ettinger et al (2009) associated gestational diabetes with increasing environmental arsenic exposures. Our WIFN-Western University research partner-ship analyzed 71 POPs (20 pesticides and 71 PCB congeners) in serum; arsenic in blood and hair; and cortisol in hair (as a biomarker of psychosocial stress) in 57 volunteers at the Walpole Island Health Centre. We simultaneously conducted a health status survey with these individuals. Several factors relevant to T2D emerged from these investigations. Geometric mean plasma concentrations of several POPs positively associated with risk for T2D were significantly higher at WIFN than in general members of the Canadian (Health Canada, 2010 data) or US (NHANES, 2009 data) populations suggesting higher risk for T2D as a result of these current exposures. Blood concentra-tions of arsenic at WIFN approached those that have been pos-itively associated with gestational diabetes by Ettinger and her colleagues (2009). The hair cortisol content of WIFN volun-teers is significantly greater than in a Caucasian reference group residing near London, Ontario (Henley et al, 2013). Given that lower socio-economic status is positively associated with met-abolic syndrome (Abraham et al, 2007) our results suggest that combined environmental exposures to POPs and arsenic in concert with psychosocial stress at WIFN are partly responsible for the 3-5 fold higher incidence of T2D in First Nations com-munities in Canada.

W36SESSION 4

(Abstract ID: 70)

Cancer

FRI. NOV. 21 – 11:00AM-11:45AM

Addressing gaps in the continuity of cancer care with and for First Nations, Inuit and Métis living in rural and remote communities in Canada.

Colleen Patterson, Pam Tobin

Canadian Partnership Against Cancer

The Canadian Partnership Against Cancer has recently launched a national initiative to improve cancer care disparities experi-enced by First Peoples in Canada. This workshop will provide a high level overview of the initiative that includes partners from across First Nations, Inuit and Métis organizations, the health sector and the Partnership. The overall goal of the initiative is to


improve the cancer patient journey from diagnosis to transitions in care back to an individual’s home community.

This collaborative approach has been implemented among 9 jurisdictions (7 provinces and 2 territories) and will help us learn from one another and identify common solutions to improve the experience for First Nations, Inuit and Métis can-cer patients.

Through a brief presentation, we will demonstrate how engage-ment is being facilitated in participating jurisdictions and pro-vide context about why appropriate engagement of First Peoples improves the likelihood of initiative support and sustainability.

The focus will benefit individuals interested in learning more about engagement. In addition, examples of lessons learned will be shared through an Indigenous lens of story-telling.

Throughout the workshop, linkages will be drawn to cancer control disparities and promising strategies for community engagement among the Indigenous populations of Australia, New Zealand, Canada and the United States.

This is an opportunity for dialogue about what participants think are the health care disparities in their own regions and what is needed for the sustainability of people-specific cancer control initiatives that best reflect the needs and priorities of First Nations, Inuit and Métis communities.

W37SESSION 4

(Abstract ID: 148)

Cultural Safety

FRI. NOV. 21 – 11:00AM-11:45AM

Clinical tips for culturally-safe care: A new Consensus Guide for Health Professionals working with First Nations, Inuit and Métis

Sara Wolfe

SOGC

Youthful. Increasingly urbanized. Rapidly growing. First Nations, Inuit and Métis comprise the fastest growing segment of the Canadian population, with a birth rate that is nearly double that of the non-Aboriginal population. Whether working in urban, rural or remote areas, most women’s health professionals will encounter Aboriginal peoples in their practices and health professionals need skills and training to provide culturally-safe care.

Pregnancy is a unique opportunity to acknowledge and affirm the sexual and reproductive health rights, values and beliefs of First Nations, Inuit and Métis. Yet, many Aboriginal women experience poor access to culturally-safe maternal health care, and statistics show that this often leads to poor maternal health outcomes Ð low and high birth weight babies, preterm birth, gestational diabetes, caesarean sections and poor access to spe-cialist care.

In this session, we will present key facts, clinical tips and evi-dence-based recommendations for improved, culturally-safe care for Aboriginal women as published in the 2013 Consen-sus Guide for Health Professionals working with First Nations, Inuit and Métis developed by the Society of Obstetricians and Gynaecologists of Canada (SOGC)in partnership with the National Aboriginal Health Organization (NAHO).

W38WITHDRAWN

W39SESSION 4

(Abstract ID: 74)

Social Work

FRI. NOV. 21 – 11:00AM-11:45AM

Rahskwahseron:nis – Building bridges with Indigenous communities through decolonizing social work education

Michael Loft, Nicole Ives, Courtney Montour

McGill University, School of Social Work

This presentation focuses on how an interdisciplinary course can build bridges with Indigenous communities and nurture culturally safe practices through decolonizing social work edu-cation. McGill University’s School of Social Work began its first cultural immersion course, with the collaboration of the Kahn-awake Mohawk community, in 2010. The course creates space for students to gain insight into the cultural, social, economic, and health contexts of one First Nations community from the community’s perspective. It includes a unique grouping of Social Work, Law, Medicine and Anthropology students and introduces them to Indigenous teachings, particularly how these teachings connect with and apply to their own areas of study and their own cultural identities. Facilitating these connections supports the students’ practice by making evident firsthand how a holistic approach can address the multifaceted challenges fac-ing Indigenous families and communities. The course provides students with a grounded understanding of context when work-ing with Indigenous communities- they live and learn firsthand from community members through presentations, interactive workshops, cultural activities and adapted ceremonies.

Cultural immersion initiatives provide an opportunity to strengthen relationships and understanding among Indigenous and non-Indigenous learners, and aid in decolonizing social work practices. Presenters will discuss strategies on how social work educators can engage Indigenous communities in the pro-cess of social work learning, by facilitating community connec-tions and centering mutual dialog. Presenters will also describe how social work education today can be used to liberate and heal ruptures in our social fabric.


W40SESSION 4

(Abstract ID: 173)

Research

FRI. NOV. 21 – 11:00AM-11:45AM

Storytellers as Public Health Facilitators

Joahnna Kathleen Berti, Jeanette Levall, David Osawabine

Debajehmujig Storytellers

Storytellers as Public Health Facilitators Debajehmujig Storytell-ers proposes to deliver a community based story creation process, utilizing health professionals, Aboriginal Traditional Knowledge and community Elders. The Storytellers pioneered a unique story creation process that involved community Elders, artists, children and youth to create works that would reflect issues directly back to the community in ways that would deepened their under-standing and acceptance of their circumstances and facilitate pos-itive change. Debajehmujig Storytellers has been Canada’s First Aboriginal Theatre Company to be based in a Reserve commu-nity, Wikwemikong First Nation; touring with professional works, by and about Canada’s Indigenous people. Shirley Cheechoo started the company on Manitoulin Island in 1984.

The mandate of the organization was to share and educate about the culture, heritage and life ways of the Anishnabe. Since 1997, the Storytellers have partnered with Aboriginal Health Centres and Public Health Programs to engage Aboriginal communities in raising awareness about lifestyle changes that would impact community mental, physical and social health.

The process was developed through the company’s outreach practice in isolated and remote First Nations in the far North. The creation process identifies the community issue through community contacts addressing the issue, explores the com-munity challenge from a Traditional Healing perspective, and collaboratively generates a collaborative group metaphor for the change that needs to take place.

The workshop will utilize a small group collaborative format to bring participants through the creation process, building the confidence of participants to optimize project building within their own communities.

W41SESSION 5

(Abstract ID: 106)

Substance Abuse

FRI. NOV. 21 – 2:15PM-3:00PM

Prescription Drug Misuse - Looking at Prevention in Indigenous Communities through a Population Health Lens

Cheryl Currie

University of Lethbridge

Background: Psychoactive prescription drug misuse (PDM) is an increasing problem worldwide. In Canada, where pre-scription drugs are readily available, the associated harms have become a leading safety and public health concern. A number of Indigenous communities in Canada, both urban and rural,have identified PDM as a significant and growing concern.

Issue: To date, most work on substance use has focused on alco-hol and illicit drugs. The paucity of information available on the prevention, early identification and treatment of prescription drug problems has left both communities and health profession-als uncertain on how best to proceed.

Workshop: In this workshop I will examine key determinants of PDM among Indigenous youth and adults as identified in the various studies I have conducted on this topic. In this interactive workshop I will discuss what it means to approach PDM from an individual vs. population health perspective, and what it means to focus on the causes of cases or the causes of incidence and why it matters. I will review current evidence-based programs that are or may be adapted to prevent PDM within Indigenous communities, using the Frieden Framework for Public Health Action to organize audience participation. This workshop will generate interactivity and critical thinking across audience members. Space will be provided to brainstorm answers to challenging questions and to work as a group to consider those answers in the context of what is being learned. Attendees will be able to use this information to consider population-based strategies to address PDM in their communities.

W42SESSION 5

(Abstract ID: 174)

Women’s Health

FRI. NOV. 21 – 2:15PM-3:00PM

Beyond The Womb: Encouraging healthy pregnancies through cultural reconnection

Ashley Lamothe, Roslynn Baird

Southern Ontario Aboriginal Diabetes Initiative

Gestational Diabetes is a form of high glucose during preg-nancy and affects Indigenous women at a higher rate than the average Canadian women (4% of pregnancies versus 18%).Both Gestational Diabetes and prenatal high glucose can increase the rate of Childhood Obesity in children. The Southern Ontario Aboriginal Diabetes Initiative (SOADI) is a non profit organi-zation with the goal of reducing the staggering rates of diabe-tes in Southern Ontario through prevention and management, including Gestational Diabetes. In 2014, SOADI created the 7 Generations Gestational Diabetes Prevention Program with the goals of:- Raise awareness of Gestational Diabetes separate from Type 1 and 2;- Educate Front Line workers on incorporating


GDM material into regular programming;- Encourage Indig-enous specific content for before, during and after pregnancy. This was accomplished through resource tool kit development and Front Line Worker Training. In amalgamating medical information with traditional knowledge, 7 Generations has been able to develop a solid base of cultural programming and increase awareness to Indigenous communities. This being brought forward as a cultural GDM best practice and can be adapted to a variety of community programs. Future prenatal programs with focus on GDM prevention are needed to reduce high glucose during pregnancy thus reducing the risk level of childhood obesity. This can be done by returning to original instructions of health and wellness and keeping mothers, fathers and family in finding and keeping balance before, during, after and beyond the womb.

W43SESSION 5

(Abstract ID: 119)

Children’s Health

FRI. NOV. 21 – 2:15PM-3:00PM

Issues in service delivery to Canadian First Nations, Métis, and Inuit children with speech and language difficulties

Alice A. Eriks-Brophy, Francis Lori-Anne Davis-Hill, Jacque-line Dawn Smith, Laura Todd Hunter Leah Rae Radziwon

University of Toronto, Six Nations Health Services

To date, no principles or procedures deemed to be appropriate to assessment and intervention for First Nations, Métis, or Inuit children who are referred with potential speech and language difficulties and who present with a variety of communication and behavioral characteristics have been agreed upon in the field in order to ensure that these children receive appropriate and culturally valid services. This situation is compounded by a lack of culturally adapted test tools, the lack of accessible services in speech-language pathology, especially from culturally com-petent clinicians, and the diversity of the cultural, linguistic, and geographic environments of First Nations, Métis, and Inuit children in Canada; all of which complicate the situation sur-rounding appropriate service delivery to these children. The development of a culturally valid approach to assessment and intervention is therefore urgently needed and requires careful deliberation and discussion. This presentation will discuss the diverse issues surrounding valid and unbiased speech and lan-guage assessment and intervention for Canadian First Nations, Métis, and Inuit children. Questions for consideration in ser-vice provision include issues surrounding the appropriate use and scoring of existing standardized tests, the potential utility of developing new assessment tools that might be more applicable to the population, and the desirability of adopting alternative perspectives on assessment and intervention that may ensure

they these children receive more appropriate services. The pre-sentation will include implications for culturally appropriate assessment and intervention for First Nations, Métis, and Inuit children in domains other than speech and language, including psychology and education.

