Risks of perinatal death were somewhat but not significantly higher in the Hudson Bay communities with midwife-led maternity care compared with the Ungava Bay communities with physician-led maternity care. These findings are inconclusive, although the results excluding extremely preterm births are more reassuring concerning the safety of midwife-led maternity care in remote indigenous communities.

Objectives. This paper provides highlights of a utilization-focused evaluation of a collaborative Pan-Arctic Inuit Wellness TV Series that was broadcast live in Alaska and Canada in May 2009. This International Polar Year (IPY) communication and outreach project intended to (1) share information on International Polar Year research progress, disseminate findings and explore questions with Inuit in Alaska, Canada and Greenland; (2) provide a forum for Inuit in Alaska, Canada and Greenland to showcase innovative health and wellness projects; (3) ensure Inuit youth and adult engagement throughout; and (4) document and reflect on the overall experience for the purposes of developing and "testing" a participatory communication model. Study design. Utilization-focused formative evaluation of the project, with a focus on overall objectives, key messages and lessons learned to facilitate program improvement. Methods. Participant observation, surveys, key informant interviews, document review and website tracking. Results. Promising community programs related to 3 themes -men's wellness, maternity care and youth resilience -in diverse circumpolar regions were highlighted, as were current and stillevolving findings from ongoing Arctic research. Multiple media methods were used to effectively deliver and receive key messages determined by both community and academic experts. Local capacity and new regional networks were strengthened. Evidence-based resources for health education and community action were archived in digital formats (websites and DVDs), increasing accessibility to otherwise isolated individuals and remote communities. action. Consistent with a communication for social change approach, the project created new networks, increased motivation to act and provided new tools to do so, and increased local community involvement and "voice" in the discussion and dissemination of successful strategies to promote Inuit wellness.

The three-part television broadcast Qanuqtuurniq*finding the balance was an International Polar Year communications and outreach project concerning Inuit health and wellness. The goal of this project was to engage the Inuit public and others in ''real-time'' dialogue about health and wellness issues and health research, and to deliver key messages. It was aired live in the Inuit language (with English captions/sub-titles) from Iqaluit, Nunavut, Canada, in May 2009 and simultaneously webcast. Qanuqtuurniq*finding the balance used an Inuit communications model for remote communities that was developed in the Arctic in 1994 by the Inuit Broadcasting Corporation/Inuit Communications. In Qanuqtuurniq*finding the balance more than 250 people were engaged through the use of a diverse range of methods, including content working groups, stakeholder input, music recordings, pre-recorded community programme videos, live and public screening of the broadcasts, live panels, live audiences, public phone-ins, Skype video-conferencing and real-time online chat, focus groups and e-mail. This article examines the project in light of the principles of ''community engagement'', demonstrating that Qanuqtuurniq* finding the balance exemplifies community engagement in a number of significant ways, including heavily involving community members in the selection of the health theme content of the televised programmes and through the formation of focus groups. Based on challenges encountered during the Qanuqtuurniq*finding the balance project, the article offers recommendations for future projects.

BackgroundTobacco reduction is a major priority in Canadian Inuit communities. However, many Inuit frontline health workers lacked the knowledge, confidence and support to address the tobacco epidemic. Given vast distances, high costs of face-to-face training and previous successful pilots using distance education, this method was chosen for a national tobacco reduction course.ObjectiveTo provide distance education about tobacco reduction to at least 25 frontline health workers from all Inuit regions of Canada.DesignPromising practices globally were assessed in a literature survey. The National Inuit Tobacco Task Group guided the project. Participants were selected from across Inuit Nunangat. They chose a focus from a “menu” of 6 course options, completed a pre-test to assess individual learning needs and chose which community project(s) to complete. Course materials were mailed, and trainers provided intensive, individualized support through telephone, fax and e-mail. The course ended with an open-book post-test. Follow-up support continued for several months post-training.ResultsOf the 30 participants, 27 (90%) completed the course. The mean pre-test score was 72% (range: 38–98%). As the post-test was done using open books, everyone scored 100%, with a mean improvement of 28% (range: 2–62%).ConclusionsAlthough it was often challenging to contact participants through phone, a distance education approach was very practical in a northern context. Learning is more concrete when it happens in a real-life context. As long as adequate support is provided, we recommend individualized distance education to others working in circumpolar regions.