Indigenous Peoples Health

GOALS

Preventing diabetes and its complications among Indigenous youth through the Indigenous Youth Mentorship Program (IYMP) – a multi-generational and resiliency-focused empowerment program

Building capacity in respectful engagement of Indigenous people in patient-oriented research

Rippling out of the Indigenous Youth Mentorship Program (IYMP)

Alex McComber

Co-Investigators

Caroline Chartrand, Barry Lavallee, Nancy Young, Marie-Claude Tremblay

Not too long ago all it was almost unheard of for a child to develop what has traditionally been an adult-onset condition, that of type 2 diabetes (T2D).  Yet T2D is the fastest growing pediatric chronic condition, with Indigenous populations among the most affected.   In Canada, nearly half of new cases of T2D reported in endocrinology clinics are among Aboriginal children and youth, and this trend is expected to continue.  Indigenous and Aboriginal health strategies are a top priority for federal and provincial policymakers as Canadian agencies seek to address concerns articulated in the Truth and Reconciliation Commission of Canada: Calls to Action.  Many programs exist to engage youth in activities that promote healthy lifestyles, however, not all are suited to the unique needs and traditions of Indigenous Peoples.  This is what inspired the development of the Indigenous Youth Mentorship Program (IYMP) (formerly the Aboriginal Youth Mentorship Program).  This resilience-based approach to wellness was co-developed with Indigenous youth and leaders in Winnipeg and northern Manitoba along with researchers and community members, currently under the direction of Dr. Jon McGavock from the University of Manitoba. Delivered by Indigenous adolescents for Indigenous children in their communities, the IYMP builds on the strengths of its participants and helps to create healthy inclusive communities.  It is guided by an Indigenous medicine wheel concept of health called the Circle of Courage from Lakota scholar Dr. Martin Brokenleg and consists of four spokes; belonging, independence, mastery and generosity.  The program includes after-school peer-led physical activities, healthy snacks, games, and education and leadership activities for elementary school-aged students. Each community has the opportunity to tailor components of the program to meet its own unique needs, teachings and cultural values.

IYMP is currently offered in thirteen Indigenous communities across Canada.  Initial results have shown that children and youths that participated in the program experience increased self-esteem, reduced weight gain and healthier dietary choices, compared to those not in the program. Initial evaluation of the program indicated up to a 12% reduction in developing risk factors associated with developing T2D.  Given this success, it is the mission of both Diabetes Action Canada and IYMP to ripple out this program more broadly in Indigenous communities.  With the help of philanthropic donors, Diabetes Canada, and Manulife Financial, we are one step closer to accomplishing this goal.  With the funding received by these partners, we have opened another IYMP site at the First Nations School in Toronto – the first inner-city urban site.   Once the effectiveness of this program is evaluated we plan to open additional sites in Northern Ontario in 2018-19.

The Indigenous medicine wheel concept of health called the Circle of Courage, a model of positive youth development was first described in the book Reclaiming Youth at Risk, co-authored by Larry Brendtro, Martin Brokenleg, and Steve Van Bockern. The model integrates Native American philosophies of child-rearing, the heritage of early pioneers in education and youth work, and contemporary resilience research. The Circle of Courage is based on four universal growth needs of all children: belonging, mastery, independence, and generosity.

Our Indigenous Peoples Patient Circle co-develops a respectful engagement approach to patient-oriented research

In collaboration with Can-SOLVE CKD (SPOR Chronic Disease Network in Chronic Kidney Disease) and their Indigenous Patient Engagement and Research Council, our Indigenous Peoples Patient Circle members are creating a new training platform to enable respectful partnerships with Indigenous People in Research. This learning pathway, named Wabishki Bizhiko Skaanj (wah-bish-kih biish-ih-goo skaa-nch) aims to enhance the Indigenous perspective and support partnerships that consider existing racial biases, Indigenous voices and stories, the impact of colonization on Indigenous health, and culturally safe health research practices.  This learning pathway will ultimately change the way that researchers approach and engage members of the Indigenous Community and it is expected to be adopted by Canadian Institutes of Health Research (CIHR) to augment the existing Patient Engagement curriculum.

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