W44SESSION 5

(Abstract ID: 247)

Traditional

FRI. NOV. 21 – 2:15PM-3:00PM

Teaching cultural competence in the federal government - the Indigenous Community Development course

Rose LeMay

First Nations and Inuit Health Branch, Health Canada, FNIHB or Aboriginal Affairs and Northern Development Canada

The Indigenous Community Development course is an inten-sive two-day course for federal government employees, with a focus on building Indigenous cultural competence. Cultural competence is defined as first knowledge of Canada’s history and long-term impacts from colonization and Indian residential schools, second the personal awareness of one’s own culture so as to be able to respect others’ cultures, and third resulting in effective relationships with Aboriginal peoples in Canada. The key learning objectives are to increase cultural competence, increase knowledge on Canada’s history, and to build partner-ships of support for Aboriginal community success. Over 1000 participants have taken the highly successful course. This work-shop will cover two aspects of the two-day course: essential factors of Aboriginal cultural competence, and an overview of Canada’s history of relationship with Aboriginal peoples and the long-term impacts on health and community well-being.

W45SESSION 5

(Abstract ID: 197)

Environmental

FRI. NOV. 21 – 2:15PM-3:00PM

Uranium Mining and Health: Facts, Figures and Questions

Dale M. Dewar

Society of Rural Physicians of Canada

Uranium mining occurs mainly on indigenous territories whether in Canada and around the world. Uranium has distinct effects upon health. Research has been limited and many ques-tions remain.


Uranium is a radioactive heavy metal; mining is a messy busi-ness and environmental contamination occurs. Health effects of heavy metals are known but the longer term effects of radioac-tivity have been poorly examined.

This is a review of the current literature; it will present what is known about the effects of uranium on health and also present the questions that have arisen amongst people living in affected areas in Northern Saskatchewan, Australia and Arizona.

W46SESSION 5

(Abstract ID: 122)


FRI. NOV. 21 – 2:15PM-3:00PM

Respiratory health in First Nations, Inuit and Métis communities: Raising awareness through community outreach and engagement

Jennifer Dawn Walker, Oxana Latycheva, Wayne Warry

Nipissing University, Ontario Lung Association, Centre for Rural and Northern Health Research

Respiratory health is an important issue facing First Nations, Inuit and Métis communities. Higher prevalence of chronic respiratory disease in these communities is related to the con-fluence of risk factors arising from marginalization and poverty. Many of these risk factors are modifiable and communities can improve their outcomes by raising awareness of key environ-mental risk factors. However, there is a need for culturally safe materials and methods for sharing information about respiratory health in First Nations, Inuit and Métis communities.

To address this, a participatory intervention model was devel-oped to empower communities to create better awareness and to establish community-based resources on respiratory health. The project was led by the Asthma Society of Canada in part-nership with the Assembly of First Nations, Inuit Tapiriit Kanatami, Métis Nation of BC, and AllerGen NCE Inc. The model was implemented in five First Nations communities, one Métis community and one Inuit community across Canada in 2011/12.

This presentation will provide an overview of the model, the toolkit of resources that were developed, and the evaluation results. In general, the model and the toolkit materials were well-received by the communities. The process of implement-ing the model incorporated substantial community engagement and capacity building activities. Overall, participating commu-nities expressed increased levels of respiratory health awareness over the course of the project. In addition, the community sup-port for respiratory health practices increased in most commu-nities on most measures. Some communities showed marked progress in the development of community capacity to address respiratory health in their communities.

W47SESSION 5

(Abstract ID: 192)

Cultural Safety

FRI. NOV. 21 – 2:15PM-3:00PM

A new way of looking at good practices in Aboriginal communities: The Canadian Best Practice Initiative’s Aboriginal Ways Tried and True Methodological Framework

Nina Jetha, Lori Meckelborg, Andrea L.K. Johnston

Public Health Agency of Canada, Johnston Research Inc.

The Public Health Agency of Canada’s Canadian Best Practices Initiative (CBPI) is pleased to share a ground-breaking, cultur-ally relevant, and inclusive framework with which to identify systematically assess Aboriginal health promotion and preven-tion interventions.

This innovative approach expands our understanding of what constitutes practice-based evidence and provides a new tool to identify and include evidence-based interventions within a cul-tural context that respects traditional approaches to health and wellness. Using this tool, the CBPI has identified 30 new First Nations, Inuit and Métis interventions on priority public health topics that include mental wellness, strong healthy bodies, and maternal and child health which will be shared on the Best Prac-tices Portal (http://cbpp-pcpe.phac-aspc.gc.ca) in a new section entitled: Aboriginal Ways Tried and True. These interventions are intended to inspire and support public health practitioners, program developers, evaluators, and others by sharing informa-tion on programs and processes that have worked in Aboriginal contexts and thus helping to address health inequities.

This exciting framework will be described in this workshop along with a guided tour of the Best Practices Portal. The pre-senter(s) will share their experience with the development of the Framework methodology and selection criteria and will also introduce several of the selected Aboriginal Ways Tried and True featured on the Portal.

W48SESSION 5

(Abstract ID: 65)

Health Systems

FRI. NOV. 21 – 2:15PM-3:00PM

Back to Moss: Developing and Integrating Public Health Services for Northern Ontario First Nations Communities

Janet Gordon, Emily Paterson

Sioux Lookout First Nations Health Authority, Sioux Lookout Firs Nations Health Authority


The Sioux Lookout Area Chiefs, under Resolution 10/06, man-dated the Sioux Lookout First Nations Health Authority (SLF-NHA) to develop a regional public health system for 31 First Nations Communities in the Sioux Lookout Area. SLFNHA is developing the model with a three-year grant from the Health Services Integration Fund and in partnership with the First Nations Inuit Health Branch, the Ministry of Health and Long-term Care, local public health units, Northwestern LHIN, Tribal Councils, and First Nations communities. As 80% of our com-munities are remote fly-in communities, access to health services poses a continual challenge. Although there are some public health programs and services, the variety of funders and managers creates a patchwork system. Through our efforts of collaboration, we aim to integrate services to create a unique system that fits the needs of our First Nations communities while meeting the Ontario Public Health Standards. To date, we have conducted an environ-mental scan of First Nations public health systems, an assessment of public health services and human resources in our communi-ties, a conference with health directors, key informant interviews with frontline health program staff, and community sessions to inform the development of the public health framework. In Feb-ruary 2015 we will present a model and implementation plan to the Sioux Lookout Area Chiefs. During our workshop we will outline the steps of our project and allow opportunities for partic-ipants to share their perspectives and recommendations for a First Nations public health system.

W49SESSION 5

(Abstract ID: 105)

Midwifery

FRI. NOV. 21 – 2:15PM-3:00PM

Aboriginal Midwifery: Aboriginal Midwives working in Every Aboriginal Community

Ellen M. Blais

Association of Ontario Midwives

The Association of Ontario Midwives has been working to reclaim birth in Aboriginal communities across Ontario. This presentation will shed light on the work of many Aboriginal midwives and community stakeholders who are passionate about Aboriginal babies being born on the land to which they belong, and the work that has been done to try and open up a funding stream for communities across Ontario will be dis-cussed. The pathways to practice and the work of Aboriginal midwives working under the Exemption Clause in the Mid-wifery Act, as well as other models of Regulated midwifery care for Aboriginal families will be outlined. Traditional teachings about pregnancy and birth will also be shared.

The role of self determination for communities in bringing birth back is vital for the health of these communities as the mid-wife is often the only supports a woman may have during her

pregnancy in both rural and urban settings. Aboriginal midwives are also community leaders that can work with families in the context of the child welfare system to decrease stress in pregnancy and increase the rates of healthy outcomes for mothers and their babies by practicing culturally safe care and by integrating cultural practices and traditions in pregnancy, during birth and the post-partum. A short 4 minute film of a client story will be part of the presentation to highlight the role of the Aboriginal midwife in mitigating the social determinants of health.

W50SESSION 5

(Abstract ID: 179)

Research

FRI. NOV. 21 – 2:15PM-3:00PM

Addressing health inequalities by Indigenizing health services and research

Julie Bull

University of New Brunswick

There are significant health disparities between Indigenous and non-Indigenous people in Canada. Health care professionals play a key role in addressing these disparities. In order to meet the needs of Indigenous people, it is necessary to involve Indig-enous people themselves in the design and delivery of health care services and research. By drawing on the principles of eth-ical research involving Indigenous people (including OCAP (Ownership, Control, Access, Possession) and the Tri Council Policy Statement for Research Involving Humans, Chapter 9, Research with First Nations, Inuit, and Métis), this presentation will highlight best practices in working with Indigenous people while providing a framework by which clinicians and research-ers can meaningfully engage with Indigenous people. By focus-ing on a wholistic method with self-determination at the core, this presentation will illustrate how to implement the principles into practice by highlighting the integral role of relationship building with Indigenous people.

W51SESSION 6

(Abstract ID: 157)


FRI. NOV. 21 – 3:15PM-4:00PM

Embedding First Nations approaches into the preven-tion and management of chronic disease

Shannon Tania Waters

First Nations Health Authority

The First Nations Health Authority [FNHA] is currently devel-oping strategies to promote mental wellness and address chronic conditions, such as cancer, vascular disease and HIV.


The FNHA is taking a collaborative approach to developing these strategies in order to share knowledge and build capacity among healthcare providers who serve Indigenous people.

All strategies will include shared definitions of cultural safety and competency, patient-centred care and the role and place of spirituality and traditional healing. The strategies will also con-sider care across the continuum and across the lifespan.

First Nations people consider the mental, emotional, spiritual and physical aspects of health and the focus of the strategies will be “health through wellness’.This perspective will be a common FNHA approach to strategies for mental wellness and chronic conditions, meaning that wellness and wholistic perspectives will “surround’ each strategy so that keeping people well and supporting them across their life journey will be based on com-mon approaches.

As the FNHA has limited direct operational oversight for care delivery, the strategies will elaborate on the role of advocacy, engagement and collaborative partnerships.

FNHA’s vascular strategy [heart disease, stroke, diabetes, renal disease] is set for release in October 2014. This work is being done in partnership with government, experts and research institutes. The strategy, process, successes, challenges and rec-ommendations for improvement will be presented at the Indig-enous Health Conference.

W52SESSION 6

(Abstract ID: 128)

Substance Abuse

FRI. NOV. 21 – 3:15PM-4:00PM

Honouring Our Strengths: Indigenous Culture as Inter-vention in Addictions Treatment

Colleen Dell, Carol Hopkins, Peter Menzies

University of Saskatchewan, National Native Addictions Partnership Foundation (NNAPF), CAMH

The aim of our community-based research team’s work is to eval-uate the effectiveness of First Nations culture as a health inter-vention in alcohol and drug treatment. Health for First Nations is broadly envisioned as wellness and is understood to exist where there is physical, emotional, mental, and spiritual harmony. We gathered understanding of how Indigenous traditional culture is understood and practiced at a sample of 12 First Nations residen-tial treatment programs by undertaking a three day environmen-tal scan. From this, a valid instrument to measure the impact of cultural interventions on client wellness is being developed. We prioritized Indigenous knowledge in our data analysis. In doing so, we applied 3 “lenses’ to analyzing the information we collected across the treatment centres. We involved treatment centre partici-pants, Indigenous knowledge keepers and research team members. Our work resulted in the development of a wellness framework

addressing physical, emotional, mental, and spiritual wellbeing and the identification of 22 cultural interventions to facilitate well-ness. These results were verified among our varied team members, participating treatment centres and their communities at large. Indigenous knowledge shares that traditional culture is vital for client healing. Our project is the first of its kind in Canada and is suitably timed with renewal processes underway in Canada’s First Nations addictions treatment system. A key recommendation of the renewal has been the establishment of a culturally competent evidence base to document the nature and demonstrate the effec-tiveness of cultural interventions within treatment programs.

