Samara Wessel

Objectives: The lack of Indigenous health care data in Canada makes it challenging to plan health care services and inform Indigenous leadership on the health care needs of their respective Nations and communities. Several Canadian health care organizations have implemented a voluntary Indigenous identifier of patients within their electronic medical records. This study examines facilitators and barriers to implementing such a voluntary self-reported Indigenous identifier, from the perspective of key stakeholders who work at four Canadian health providers where an Indigenous identifier has been implemented. Methods: The four Canadian sites comprise three hospitals and one health authority. At each site, key stakeholders participated in semi-structured qualitative interviews. Interviews were transcribed and coded. Relevant documents that were publicly available or provided by each site were reviewed. Results: There were four primary findings. First, for the introduction of an Indigenous identifier to be successful there must be pre-existing strong and trusting relationships between Indigenous communities and health care organizations. Second, health care organizations must provide training for those who ask clientele to self-identify as Indigenous, to overcome issues such as any patient backlash. Third, for the relationship between Indigenous people and health organizations to flourish, data governance must be Indigenous-led. Finally, the collection of Indigenous identifier data can enhance Indigenous health care services and health care service planning and delivery. Conclusions: Due to the ongoing distrust of government and health care services among Indigenous peoples and communities, special considerations are required prior to the implementation of an Indigenous identifier. Of primary importance is how health care organizations can contribute to Indigenous data governance and minimize potential harms associated with the collection of such data. The findings of this study can be used to guide other health care sites and Indigenous leaders aspiring for more robust health data by implementing voluntary Indigenous identity data collection.

Across Canada, Indigenous identity data is not routinely collected in healthcare settings. This paper focuses on [province] and whether the largest and only province-wide healthcare services organization in Canada, [healthcare organization name] should implement an Indigenous identifier in their new electronic medical record system. Due to the current absence of an Indigenous identifier, it is difficult to identify Indigenous peoples in administrative healthcare data to guide healthcare decision-making specifically for Indigenous peoples and to assist with population-specific disease surveillance and prevention programs. Moreover, it is often challenging for Indigenous nations, communities, and organizations to access this data. The data that does exist in [province] frequently excludes large segments of the Indigenous population. Indigenous researchers globally have called for improved health data in alignment with Indigenous research principles, data governance and sovereignty. This paper reports on an exploratory study of potential avenues to enhance availability of Indigenous specific health data in [province]. Of interest are possible supports, concerns, and potential barriers for the introduction of a policy to collect self-disclosed Indigenous identity data in the [org] new electronic medical record system. This research included interviews and focus group sessions with diverse subject matter experts including academics, Indigenous health practitioners and healthcare administrators. The project was embedded in the [removed] which is an [province] based research network for improving primary health with and for Indigenous peoples

Two years after the introduction of the new Teaching Quality Standard in Alberta, Indigenous and non-Indigenous researchers from eight teacher education programs came together to examine how teachers were weaving Indigenous knowledges into their classrooms. The fifth competency of the standard requires that all Alberta teachers possess a foundational knowledge of First Nations, Métis, and Inuit and apply that knowledge in the classroom. Two hundred and forty-seven teachers, both non-Indigenous and Indigenous, responded to a survey, and another 30 participated in follow-up interviews. Results point to challenges and successes that teachers have experienced, the people that support their work, and how the integration of Indigenous knowledges acts as a tool to combat racism against Indigenous Peoples. Although teachers reported increased efficacy in applying a foundational knowledge of Indigenous Peoples, a multicultural perspective prevented some from understanding the unique nature of racism against Indigenous Peoples.

Objective: Both Indigenous and non-Indigenous governments and organizations have increasingly called for improved Indigenous health data in order to improve health equity among Indigenous peoples. This scoping review identifies best practices, potential consequences and barriers for advancing Indigenous health data and Indigenous data sovereignty globally. Methods: A scoping review was conducted to capture the breadth and nature of the academic and grey literature. We searched academic databases for academic records published between 2000 and 2021. We used Google to conduct a review of the grey literature. We applied Harfield’s Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT) to all original research articles included in the review to assess the quality of health information from an Indigenous perspective. Results: In total, 77 academic articles and 49 grey literature records were included. Much of the academic literature was published in the last 12 years, demonstrating a more recent interest in Indigenous health data. Overall, we identified two ways for Indigenous health data to be retrieved. The first approach is health care organizations asking clients to voluntarily self-identify as Indigenous. The other approach is through data linkage. Both approaches to improving Indigenous health data require awareness of the intergenerational consequences of settler colonialism along with a general mistrust in health care systems among Indigenous peoples. This context also presents special considerations for health care systems that wish to engage with Indigenous communities around the intention, purpose, and uses of the identification of Indigenous status in administrative databases and in health care settings. Partnerships with local Indigenous nations should be developed prior to the systematic collection of Indigenous identifiers in health administrative data. The QAT revealed that many research articles do not include adequate information to describe how Indigenous communities and stakeholders have been involved in this research. Conclusion: There is consensus within the academic literature that improving Indigenous health should be of high priority for health care systems globally. To address data disparities, governments and health organizations are encouraged to work in collaboration with local Indigenous nations and stakeholders at every step from conceptualization, data collection, analysis, to ownership. This finding highlights the need for future research to provide transparent explanation of how meaningful Indigenous collaboration is achieved in their research.

Anti-Indigenous racism is the result of a lack of knowledge about Indigenous peoples according to Senator Murray Sinclair (Ho, 2019). Teacher education is one of the most powerful ways to combat racism towards Indigenous peoples as it impacts not only pre-service teachers but in-service teachers, their students, and their families. Alberta’s new Teaching Quality Standard was released in 2018 (TQS, 2020) and requires all Alberta teachers to possess and apply a foundational knowledge of Indigenous peoples. The study examines how teacher education institutions in Alberta are integrating Indigenous perspectives into their programming and how they plan to further this integration through collaboration between institutions and connections with schools.