NWT RESEARCH DATABASE

Regions: Inuvialuit Settlement Region, Gwich'in Settlement Area, Sahtu Settlement Area, North Slave Region, South Slave Region

Tags: health care evaluation, aboriginal community, health promotion, cancer

Objective(s): To improve First Nations, Inuit and Métis cancer patient transition experiences from the time of diagnosis, through treatment of care and upon discharge to a variety of community-based and primary care services.

Project Description: The goals of this project are: 1. to improve First Nations, Inuit and Métis cancer patient transition experiences from the time of diagnosis, through treatment of care and upon discharge to a variety of community-based and primary care services; 2. to develop sustainable working relationships amongst First Nations, Inuit and Métis communities and primary and oncology care providers; 3. to increase First Nations, Inuit and Métis community ownership of strategies for improved cancer outcomes; and 4. to increase availability of culturally relevant and safe knowledge and information for primary care and oncology care providers of the care needs of First Nations, Inuit and Métis cancer patients, families, care providers, and communities. Over three years, the project will roll out in three interdependent phases. Phase One is focused on building trusting relationships with participants while finalizing the ethical processes to be carried out in 12 communities from the Northwest Territories, British Columbia, Manitoba, and Alberta, ensuring respect and cultural safety for all participants. Phase Two will use storytelling and dialogue in safe environments to produce audio-visual and written support resources and tools for sharing and refining with First Nations, Inuit, and Métis communities and health care professionals from community, primary, and oncology care systems. Phase Three will focus on the distribution of the support resources and tools among First Nation, Inuit and Métis communities, health care networks, and health care providers in the Northwest Territories, British Columbia, Alberta, and Manitoba. First Nations, Inuit, and Métis community members in the Northwest Territories will have the opportunity to tell their cancer journey stories. The aim is to interview between 20-30 voluntary participants for a maximum of four hours each. There are two types of participants: community members and healthcare professionals – details are as follows: •Community members: The GNWT has a formal relationship with the Elder’s Advisory Group, outlined in a Terms of Reference. This group is composed of influential elders representing regions across the territory. Project team members in NT are working with the Elder’s Advisory Group to request participation from cancer survivors and patients, along with their family and friends, in three communities: Fort Resolution, Fort Good Hope, and Aklavik. The team anticipates 10-20 community participants in total. •Healthcare Professionals: The project team in NT is working with the Regional Health Authorities to request participation from primary care nurses and doctors working with First Nations, Inuit and Métis cancer patients. The team anticipates 5-10 healthcare participants in total. When project team members first visit the community, a project introduction feast or ceremony will be facilitated, at which time the project summery and consent process will be described. Subjects will have an opportunity to ask questions, and the facilitator will provide as much time as needed to ensure all subjects are confident that they understand the purpose of the dialogue/video sessions. Once the facilitator is able to confirm that subjects are comfortable in speaking and sharing their stories or responses, either alone or with a support group, subjects will be asked to sign the project consent form if they would like to continue their participation in the project and will obtain a copy of the signed form. Subjects will also be asked, but not required, to sign the GNWT consent form. Extra consent forms will be available on-hand during every visit into each community. Using video as a means to create a dialogue between two parties builds on First Nations, Inuit, and Métis storytelling traditions and ways of knowing. All participants will have the opportunity to provide input on the content and feel of the final products. The final audio-visual and written support resources and tools will be delivered to First Nations, Inuit, and Métis communities in the Northwest Territories, British Columbia, Alberta and Manitoba and made available online in 2016. The research team expects that open, continuing discussions will improve mutual understanding between First Nations, Inuit, and Métis cancer patients and their health care providers. Reduced worry about cancer pathways, fewer misconceptions, and a greater appreciation of the other’s values and traditions, should lead to positive change in attitudes, perceptions, and behaviors—and, ultimately, improved patient outcomes. Additional impacts include: •enhanced visibility of local cancer champions, particularly cancer survivors in the NWT; •dispelled myths and reduced stigma with regard to cancer among First Nations, Inuit and Métis peoples; •recognition of the value of other forms of healing, such as traditional medicine; •increased education, awareness, and promotion of cancer screening and cancer prevention; •additional, easily available, resources of written and visual support resources for First Nations, Inuit and Métis cancer patients; and •capacity building for those working with cancer patients within the community. Results will be communicated during the dialogue and storywork process, participants will be sent a DVD copy of their interviews and reactions. Once dialogues are completed, the final product will be sent to all participants. Using the final video and project findings, Transition Support Resources and user guides will be developed and disseminated to health care facilities and band offices across British Columbia, Alberta, Manitoba and the Northwest Territories. These resources may be available in various forms, such as online, video, or written material. Findings from the project will be shared with NWT communities, as well as disseminated across Canada through various conduits, such as online or written material. The fieldwork for this study will be conducted from October 20, 2014 to December 31, 2014.