W53SESSION 6

(ABSTRACT ID: 151)

Women’s Health

FRI. NOV. 21 – 3:15PM-4:00PM

The Aboriginal Women’s Health Intervention: What is the potential for contributing to social change?

Colleen Varcoe, Jane Inyallie, Linda Day, Madeleine Dion-Stout, Holly MacKenzie, Annette Browne, Marilyn Ford-Gilboe

University of British Columbia, Central Interior Native Health, Vancouver Native Health Society, University of Western Ontario

Indigenous women in Canada experience disproportionate levels of intersecting forms of violence including interpersonal and structural violence such as racism and policy-induced pov-erty. Our goals are to (a) examine whether a health promotion intervention designed for women who have experienced inti-mate partner violence can improve the health and wellbeing of Indigenous women living in an urban context and (b) make a “shift happen” to disrupt pernicious stereotypes about Indige-nous women that obscure the effects of and responses to inter-secting forms of violence. The study involves the integration of culture and traditional practices in an Elder-supported Cir-cle, and 1:1 support of the women by nurses. We are working simultaneously to support women to improve their health, and shift public and health care providers’ perceptions in order to promote social justice, and health and healthcare equity. In this workshop, we discuss our development process, including: a) guidance from an expert reference group of Indigenous women, and interviews with Elders, b) integration of Cree concepts to loosen the colonial confines of working in English, and c) a pilot test for acceptability and feasibility prior to the full study. We discuss the results from the pilot showing considerable improvement in health and quality of life for participants, and changes made to the intervention based on the pilot. We also report findings from the first cohort of women who completed the intervention in the full study. Workshop participants will engage in dialogue regarding how research findings can be used toward broader change.


W54SESSION 6

(Abstract ID: 171)

Food Security/Nutrition

FRI. NOV. 21 – 3:15PM-4:30PM

Use-and-Occupancy Mapping: A tool to support food security in aboriginal communities

Daniel Tobias

D.Tobias Consulting Inc.

Food security is a major issue in many aboriginal communi-ties. For many of those communities, land and marine-based resources such as fish, moose, caribou and waterfowl are a major source of high quality calories. These resources have been destroyed in some communities and are threatened in others by extractive-industries such as mining, logging and oil and gas. Land Use-and-Occupancy Mapping is a survey research-method, first developed by the Inuit in Arctic Canada, that is used to document a community’s reliance on these land and marine-based food resources. The data and geo-coded maps, the products of these surveys, are used by aboriginal communi-ties as evidence of their use of the land as a food-supply in nego-tiations with resource companies and government agencies.

This workshop will: describe the use-and-occupancy map-ping methodology used by the presenter over the past six years as documented in the 2010 best-methods book, “Living Proof: The Essential Data-Collection Guide for Indigenous Use-and-Occupancy Map Surveys” (T. Tobias 2009); articulate the strategies used to implement this methodology in aboriginal communities across Canada and Australia; provide examples of situations where this tool has been useful; showcase some of the finished map products; and provide participants with the opportunity to role play negotiations using maps that do and do not include use-and-occupancy mapping data to highlight the value of the tool.

W55SESSION 6

(Abstract ID: 232)

Cultural Safety

FRI. NOV. 21 – 3:15PM-4:00PM

A Journey to Cultural Competency and Safety: Highlights of IPAC-AFMC Collaborative Activities

Darlene Janet Kitty

Indigenous Physicians Association of Canada

The Indigenous Physicians Association of Canada (IPAC) has collaborated with the Association of Faculties of Medicine of Canada (AFMC), producing several documents regarding First Nations, Inuit and Métis (FNIM) Core Competencies,

Admissions and Curriculum, which will be briefly described. In 2008, two surveys were conducted to see how Canadian med-ical schools were carrying out these recommendations. This year, a survey of all Canadian medical schools was conducted, looking at Indigenous student recruitment, admissions and support including academic, personal and financial resources. Indigenous health curriculum content and methods, as well as community engagement as outlined in the FNIM Core Compe-tencies and Curriculum Toolkit was also surveyed. This survey assessed how well Canadian medical schools have taken on the recommended curricular and admissions activities outlined by IPAC and AFMC. We found similar and innovative ways that Indigenous health curriculum, Admissions and Student support are carried out. Results showed that most schools incorporate lecture and case-based activities to teach Indigenous health, and are encouraged to utilize Indigenous community resources, such as Elders, to add cultural perspectives. There are clinical expe-riences offered by most schools, including urban centres, rural and remote communities. Various recruitment activities have helped to increase medical schools admissions of Indigenous students since 2008. Canadian medical schools have progressed in producing Indigenous physicians and training all students to become culturally competent in working in a culturally safe way, with Indigenous patients, families and communities. This can be potentially echoed in other health professional programs, ultimately to reduce Indigenous health inequities through cul-tural competency and safety.

W56SESSION 6

(Abstract ID: 156)

Midwifery

FRI. NOV. 21 – 3:15PM-4:00PM

Revolutionary Care: Indigenous Midwifery

Cheryllee Bourgeois, Billie Allan

Seventh Generation Midwives Toronto, Well Living House

This workshop will address the role of Indigenous midwives in their communities and the revolutionary nature of their work. More specifically, the presenters will highlight Indige-nous midwifery led research, including an ambitious commu-nity based population health research study currently under-way in Toronto. In addition, participants will be introduced to examples of Indigenous midwifery leadership in health care systems change as demonstrated through ground breaking proj-ects such as the Toronto Birth Centre, the Midwifery program in the North West Territories and the efforts of the National Aboriginal Council of Midwives (NACM) to bring birth closer to home for Indigenous people in Canada. Finally, the presenta-tion will discuss Indigenous approaches to health care provision in reproductive,maternal and infant health that create lasting positive impacts for women, infants, families, communities and Nations.


Participants will be invited to engage in dialogue about the ongo-ing revitalization of Indigenous midwifery and the implications for their own areas of work. This workshop will be of particular interest to health care practitioners and social service providers working with Indigenous women of childbearing age, as well as policy makers and researchers working to advance the health and well being of Indigenous families, communities and Nations.

W57SESSION 6

(Abstract ID: 180)

Research

FRI. NOV. 21 – 3:15PM-4:00PM

Using record linkage to study chronic diseases in the Métis population in Ontario

David Henry, Storm J Russell, Wenda Watteyne, Saba Khan

Institute for Clinical Evaluative Sciences and University of Toronto, Métis Nation of Ontario , Institute for Clinical Evaluative Sciences

The Métis Nation of Ontario (MNO) maintains a register for those who can supply genealogical documentation and proof of Aboriginal ancestry. A data sharing and governance agreement was established between MNO and ICES to enable linkage of the citizenship registry with Ontario health administrative data. Of 14,480 individuals in the Métis registry, 14,021 (96.8%) were linked. After anonymisation the linked records were used to study the incidence and prevalence of a range of chronic dis-eases and cancer. We can identify several factors underpinning the success of this work: 1) the project was conceived of and initiated by the MNO who retained control at all times 2) ICES is a prescribed entity that can legally receive link and analyse personal health information. This avoided lengthy applications to government departments to release data 3) engaged from the start ICES brought technical skills in the linkage and analysis of data and clinical expertise to the interpretation of findings. 3) planning and execution of the analysis and writing phases of studies were collaborative at all times 4) final decisions about data presentation and interpretation were made by the MNO 5) communication of the data was planned and carried out collab-oratively. The products of this work included reports generated for use by the Métis population, health professionals and pol-icy makers, and fact sheets disseminated at multiple meetings. These experiences and data from the studies will be presented at the workshop.

W58SESSION 6

(Abstract ID: 81)

Social Work

FRI. NOV. 21 – 3:15PM-4:00PM

One Canoe, One Oar: Navigating mental health with our Indigenous youth, a wholistic approach.

Ela Smith

Wholistic Child and Youth

The question of how to work “effectively “with Aboriginal children, youth and their families has been largely debated in social work and particularly in the field of mental health and addictions. Indigenous mental health workers insist on the need to develop practices rooted in the worldviews of Indigenous people, the culture and traditions of our different Nations.

This interactive workshop will present a social work, Indig-enous-based approach to work with Aboriginal youth facing mental health and addictions from the perspective of a canoe trip. The guiding principle of our agency: One Canoe, One Oarwill be developed. This approach is rooted in Indigenous principles of self-determination, non-interference, intercon-nectedness, relational and reciprocal therapeutic work.

According to this principle, we embark on a journey with our clients on their canoe. The canoe has room for more than one person, but there is only one oar. The oar belongs and must remain in the hands of the client so that he or she can determine the course of the journey. If the goal of the therapy may be the same from a Eurowestern perspective (allowing the client to acquire enough navigating skills to be able to paddle the canoe, make a safe journey, and ideally, enjoy the ride) the clinician’s role, the course of the therapy and the clinical setting are sig-nificantly different from the One Canoe, One Oar perspective.

W59SESSION 6

(ABSTRACT ID:162)

Women’s Health

FRI. NOV. 21 – 3:15PM-4:00PM

Solidarity not appropriation: How non-Indigenous healthcare providers and organizations can support Indigenous women’s reproductive justice and sovereignty

Holly A. McKenzie


Many non-Indigenous organizations provide reproductive health services informed by reproductive choice, or a pro-choice politics. Indeed, since within the current conservative climate access (and legal rights) to abortion and birth control


remains under threat, providing pro-choice services is political. However, as women of colour have consistently pointed out, the “pro-choice’ framework is limited. Women of colour con-tinue to fight for their right to give birth to and raise their own children, a right denied to many Indigenous women in Canada through several colonial mechanisms, such as, the coercive ster-ilization of Indigenous women and the apprehension of Indig-enous children from their families through residential schools and the child welfare system. Pro-choice organizing and ser-vices continue to marginalize these historical and present-day violations of Indigenous women’s rights.

A number of organizations led by women of colour have articu-lated, and employ, a reproductive justice framework. Reproduc-tive justice asserts that one has the right to determine whether or not to have children and to raise one’s children in safe and healthy environments. Indigenous women’s activism has long made the interconnections between reproductive justice and community self-determination visible. First, this workshop will explore how “reproductive choice’ and “reproductive justice’ frameworks make certain violations of Indigenous women’s reproductive self-determination (in)visible. We will discuss how recently some pro-choice services and organizations have adopted the label ‘reproductive justice’ without significantly changing their practices. Finally, we will examine how repro-ductive service providers can better support Indigenous wom-en’s reproductive justice and self-determination while disrupt-ing politics of exclusion, domination and appropriation.


Poster AbstractsP01(Abstract ID: 59)

Anishinaabek Cervical Cancer Screening Study: A mixed-methods approach to a community-based participatory cervical screening project in Indigenous communities of Northwest Ontario

Brianne Wood, Julian Little, Pauline Sameshima, Pamela Wakewich, Ingeborg Zehbe

University of Ottawa, Lakehead University, Thunder Bay Regional Research Institute

Histories of colonialism have led to health inequities that con-tinue in most Indigenous communities today. In particular, First Nations women endure a higher burden of cervical cancer compared to the general population. The Anishinaabek Cer-vical Cancer Screening Study (ACCSS) is a community-based participatory research project investigating the cervical cancer burden in ten First Nations communities in Northwest Ontario. In ACCSS, findings from qualitative interviews and focus groups helped to inform and implement a cluster-randomized controlled cervical screening trial (ISCRTN84617261). In this trial, communities were randomized such that women were first offered either (1) Pap testing, the current cervical screening modality offered in Ontario, and a self-collection method for HPV testing later; or (2) the self-collection method followed by Pap testing. In ACCSS, community-based research assistants (CBRAs), a community steering committee, and local health care providers have shaped how cervical screening is offered to women as part of the ACCSS trial. Incorporating arts-inte-grated research into new educational strategies, working with CBRAs to engage community members in culturally sensitive dialogue about cervical cancer, and frequent communication with community representatives encouraged active commu-nity participation in ACCSS. The mixed-methods approach in ACCSS allows multiple voices to be presented, from screening participants to health care providers and community stakehold-ers, broadening our understanding of cervical screening cul-ture in these First Nations communities. The community-based approach with attention to ethical, reparative outlooks, along-side mixed research methodologies will enhance the relevance and impact of ACCSS when sharing findings with communities and making recommendations to stakeholders about cervical screening.

