Indigenous communities and federal funding agencies in Canada have developed policy for ethical research with Indigenous Peoples. Indigenous scholars and communities have begun to expand the body of research regarding their peoples, and novel and innovative methods have begun to appear in the published literature. This review attempts to catalogue the wide array of Indigenous research methods in the peer-reviewed literature and describe commonalities among methods in order to guide researchers and communities in future method development. A total of 64 articles met inclusionary criteria and five themes emerged: General Indigenous Frameworks, Western Methods in an Indigenous Context, Community-Based Participatory Research, Storytelling, and Culture-Specific Methods.

https://ojs.lib.uwo.ca/index.php/iipj/article/download/7515/6159

Indigenous Research Methods: A Systematic Review

Background: There is a widely held assumption that research engagement improves health-care
performance at various levels, but little direct empirical evidence.
Objectives: To conduct a theoretically and empirically grounded synthesis to map and explore plausible
mechanisms through which research engagement might improve health services performance. A review of
the effects on patients of their health-care practitioner's or institution's participation in clinical trials was
published after submission of the proposal for this review. It identified only 13 relevant papers and, overall,
suggested that the evidence that research engagement improves health-care performance was less strong
than some thought. We aimed to meet the need for a wider review.
Methods: An hourglass review was developed, consisting of three stages: (1) a planning and mapping
stage; (2) a focused review concentrating on the core question of whether or not research engagement
improves health care; and (3) a wider (but less systematic) review of papers identified during the two
earlier stages. Studies were included in the focused review if the concept of ‘engagement in research’ was
an input and some measure of ‘performance’ an output. The search strategy covered the period 1990 to
March 2012. MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature
(CINAHL), Web of Science and other relevant databases were searched. A total of 10,239 papers were
identified through the database searches, and 159 from other sources. A further relevance and quality
check on 473 papers was undertaken, and identified 33 papers for inclusion in the review. A standard
meta-analysis was not possible on the heterogeneous mix of papers in the focused review. Therefore an
explanatory matrix was developed to help characterise the circumstances in which research engagement
might improve health-care performance and the mechanisms that might be at work, identifying two main
dimensions along which to categorise the studies: the degree of intentionality and the scope of the impact.
Results: Of the 33 papers in the focused review, 28 were positive (of which six were positive/mixed) in
relation to the question of whether or not research engagement improves health-care performance. Five
papers were negative (of which two were negative/mixed). Seven out of 28 positive papers reported some
improvement in health outcomes. For the rest, the improved care took the form of improved processes of
care. Nine positive papers were at a clinician level and 19 at an institutional level. The wider review
demonstrated, for example, how collaborative and action research can encourage some progress along the
pathway from research engagement towards improved health-care performance. There is also evidence
that organisations in which the research function is fully integrated into the organisational structure
out-perform other organisations that pay less formal heed to research and its outputs. The focused and
wider reviews identified the diversity in the mechanisms through which research engagement might
improve health care: there are many circumstances and mechanisms at work, more than one mechanism is
often operative, and the evidence available for each one is limited.
Limitations: To address the complexities of this evidence synthesis of research we needed to spend
significant time mapping the literature, and narrowed the research question to make it feasible. We
excluded many potentially relevant papers (though we partially addressed this by conducting a wider
additional synthesis). Studies assessing the impact made on clinician behaviour by small, locally conducted
pieces of research could be difficult to interpret without full knowledge of the context.
Conclusions: Drawing on the focused and wider reviews, it is suggested that when clinicians and
health-care organisations engage in research there is the likelihood of a positive impact on health-care
performance. Organisations that have deliberately integrated the research function into organisational
structures demonstrate how research engagement can, among other factors, contribute to improved
health-care performance. Further explorations are required of research networks and schemes to promote
the engagement of clinicians and managers in research. Detailed observational research focusing on
research engagement within organisations would build up an understanding of mechanisms.

