Asthma Prevention and Management for Aboriginal People: Lessons From Mi’kmaq Communities, Unama’ki, Canada, 2012

Abstract

BackgroundAsthma affects at least 10% of Aboriginal children (aged 11 or younger) in Canada, making it the second most common chronic disease suffered by this demographic group; yet asthma support strategies specific to Aboriginal peoples have only begun to be identified.Community ContextThis research builds on earlier phases of a recent study focused on identifying the support needs and intervention preferences of Aboriginal children with asthma and their parents or caregivers. Here, we seek to identify the implications of our initial findings for asthma programs, policies, and practices in an Aboriginal context and to determine strategies for implementing prevention programs in Aboriginal communities.MethodsFive focus groups were conducted with 22 recruited community health care professionals and school personnel in 5 Mi’kmaq communities in Unama’ki (Cape Breton), Nova Scotia, Canada, through a community-based participatory research design. Each focus group was first introduced to findings from a local “social support for asthma” intervention, and then the groups explored issues associated with implementing social support from their respective professional positions.OutcomeThematic analysis revealed 3 key areas of opportunity and challenges for implementing asthma prevention and management initiatives in Mi’kmaq communities in terms of 1) professional awareness, 2) local school issues, and 3) community health centers.InterpretationCulturally relevant support initiatives are feasible and effective community-driven ways of improving asthma support in Mi’kmaq communities; however, ongoing assistance from the local leadership (ie, chief and council), community health directors, and school administrators, in addition to partnerships with respiratory health service organizations, is needed.

Mālama nā makua i nā keiki me ka hānō: Native Hawaiian parents caring for their children with asthma

“…This suggestion for support groups is in alignment with indigenous communities' philosophy of a "community-raised child" (Castleden et al, 2016). Other indigenous people such as the Mi'kmaq have expressed strong interest in the development of support groups that will provide a larger network of community help and understanding (Castleden et al, 2016). One focus group of tribal Native American participants recommended having asthma education be delivered at monthly family dinners and sporting events "because tribal communities are familyoriented, and have many community events" (Rodehorst-Weber, Wilhelm, Stepans, Tobacco, & delaPaz, 2009).…”

“…This suggestion for support groups is in alignment with indigenous communities' philosophy of a "community-raised child" (Castleden et al, 2016). Other indigenous people such as the Mi'kmaq have expressed strong interest in the development of support groups that will provide a larger network of community help and understanding (Castleden et al, 2016).…”

“…Family support (Scheckner, Arcoleo, & Feldman, 2015) and higher levels of family connectedness and stronger ethnic identity appear to be protective factors against asthma-related limitations (Koinis-Mitchell et al, 2012). Family group orientation is customary in Asian cultures (Purnell, 2014) as well as indigenous peoples such as Native Americans (McCubbin, Thompson, Thompson, McCubbin, & Kaston, 1993) and Aboriginal people of Canada (Castleden et al, 2016).…”

“…Focus groups for data collection in this study allowed Hawaiian parents to respond to openended questions in their own words and from their unique perspectives regarding health, beliefs, values, practices, cultural interpretations, and cultural insights (Bernard & Ryan, 2010;Castleden et al, 2016). We conducted the focus groups in the informal "talk story" format, an acceptable form of gaining information from native Hawaiians (Andrade, 2008).…”

Mālama nā makua i nā keiki me ka hānō: Native Hawaiian Parents Caring for Their Children with Asthma, (Part 2)

“…Focus groups for data collection in this study allowed native Hawaiian parents to respond to open-ended questions in their own words and from their own unique perspectives regarding health, beliefs, values, practices, cultural interpretations, and cultural insights (Bernard & Ryan, 2010; Castleden et al, 2016). The focus groups were conducted in the informal “talk story” format that was an acceptable form of gaining information from native Hawaiians (Andrade, 2008).…”