P02(Abstract ID: 96)

Cultural Adaptation of a Shared Decision Making Tool With Aboriginal Women: A Qualitative Study

Janet Jull, Audrey Giles, Yvonne Boyer, Dawn Stacey

University of Ottawa, Institute of Population Health, University of Ottawa, Brandon University

Objective: This study describes the adaptation and usability testing of the Ottawa Personal Decision Guide (OPDG) to sup-port health decision-making by Aboriginal women.

Methods: An interpretive descriptive qualitative study was con-ducted using a postcolonial theoretical lens. An advisory group with representation from the Aboriginal community partner (Minwaashin Lodge) developed a mutually agreed-upon ethical framework. Eligible participants were women at Minwaashin Lodge, which provides support to Aboriginal women who are survivors of violence. The OPDG was first discussed with par-ticipants in focus groups and then used with decision coaching during individual usability testing interviews. Iterative adapta-tions were made to the OPDG. Transcripts were coded using thematic analysis with themes identified and then corroborated by Minwaashin Lodge leaders.

Results: Nineteen Aboriginal women identifying as First Nations, Métis or Inuit participated in one of two focus groups (n=13) or usability interviews (n=6). Seven themes reflected or affirmed OPDG adaptations: 1) “This paper makes it hard for me to show that I am capable of making decisions”; 2) “I am responsible for my decisions”; 3) “My past and current expe-riences affect the way I make decisions”; 4) “People need to talk with people”; 5) “I need to fully participate in making my decisions”; 6) “ I need to explore my decisions in a meaningful way”; 7) I need respect for my traditional learning and commu-nication style”.

Conclusion: A culturally adapted lower health literacy version of the OPDG with decision coaching was found to better meet the needs of a population of Aboriginal women.


Prevalence of Abuse and Intimate Partner Violence Surgical Evaluation (PRAISE) in Nunavut: proposed project

Aparna Swaminathan, Kim Madden, Mohit Bhandari

Family Medicine Centre, St. Joseph’s Health Centre, Toronto, McMaster University, Division of Orthopedic Surgery, McMaster University

Background: The experience of violence in aboriginal com-munities in Canada has far out-paced efforts to quantify the scale of the problem and develop effective interventions. The situation in Nunavut is particularly acute: the rate of police-re-ported violent crimes against women in Nunavut is 13 times higher than the rate for Canada overall, with the majority of these crimes caused by an intimate partner. The Prevalence of Abuse and Intimate partner violence Surgical Evaluation (PRAISE) in orthopedic fracture clinics is the largest multi-national prevalence study of its kind in orthopedics. Its study


team will now turn its focus to documenting the experiences of women presenting to health centres with musculoskeletal trauma in Nunavut.

Methods: A partnership will be established with the Government of Nunavut, orthopedic centres in Ottawa, Winnipeg and Yel-lowknife, as well as other agencies working on this issue in the territory. The project will seek to establish the prevalence rate of intimate partner violence experienced by women presenting to health centres in Nunavut with musculoskeletal injuries. Women who consent will anonymously answer a validated questionnaire on their health and experience of violence in the past 12 months and in their lifetime. The target sample size will be500 completed questionnaires over a6 month period. All participants will be given information on local resources for support.

Expected Outcomes: A multivariable logistic regression analysis will be used to analyze and investigate the risk factors associated with IPV. The findings will be shared with the participating agencies to aid their existing activities, program development and impact assessment.


The Green Light Program: A Community Chosen Health Intervention

Vivian R Ramsden, Kathleen McMullin, Priscilla Gardipy, Jarret Nelson, Shari McKay, Chandima Karunanayake, Sylvia Abonyi, Jo-Ann Episkinew, Punam Pahwa, James Dosman

University of Saskatchewan, Willow Cree Health Centre, Duck Lake, SK, William Charles Health Centre, Montreal Lake Cree Nation, Montreal Lake, SK, University of Regina

Background: In partnership with two Saskatchewan First Nations communities, the study entitled Assess, Redress, Re-assess: Addressing Disparities in Respiratory Health Among First Nations People aims to improve respiratory health out-comes with community members. The Green Light Program, celebrating smoke-free homes, is a community chosen, evi-dence-informed activity to be undertaken by and with the community.

Objective: To increase the number of smoke-free homes and thereby reduce the impact that environmental tobacco smoke has on children and older adults in communities that have high rates of tobacco mis-use.

Methods: The overall design of this community chosen, evi-dence-informed activity was informed by participatory health research (the communities will be engaged in the implemen-tation of the Green Light Program), transformative action research and program evaluation.

Results: Number of homes in Community A that participated in the research study=173/321=53.9%. Number of homes that

were smoke-free at Baseline in Community A= 73/173=42.2%. However, all 321 households in Community A will be invited to participate in the Green Light Program.

Number of homes in Community B that participated in the study=233/259=90%. Number of homes that were smoke free at Baseline in Community B=117/233=50.2%. However, all 259 households in Community B will be invited to participate in the Green Light Program.

By choosing the Green Light Program, these communities became part of a larger initiative which includes 61 other com-munities in Saskatchewan & Manitoba.

Conclusions: Since this is the second year of a five year program, results will be reported to September 30, 2014.


The Development and Testing of an Aboriginal Chil-dren’s Interactive Measure of Pain and Hurt

Margot Latimer, Sharon Rudderham, Vanessa Nickerson, Kayla Rudderham, Allen Finley

IWK Health Centre, Eskasoni Health Centre

Background: Aboriginal children have a higher prevalence of chronic, disease-related and dental pain, and are more likely than non-Aboriginal children to not be treated for it. There is some indication that children are stoic and do not express their pain and hurt in a way Western clinicians are trained to assess it. Finding a culturally appropriate mechanism to assist the chil-dren to convey their hurt may be an important step in reducing it and improving Aboriginal children’s wellbeing.

Objective: To describe the development and content valid-ity testing of an Aboriginal children’s interactive hurt app mechanism.

Sample & Setting: Aboriginal children and youth from Eastern Canadian urban and rural communities.

Procedure: This presentation will outline our team’s mixed method approach used to develop a mechanism for Aborigi-nal children to convey their pain and hurt. Using a Two-eyed seeing perspective combining the best of Indigenous ways of knowing (narrative, artwork) and established Western gold standard pain assessment mechanisms a novel interactive mech-anism has been created. The steps taken to develop and validate the application’s content will be described.

Conclusion: Pain care remains a major problem in health care irrespective of culture or place of residence. Untreated pain may be even more profound and result in poorer outcomes amongst Aboriginal children given high rates of ill health. The audi-ence will learn about baseline research conducted by this team and consequently the process to develop a culturally appropriate mechanism to assist children to convey their pain and hurt.



Risk and Resilience: exploring the sexual health of Cree youth with FASD

Alanna Mihic, Florence Large, Dionne Gesink

University of Toronto, Saddle Lake Eagle Healing Lodge

Fetal Alcohol Spectrum Disorder (FASD) describes the range of permanent cognitive and behavioural disabilities in children with prenatal alcohol exposure. Youth with FASD exhibit high rates of inappropriate sexual behaviour, are highly vulnerable to sexual victimization and are perpetrators of sexual offenses.

Work from a community-based participatory research partner-ship between Saddle Lake Cree First Nation and the Univer-sity of Toronto found the sexual health of community members with FASD to be of concern to community members.

Between March and May 2014, five circles (Cree-adapted focus groups) were held to explore the sources of risk and resilience in the lives of youth with FASD living in Saddle Lake. Partic-ipants were personal and professional care-providers of youth with FASD, including biological, foster and adoptive parents, mothers with FASD, and professionals in the fields of education, social work, child social services and FASD diagnostic services.

Factors promoting resilience against sexual ill-health include champions in the home and school, which act as advocates, pro-vide stability, routine and protection. Importantly, the champi-ons themselves need support from social services. Factors pro-moting risk include: 1) the historic influence of the church and stigma around sexual health education and protection; 2) inac-curate sources of sexual health information; and 3) the failure of social services to be equipped/trained to deal with the complex needs of patients with FASD (such as co-occurring mental ill-health, addictions and disability).

Holistic and dynamic social support programming is necessary to promote family-level stability, which in turn promotes resil-ience in the youth’s lives.

P07(Abstract 270)

Mentoring Relationships and the Health and Well-Be-ing of Aboriginal Youth

David Dewit, Tara Elton-Marshall, Samantha Wells

Background. Although evidence suggests that youth involved in program-supported mentoring relationships experience many health and social benefits, little is known about the mentoring experiences of Aboriginal youth. Aboriginals often prefer to be paired with Aboriginal volunteers. However, a shortage of volunteers has resulted in most youth not being paired to vol-unteers sharing the same cultural background. The needs of Aboriginal youth may be different from those of non-Aboriginal

youth with evidence suggesting a greater emphasis on values of kinship, spirituality, self-reliance, and finding meaning in social relationships. These cultural differences, combined with a shortage of volunteers, may impact the extent to which Aborig-inal youth benefit from mainstream mentoring programs.

Objective. This study compares the mentoring relationship experiences and possible health and social benefits of pro-gram-supported mentoring for Aboriginal and non-Aboriginal youth.

Method. 130 Aboriginal youth and 848 non-Aboriginal youth ages 6-17 participated in a national survey of Big Brothers Big Sisters mentoring relationships. Non-Aboriginal youth were divided into two groups: White (European Canadian) (n=516) and other visible minorities (African, Asian, and Hispanic Canadian) (n=332). Youth and parents reported on youth men-tal health and behavior at baseline (before youth could be paired to a volunteer) and at five follow-ups (until 30 months). At follow-up, youth, parents, and volunteers reported on aspects of the mentoring relationship.

Results. 2% of the 516 adult volunteers were Aboriginal com-pared to 13% of youth. Aboriginal youth were just as likely to be paired to a volunteer as other youth but more likely to see their relationships dissolve. Aboriginal youth spent more time each week doing things with their volunteers than White youth and participated in a greater range of activities. Aboriginal youth were less likely than White youth to perceive shared sim-ilarities with their volunteers. However, they were more likely than White and other visible minority youth to view their men-toring relationships as trusting and happy. Adjusting for baseline covariates, at follow-up, mentored Aboriginal youth (relative to non-mentored youth) experienced significantly fewer con-duct and emotional problems, fewer symptoms of depression and social anxiety, and stronger social skills. Implications for culturally relevant mentoring programs are discussed.


Urban First Nations Men: Narratives Of Identity. Striving To Live A Balanced Life

Celina Carter, Jennifer Lapum, Lynn Lavallèe, Lori Schindel Martin

Ryerson University

Dominant discourse contains an abundance of negative stereo-typical images of First Nations males that are steeped in colo-nial issues. These images and racialized stories are locked in time and can influence both First Nations mens’ sense of self and health care providers’ practices. To counter these negative stereotypes a strength-based perspective and the theoretical lens of Two-Eyed Seeing was used to conduct a narrative study to explore the identity of First Nations men who identify as liv-ing a balanced life within the urban environment of Toronto.


Three First Nations men participated in two semi-structured interviews and Anishnaabe Symbol-Based Reflection. Findings indicate that these men’s narratives of identity are focused on positive mindsets and resilience. Furthermore, positive First Nations identity was supported by having mentors, knowing family histories, and connecting with healthy Aboriginal com-munities. Implications of this research are three fold, first, it provides positive stories about First Nations men striving to live a balanced life, which other First Nations men and children may benefit from hearing. Second, the positive stories counter negative stereotypes prevalent in dominant discourse. Third, it encourages healthcare providers to employ strength-based and decolonizing frameworks, as well as reflexive practices which reveal biases, in order to promote culturally safe care.


