A process for the inclusion of Aboriginal People in health research: Lessons from the Determinants of TB Transmission project

Boffa, Jody; King, M.; McMullin, Kathleen; Long, Richard

doi:10.1016/j.socscimed.2010.10.033

Cited by 33 publications

(29 citation statements)

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“…Engaging communities is paramount in TB research [27], [28] and the success of this program is attributable to strong community engagement in the design, development and delivery of the program. This study used fewer technical resources (no geographic information systems (GIS) and no genotyping) making it more applicable and accessible than other studies for front line staff to deploy in remote areas that are underserviced [14].…”

Section: Discussionmentioning

confidence: 99%

TAIMA (Stop) TB: The Impact of a Multifaceted TB Awareness and Door-to-Door Campaign in Residential Areas of High Risk for TB in Iqaluit, Nunavut

et al. 2014

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BackgroundThe incidence rate of active tuberculosis (TB) disease in the Canadian Territory of Nunavut has shown a rising trend over the past 10 years. In 2010 it was 60 times greater than the national incidence rate. The objective of the Taima (translates to “stop” in Inuktitut) TB study was to implement and evaluate a public health campaign to enhance existing TB prevention efforts in Nunavut.MethodsA TB awareness campaign followed by a door-to-door screening campaign was carried out in Iqaluit, Nunavut. The aim of the campaign was to raise awareness about TB, and to provide in-home screening and treatment for people living in residential areas at high risk for TB. Screening was based on geographic location rather than on individual risk factors.ResultsDuring the general awareness campaign an increase in the number of people who requested TB testing at the local public health clinic was observed. However, this increase was not sustained following cessation of the awareness campaign. Targeted TB screening in high risk residential areas in Iqaluit resulted in 224 individuals having TSTs read, and detection of 42 previously unidentified cases of latent TB, (overall yield of 18.8% or number needed to screen = 5.3). These cases of latent TB infection (LTBI) were extra cases that had not been picked up by traditional screening practices (34% relative increase within the community). This resulted in a 33% relative increase in the completion of LTBI treatment within the community. The program directly and indirectly identified 5/17 new cases of active TB disease in Iqaluit during the study period (29.5% of all incident cases).ConclusionsWhile contact tracing investigations remain a cornerstone of TB prevention, additional awareness, screening, and treatment programs like Taima TB may contribute to the successful control of TB in Aboriginal communities.

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Section: Discussionmentioning

confidence: 99%

TAIMA (Stop) TB: The Impact of a Multifaceted TB Awareness and Door-to-Door Campaign in Residential Areas of High Risk for TB in Iqaluit, Nunavut

et al. 2014

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“…The PNCs comprised Indigenous Elders, traditional healers, healthcare workers, former patients, and representatives from Aboriginal and governmental stakeholder groups. The process of establishing these committees and acquiring the administrative and ethical approvals is described in detail elsewhere (Boffa et al, 2011). Institutional-level ethics approvals were received from Health Canada and the Prairie province Universities of Alberta, Calgary, Saskatchewan, and Manitoba.…”

Section: Tb Disease Persistence In the Experience Of Health And Illnessmentioning

confidence: 99%

“…A major objective of the DTT project is to understand the social determinants of TB transmission among the Canadian-born adult population of Alberta, Saskatchewan, and Manitoba with the goal of contributing to the interruption of TB transmission via evidence-informed interventions. A more detailed discussion of the overall DTT project objectives and methodology has been previously published (Boffa, King, McMullin, & Long, 2011). The stories of individuals whose disease progressed to the point of potential infectiousness can reveal important insights about the circumstances that lead to moderate to advanced TB disease and, ultimately, to increased transmission.…”

Section: Introductionmentioning

confidence: 99%

“Finally when I started falling down”: Indigenous tuberculosis patient experiences of health and illness on the Canadian prairies

