Indigenous community research partnerships can help address health inequities

Janet Jull, Assistant Professor, School of Rehabilitation Therapy, Queen's University, Ontario, Angela Mashford-Pringle, Assistant Professor/Associate Director, Waakebiness-Bryce Institute for Indigenous Health, University of Toronto, Darrel Manitowabi, Associate professor, Northern Ontario School of Medicine, Laurentian University, Lindsay Brant, Educational Developer, Indigenous Pedagogies and Ways of Knowing, Queen's University, Ontario, Melody E. Morton Ninomiya, Assistant Professor, Wilfrid Laurier University; Affiliate Scientist, Centre for Addiction and Mental Health, Wilfrid Laurier University, Alexandra King, Cameco Chair in Indigenous Health and Wellness, College of Medicine, University of Saskatchewan, Priscilla Ferrazzi, Lawyer, Research Contracts Unit, Queen's University; Researcher (Adjunct Status), University of Alberta, Malcolm King, Professor, University of Saskatchewan Community Health and Epidemiology, Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Jennifer Walker, Associate Professor and Canada Research Chair in Indigenous Health, Laurentian University, Moses Gordon, Acting director, Indigenous Peoples' Health Research Centre, University of Regina, and Cheyanne Desnomie, Associate Director, Indigenous Peoples' Health Research Centre and Sessional Instructor, Department of Anthropology, University of Regina
·8 min read
<span class="caption">Gathering on the land: Indigenous ways of knowing can ensure that communities reclaim and promote health and healing.</span> <span class="attribution"><span class="source">(Melody Morton-Ninomiya)</span>, <span class="license">Author provided</span></span>
Gathering on the land: Indigenous ways of knowing can ensure that communities reclaim and promote health and healing. (Melody Morton-Ninomiya), Author provided

Building equitable research partnerships is a strong starting point for self-determination of Indigenous communities. Research is critical to inform policies that advance reconciliation and support Indigenous sovereignty.

Society relies on research to develop and contribute knowledge that can be translated into improved health and wellness. Research can also help identify, understand and address health inequities, that is, differences in health that are unnecessary, avoidable and unjust. When it is done appropriately, research contributes to more effective and sustainable health services and care products, resulting in a more equitable and strengthened health system.

We are an interdisciplinary team of Indigenous and non-Indigenous researchers. Our goal is to promote community-centred research approaches that privilege Indigenous ways of knowing, doing and being through all aspects of the research lifecycle. To assist with this, we have developed an open-access online training resource called Indigenous Community Research Partnerships.

The training resource provides guidance to researchers and others embarking on partnered research with urban, rural or remote Indigenous communities.

Whether you have lots of experience in community-based research or are a newcomer to the field, we believe our training resource has a lot to offer on your journey of learning about community-centred research. Our aim is to assist the research community to develop equitable partnerships that prioritize Indigenous ways of knowing and ensure that Indigenous communities are the primary benefactors.

Failure of western-oriented research approaches

In our society, the bias of colonial, or western-oriented and western-constructed knowledge dominates the conduct of research. The evidence derived from this standpoint reflects the structural racism that privileges knowledge derived from western methodologies. This knowledge is then used to inform the development of the policies and processes that organize our health and social systems.

Consequently, western-oriented academic approaches fail to promote Indigenous perspectives and ways of knowing in policies that affect these communities. For example, biomedical health-care models reflect values, knowledge systems, research and care practices that do not meet the needs of Indigenous people. Western-oriented academic research is often focused on disparities and deficit-based approaches identified by researchers. The approach, driven by the outside looking in, fails to consider and prioritize community needs. As well, many researchers are trained within a system that is dominated by (western-oriented) perspectives that do not allow for, or even recognize, alternate ways of thinking or worldviews.

Indigenous people demonstrate tremendous cultural resilience and capacity to innovate, and Indigenous ways of knowing can be a way forward to improve health and wellness.

Indigenous people are more likely than the general population to experience ongoing marginalization and poor health. Ineffective policies perpetuate these health and social inequities.

Principled partnerships

Research conducted with authentic partnerships and full community engagement with Indigenous people is urgently needed to address health inequities. Many researchers may not understand how to work with Indigenous communities and lack resources to guide them in conducting research that is equitable, inclusive and respectful of diverse Indigenous knowledge, ethics, practice and research sovereignty.

A principled approach to research engages different parties who may use or be recipients of research outcomes or be impacted by them. A principled approach promotes active reflection upon principles that all parties agree are important and prioritizes relationships in research partnerships. The purpose of a principled approach is to promote community relevance, participation, ownership and reciprocal capacity building, and to ensure that research will benefit Indigenous communities, centre on partnerships with Indigenous people and prioritize Indigenous ways of knowing.