/pdf/engagement-in-research-an-innovative-three-stage-review-of-48py2rw8si.pdf

Engagement in research: an innovative three-stage review of the benefits for health-care performance

A longstanding challenge of community-based participatory research (CBPR) has been to anchor evaluation and practice in a relevant theoretical framework of community change, which articulates specific and concrete evaluative benchmarks. Social movement theories provide a broad range of theoretical tools to understand and facilitate social change processes, such as those involved in CBPR. Social movement theories have the potential to provide a coherent representation of how mobilization and collective action is gradually developed and leads to systemic change in the context of CBPR. The current study builds on a social movement perspective to assess the processes and intermediate outcomes of a longstanding health promotion CBPR project with an Indigenous community, the Kahnawake Schools Diabetes Prevention Project (KDSPP). This research uses a case study design layered on a movement-building evaluation framework, which allows progress to be tracked over time. Data collection strategies included document (scientific and organizational) review (n = 51) and talking circles with four important community stakeholder groups (n = 24). Findings provide an innovative and chronological perspective of the evolution of KSDPP as seen through a social movement lens, and identify intermediate outcomes associated with different dimensions of movement building achieved by the project over time (mobilization, leadership, vision and frames, alliance and partnerships, as well as advocacy and action strategies). It also points to areas of improvement for KSDPP in building its potential for action. While this study’s results are directly relevant and applicable to the local context of KSDPP, they also highlight useful lessons and conclusions for the planning and evaluation of other long-standing and sustainable CBPR initiatives. The conceptual framework provides meaningful benchmarks to track evidence of progress in the context of CBPR. Findings from the study offer new ways of thinking about the evaluation of CBPR projects and their progress by drawing on frameworks that guide other forms of collective action.

/pdf/understanding-community-based-participatory-research-through-2p95bf9c0n.pdf

Understanding community-based participatory research through a social movement framework: a case study of the Kahnawake Schools Diabetes Prevention Project.

A long-standing challenge in community-based participatory research (CBPR) has been to anchor practice and evaluation in a relevant and comprehensive theoretical framework of community change. This study describes the development of a multidimensional conceptual framework that builds on social movement theories to identify key components of CBPR processes. Framework synthesis was used as a general literature search and analysis strategy. An initial conceptual framework was developed from the theoretical literature on social movement. A literature search performed to identify illustrative CBPR projects yielded 635 potentially relevant documents, from which eight projects (corresponding to 58 publications) were retained after record and full-text screening. Framework synthesis was used to code and organize data from these projects, ultimately providing a refined framework. The final conceptual framework maps key concepts of CBPR mobilization processes, such as the pivotal role of the partnership; resources and opportunities as necessary components feeding the partnership's development; the importance of framing processes; and a tight alignment between the cause (partnership's goal), the collective action strategy, and the system changes targeted. The revised framework provides a context-specific model to generate a new, innovative understanding of CBPR mobilization processes, drawing on existing theoretical foundations.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/ajcp.12142

Can we Build on Social Movement Theories to Develop and Improve Community-Based Participatory Research? A Framework Synthesis Review.

Service utilisation by refugee families may be affected by the mismatch between Western individualistic service delivery approaches and the target communities’ more collectivist cultural patterns and practices. In addition to access barriers, utilisation of early childhood services by refugees can also be impacted upon by distrust of services, health and settlement issues, stigma, unfamiliarity with early childhood programmes, and fear of child protection and other legal systems. This low service utilisation sits in conflict with the need for early interventions for very young children, who are in the peak period of brain development. This article explores the implementation of a model to address these issues in early childhood work with refugee families and communities, with the intent to increase service uptake. Some strategies to address potential barriers will be described in the context of a community engagement model that includes consultation, relationship building, collaborative flexible service design and delivery, partnerships in community capacity building and cross-referral. Flexible, culturally appropriate interventions can enhance strengths based, non-pathologising and development-focused approach. A community engagement approach will, nevertheless, present challenges for service providers who must be willing to adapt their practices. Services and funding bodies need to recognise that this process is lengthy and resource intensive, but will ultimately lead to better service delivery and uptake, potentially leading to improvements in health, development and relational outcomes, for children and families from refugee backgrounds.

Relationship Building, Collaboration and Flexible Service Delivery: The Path to Engagement of Refugee Families and Communities in Early Childhood Trauma Recovery Services

Mano a Mano (Spanish translation: "Hand to Hand") is a nonprofit organization that is working in partnership with underserved Bolivian communities to cocreate medical infrastructures and to improve health. Using community-based participatory research (CBPR) methods, Mano a Mano engages local government and community leaders, health care providers, educators, and ordinary citizens in a manner that taps local strengths and resources to allow all participants to work together to realize this mission. After describing Bolivia's call for improved access to high quality care in its poor and underserved rural areas, we outline the Mano a Mano's CBPR approach and sequence to answer this call, the culmination of its efforts to date (including the establishment of 119 health care facilities), lessons learned, and next steps in the formal evaluation and extension of this collaborative work.

Dan Narr

Papers

Mano a Mano: Improving health in impoverished Bolivian communities through community-based participatory research.