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Racism toward Indigenous Peoples continues to permeate the health care system, a reality the authors know all too well in their shared and yet unique personal and professional experiences. Although acknowledging and speaking up against racial injustice is daunting, and is often met with disregard or inaction, the authors contend that this is a necessary undertaking to redress the ongoing harms of colonialism. Correspondingly, those who do speak up must not have their voices silenced. Instead, the perspectives that Indigenous Peoples have regarding their own experiences of racism must be heeded seriously and produce real and tangible solutions. In narrating their own encounters confronting and challenging racism, the authors juxtapose activism and resistance with the preservation of Indigenous Knowledge as a catalyst for propelling the necessary changes forward within health care to end racism. To truly have an impact, all efforts taken to address racism must occur alongside advancing equity of care and human rights for and by Indigenous Peoples at individual, community, and systemic levels. Changes are not needed after more evidence. The time to act is now. [ABSTRACT FROM AUTHOR]

Asthma is one of the most common chronic conditions affecting Aboriginal children and adolescents in Canada, with associated high rates of hospitalization and emergency room visits. Social support deficits and social isolation pose significant problems for Aboriginal families coping with asthma challenges. However, support interventions that focus on the unique support needs of parents of Aboriginal children affected by asthma have not been investigated. Consequently, our study introduced support interventions to meet parents' perceived support needs and intervention preferences. The study was conducted in urban and rural sites in three Canadian provinces. The interdisciplinary research team encompassed Aboriginal researchers and knowledge users, and the multimethod participatory research design was guided by Aboriginal community advisory committees. Diverse support interventions, designed to address the particular preferences and needs of parents in specific communities, were offered. Seventy-seven parents participated. These parents reported expanded support resources, increased support seeking, improved coping skills, and decreased support and education needs following the interventions, which were tailored to their unique needs. These participatory interventions were considered accessible, acceptable, relevant, and useful by parents. [ABSTRACT FROM AUTHOR]

Rural and remote Indigenous communities face unique challenges, and they must drive solutions for sustaining and maintaining distinct nursing practices. Resourcing Indigenous community needs and aspirations for health depends on sustainable funding and an appropriately resourced nursing workforce. An Indigenous community-engaged research team led a program of study exploring Indigenous systems of care with three distinct communities. We used Indigenous research methodologies to identify obstacles to care and ways to advance nursing and healthcare delivery according to unique values and demographical and geographical influences. Using a collaborative analysis approach with communities, we identified themes related to resourcing nursing positions, supporting nursing education and valuing nursing influence in determining program priorities. The voice of the community in research is a powerful force for advocacy, ensuring that nurses are supported in relationships with communities and in designing programs that fit the community's vision for health and wellness. We recognize the essential contributions of nurse leaders to policy processes in formulating and coordinating ideas for program redesign across and within levels of organizations for health and social justice impacts. We conclude our paper by noting implications for nursing leadership in diverse settings with the goal of sustaining a nursing workforce to provide culturally safe, wellness-focused care., (Copyright © 2023 Longwoods Publishing.)

La recherche en santé autochtone au Canada a été négligée dans le passé et qualifiée de problématique, notamment en raison du manque de collaboration avec les peuples autochtones. L'Énoncé de politique des trois Conseils sur l'éthique de la recherche avec des êtres humains décrit au chapitre 9 la conduite éthique de la recherche axée sur les Premières nations, les Inuits et les Métis. Les principes PCAP® des Premières nations (propriété, contrôle, accès et possession) soulignent l'importance majeure de l'engagement et de la gouvernance autochtones. En vue d'assurer que les buts et les activités de la recherche développée soient réalisés en partenariat complet et significatif avec les peuples et les communautés autochtones, il est possible de faire appel à des méthodes de recherche participative communautaire (RPC) intégrant leur plein engagement. Les recherches utilisant des ensembles de données secondaires, telles que les données administratives sur la santé recueillies en routine, ne devraient plus être exclues de cette approche. Notre objectif était de décrire comment notre équipe de chercheurs universitaires, alliée à un organisme national de santé autochtone, a adapté les méthodes de RPC dans le cadre d'un projet de recherche utilisant des données recueillies antérieurement pour examiner les lacunes dans la prestation de soins de fin de vie aux peuples autochtones en Ontario. Nous décrivons le processus d'élaboration de ce partenariat de recherche et expliquons comment l'intégration des principes de base et des processus de formation du savoir autochtones ont guidé cette collaboration. Notre partenariat de recherche, qui implique l'adaptation de méthodes de RPC, illustre un processus d'engagement qui pourrait guider d'autres chercheurs désirant mener des recherches en santé autochtone à l'aide de données déjà recueillies. Nous faisons aussi état d'une entente de recherche transparente, négociée équitablement entre un organisme national de santé autochtone et des chercheurs, qui pourrait servir de cadre pour des collaborations de recherche similaires. Il est essentiel de s'assurer que les perspectives autochtones soient au cœur des processus de recherche et qu'elles soient reflétées dans ceux-ci lorsque des données administratives sur la santé sont utilisées., Indigenous health research in Canada has a chequered past and has been identified as problematic and lacking in appropriate collaboration with Indigenous people. The Tri-Council Policy Statement on Ethical Conduct for Research Involving Humans, Chapter 9 describes ethical conduct of research regarding First Nations, Inuit, and Métis Peoples. First Nations Ownership, Control, Access, and Possession (OCAP®) Principles highlight the necessity of Indigenous engagement and governance. To ensure that the aims and activities of the research being developed are in full and meaningful partnership with Indigenous peoples and communities, community-based participatory research (CBPR) methods provide a process in which full engagement is possible. Research utilizing secondary data sets, such as routinely collected health administrative data, should no longer be excluded from this approach. Our aim was to describe how our research team of academic researchers and a national Indigenous health organization adapted CBPR methods in a research project using previously collected data to examine end-of-life health care service delivery gaps for Indigenous people in Ontario. We describe the process of how we developed our research partnership and how grounding principles and Indigenous ways of knowing guided our work together. Through the adaptation of CBPR methods, our research partnership illustrates a process of engagement that can guide others hoping to conduct Indigenous health research using previously collected data. We also present a transparent research agreement negotiated equally by a national Indigenous health organization and research scientists, which can also be used as a framework for others wishing to establish similar research partnerships. Ensuring that Indigenous perspectives are central to and reflected in the research process is essential when using health administrative data.