Abonyi¹,

Mayan²,

Boffa³

et al. 2017

IJIH

Self Cite

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This paper adds evidence to a growing body of literature seeking to understand the disproportionate occurrence of tuberculosis (TB) in Indigenous populations of Canada and reveals insights that may inform effective interventions. As a disease, TB is recognized as a disorder of the body, for which there are successful treatments. Its persistence in some populations, however, requires an understanding of TB as an illness, whereby disease is shaped into behaviours and experiences. Fifty-five self-identified Indigenous participants with infectious pulmonary TB completed a questionnaire and an interview as part of the Determinants of Tuberculosis Transmission (DTT) project. Questionnaire data report on sociodemographic information and exposure to TB risk factors, while interview data describe participants' experiences of TB within the context of their personal histories and everyday lives. Analysis showed that TB symptoms did not stand out as unusual in the everyday life and health experiences of participants. State of health and decisions about accessing healthcare were associated with socioeconomic deprivation, as well as negative experiences connected with historical and contemporary impacts of colonization. The "tipping point" concept effectively captures the shift in health that pushes participants to seek healthcare. Family, friends, and other caregivers are important influences and need to be part of the effort to avoid advanced TB illness and stop the cycle of transmission. More significantly, there is a need to address the structures and systems that produce and perpetuate life conditions that result in a usual state of compromised health. KeywordsTuberculosis, Indigenous, Canada, social determinants of health, illness experience, tipping point Note on TerminologyWe use the term Indigenous throughout this paper to refer to the first inhabitants of what is now called Canada. In a global context, this term links peoples in similar circumstances of colonization. Where it appears in the text, the term Aboriginal refers to a formal recognition of Indigenous people in Canada in the Constitution Act of 1982, as members of three groups: First Nations ("Indians"), Métis, and Inuit. Terms used throughout this paper reflect those used in source material. Where we report epidemiological information from our research, we use terms consistent with federal government reporting standards for comparability. AcknowledgementsThank you to the 55 people who shared their stories with the project team with the hope that their experiences will change for the better the programs, policies, and services that aim to eliminate TB from Indigenous people and communities.

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“…This is a major issue, for example, in working with First Nations communities in Canada where trust is fragile at best (Boffa et al. ) as mainstream non‐Indigenous scholars have a long history of implicitly supporting settler colonialism with scientific “truths.” Yet if we eschew our expertise entirely, and allow various publics to determine the questions that are relevant, the methods we use, the arguments made, and the policy implications to follow, then what price do we pay in terms of intellectual autonomy? This is a tightrope in collaborative work, determined in often complicated contexts of ethical, practical, and instrumental grounds where such claims to authority must be negotiated.…”

Section: Sociology As a Critical Nexusmentioning

confidence: 99%

Critical Nexus or Pluralist Discipline? Institutional Ambivalence and the Future of Canadian Sociology

Puddephatt

McLaughlin

2015

Canadian Review of Sociology

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While some scholars believe in a transdisciplinary future for the social sciences and humanities, we argue that sociology would do well to maintain its disciplinary borders, while celebrating the plurality of its intellectual, social, and political content. Although a pluralist position can threaten disciplinary coherence and increase fragmentation, we argue the counterbalance ought to be convergence around shared institutional norms of knowledge production. Establishing these norms is not easy, since there is a great deal of institutional ambivalence at play in the field of sociology. As such, sociology is pushed and pulled between two poles of at least four major continuums of knowledge production, which include the following: (1) interdisciplinary versus discipline-based research; (2) political versus analytical scholarship; (3) professional versus public/policy sociology; and (4) local/national versus global audiences. Since both sides of these ideal-typical continuums contain their own pathologies, we propose adopting a balanced position to correct for the shortcomings of each. Rather than imposing one philosophical or theoretical paradigm for the field, we suggest that embracing the "chaos" of our diverse forms of knowledge and centralizing and integrating findings will serve to strengthen our collective efforts in the long term.

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A process for the inclusion of Aboriginal People in health research: Lessons from the Determinants of TB Transmission project

Cited by 33 publications

References 9 publications

TAIMA (Stop) TB: The Impact of a Multifaceted TB Awareness and Door-to-Door Campaign in Residential Areas of High Risk for TB in Iqaluit, Nunavut

TAIMA (Stop) TB: The Impact of a Multifaceted TB Awareness and Door-to-Door Campaign in Residential Areas of High Risk for TB in Iqaluit, Nunavut

“Finally when I started falling down”: Indigenous tuberculosis patient experiences of health and illness on the Canadian prairies

Critical Nexus or Pluralist Discipline? Institutional Ambivalence and the Future of Canadian Sociology

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