NWT RESEARCH DATABASE

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

Tags: health, perscriptions, physician

Objective(s): To help identify views on planetary health informed healthcare, views on the introduction of planetary health informed prescribing into the regional health care system, and the potential barriers and facilitators with the adoption of planetary health informed prescribing.

Project Description: This licence has been issued for the scientific research application No.5117. The Principal Investigator (PI) will carry out focus groups with public and community stakeholders, and interviews with physicians to help identify views on planetary health informed healthcare, views on the introduction of planetary health informed prescribing into the regional health care system, and the potential barriers and facilitators with the adoption of planetary health informed prescribing. The results will be used to identify how the adoption of planetary health informed prescribing may be operationalized. There are no conflicts of interest identified and the Declaration of Helsinki will be followed in this research Inclusion/exclusion criteria: Phase 1 focus groups: Participants will be recruited from the NWT. This region has one health care system only, so all people living in this area are potential ‘patients’ of the system. For this reason, the stakeholder groups are focused on other attributes determined to be more appropriate for representation. Each focus group demographic was carefully chosen based on background research, the student’s lived experience practicing as a clinician for 11 years in the region, and the most common groups engaged in this region for this type of research. Each group was determined to be the most important to help answer the research questions for this study. Best effort will be made to include a broad range of ages and genders within the age criteria noted below to ensure best representation of the population. There are six main target populations for the focus groups with inclusion criteria as follows: Large community general public member focus group: Lives in either Yellowknife, Hay River, Fort Smith, or Inuvik. The participant is willing and able to give informed consent for participation in the study. The participant will be male or female, aged 18 years or above (no upper age limit), fluent in English and currently living in the NWT. Small community general public members focus groups. Participants live in a community other than Yellowknife, Hay River, Fort Smith, or Inuvik. Participant is willing and able to give informed consent for participation in the study. Participant is male or female aged 18 years or above (no upper age limit), fluent in English and currently living in the NWT. Indigenous Elders: Participants will be male or female, aged 50 years or above (no upper age limit), fluent in English and currently living in the NWT. The participant is willing and able to give informed consent for participation in the study Young adults: Male or Female, aged 18 years or above (no upper age limit), fluent in English and currently living in the NWT. The participant is willing and able to give informed consent for participation in the study. Health authority stakeholders: Participants will be currently working within an NWT health authority at the leadership, policy, or managerial level. Fluent in English and currently lives in the NWT. The participant is willing and able to give informed consent for participation in the study. Allied health stakeholders: Currently working within allied health in the NWT, fluent in English and currently living in the NWT. The participant is willing and able to give informed consent for participation in the study Phase 2 interviews: Between 12 to 25 physician participants will be recruited from the Northwest Territories (NWT), Canada. Best effort will be made to include a broad range of ages and genders within the age criteria noted below, in addition to years of practice variation, specialty, and the practice region to ensure best representation of the clinician population. Physician interview inclusion criteria are as follows: Participants will Live and practice in the NWT, Canada, as a primary care physician or physician specialist (self-reported). Participant is willing and able to give informed consent for participation in the study. Participant is male or female aged 18 years or above (no upper age limit), fluent in English and currently living in the NWT. Focus group participants will be recruited through existing and well-established networks and contacts known to the student investigator. Snowballing will be left available as an option for recruitment if deemed necessary. As this is a small region, there are very few strangers, and a phonebook still exists for the region. Despite large connections innate within communities, the research team are confident that individuals will still feel very comfortable saying no if they do not want to participate. This is based on previous research work within the region where participants would have no problem turning down involvement if they were not comfortable. Participants will include a range of public and community stakeholders relevant to the region’s culture and demographics including large community general public members, small community general public members, Indigenous Elders, young adults, health authority stakeholders, and allied health stakeholders. Participants will be selected based on their variation in gender, role, and position within these six pre-identified target groups. Potential participants will be contacted by email or telephone. This information is available through the region’s phonebook as well as local connections. Where names of specific individuals are not known, the student will email the appropriate organization to advertise the study (Study Recruitment Email). The student will only email 2-3 people at a time, then move on pending interest in the first group. This will avoid having to turn people away if the study gets more interest than expected. Participants will be sent an email inviting them to take part in the study (Email Invitation), this will include a Participant Information Leaflet (PIL) giving them additional information about what the study would involve. Participants contacted by telephone will be given brief verbal versions of the invitation and PIL with written documents sent by follow-up email. Participants will be asked to respond with expressions of interest in the study (either by email reply or indicating interest during phone call/meeting) and provide some basic information about their community of residence in the NWT. Participants will be selected from those indicating interest and contacted by email or telephone to arrange a date and time for the focus group. Participants will be emailed a copy of the Informed Consent Form (ICF). Physician interview participants will be recruited in the NWT health care region. The NWT health care region has one overarching medical association and health system which employs, coordinates, and manages all physicians, with all having a health system issued email address and connection to the medical association. Physician participants will be recruited through existing and well-established networks and contacts known to the PI. Snowballing will be left available as an option for recruitment if deemed necessary. Participants will be selected based on their variation in age, gender, years of practice, specialty, and the practice region within the NWT to be best representative of the physician practicing population. The student will hold open the option for snowballing if needed from participants who have agreed to participate. One follow-up email or telephone call will be conducted with non-respondents. Participants will be sent an email inviting them to take part in the study (Email Invitation), this will include a Participant Information Leaflet (PIL) giving them additional information about what the study would involve. Participants contacted by telephone will be given brief verbal versions of the invitation and PIL with written documents sent by follow-up email. Participants will be asked to respond with expressions of interest in the study (either by email reply or indicating interest during phone call/meeting). Participants will be then contacted by email or telephone to arrange a date and time for the interview. Participants will be emailed a copy of the Informed Consent Form (ICF). Process for consent: A verbal version of the PIL and Informed Consent will be presented to the participants detailing no less than: the exact nature of the study; what it will involve for the participant; the implications and constraints of the protocol; any risks involved in taking part. It will be clearly stated that the participant is free to withdraw from the study at any time for any reason without prejudice to future care, and with no obligation to give the reason for withdrawal. The participant will be allowed as much time as wished to consider the information, and the opportunity to question the student investigator to decide whether they will participate in the study. As focus groups will be carried out remotely, and it can take time with the rest of the focus group participants waiting to take verbal informed consent, the student will phone participants 1-2 days before the focus group to take verbal consent over the phone. For interviews, verbal consent will be taken at the start of the interviews. A copy of the record of Informed Consent will be given to the participant. The original form, signed by the researcher, will be retained at the host site The student PI is from the NWT and is well connected to many of the communities through her previous work as a clinician and as board chair of the Arctic Indigenous Wellness Foundation. Due to this, communications will be done through phone and email to key contacts, as well as virtual presentations on the progress as well as on the final outcomes of the research work. The fieldwork for this study will be conducted from January 17, 2022 to December 31, 2022.