Suicide Prevention Interventions in the Circumpolar North: a Scoping Review

Jennifer Redvers, Sahar Fanian, Susan Chatwood


Background: In circumpolar regions, Indigenous populations experience disproportionately higher rates of suicide than non-Indigenous populations, most notably among youth. Sui-cide presents a serious public health problem across northern regions. Thus, there is need for a review of current suicide pre-vention efforts for Indigenous peoples in circumpolar regions in order to inform future interventions.

Objective: This scoping review examines publications in the primary and grey literature in order to map current suicide interventions and mental health promotion efforts targeting Indigenous communities across the circumpolar north.

Design: Online databases were searched to identify suicide inter-ventions for Indigenous peoples in circumpolar regions from 2004-2014. To capture relevant interventions published outside of the primary literature, regional, national and international researchers, policymakers, health practitioners and community members were consulted and online searches were performed.

Results: Of 187 papers examined in the primary literature, 17 articles published from 2004-2014 described specific suicide interventions for circumpolar Indigenous peoples. Among these, 8 provided a description of evaluation methods and results. The majority of relevant publications were found in the grey literature.

Conclusions: Publications on suicide interventions for Indige-nous populations in circumpolar regions are lacking in the pri-mary literature and, among those published, there exists a bias in favour of North American interventions. Furthermore, there is critical need for more evaluations to be conducted and for the development of new evaluation tools and indicators. The present literature suggests that community-based, culturally-relevant

interventions are essential to preventing suicide and promoting mental wellness and resiliency among Indigenous groups in cir-cumpolar contexts.


Relieving the measurement dilemma: A revolutionary method for assessing risk of abuse and diversion in pain patients

Carina Fiedeldey-Van Dijk

ePsy Consultancy

While the misuse, abuse and diversion of chronic pain drugs are alarmingly on the rise in North America, aberrant behav-ior remains under-detected and –reported. The Risk Assess-ment for Controlled Substances™ (RACS) is psychometric measure of an individual’s risk of diverting medication from what is intended. This may stem from varying behavior pat-terns associated with Abuse, Manipulation, and/or Deception, depending on six drivers of aberrancy:

Derivative Effect Personal Desperation Emotional Need Transactional Strain

Unsupportive Context Symptomatic State

Also included in the assessment is a Depression Indicator and Critical Alerts. The RACS the preferred detector to provide an individual’s scientifically orchestrated diversion results at your fingertips in one package. The RACS was developed to offer six parallel versions of 43 statements that individuals can complete in about five minutes during consecutive visits to health provid-ers. This feature enables dynamic tracking over time to verify and highlight changes in patient/client behavior.

Providers get assessment results from the RACS in graphed and listed formats, with the ability to drill down further where needed. Specifically, comparative percentage scores are pro-vided for each of the above aspects, along with a simple inter-pretational guideline indicating any degree of risk. Providers are able to view specific aberrancy indicators that may be partic-ularly revealing in understanding and follow-up of an individ-ual’s displayed risk of diversion. Published by Verimed, results from the RACS can also help combat medical insurance fraud, offer a safer supply chain, and identify individuals early on with the purpose of effecting early treatment.


Naturally Acquired Antibody in an Aboriginal Population at High Risk for Invasive Haemophilus influenzae Type A Disease

Eli B Nix, Kylie Williams, Andrew Cox, Frank St. Michael, William McCready, Marina Ulanova


Northern Ontario School of Medicine, National Research Council

Background. Haemophilus influenzae type a (Hia) has emerged as an important cause of invasive bacterial disease among certain North American Indigenous groups. Anti-Hia capsular poly-saccharide antibodies are the major defence mechanism against invasive infection. Predominantly, adult cases of invasive Hia disease occur among immunocompromised individuals.

Methods. Functional antibody activity against Hia was studied in 70 Aboriginal and 70 non-Aboriginal healthy adults using a serum bactericidal assay (SBA). Anti-Hia capsular polysaccharide antibody concentrations (IgG, IgM) and functional activity were assessed in 30 Aboriginal and 30 non-Aboriginal patients with chronic renal failure (CRF) and compared to those of healthy controls of corresponding ethnic background and similar age.

Results. Among healthy adults, the Aboriginal group exhibited significantly higher anti-Hia functional antibody activity com-pared to those of the non-Aboriginals. The same was true for Aboriginal versus non-Aboriginal CRF patients. Regarding the naturally acquired anti-Hia antibody, overall IgM concentra-tions were markedly higher compared to IgG.

Conclusion. Our results suggest that the high rate of invasive Hia disease among affected Aboriginal populations is not due to a decreased capacity to produce functional anti-Hia antibodies. Increased anti-Hia antibody functional activity among Aborig-inal groups may be explained by a high rate of Hia circulation within Aboriginal communities.


Exposure to persistent organic pollutants and elevated psychosocial stress may enhance the risk for Type 2 diabetes at Attawapiskat First Nation in northern Ontario

John R. Bend, Barbara Lent, Mary Jane Tucker, Zahra Jahedmotlagh, Carol P Herbert, Dean Jacobs, Joyce Johnson, Jackie Hookimaw-Witt, Norbert Witt, John Hookimaw (deceased), Mike Gull, Theresa Spence, Regna Darnell, Gideon Koren, Stan Van Uum, Charles G Trick

Department of Pathology, Siebens-Drake Medical Research Institute, Schulich Medicine & Dentistry, Western University, Department of Family Medicine, Schulich Medicine & Dentistry, Western University, Department of Medicine, Schulich Medicine & Dentistry, Western University, Department of Pathology, Schulich Medicine & Dentistry, Western University, Departments of Family Medicine and Pathology, Schulich Medicine & Dentistry, Western University, Walpole Island Heritage Centre, Attawapiskat First Nation, Former Council Mem-ber, Attawapiskat First Nation, Chief, Attawapiskat First Nation, Departments of Anthropology, Social Sciences and Pathology, Schulich Medicine & Dentistry, Western University, Departments of Medicine and Paediatrics, Schulich Medicine & Dentistry, Western University,

Department of Biology, Science and Interfaculty Program in Public Health, Schulich Medicine & Dentistry, Western University

Results of recent research show, in many epidemiological stud-ies, a positive correlation between exposures to persistent organic pollutants (POPs) and an increased risk for Type 2 diabetes (T2D). Moreover, stress related to lower socio-economic status is posi-tively correlated with metabolic syndrome, a precursor to T2D. A research partnership between the Attawapiskat First Nation, its Health Centre and Western University analyzed 91 POPs (20 pesticides and 71 PCB congeners) in serum; and hair cortisol, a known biomarker for psychosocial stress, in 50 volunteers. The geometric mean concentrations of almost all POPs analyzed in serum were significantly higher at Attawapiskat than at Walpole Island First Nation, and were significantly higher at Walpole Island than in representative members of the Canadian and US populations, as measured by Health Canada in 2010 and the US Centres for Disease Control (NHANES in 2009). In addition, hair concentrations of cortisol were significantly higher in volun-teers from Attawapiskat than in those from Walpole Island, which in turn were significantly higher than in a Caucasian reference group. In concert, these results from analysis of two risk factors for T2D (exposure to selected POPs and psychosocial stress) show that community members of remote Attawapiskat First Nation are at greater risk for T2D than community members at Walpole Island, who, in turn, are at greater risk than members of the Cana-dian and US populations analyzed during recent surveys. These data may help to explain the 3-5 fold higher incidence of T2D in First Nations in Canada than in other Canadians.


Cancer-Related Risk Factor Prevalence and Screening Participation in Ontario Off-Reserve First Nations and Métis Adults

Abigail Amartey

Cancer Care Ontario

The extensive array of health-related indicators within the Cana-dian Community Health Survey (CCHS) provides the most comprehensive look at cancer-related risk factors and screening behaviour among Ontario’s First Nations and Métis population.

CCHS surveys from 2007-2011 were combined to increase the sample of Ontario’s off-reserve First Nations and Métis respon-dents, in order to estimate the prevalence of smoking, obesity, alcohol consumption, physical activity, diet, and colorectal, breast, and cervical screening uptake. Odds ratios adjusted for socioeconomic factors (SES) were also obtained, and non-Ab-original Ontarians were analyzed for comparison.

Significantly higher rates of smoking and obesity were found in both the First Nations and Métis population compared to non-Aboriginal Ontarians. Significantly heavier alcohol con-sumption was reported among First Nations and Métis males,


while inadequate fruit and vegetable consumption was more reported among First Nations. First Nations women were more likely to report having had an FOBT (colorectal cancer screen-ing test) in the past two years than non-Aboriginal women. After adjusting for SES, a no longer significant difference in alcohol consumption and fruit and vegetable intake among Métis males and First Nations males, respectively, compared to non-Aboriginal males was seen.

Understanding how the prevalence of these risk factors varies in subgroups is essential to informing cancer prevention and control programs tailored to the specific needs of these groups, and to monitor equity. Analyses such as these should be repeated over time to monitor trends and track progress toward targets for improvement.


Imbalance of Prevalence and Specialty Care for First Nations with Osteoarthritis in Alberta

Cheryl Barnabe, Allyson Jones, Don Voaklander, Christine Peschken, Joanne Homik, John Esdaile, Sasha Bernatsky, Brenda Hemmelgarn, Deborah Marshall

University of Calgary, University of Alberta, University of Manitoba, Arthritis Research Centre of Canada, McGill University

Objective: Estimate the population-based prevalence and healthcare use for osteoarthritis (OA) by First Nations (FN) and non-First Nations (non-FN) in Alberta.

Methods: A cohort of adults with OA (32 physician claims in 2 years or 1 hospitalization with ICD-9-CM code 715x or ICD-10-CA code M15-19, years 1993-2010) was defined, with FN determination by premium payer status. Prevalence rates (2007/8) were estimated from the cohort and the population registered with the Alberta Health Care Insurance Plan. Rates of outpatient primary care and specialist (orthopedics, rheuma-tology, internal medicine) visits; arthroplasty (hip and knee); and all-cause hospitalization were estimated.

Results: OA prevalence in FN was twice that of the non-FN population (16.1 vs 7.8 cases/100 population; standardized rate ratio (SRR) adjusted for age and sex 2.06, 95%CI 2.00-2.12). The SRR (adjusted for age, sex and location of residence) for primary care visits for OA was nearly double in FN compared to non-FN (SRR 1.88, 95%CI 1.87-1.89), and internal medicine visits were increased (SRR 1.25, 95%CI 1.25-1.26). Visit rates with an orthopedic surgeon (SRR 0.49, 95%CI 0.48-0.50) or rheumatologist (SRR 0.62, 95%CI 0.62-0.63) were lower in FN with OA. Hip and knee arthroplasties were performed less frequently in FN (SRR 0.48, 95%CI 0.47-0.49), but all-cause hospitalization rates were higher (SRR 1.59, 95%CI 1.58-1.60).

Conclusion: We estimate a 2-fold higher prevalence of OA in the FN population, with differential healthcare use. Reasons for higher use of primary care and lower use of specialty services

and arthroplasty compared to the general population are not yet understood.


Prevalence of Inflammatory Arthritis Conditions in the First Nations Population of Alberta

Cheryl Barnabe, C Allyson Jones, Don Voaklander, Deborah Marshall , Christine Peschken, Lawrence Joseph, Sasha Bernatsky, John Esdaile, Brenda Hemmelgarn

University of Calgary, University of Alberta, University of Manitoba, McGill University, University of British Columbia

Objective: The prevalence of inflammatory arthritis (IA) con-ditions of Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), Psoriatic Arthritis (PsA), Reactive Arthritis (ReA), and Crystal Arthritis has not been widely studied in First Nations (FN) populations. Prevalence estimates from Alberta would provide a good overall view of the IA landscape given the rich diversity in tribal ancestry.

