Reflecting on the use of /Two-Eyed seeing in a study examining hospital-based Indigenous wellness services in the Northwest Territories, Canada.

/Two-Eyed Seeing (E/TES) is a Mi'kmaw guiding principle that emphasises the importance of bringing together the strengths of Indigenous knowledges and Western knowledges to improve the world for future generations. Since its introduction to the academic community, E/TES has been taken up more frequently in Indigenous health research. However, as it is increasingly used, Elders and scholars have affirmed that it is at risk of being watered down or tokenised.

How Etuaptmumk/Two-Eyed Seeing is used in indigenous health research: A scoping review.

Our scoping review sought to describe how Etuaptmumk or Two-Eyed Seeing is used and reported on in Indigenous health research. Using the JBI scoping review methodology, we extracted uses of Etuaptmumk/Two-Eyed Seeing from 83 articles and then categorized the reported uses of Etuaptmumk/Two-Eyed Seeing according to Huria et al.'s eight CONSIDER statement domains (governance, prioritization, relationships, methodologies, participation, capacity, analysis and interpretation, and dissemination).

Case management in primary healthcare for people with complex needs to improve integrated care: a large-scale implementation study protocol.

Introduction: Case management (CM) is among the most studied effective models of integrated care for people with complex needs. The goal of this study is to scale up and assess CM in primary healthcare for people with complex needs.

Methods And Analysis: The research questions are: (1) which mechanisms contribute to the successful scale-up of CM for people with complex needs in primary healthcare?; (2) how do contextual factors within primary healthcare organisations contribute to these mechanisms? and (3) what are the relationships between the actors, contextual factors, mechanisms and outcomes when scaling-up CM for people with complex needs in primary healthcare? We will conduct a mixed methods Canadian interprovincial project in Quebec, New-Brunswick and Nova Scotia.

Impacts of colonization on Indigenous food systems in Canada and the United States: a scoping review.

Background: Indigenous populations in Canada and the United States (US) have maintained reciprocal relationships with nature, grounded in respect for and stewardship of the environment; however, disconnection from traditional food systems has generated a plethora of physical and mental health challenges for communities. Indigenous food sovereignty including control of lands were found to be factors contributing to these concerns. Therefore, our aim was to conduct a scoping review of the peer-reviewed literature to describe Indigenous disconnection from Indigenous food systems (IFS) in Canada and the US.

Interventions for Indigenous Peoples making health decisions: a systematic review.

Background: Shared decision-making facilitates collaboration between patients and health care providers for informed health decisions. Our review identified interventions to support Indigenous Peoples making health decisions. The objectives were to synthesize evidence and identify factors that impact the use of shared decision making interventions.

Envisioning Indigenous and biomedical healthcare collaboration at Stanton Territorial Hospital, Northwest Territories.

To improve the quality of care for Indigenous patients, local Indigenous leaders in the Northwest Territories, Canada have called for more culturally responsive models for Indigenous and biomedical healthcare collaboration at Stanton Territorial Hospital. This study examined how Indigenous patients and biomedical healthcare providers envision Indigenous healing practices working successfully with biomedical hospital care at Stanton Territorial Hospital. We carried out a qualitative study from May 2018 - June 2022.

Call Individuals to Action.

This commentary calls on individuals, researchers and leaders to reconsider the sustained and ongoing impact of colonialism with respect to our individual commitment to relationships in a context where policy alone will not address the issues we face. The author intends to recognize people's individual power and accountability in their relationship with Indigenous Peoples and describes how relationships, in the end, will drive the change that is needed. The author raises the need for distinctions-based legislation to carry and convey the intention for change.

Breaking trail in the Northwest Territories: a qualitative study of Indigenous Peoples' experiences on the pathway to becoming a physician.

Currently, there is a lack of Indigenous physicians in the Northwest Territories (NWT), Canada. The goal of this qualitative study was to explore the underlying factors that influence the journey to becoming a medical doctor and returning home to practice for Indigenous students from the NWT. Eight qualitative, semi-structured interviews were conducted by phone or in-person.

How is Etuaptmumk/Two-Eyed Seeing characterized in Indigenous health research? A scoping review.

Our scoping review sought to consider how Etuaptmumk or Two-Eyed Seeing is described in Indigenous health research and to compare descriptions of Two-Eyed Seeing between original authors (Elders Albert and Murdena Marshall, and Dr. Cheryl Bartlett) and new authors. Using the JBI scoping review methodology and qualitative thematic coding, we identified seven categories describing the meaning of Two-Eyed Seeing from 80 articles: guide for life, responsibility for the greater good and future generations, co-learning journey, multiple or diverse perspectives, spirit, decolonization and self-determination, and humans being part of ecosystems.

Patient healthcare experiences in the Northwest Territories, Canada: an analysis of news media articles.

The factors that influence patient healthcare experiences are complex and connected to place. In northern Canada, the socio-historical context and the inequitable distribution of health services are unique influences on patients. The objective of this study was to examine the characteristics of patient healthcare experiences as reported through news media in the Northwest Territories.

The north is not all the same: comparing health system performance in 18 northern regions of Canada.

We investigated the availability of health system performance indicator data in Canada's 18 northern regions and the feasibility of using the performance framework developed by the Canadian Institute for Health Information [CIHI]. We examined the variation in 24 indicators across regions and factors that might explain such variation. The 18 regions vary in population size and various measures of socioeconomic status, health-care delivery, and health status.

Mental health services in the Northwest Territories: a scoping review.

The impacts of colonization have had significant impacts on the mental health and community wellness Indigenous peoples in the Northwest Territories (NWT). It is important that all communities in the NWT have access to key services in a culturally relevant way in achieving mental and community wellness. A scoping review was conducted to identify mental health services available in the NWT.