A principled approach begins with following the key principle of Reconciliation of Ethical Spaces:

“Protecting Indigenous ethical space involves a series of stages of dialogue starting with conversations prior to the design of research through to the dissemination of results and perhaps even afterwards. Fundamental to this process is an ongoing respect for both parties’ ethical spaces and a continual questioning of ‘is this ethical?’”

Research that benefits Indigenous communities

Effective research requires a deeply engaged and relationally accountable approach to partnerships with Indigenous communities. In academic and learning institutions, researchers must learn to cultivate and invest in genuine relationships to generate useful and relevant evidence.

The Indigenous Community Research Partnerships training resource was developed to educate researchers and researchers-in-training in the development of respectful research partnerships with Indigenous communities that can lead to the conduct of research that advances societal change. The intent is to prepare researchers to work in ways that are important to Indigenous communities and individuals, who will be the ultimate beneficiaries of research.

Read more: How a university can embed Indigenous knowledge into the curriculum and why it matters

The Indigenous Community Research Partnerships training resource complements other important initiatives to advance health equity and societal change. There are also important policy level initiatives in academic institutions.

Academic research can be conducted to better benefit Indigenous communities. Research partnerships are central to building the research evidence that meets Indigenous community-level needs. Researchers can support work that leads to societal change and opportunities for everyone to achieve optimal health and wellness.

A principled approach to research will contribute to what should be the ultimate goal, namely, health for all.

We thank the following people for their support and contributions to the article: Melissa Ireland, director and interim senior advisor, Office of Indigenous Initiatives at Wilfrid Laurier University; Penny Moody-Corbett, retired associate dean research, Northern Ontario School of Medicine; doctoral student Andrew Forbes at the University of Ottawa; professor Ian Graham at the University of Ottawa and lead of the Integrated Knowledge Translation Research Network; Rebecca Sweetman and Julian Enright who are members of the Arts and Science Online Multimedia Team at Queen’s University.

This article is republished from The Conversation, a nonprofit news site dedicated to sharing ideas from academic experts. It was written by: Janet Jull, Queen's University, Ontario; Alexandra King; Angela Mashford-Pringle, University of Toronto; Cheyanne Desnomie, University of Regina; Darrel Manitowabi, Laurentian University; Jennifer Walker, Laurentian University; Lindsay Brant, Queen's University, Ontario; Malcolm King, Simon Fraser University; Melody E. Morton Ninomiya, Wilfrid Laurier University; Moses Gordon, University of Regina, and Priscilla Ferrazzi, University of Alberta.

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Janet Jull receives funding from the Canadian Institutes of Health Research and Social Sciences and Humanities Research Council.

Alexandra King, MD, FRCPC has an academic appointment at the University of Saskatchewan. She is the inaugural Cameco Chair in Indigenous Health and Wellness, an endowed research chair established by the Royal University Hospital Foundation through a generous donation from Cameco and from the Department of Medicine. She receives funding from the Canadian Institutes of Health Research, the Public Health Agency of Canada, the Canadian Liver Foundation, and pharmaceutical companies (Gilead Sciences, AbbVie, Merck). She is affiliated with the Sanctum Care Group (board member), and serves on a variety of local, national and international working groups and councils.

Angela Mashford-Pringle works for University of Toronto. She receives funding from Social Sciences and Humanities Research Council, Canadian Institutes of Health Research and eCampus Ontario.

Darrel Manitowabi receives funding from the Canadian Institutes of Health Research, the Alberta Gambling Research Institute, the Ontario Ministry of Labour, and Indigenous Services Canada.

Jennifer Walker receives funding from the Canadian Institutes of Health Research, the Ontario SPOR Support Unit, the Government of Ontario, and the Public Health Agency of Canada. She is a Core Scientist with the Institute for Clinical Evaluative Sciences. She is also affiliated with the Canadian Consortium on Neurodegeneration in Aging and the Health Data Research Network. She is on the Board of Directors for Research Canada.

Malcolm King is a Professor of Community Health and Epidemiology at the University of Saskatchewan and an Adjunct Professor in the Faculty of Health Sciences, Simon Fraser University. Malcolm King receives funding from CIHR for Indigenous health research.

Melody E. Morton Ninomiya receives funding from Canadian Institutes of Health Research and Social Sciences & Humanities Research Council for community-partnered studies with Indigenous communities and Indigenous Knowledges in research, respectively.

Priscilla Ferrazzi consults to Inuit Tapiriit Kanatami and the Law Society of Nunavut. She has received funding from the Canadian Institutes of Health Research, the Social Science and Humanities Research Council of Canada, and The Law Foundation of Ontario. Priscilla is a lawyer working at Queen's University and an Adjunct Professor in the School of Public Health and Adjunct Assistant Professor in the Faculty of Rehabilitation Medicine a the University of Alberta. She is also an executive member of the Canadian Society for Circumpolar Health.

Cheyanne Desnomie, Lindsay Brant, and Moses Gordon do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.