Methods: Population-based healthcare data (years 1993 to 2011) was used to define cohorts of people with RA, AS, Ps, ReA and crystal arthritis based on ICD-9-CA and ICD-10-CM codes (2 physician billing codes or 1 hospitalization). Disease prevalence rates in fiscal year 2008/2009 were used to calculate a rate ratio (RR) for FN relative to non-FN.

Results: RA was the most prevalent IA condition in FN, with an RR of 1.81 (95%CI 1.74-1.88, p<0.001) compared to non-FN. AS (RR 1.72 (95%CI 1.57-1.88, p<0.001) and ReA (RR 2.23 (95%CI 1.23-4.02, p=0.0063) were also more fre-quent in FN. PsA was less frequent (RR 0.77 (95%CI 0.62-0.95, p=0.0118). Crystal arthritis was the most frequent IA in non-FN, with an RR three times that of FN (RR non-FN to FN 2.89 (95%CI 2.67-3.13, p<0.001).

Conclusion: RA is the most frequent IA in the FN population of Alberta. RA, AS and ReA prevalence estimates in FN are twice that of the non-FN population, whereas PsA and crys-tal arthritis are less frequent. These results further explain the higher self-reported rates of arthritis conditions in the FN pop-ulation and validate the need for enhanced IA health services to address disease burden.


Housing Conditions and Respiratory Outcomes in two Saskatchewan First Nations Communities

Shelley Kirychuk, Donna Rennie, Chandima Karunanayake, Joshua Lawson, Eric Russell, Jeremy Seeseequasis, Everett Gamble, Daisy Bird, Arnold Naytowhow, Punam Pahwa, Sylvia Abonyi, Jo-Ann Episkenew, James Dosman

University of Saskatchewan - CCHSA, University of Saskatchewan,


Beardy’s and Okemasis First Nation, Montreal Lake Cree Nation, University of Regina

Housing conditions are known to be associated with respiratory outcomes such as respiratory infections, bronchitis and asthma in First Nations populations. Little is known about the housing conditions responsible for respiratory conditions in Saskatche-wan First Nations reserves. We examined housing factors and respiratory health in two rural First Nations communities in Saskatchewan.

METHODS: Adults and children completed respiratory ques-tionnaires and lung function testing while 144 homes under-went environmental assessments. Environmental assessments included an interviewer administered housing survey, floor dust collection, and temperature and relative humidity measures. Floor samples were assessed for endotoxin and beta 1-3 glucans.

RESULTS: Homes were visited between January and April 2014. Preliminary results from the homes undergoing assess-ment showed that most homes were 2-4 bedroom with the majority (59%) built after 1990. Average number of people/home was 4.24±1.51. There were 44.4% of homes that needed major repairs and 61.1% had water or dampness in their home in the past 12 months with a quarter of homes that were wet or damp for more than 30 days of the year. Major reasons for water damage were surface water from flooding/raining (26.4%) plumbing malfunctions (21.5%) and leaks in the wall/roof (10.4%) resulting in 49.3% of homes having damage. The majority of reported damage was in the basement/crawl space (31.9%) and bathrooms (18.1%). A musty odour was reported in 53.2% of homes.

CONCLUSIONS: Water damage is a major contributor to housing damage. Addressing water related conditions within these communities should assist in improving the respiratory health of residents.


Canada’s Compassion for Aboriginal Canadians

Nicole Johnstone


In 2005, half of Canada’s aboriginal people had an income below $16,752, which was almost $10,000 less than their non-aborigi-nal counterparts. A median income of $11,229 was reported for on reserve aboriginals in the same year. Overcrowding remains high in aboriginal housing with aboriginals being three to nine times more likely to live in crowded conditions than non-ab-originals. On reserve, 40% of homes required major repair in 2006, and aboriginal homes are three times more likely to be in need of major repair than non-aboriginal homes. These liv-ing conditions are unsatisfactory in a developed country such as Canada, and greatly impact the health and well-being of the aboriginal population. The federal government is aware of the

statistics, yet there have been very few changes to the living con-ditions of aboriginal people. The federal government continues to offer humanitarian aid and assistance to other countries. In the 2012-13 fiscal year, the federal government offered nearly 5.5 billion in financial aid to Africa, Asia, the Americas, Eastern Europe, and the Middle East. In the past few years, Canada has accepted tens of thousands of refugees from Syria, Afghanistan, Somalia, Pakistan, and Iraq, and provided financial assistance and free healthcare to these newcomers. The Government of Canada website boasts, “Our compassion and fairness are a source of great pride for Canadians.”Therefore, it is the duty of the government to extend the same compassion towards our aboriginal Canadians to ensure improved living conditions and an acceptable standard of living in our developed country.


Community-based participatory research to address cistern drinking water quality: Experiences from Beardy’s & Okemasis First Nation, Saskatchewan

Karlee McLaughlin, Lalita Bharadwaj

University of Saskatchewan, University of Saskatchewan, School of Public Health

The provision of safe drinking water (SDW) is a key driver of public health, yet access to this valuable resource is a perennial problem in First Nations communities across Canada. Addi-tionally, waterborne infections are an alarming 26 times higher in First Nations. Inequity in access to SDW is linked to his-torical discriminatory governmental policies that have disad-vantaged Canada’s First Nations. Access to SDW is tied to the Indian Act as a Federal responsibility. However, as of 2013, the Federal government transferred SDW responsibility and legal liability to First Nation communities by passing of Bill-S-8 The SDW for First Nations Act. Legally binding standards created and enforced by the Federal Government now apply to First Nations Bands. The community of Beardy’s & Okemasis First Nation is one community that has been affected by pol-icy in Saskatchewan, with over half of the reserve on cisterns. However, cisterns are known as the “prairie problem” due to frequent contamination issues and limited attention in terms of government initiatives and academic research. In partner-ship with this community, research will identify the potential risks to water quality through the supply chain of trucked water delivery to cistern. Water trucks and selected residential cisterns will be analyzed for drinking water quality, deterioration and point source contamination from the period of July-October 2014. Analyzing multiple water parameters, asking key infor-mant interviews and characterizing the risk of contamination. The data gathered will advance guidelines on management, monitoring, and strengthen governmental policy change for SDW for First Nations across Canada.



Investigating environmental determinants of injury and trauma in the Canadian North

Agata Durkalec, Chris Furgal, Mark Skinner, Tom Sheldon

Trent University, Nunatsiavut Government

Unintentional injury and trauma rates are disproportionately high in Inuit regions, and environmental changes are predicted to exac-erbate injury rates. However, there is a major gap in our under-standing of the risk factors contributing to land-based injury and trauma in the Arctic. We investigated the role of environmental and other factors in search and rescue (SAR) incidents in Nain, an Inuit community in Nunatsiavut, northern Labrador. We used a collaborative mixed methods approach that involved universi-ty-community research partnerships with Nain Ground Search and Rescue and the Nunatsiavut Government. We analyzed SAR records from 1995 to 2010 and conducted key consultant inter-views in 2010 and 2011. Data showed an estimated annual SAR incidence rate of 19 individuals per 1,000. Weather and ice condi-tions were the most frequent contributing factor for cases. In con-trast with other studies, intoxication was the least common factor associated with SAR incidents. The incidence rate was six times higher for males than females, while land-users aged 26_35 had the highest incidence rate among age groups. Thirty-four percent of individuals sustained physical health impacts. Results demon-strate that environmental conditions are critical factors contrib-uting to physical health risk in Inuit communities, particularly related to travel on sea ice during winter. Age and gender are important risk factors. Our study also points to issues of under-reporting of land-based injury and trauma, and the inadequacy of current injury surveillance systems. This knowledge is vital for informing management of land-based physical health risk given rapidly changing environmental conditions in the Arctic.


Exploring the environment as a determinant and place of Indigenous health: A case study of Inuit-sea ice relationships

Agata Durkalec, Chris Furgal, Mark Skinner, Tom Sheldon

Trent University, Nunatsiavut Government

This study contributes to our understanding of Indigenous health and sociocultural and place-based dimensions of health and well-being by investigating the relationship between one key element of the environment _ sea ice _ and diverse aspects of Inuit health. We used a case study design and community-based participatory research approach with the community of Nain in Nunatsiavut, northern Labrador, Canada. Focus groups (n=2), interviews (n=22), and participant observation were conducted in 2010-11. We demonstrate a strong overall positive relationship

between sea ice use and health, with primarily positive impacts for non-physical health aspects (mental/emotional, social, mate-rial, cultural) and negative impacts for physical health. The impor-tance of ‘place-meanings’ _ the experience of being on the ice and the role of sea ice as a platform for hunting _ emerged as central themes. Environmental change was associated with the loss of health benefits and impacts on place-meanings and knowl-edge. Our findings demonstrate the complex ways that a criti-cal element of the environment influences Inuit health, and the value of incorporating place-based approaches into investigations of Indigenous health. They also demonstrate how climate change acts an agent of environmental dispossession. Using this case study, we developed a conceptual model of the role of environment for health that integrates key concepts in health geography (e.g., a concern for place, well-being, and culture) into a population health approach, furthering our understanding of the role and meaning of environment for health.


Generational Differences in Traditional Food Knowledge in Southwestern Ontario

Hannah Tait Neufeld

Western University

Major disparities in the health status of Canada’s Indigenous populations continue to exist, including shorter life expectancies and significantly higher rates of chronic disease than the gen-eral population. Rates have reached epidemic proportions, yet prevention research has focused quite narrowly on behavioural change, with little recognition of the broader social, cultural, historical or environmental factors that may influence food security in contemporary First Nation contexts, such as how food insecurity may be related to cultural loss or the inter-gen-erational trauma of residential schools. Students suffered sig-nificant cultural loss, including loss of language, ties to family, and traditional teachings, which led to disrupted transmission of traditional knowledge across generations. A shift from tradi-tional foods to market foods has been shown to negatively affect dietary quality and cultural identity in many communities, and contribute towards a decline in nutritional status and overall health. The research is nested within the structure of a larger on-going collaborative food choice study between the South-west Ontario Aboriginal Health Access Centre (SOAHAC), and Western University. Building on research gaps revealed in earlier collaborative research, the study examines the potential mechanisms that have impacted the inter-generational transfer of knowledge around traditional food, including access to, and availability, of traditional foods within urban and reserve-based First Nation communities in Southwestern Ontario. Results presented as stories and photographs will highlight: current knowledge surrounding access, availability and traditional food practices between generations of urban and rural First Nation


families; and the historical context of present day urban and rural food environments.

P22Abstract ID: 20

Surveying and Identifying the Need for Northern Medical Elective Opportunities for University of Ottawa Students

Kendra Barrick, Leigh Fraser Roberts

University of Ottawa, Children’s Hospital of Eastern Ontario

Context: The University of Ottawa Faculty of Medicine has no established northern elective program in Nunavut for students. Medical students have demonstrated a strong interest in pursuing further training in northern and/or Aboriginal communities. The purpose of this project is to initiate contact and facilitate communication between the University of Ottawa and medical practitioners in Nunavut. This information will help identify the need for northern medical electives for medical students. Ideally, this will help facilitate the creation of funded medical elective opportunities for medical students in pre-clerkship and clerkship in the Canadian north.

Intervention: A survey was developed to assess the current pro-grams that exist between Canadian medical schools and north-ern communities and administered to a list of northern medi-cal elective program contacts from across Canada. The survey assessed the strengths of established elective programs and key logistical issues and funding sources for programs. Another survey was developed for medical students at the University of Ottawa to quantify the current interest in pursing northern medical electives. Then, funding sources necessary for program development were investigated. Finally, the Faculty of Medi-cine at the University of Ottawa and other funding sources were contacted to determine the potential for creating financial bur-saries to assist in the costs associated with developing a northern elective program.

Observations/Discussion: Surveys highlighted numerous exist-ing programs throughout Canada, primarily funded by medical faculties and grants, as well as a strong student interest and need for northern and Aboriginal medical electives opportunities. No bursaries/funding currently exist for northern electives.