Patient transportation in Canada's northern territories: patterns, costs and providers' perspectives.

Introduction: Canada's northern territories are characterized by small, scattered populations separated by long distances. A major challenge to healthcare delivery is the reliance on costly patient transportation, especially emergency air evacuations (medevacs). The purpose of this study was to describe the patterns, costs and providers' perspectives on patient transportation, and identify potential factors associated with utilization and performance.

Improving access to Indigenous medicine for patients in hospital-based settings: a challenge for health systems in northern Canada.

In this commentary, we argue that Indigenous patients in the Northwest Territories (NWT) have a right to access traditional medicine and related practitioners as a part of the continuum of medical care. Indigenous people make up over half of the NWT population, spread over vast geographic areas with representation from First Nations, Inuit and Métis (FNIM) people. Ensuring barrier-free access to traditional medicine and providers in a culturally respectful environment is a challenge that requires structural transformation in the territorial health system.

Improving access to Indigenous medicine for patients in hospital-based settings: a challenge for health systems in northern Canada.

In this commentary, we argue that Indigenous patients in the Northwest Territories (NWT) have a right to access traditional medicine and related practitioners as a part of the continuum of medical care. Indigenous people make up over half of the NWT population, spread over vast geographic areas with representation from First Nations, Inuit and Métis (FNIM) people. Ensuring barrier-free access to traditional medicine and providers in a culturally respectful environment is a challenge that requires structural transformation in the territorial health system.

Building on Primary Care Reforms and Indigenous Self-Determination in the Northwest Territories: Physician Accountability and Performance in Context.

This commentary responds to Marchildon and Sherar's (2018) paper, "Doctors and Canadian Medicare: Improving Accountability and Performance," in which they explore questions around governance and physician accountability in Canada. This response situates the issues raised in a northern context by sharing experiences with primary care reform in the Northwest Territories and exploring the implications these changes have had for physician accountability and reported system improvements. Physician leadership and accountability are further explored in the northern context, where health systems for Indigenous communities include multiple jurisdictions and transitions in governance advance the self-government, land claims and treaty rights of Indigenous peoples.

Reconciliation and Health Systems Performance in Northern, Indigenous and Rural Communities.

This commentary calls for a broader conceptualization of the healthcare system and proposes a health systems performance framework that will guide reconciliation and health system improvements in northern, Indigenous and rural communities. Reconciliation provides an opportunity to develop more reciprocal approaches to performance framework and indicator development in Indigenous and northern regions. An enhanced performance framework will inform management that is underpinned by policies and actionable strategies that build on evidence and Indigenous knowledge to inform health systems improvements.

Comparing health care workforce in circumpolar regions: patterns, trends and challenges.

Background: The eight Arctic States exhibit substantial health disparities between their remote northernmost regions and the rest of the country. This study reports on the trends and patterns in the supply and distribution of physicians, dentists and nurses in these 8 countries and 25 regions and addresses issues of comparability, data gaps and policy implications Methods: We accessed publicly available databases and performed three types of comparisons: (1) among the 8 Arctic States; (2) within each Arctic State, between the northern regions and the rest of the country; (3) among the 25 northern regions. The unit of comparison was density of health workers per 100,000 inhabitants, and the means of three 5-year periods from 2000 to 2014 were computed.

Indigenous Values and Health Systems Stewardship in Circumpolar Countries.

Circumpolar regions, and the nations within which they reside, have recently gained international attention because of shared and pressing public policy issues such as climate change, resource development, endangered wildlife and sovereignty disputes. In a call for national and circumpolar action on shared areas of concern, the Arctic states health ministers recently met and signed a declaration that identified shared priorities for international cooperation. Among the areas for collaboration raised, the declaration highlighted the importance of enhancing intercultural understanding, promoting culturally appropriate health care delivery and strengthening circumpolar collaboration in culturally appropriate health care delivery.

Transforming Health Care in Remote Communities: report on an international conference.

An international conference titled "Transforming Health Care in Remote Communities" was held at the Chateau Lacombe Hotel in Edmonton, Canada, April 28-30, 2016. The event was organized by the University of Alberta's School of Public Health, in partnership with the Institute for Circumpolar Health Research in Yellowknife, Northwest Territories, and the Qaujigiartiit Health Research Centre in Iqaluit, Nunavut. There were 150 registrants from 7 countries: Canada (7 provinces and 3 territories), United States, Denmark, Iceland, Norway, Sweden, and Australia.

Performance indicators for maternity care in a circumpolar context: a scoping review.

Background: In circumpolar regions, harsh climates and scattered populations have prompted the centralization of care and reduction of local maternity services. The resulting practice of routine evacuation for birth from smaller towns to larger urban centres points to a potential conflict between the necessity to ensure patient safety and the importance of delivering services that are responsive to the health needs and values of populations served.

Objective: To identify recommended performance/quality indicators for use in circumpolar maternity care systems.

Community-based adaptation research in the Canadian Arctic.

Community-based adaptation (CBA) has emerged over the last decade as an approach to empowering communities to plan for and cope with the impacts of climate change. While such approaches have been widely advocated, few have critically examined the tensions and challenges that CBA brings. Responding to this gap, this article critically examines the use of CBA approaches with Inuit communities in Canada.

Assessing clinical support and inter-professional interactions among front-line primary care providers in remote communities in northern Canada: a pilot study.

Background: Primary care in remote communities in northern Canada is delivered primarily by nurses who receive clinical support from physicians in regional centres and the patient transportation system. To improve continuity, quality and access to care in remote northern communities, it is important to understand the perspectives of front-line providers and the complex challenges they face.

Objective: To design and implement a survey of primary care providers to identify issues relating to inter-professional communication, clinical support and patient evacuation.