NWT RESEARCH DATABASE

Regions: Inuvialuit Settlement Region, Gwich'in Settlement Area

Tags: health, health care, health promotion

Objective(s): 1) To list and identify all health promotion programs currently underway in the community of Aklavik, NT; 2) to identify popular perceptions of the meaning of health, the most significant barriers to health, and health interventions considered most important by the people of Aklavik.

Project Description: This study aims to support the work of the Aklavik Health Committee, and to offer tools to help improve health promotion practice in the north. To accomplish this, this study has two research objectives: 1) to list and identify all health promotion programs currently underway in the community of Aklavik, NT; 2) to identify popular perceptions of the meaning of health, the most significant barriers to health, and health interventions considered most important by the people of Aklavik. This information will be made available to the community of Aklavik through community presentations and through a plain-language booklet co-designed with the Aklavik Health Committee. This project uses three methods for collecting data: 1) participant observation; 2) semi-structured interviews; and 3) focus groups/workshops. 1) For this research project, participant observation essentially involves being in the community of Aklavik for an extended period of time to observe different health promotion programs in action. This is a commonly used practice in social anthropology. It will be used to gain general information about health promotion programs taking place in Aklavik, and to identify key informants for interviews. On the recommendation of the Aklavik Health Committee, the community radio station will be used to publicly describe this research to people in the community, to share contact information that community members can use to get more information, and to welcome phone-in questions about the research. The researcher will follow protocol for informed consent before proceeding with any key informant interviews. In this sense, in accordance with the University of Toronto’s Guidelines for Ethical Conduct in Participant Observation, the consent process will be dynamic and continuous, responsive to both the community and to individual potential participants. 2) Semi-structured interviews are interviews that use a few key questions to guide an otherwise open interview. This allows the researcher to gather information about key research themes, while allowing the participant to guide the interview process by choosing what directions they would like to take the interview. Interviews will be as long or as short as the participant desires. All interviews will happen at a location selected by the interviewee. The interview questions are general in nature, and include questions about people’s perceptions of meaning of “health”, its determinants, and the interventions they consider most needed in their community. Interviews will also be used to gather data on health promotion programs currently underway in Aklavik. Interviews will be recorded using an audio recorder to help ensure accuracy in transcription. Participants will have control of the recording device during interviews, and will be able to turn the audio recorder on or off as they choose. Key informants will be selected on the basis of their role in the community (with a special effort to include members of the health committee, and people involved in health promotion programs). An additional sample of 30 people will be randomly selected for potential interviews using a random number generator to select households from the phone book. An equal number of men and women is the goal, and each participant's gender will be recorded in order to monitor equity in the sample. I will also collect information on whether each participant is a beneficiary of a particular land claim agreement (eg. Gwitch'in or Inuvialuit) in order to monitor the equity of sampling. Data on age will also be collected, and during each interview note will be taken of whether the interviewee is alone or in the presence of other family or community members. This information will be valuable for interpreting the data. 3) Focus groups are a form of group interview or workshop, where a number of people gather together to explore a topic or group of topics. Focus groups have been included in this research design at the special request of the Aklavik Health Committee (AHC), and offer a way of gaining insight into the multiple voices and perspectives surrounding health and health promotion in Aklavik. Because they offer another way of collecting information about the same questions explored in interviews, they will improve the overall validity and strength of the study. The focus groups in this study will be organized around the same questions used for individual interviews, and will be similarly open-ended, meaning that the group can take the discussion in any direction they like. This study will convene up to four focus groups of approximately 6-8 people. Each focus group will last approximately one hour. All focus groups will be conducted either by the primary investigator, or by members of the Aklavik Health Committee, based on the preference of the Health Committee. Members of the Health Committee will be trained by the primary investigator in focus group facilitation, confidentiality, and informed consent prior to the focus group interviews. One focus group will include members of the Aklavik Health Committee, and will offer an opportunity to explore the committee’s experiences in a group setting. This focus group with be facilitated by the primary investigator. Another of the focus groups will include Elders from the community, whose unique voices offer especially important and respected perspectives on health. Elders will be contacted using a snowball sampling method, which means that key informants will suggest elders for participation. A special meeting including members of the Aklavik Health Committee will take place at the Joe Greenland Center to introduce the research to the Elders living there, and create an opportunity to ask questions about the research. All Elders who wish to participate are welcome. The remaining focus groups will include a random sample from the community, using the same sampling methods used to contact potential participants for interviews. Focus groups will take place at the Aklavik Learning Center or at Moose Kerr School, at a date and time to be determined. This research will also provide opportunities for capacity-building at the level of the Health Committee through training in research skills including focus group facilitation. It also extends the Committees ongoing experience as a key community partner in health research in the north, and as an example for other communities. There are three ways that the results of this study will be communicated to people in the community of Aklavik, and to individuals and communities elsewhere in the north. First, the Aklavik Health Committee has requested that data from this study be made available for local and regional use through the production of a plain language document to be distributed to people in Aklavik and across the Beaufort Delta Region and beyond to other northern communities. This document will introduce the Aklavik Health Committee, and will include data gathered through this study. An action-based component of this study involves my logistical and analytical support for the creation of this document in the spring and summer of 2010. Creative and analytical control over the production of this document will sit with the Aklavik Health Committee. Copies of this document will reside in the community of Aklavik and will be available from the Aklavik Health Committee. In addition, Andrew Bresnahan (the primary investigator) and the Aklavik Health Committee will do a series of public presentations introducing the health committee and the results of the research in the spring and summer of 2010. These short and accessible presentations will be conducted in public places such as Moose Kerr School, the Sittichinli Recreational Complex, and the Joe Greenland Center, and where appropriate may be timed to correspond with other community events. An additional form of communication will be in the form of academic papers and conference presentations, and will be directed towards health researchers and health care providers, in the hope of improving health promotion practices in Aklavik and across the north. The Aklavik Health Committee will be contacted prior to presentations, and copies of presentation materials and abstracts will be made available to members of the Committee. The fieldwork for this study will be conducted from April 10, 2010 to August 20, 2010.