Background: Many Indigenous people face diverse social and health challenges that stem from the historic and ongoing effects of colonization¹. These challenges include pre-existing health conditions that are under-diagnosed and under-reported due to a lack of knowledge in addition to substandard living environments, and a lack of access to basic necessities such as clean drinking water, nutrition and medical services¹.

Over time, misconceptions about the history and matters regarding Indigenous peoples of Canada have perpetuated maltreatment of and discrimination towards this population. There is a strong link between discrimination and healthcare outcomes that need to be recognized².

Growing evidence suggests that if care is perceived to be racially discriminatory, the recipients of this care are at a greater risk of poorer physical and mental health outcomes. This racially discriminatory care can take the form of a lack of compassionate care or the failure to acknowledge the vulnerability of Indigenous communities or populations³. In addition to acting as a social stressor, discrimination can adversely impact health outcomes by restricting access to healthcare services and impacting willingness for individuals to seek treatment. This can be detrimental because a lack of preventative and timely care can lead to adverse health outcomes.³  

Therefore, the active practice of cultural safety by healthcare providers and healthcare-affiliated workers can help minimize discrimination towards Indigenous peoples of Canada. Cultural safety training enables and encourages healthcare providers to evaluate and reflect on how their personal beliefs, actions, and past experiences impact the healthcare system and delivery of care towards marginalized groups like Indigenous populations. A standard of care that integrates cultural safety can make healthcare services more accessible for Indigenous peoples of Canada. This can improve healthcare utilization, enhancing health outcomes for this population.

Objective: To assess the integration of cultural safety in the delivery of care to Indigenous peoples of Canada by healthcare providers and healthcare-affiliated workers.  

Methods: A cross-sectional analysis will be performed through a structured and anonymous questionnaire which will consist of both multiple-choice questions and short answer questions. The multiple-choice questions will be scored for the quantitative analysis, and the short answer responses will inform the qualitative analysis. Literature on cultural safety in combination with the knowledge gained from partnering with Indigenous members of the community will be used to establish the main themes of the questionnaire. The inclusion criteria for the study includes healthcare practitioners (e.g., nurses, physicians, paramedic) and healthcare-affiliated workers (e.g., social workers, personal support workers, occupational therapists). The questionnaire will be disseminated online through various social media platforms (e.g., Facebook, Instagram) and a purposive sampling method.

Conclusion: Results of this study will provide insight into addressing the potential gaps in knowledge among healthcare providers when delivering care to Indigenous peoples of Canada. Additionally, this study may help provide information on methods of  delivering culturally sensitive care in healthcare settings and increasing accessibility to healthcare services within Indigenous populations.

References

1. Gunn K. Indigenous peoples and COVID-19: protecting people, protecting rights | first peoples law [Internet]. Canada: First Peoples Law. 2020 [cited 12 July 2020]. Available from: https://www.firstpeopleslaw.com/index/articles/449.php

2. Allan B, Smylie J. First peoples, second-class treatment: The role of racism in the health and well-being of Indigenous peoples in Canada. Toronto: The Wellesley Institute [ebook]. 2015 [cited 15 August 2020]. Available from: https://www.wellesleyinstitute.com/wp-content/uploads/2015/02/Full-Report-FPSCT-Updated.pdf

3. Williams, DR, Lawrence, JA, Davis, BA, Vu, C. Understanding how discrimination can affect health. Health Serv Res [Internet]. 2019 [cited 12 August 2020]; 54: 1374– 1388. Available from: https://doi.org/10.1111/1475-6773.13222