NWT RESEARCH DATABASE

Regions: Inuvialuit Settlement Region, Gwich'in Settlement Area

Tags: health, public health

Objective(s): To develop a comprehensive approach to investigating community health problems related to H. pylori infection in NWT communities and to identify public health solutions that respond to community health care needs as perceived by community members and health authorities.

Project Description: This research aims to answer questions posed by NWT community members and their health care providers. The long term objectives are to develop a comprehensive approach to investigating community health problems related to H. pylori infection in NWT communities and to identify public health solutions that respond to community health care needs as perceived by community members and health authorities. This project targets all residents of Aklavik (estimated age distribution in 2004 from NWT Bureau of Statistics appears below); inclusion of the entire community will enhance participation and achieve broad representation. Study Methods Community Participation and Knowledge Exchange Community participation in the research process and sharing resulting knowledge with community members are cornerstones of accepted standards for conducting research in Aboriginal communities. This project incorporates the principles of the Association of Canadian Universities for Northern Studies (ACUNS) and the Canadian Institute for Health Research's Institute for Aboriginal People's Health. As an NEAHR co-investigator, Dr. Fletcher will oversee the incorporation of these standards in this research. Because community participation and knowledge exchange are mutually supportive, these dimensions of the research will operate from start to finish. As a preliminary step before conducting research, Karen Goodman sought community approval for this project at a meeting she attended in Aklavik on November 21, 2006 of the Aklavik Health Committee, with representation from the Hamlet of Aklavik, the Aklavik Community Corporation, the Gwich’in Band leadership, elders, the Old Folk’s Home, the Aklavik Health Centre, and the Arctic Health Research Network Aklavik chapter. The Study Planning Committee has decided how to recruit participants, which supplemental biologic specimens (e.g., blood or stool) to collect, and how to implement data collection. This committee provided input for and approved the informed consent documents and research questionnaires. The Study Planning Committee has provided input on how to develop communication media for sharing information with the community. Treatment Aklavik residents who tested positive for H. pylori infection were invited to participte in a treatment trial. At random, they were assigned to either the standard treatment or an alternative treatment that has shown promising results in trials conducted elsewhere. For participants who had biopsies taken and had cultures that were positive for H. pylori in the microbiology lab, there was information about which antibiotics their H. pylori organisms were susceptible to. This information was used to assign treatment. Participants with H. pylori infection who were not eligible to participate in the treatment trial were prescribed appropriate treatment based on their health status. Participants who completed treatments were offered a post-treatment breath test at least 8 weeks after completing treatment to see if their H. pylori infection cleared. In subsequent years, long term follow up of treatment will be carried out to identify factors associated with remaining infection-free. Study Planning Committee workshops have been developing strategies for communicating study information to community members, with particular consideration to targeting groups such as youth and elders. Throughout the project, information has been disseminated to the community by means of radio broadcasts, flyers, and progress reports. One new strategy that is underway involves the creation of a video documentary, now near completion, to convey to the community how the research has been carried out within the community and remotely at the University of Alberta. In addition, a community meeting was held in November 2009 to present early findings from the research to the community using a slide presentation. The fieldwork for this study will be conducted from March, 2010 to December 31, 2010.