Foundations

Previous Initiatives

This work draws on a number of initiatives to synthesize First Nation experiences in Alberta with the overdosecrisis, from research collaborations with the Alberta First Nations Information Governance Centre, collaborations with partners within health systems, and efforts to centre the voices of people most impacted by this crisis.

Healing the Whole Human Being: Realist Review of Best Practices and Contextual Factors for Preventing & Treating Opioid Misuse in Indigenous Contexts in Alberta

Henderson, R., Wadsworth, I.W., Healy, B., McInnes, L., Danyluk, A., Crowshoe, L.  (2020.). Alberta First Nations Information Governance Centre & University of Calgary Department of Family Medicine.

This knowledge synthesis aimed to understand what interventions effectively prevented or treated opioid dependency in Indigenous contexts. The focus was on exploring non-pharmaceutical wraparound models, such as programs that integrated with a person's daily life, including social programs, holistic or spiritual programs, counselling, and therapy.

In the context of Indigenous communities in Alberta, the goal was to find answers to the following questions:

  • What were the best practices for preventing, treating, and reducing harm related to opioid misuse?

  • What contextual factors contributed to opioid misuse, and how did community-based responses shape this issue?

  • Which wraparound support models showed promise in initiating and maintaining the recovery of individuals with opioid use disorder?

Healing the Whole Human Being:

Project Introduction Video

This video introduces the Healing the Whole Human Being project conducted out of the University of Calgary. In the video series Iskotoahka Billy Wadsworth, engages in conversations with a frontline worker, a family physician, an addictions specialist, a researcher, a patient in recovery and an Indigenous Elder. The video series is intended for those who are affected by and work to address the overdose crisis in Indigenous communities. 

This study systematically searched international literature to find the best practices for treating opioid dependence in Indigenous contexts. The analysis followed a realist review methodology and involved a two-step knowledge contextualization process. This process included a Knowledge Holders Gathering to initiate the literature search and analysis, as well as five consensus-building meetings to synthesize relevant findings.

 

The findings from this realist review highlight compassion and self-determination as crucial program mechanisms. These mechanisms not only contribute to reducing substance use but also have the potential to address systemic health inequities and social determinants of health in Indigenous communities.

Abstract

In 2015, the Truth and Reconciliation Commission (TRC) of Canada outlined 94 Calls to Action, which formalized a responsibility for all people and institutions in Canada to confront and craft paths to remedy the legacy of the country’s colonial past. Among other things, these Calls to Action challenge medical schools to examine and improve existing strategies and capacities for improving Indigenous health outcomes within the areas of education, research, and clinical service.

This article outlines efforts by stakeholders at one medical school to mobilize their institution to address the TRC’s Calls to Action via the Indigenous Health Dialogue (IHD). The IHD used a critical collaborative consensus-building process, which employed decolonizing, antiracist, and Indigenous methodologies, offering insights for academic and nonacademic entities alike on how they might begin to address the TRC’s Calls to Action. Through this process, a critical reflective framework of domains, reconciliatory themes, truths, and action themes was developed, which highlights key areas in which to develop Indigenous health within the medical school to address health inequities faced by Indigenous peoples in Canada.

Education, research, and health service innovation were identified as domains of responsibility, while recognizing Indigenous health as a distinct discipline and promoting and supporting Indigenous inclusion were identified as domains within leadership in transformation. Insights are provided for the medical school, including that dispossession from land lays at the heart of Indigenous health inequities, requiring decolonizing approaches to population health, and that Indigenous health is a discipline of its own, requiring a specific knowledge base, skills, and resources for overcoming inequities.

A Realist Review of Best Practices and Contextual Factors Enhancing Treatment of Opioid Dependence in Indigenous Contexts

Henderson, R., McInnes, A., Danyluk, A. et al. (2023). Harm Reduction Journal 20, 34.

Public health emergencies such as the COVID-19 pandemic disrupt already-strained harm reduction efforts and treatment availability. This study sought to answer three research questions: How do public health emergencies affect people who use opioids and other drugs (PWOUD)? How can health systems respond to novel public health emergencies to support PWOUD? How can the findings of this review be applied to Alberta to inform local stakeholder responses to the pandemic?

 

The results of the review were applied to the local pandemic response in Alberta, Canada, using a process called Nominal Group Technique (NGT). Frontline providers and stakeholders in Alberta participated in this process. They suggested that addressing multiple crises simultaneously and allocating sufficient resources to address both social and health systems issues are crucial in preparing a system to support PWOUD during disasters.

Truth and Reconciliation in Medical Schools: Forging a Critical Reflexive Framework to Advance Indigenous Health Equity

Henderson, R., Sehgal, A., Barnabe, C., Roach, P., & Crowshoe, L. (2023). Academic Medicine: Journal of the Association of American Medical Colleges

Abstract

In Alberta, First Nations members visit Emergency Departments (EDs) at almost double the rate of non-First Nations persons. Previous publications demonstrate differences in ED experience for First Nations members, compared to the general population. The Alberta First Nations Information Governance Centre (AFNIGC), First Nations organizations, Universities, and Alberta Health Services conducted this research to better understand First Nations members' ED experiences and expectations

Abstract

Recent deaths of Indigenous patients in the Canadian healthcare system have been attributed to structural and interpersonal racism. Experiences of interpersonal racism by Indigenous physicians and patients have been well characterized, but the source of this interpersonal bias has not been as well studied. The aim of this study was to describe the prevalence of explicit and implicit interpersonal anti-Indigenous biases among Albertan physicians.

Prevalence and Characteristics of Anti-Indigenous Bias Among Albertan Physicians: a Cross-Sectional Survey and Framework Analysis

Roach, P., Ruzycki, S., Hernandez, S., Carbert, A., Holroyd-Ledic, J., Ahmed, S., Barnabe, C. (2023).

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