Transforming the Health Landscape in Northern Communities: Shared Leadership for Innovation in Nursing Education

Lois Berry, Lorna Butler, Amy Wright

University of Saskatchewan, College of Nursing

People living in northern areas throughout the world expe-rience poorer health status than their southern neighbours.

Accessibility to health care services and availability of health care professionals play a role in the building of health capac-ity in northern regions. The College of Nursing at the Uni-versity of Saskatchewan developed a principled approach to the creation of an Indigenous nursing workforce in Northern Saskatchewan. This approach builds on Williams’ concept of Therapeutic Landscapes, which recognizes the connectedness among environment, social interaction, and symbolic meaning within a population, and offers a way to analyze the influence of the contextual factors of place on health, and values and atti-tudes on well-being. In order to succeed, the College developed mutually beneficial, capacity-building relationships with north-ern communities, finding local champions to assist them. They reorganized their administrative structure to give visibility to their northern relationships, and built a distributive learning approach based on the commitment to “learn where you live”. Measuring the success of such approaches requires the devel-opment of new and innovative evaluation strategies, beyond the usual markers of individual student success. It requires approaches that capture the impact of such education program-ming on the fabric of the community as a whole.


Inflammatory Arthritis Treatment Outcomes at a First Nations Reserve Rheumatology Specialty Clinic

Cheryl Barnabe, Erin Bell, Sharon LeClercq, Dianne Mosher, Hani El-Gabalawy, Marvin Fritzler

University of Calgary, University of Manitoba

Introduction: Inflammatory arthritis disproportionately affects Canada’s First Nations population. Treatment outcomes may be ameliorated by health service models that mitigate logistical barriers to care and provide specialty services embedded in the primary care context. This study assessed the effectiveness of a specialty care model delivered in a First Nations primary care setting.

Methods: Participants were recruited to an arthritis screening program held in a First Nations community ( June 2011-August 2012). Patients with IA received ongoing follow-up with col-lection of disease activity measures, patient-reported outcomes, and treatment recommendations. Repeated measures ANOVA was used to examine disease activity measures over 24 months. The frequency of treatment changes based on moderate or high disease activity state was calculated.

Results: 131 visits by 47 participants (79% female, mean age 47 years, diagnosis of rheumatoid arthritis n=34) occurred over the 24 month study period. At the baseline visit 70.6% of participants had moderate or high disease activity. Significant decreases in joint counts were achieved (mean swollen joint count decrease 7.0, 95% CI 3.5-10.4, p=0.0061; mean tender joint decrease 7.2, 95% CI 4.1-10.3, p=0.0116). Patient-reported outcomes for pain, global assessment and physical function were


not significantly improved during treatment. A recommenda-tion for treatment change based on moderate or high disease activity was made at 67% of visits.

Conclusions: The program addressed physician-derived disease activity targets, but patient-reported outcomes were not signifi-cantly improved during follow-up. Modifications to the model such as involvement of a multi-disciplinary team to address holistic aspects of First Nations health is critical.


A Chart Audit of First Nation and Métis Patients in a Saskatoon, Saskatchewan Hospital

Charlene Haver, Gary Eagle, Tamara Colton, Caitlin Cot-trell-Lingenfelter, Gabe Lafond

University of Saskatchewan/Saskatoon Health Region, Saskatoon Health Region, University of Saskatchewan

Introduction: Many patients admitted to St. Paul’s Hospital (Saskatoon, Saskatchewan) are First Nation and Métis; however, little is known about these populations’ and their health care use. Upon request from the First Nation and Métis Health Ser-vice, the Vice-President Research and Innovation Office con-ducted a chart audit to determine characteristics of First Nation and Métis patients and their hospital stay.

Methodology: A retrospective chart audit was completed with patients from February 2012-December 2013. Inclusion criteria consisted of any First Nation or Métis patient admitted to gen-eral medicine or renal wards.

Results: A total of 103 First Nation patients were identified. Métis patients were unable to be identified due to current health information recording standards. The mean age of First Nation patients was 48.4 (±17.5 years) and 70% were admitted through the Emergency Department. Fifty-three percent resided in urban areas, 32% rural, and 13% lived on reserves across Sas-katchewan. Length of stay (LOS) for patients on reserve (31.3 days) was significantly longer than LOS for patients in rural (7.0 days) or urban (9.1 days) areas (p<0.05). Twenty-eight percent had a delay in discharge, with 17% delayed for medical issues / complications and 11% delayed for navigation issues (i.e. transportation or approval from Non-Insured Health Benefits).

Conclusion: This work provides preliminary evidence that disparities exist for First Nation patients living on reserve and highlights the need for patients to have the option to self-iden-tify upon admission. Patient-oriented research is needed, in partnership with First Nation and Métis peoples to improve services and provide optimal care.


Improving First Nations health through appropriate eHealth technologies

Tracey A Herlihey, Alison Jones, Olga Kniazeva, Elizabeth Stacy, Justyna Berzowska, Helen Novak Lauscher, Svetlena Taneva Metzger, Anjum Chagpar, Erin Schellings, Jeff Niles, Kendall Ho, Joseph Cafazzo, Valerie Flynn

Healthcare Human Factors, eHealth Strategy Office, University of British Columbia, First Nations and Inuit Health Branch, Health Canada

The benefits of electronic health (eHealth) technologies are many, including enhanced patient safety, improved access to care and improved health information management. While eHealth tools are widely used in urban centres and increasingly in isolated care facilities, there remains a need to modernize health service delivery within remote and isolated First Nations communities.

Health Canada’s First Nations and Inuit Health Branch (FNIHB) is working to modernize and transform the way health services are delivered in remote and isolated First Nations nursing sta-tions through eHealth technologies. To ensure a successful tran-sition to modernized health service delivery, it is critical that the selection and implementation of eHealth technologies acknowl-edges and takes into consideration the unique challenges related to the demographics, geographical location, and political cli-mate of First Nations communities.

To this end, FNIHB engaged researchers at Healthcare Human Factors in Toronto and the University of British Columbia’s eHealth Strategy Office to identify communication and tech-nology needs in First Nations nursing stations and to recom-mend appropriate eHealth tools.

The research team adopted a three-pronged approach: 1) a sur-vey was distributed to regional health employees; 2) job shad-owing and focus groups took place with front line staff at four nursing stations across three provinces; and 3) preliminary rec-ommendations were presented at a technology showcase event for nursing station staff and FNIHB personnel for validation purposes.

Based on the findings, a series of recommendations outlining how the needs of First Nations nursing stations can best be met with eHealth technologies were devised.


First Nations Experience of the 2013 Alberta Floods: Media Representations and First Hand Experiences

Kaela A. Schill, Wilfreda E. Thurston

University of Calgary

Background: In June 2013, a severe flood affected a 55,000 km2 area in southern Alberta, Canada. Many residents from the First Nations reservations of Siksika and Stoney were displaced from their homes as a result of the flooding.

Methods: By combining the results of a media analysis


with key informant interviews, the authors explored how non-Aboriginal Canadians frame First Nation issues, and how individuals involved in First Nation flood relief efforts responded to these frames.

Results: Four frames emerged from the newspaper articles col-lected for the media analysis, called the “sympathetic frame”, the “unprecedented support frame”, the “unappreciative or ‘whining’ frame”, and the “property damage or loss frame”.The interview data revealed the perception of bias in print media, reflecting larger social issues surrounding Aboriginal peoples in Canada. Participants perceived the media simultaneously as a tool, and as a “double-edged sword”. Social media also emerged as a means by which local leadership reaches members of their communities.

Discussion: The interview data indicated that First Nations communities use (or avoid)coverage to the benefit of the com-munity,indicating a more nuanced approach to media relations than is reflected in existing literature. Further,the assumption that First Nation communities desire mainstream media cov-erage may be ethnocentric in and of itself. Our findings sup-port existing literature that indicates that technology provides First Nation members with a means of emerging as agents and political actors in an otherwise oppressive context, in this case, through the use of social media

P28Abstract ID: 146

Inuit Health Human Resources Framework and Action Plan

Joyce Ketura Ford


The Inuit Health Human Resources Framework and Action Plan 2011-2021 (IHHRFAP) developed by Inuit Tapariit Kanatami and the four Inuit regions has as its vision “to advance Inuit health by creating an Inuit workforce that will deliver a full spectrum of health and wellness services within Inuit communities, primarily in the Inuit language”. The IHHRFAP will help to reduce the health disparities between Inuit and the rest of Canadians.

This poster presentation will outline the vision of the frame-work and the six goals and main actions of the Action Plan.

P29WITHDRAWN


Storytellers as Medical Educators

Maurianne Reade, Shelagh McRae, Joahnna Berti, Bruce Naokwegijig

Manitoulin Central Family Health Team, Northern Ontario School of Medicine, Gore Bay Medical Clinic, Northern Ontario School of

Medicine, Debajehmujig Storytellers

We describe a pilot project where medical students on rural placements joined Manitoulin Island’s Debajehmujig storytell-ers. The mandate of the Debajehmujig storytellers is to edu-cate and share original creative expression with Native and Non-Native peoples, thereby vitalizing Anishnaabeg culture, language and heritage. The project aim was to show learners how arts organizations engage in the health of their communi-ties while experiencing opportunities to practice communica-tion and interview skills.

The students were introduced to previous community health projects from the Debajehmujig archives, including the Elders Gone AWOL initiative. However, most of their time was spent in simulated patient scenarios, exploring themes of mental ill-ness and social disadvantage. Animators developed complex characters utilizing their culturally relevant knowledge and lived experiences, curriculum objectives from the Northern Ontario School of Medicine, and resources on cognitive error. The social context for each condition was constructed with special consideration given to cross cultural issues in North-ern health care and regional economic realities. Following each interview, the animator provided formative feedback.

The simulation format allows for a safe learning environment in emotionally complex situations, while reflecting Bleakley, Bligh and Brown’s(2011) “strong patient-centred exchange”. Debajehmujig storytellers incorporated Anishnaabeg views as authors, as “patients” and as educators. Native authorship of patient scenarios in particular may help to address the challenges as identified by Ewen et al (2011) in “achieving consistency, authenticity and avoiding stereotyping of Indigenous patients within case development and implementation.” A project that began with a focus on arts and communication has relevance to cultural competency education.


Unpacking the mechanisms related to the engagement of Australian Aboriginal families and young people in social and emotional wellbeing programs: A realist review

Margaret Cargo, Peter Lekkas, Alwin Chong, Ellie Piggott, David Evans

University of South Australia, University of Adelaide

Background: Aboriginal peoples are over-represented in statis-tics related to the utilisation of mental health services, hospital separation for injury and self-harm, and incarceration. Few sys-tematic reviews of Aboriginal social and emotional wellbeing (SEWB) provide decision-makers in the Aboriginal communi-ty-controlled and government sectors with culturally applicable and transferable advice on what works, for whom and in what circumstances. Objective: To understand the core mechanisms


underpinning programs on the prevention of mental health diffi-culties and promotion of SEWB among Aboriginal children and youth. Method and Results: This realist review was based on pri-ority areas identified by policy-makers: crime and violence, sub-stance misuse, adverse mental health, cultural pride, strengthening families, strengthening communities and education. A systematic search of academic databases and the grey literature retrieved over 50 Australian programs implemented in the last 15 years for which program processes or impact information was reported for Aboriginal children and youth. Social identity theory and the cul-tural respect framework informed the initial review framework. A core set of mechanisms (i.e., trust, respect, cultural identification, physical safety, feeling comfortable, feeling supported) related to the engagement of participants and families cut across all program types; mechanisms varied by program type and contextual factors. Conclusions: History, time and factors related to the implement-ing community, sponsoring organisation, inter-agency collab-oration and the workforce emerged as powerful influencers of engagement. This review finds that “upstream” investments need to be made to establish and maintain participant engagement in order for programs to impact SEWB.


Enhanced Skills Year in Indigenous Health at The University of Toronto’s Department of Family and Community Medicine: A Program Description

Fatima Uddin, Jennifer Wesley, Difat Jakubovicz


In 2011, there were approximately 1.4 million indigenous peo-ples living in Canada, more than half of them living off reserve and in urban areas. There are many significant health and social challenges facing indigenous communities and their health care providers including poverty, chronic disease, poor mental health, and substance abuse. These struggles are rooted in the long-term effects of colonization, racism, and inequity.

Physicians interested in working with indigenous populations need to be better prepared in order to provide care in a respect-ful, knowledgeable, and culturally safe manner. They should be competent clinically, and must be sensitive to the historical, political, and cultural issues that impact the health of Canada’s indigenous peoples.

Unfortunately, very little time has been dedicated to indigenous health in undergraduate and postgraduate medical training. One way this gap is being addressed at the University of Toronto has been the development of an enhanced skills year in indigenous health in the Department of Family and Community Medicine.

This one-year fellowship strives to improve the knowledge, skills, and attitudes of the family medicine trainee in a number of areas related to the health of indigenous populations in urban, rural and remote areas of Canada. The first trainee graduated

from the program in 2011 and the second trainee will complete the program in June, 2014. This poster will be a description of the year and will describe some of the successes of the PGY3.


What is “Mino Bimaadiziwin”? Exploring the meaning(s) of “Living Well” among Anishnaabe peoples living in Northern Ontario

Kian M. Madjedi, Kevin FitzMaurice


Intro: Mino Bimaadiziwinis an Anishnaabemwin (“Ojibwe”) term that has been translated in many ways, most predominantly as “The Good Life” or “Living Well”. Although the term itself appears relatively frequently in research relating to Anishnaabe wellbeing, there have been no studies to date exploring the con-structions and definitions of Mino Bimaadiziwin at the level of the individual.

Methods: The purpose of this research is to: 1) explore the ways in which Anishnaabe persons living in Northern Ontario understand, define and conceptualize this fundamental notion of ‘wellbeing’, and 2) to use these definitions to examine per-ceptions of factors that foster and inhibit Mino Bimaadiziwin in the local context of urban Northern Ontario. Using a grounded theoretical approach rooted in Indigenous Critical Theory, semi-structured interviews were conducted with 12 Anish-naabe students and 1 elder. There were six emergent themes in the way Mino Bimaadiziwinwas understood by participants.

Discussion: Although the conceptualizations of Mino Bimaa-diziwin were diverse, Mino Bimaadiziwin was most commonly defined as 1) Living in a balanced way; 2) Respecting the inter-connectedness of all elements in Creation; 3) Living life accord-ing to the Seven Grandfather Teachings; 4) Learning and speak-ing the Anishnaabemwin language; 5) Practicing tradition and culture; and 6) Self-determination and decolonization

Conclusion: The articulation of what it means to Live Well by Anishnaabe peoples themselves may help provide a basis for the development of decolonizing community-health programs and may lay the groundwork for future health research that supports Anishnaabe wellbeing in Northern Ontario and beyond.


Sexy Health Carnival: HIV Prevention Outreach by and for Indigenous Youth

Renée Monchalin, Sarah Flicker, Jessica Danforth, Alexa Lesperance

York University, Native Youth Sexual Health Network

The Sexy Health Carnival is an Indigenous youth lead project


that creates a fun and interactive opportunity for other Indige-nous youth to become educated on HIV prevention and sexual health in a culturally appropriate way. The goal of this paper is to determine the most effective method of HIV prevention outreach for Indigenous youth.

A research team consisting of Indigenous youth from the peer-lead Native Youth Sexual Health Network and researchers at York University will be surveying Indigenous youth ages 16 to 25 at four pow-wows throughout Ontario in July and August 2014 during the implementation of the Sexy Health Carnival. The survey will have questions for youth surrounding their current HIV prevention knowledge, the Sexy Health Carni-val booths, and sexual health outreach methods. The survey responses will be collected through an offline ipad survey tool and will be exported to SPSS for analysis.

Who better to ask about the most efficient HIV prevention out-reach methods for Indigenous youth than the youth themselves? Indigenous youth’s voice can be an agent for positive change, and may be an important part of the solution to tackling the devastating HIV statistics within our communities. Through this peer-lead project, this paper will disseminate effective methods for HIV prevention outreach methods in the Indige-nous youth community.


Meeting the Health Service Needs of Urban Aboriginal Women for Co-occurring Diabetes, Mental Health and Addiction Issues

HASU Institute of Population Health, University of Ottawa, Ivy Bourgeault, Cecilia Benoit

Institute of Population Health, University of Ottawa, University of Victoria

Aboriginal adults with diabetes have high rates of co-occurring mental health and addiction, which adversely affect their over-all health and well-being. But how this is experienced specif-ically by Aboriginal women living in urban settings is largely unexplored. Though the intensity, pattern, and causal rela-tionship between co-occurring health conditions are yet to be fully explored in Aboriginal health context, they have practical implications for improving overall health of Aboriginal women as well as determining their health service needs.

This poster will begin to map out an ongoing study of urban Aboriginal women’s health service needs for co-occurring diabetes, mental health and addiction. Our methodological approach consists of three forms of primary data collection: one-on-one semi-structured interviews, surveys, and follow up deliberative focus group discussions across two phases. In the first phase, we collect data from key informants (n= 8-12), including health and social service providers and decision mak-ers. This is followed in the second phase of data collection from

urban Aboriginal women (n= 24- 36).

Preliminary thematic analysis of data reveals that separate and parallel mental and physical health treatment options do not offer interventions that are accessible, integrated and tailored for Aboriginal women dealing with co-occurring health con-ditions. Thus necessitating the use of holistic approach by com-bining Indigenous perspectives with gender sensitive and trau-ma-informed practice to address the interconnected risk factors for co-occurring chronic physical and mental health challenges, and addiction; linked to wide-based supports in housing, edu-cation, employment, recreation and the wider social network.

P36WITHDRAWN


Author IndexLast First Abstract(s)

AAbonyi Sylvia O20Allan Billie W56Allison Elaine O36Ambtman-Smith Vanessa W07Anganis Darlene O36Antone Tracy W30Apale Alisha Nicole W37Avery Kinew Kathi W28Azarpazhooh Amir W31

BBacque Jim W13Baird Roslynn W42Banerji Anna W23Beck Caroline O20Bellerose Marika O07Bend John R. O19 W35Berti Joahnna Kathleen W40Blais Ellen M. O30 W39Blumenthal Anne W33Boileau-Falardeau Michèle O05Bourgeois Cheryllee W56Browne Annette W53Bull Julie W50Burnett Kristin O04

CCastleden Heather W19Chakraborty Chandan O19 W35Chan Ben W21Chartier Martin W31Chiarelli Anna W26Chisan Sherri O16Churchill Molly W33Cidro Jamie O18Classens Linda Lou O35Cole Madeleine W15Corbett Bradley A. O19Cote-Meek Sheila W24Currie Cheryl W41

DDaigle Michelle O29Darnell Regna O19 W35Davis-Hill Francis Lori-Anne W43Day Linda W53Deleary Raymond W01Dell Colleen W52Denduyf Johanna W02Denis Jeff W19

Last First Abstract(s)

Dewar Dale M. W45Diffey Linda W27Dignan Thomas W27Dion Stout Madeleine W05 W53Dosman James O20Dowsley Martha O04Dragonetti Rosa C. O10Drossos Alex O11

EElliott Nicole Estella W12Elliott Germaine Frances W22Episkenew Jo-Anne O20Eriks-Brophy Alice A. W43Eves Robert W01Evoy Laura Lee W08

FFairney Kelly A. O09Fenton Mark O20Firestone Michelle W20FitzMaurice Kevin O22Flinders Lori W14Ford-Gilboe Marilyn W53Fowler Anna W25Furgal Chris W06

GGalloway Tracey W60Gesink Dionne O16 O31Gladue Lawrence W13Gordon Janet W21 W48Grier Angela O27Guitard Tracey W31Guzmana Marco W13

HHagar Guy W07Harp Rick O13Healey Gwen W60Henley Phaedra O19 W35Henry David W30 W57Herbert Carol P. O19 W35Hill Julie W35Ho Anita O25Hopkins Carol W01 W52

IInyallie Jane W53Irving Don W13Isaac-Mann Sonia W24



Ito Dick W31Ive Nicole W39

JJacobs Dean O19 W35Jahedmotlagh Zahra W35James Lesley W10Jameson Kristie W06Jetha Nina W47Johnston Andrea L.K. W47Johnstone Nicole O02Jones Carmen W30Jreige Steve W47Jull Janet Elizabeth W03

KKatapally Tarun O20Kewayosh Alethea W26Khan Saba W30 W57Kitty Darlene W29 W55Klair Rajbir O14Koren Gideon O19 W35

LLach Lucyna W33Lamothe Ashley W42Latycheva Oxana W46Lavallee Lynn F. O09Lavallee Barry W27LeMay Rose W44Levall Jeanette W40Lewis Stacey O36Lightning Rick O27Lodge Minwaashin W03Loft Michael W39Lys Candice O01 W08

MMacDonald Jennifer O36MacKenzie Holly W53Madjedi Kian O22 O26Makokis James O32Marchildon Gregory P. O20Marrett Loraine W26 Martens Tabitha O18 Martin Debbie W19 Mashford-Pringle Angela O28 Mayan Mari O27 McGilvery Priscilla O31 McKenzie Holly A. W59 McKinney Veronica O21 McKnight Constance W20 McMahon Eileen W32



McTavish Kristeen W06 Meawasige Amanda W18 Meckelborg Lori W47 Mendez Ivar O21Menzies Peter W52Mihic Alanna O16 O31Moeller Helle O04Montour Courtney W39Morgan Jenny Lynn O25

NNancarrow Tanya O08Nenadovic Vera O07Nishri Diane W26

OO’Connell Rod O15Osawabine David W40Oster Richard Thomas O27

PPahwa Punam O20Paterson Emily W48Pathammavong Ratsamy Norman W10Patterson Don O06Patterson Colleen W36Peters Judy O19 W35Popp Shantel W06

Q

RRae Radziwon Leah W43Rajdev Vinay W06Recollet, Vivian W09Reeves Allison O14 O23Rice John W22Richer Faisca O05Rieder Michael J. O19 W35Robbins Julian W34Rudderham Sharon O36Russell Storm J. W57Ryan Anna-Claire O08

SSchoeman Katherine O19Selby Peter L. O10Shah Chandrakant O14 O23Shaugnnessy Peggy A. O12Sheppard Amanda W26Sinclair Stephanie Ann W18Sinha Vandna W33Smith Jacqueline Dawn W43Smith Ela W58

Smylie Janet W20Sodhi Sumeet W21Stacey Dawn W03Last First Abstract(s)

Star Leona W28Stephens Christianne V. O19 O35 W35Stewart Suzanne Lea W12Suntjens Terri O16Sxwithul’txw Steve O15Sylvestre Paul W19

TTagalik Shirley W60Tait Neufeld Hannah W31Taylor Kim O25Thompson Bandy W08Tobias Daniel W54Tobin Pam W36Todd Hunter Laura W43Tomascik Paul W27Toth Ellen O27Touesnard Laurie O36Trick Charles G. O19 W35Trocme Nico W33Tucker Mary Jane O19 W35

U

VVan Uum Stan W35Varcoe Colleen W53

WWakewich Pamela O04Walker Pamela W09 O24Walker Jennifer Dawn W46Walters Dean W17Warry Wanye W46Waters Shannon Tania W51Watteyne Wenda W57Whiskeyjack Lana O16 O31White Alsena O32Williams Jessa W02Williams Rosemary O19 W35Williams Naomi W35Willison Kevin Donald O34Wolfe Sara W20 W37

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INDIGENOUS HEALTH CONFERENCE - University of Toronto · 2017-03-20 · INDIGENOUS HEALTH CONFERENCE | NOVEMBER 20-21, 2014 6 Planning Committee Anna Banerji O.Ont MD MPH FRCPC DTM&H