Engaging Indigenous families in a community-based Indigenous early childhood programme in British Columbia, Canada: A cultural safety perspective

Abstract

This article is part of a larger study that explored how an Indigenous early intervention programme in British Columbia (BC), Canada, known as the 'Aboriginal Infant Development Program' (AIDP), influenced family and children's health and well-being and was responsive to child health inequities. Postcolonial feminist and Indigenous feminist perspectives provided a critical analytical lens to this qualitative inquiry. The study was undertaken with AIDPs based in diverse community organisations located in off-reserve urban municipalities throughout the province of BC. From September 2013 to March 2014, in-depth, semi-structured interviews were undertaken with: Indigenous primary caregivers (n = 10), Indigenous Elders (n = 4), AIDP workers (n = 18) and administrative leaders (n = 3). The purpose of this article is to examine and analyse the findings that focus on how AIDP workers supported family and children's health and well-being by transforming their routine policies and practices in ways that fostered caregivers' active engagement in their programmes. Findings centre on three main themes: (i) overcoming mistrust; (ii) 'being willing to move a step forward' and (iii) resisting what's taken-for-granted. These inter-related themes are examined and discussed in relation to the concept of cultural safety. The findings have international relevancy for social and healthcare community-based programmes that are questioning how to engage with parents who may be hard to reach as a result of multi-faceted social and structural factors.

How Indigenous mothers experience selecting and using early childhood development services to care for their infants

“…Access to high-quality ECD services is extremely important to mitigate the effects of social inequity and trauma on the development and subsequent health outcomes of infants. Early childhood development programs support healthy bonding and attachment between parents and infants, provide nutritional and other health-related education, and promote positive parenting and healthy play-all leading to the healthy neurophysiological and psychological development of infants (Gerlach, Browne, & Greenwood, 2017;Halseth & Greenwood, 2019;Moore et al, 2015). Research has demonstrated that by supporting early learning, ECD services are an excellent strategy to promote equity for families facing disadvantage, and promote improved school readiness (Gerlach, Browne, & Suto, 2016;Halseth & Greenwood, 2019;Moore et al, 2015).…”

Exploring the role‐based challenges of providing culturally inclusive health care for maternal and child health nurses: Qualitative findings

“…The way the health system disciplines MCHNs by regulating the activities and practices that define the role to ensure that monitoring, surveillance and intervention are prioritized creates an important conflict for these practitioners. It means that the goals of MCHNs include changing specific childrearing practices that deviate from an unspoken and highly privileged, cultural norm—that of dominant Western, predominantly White, middleclass and heterosexual approaches to childrearing (Gerlach, Browne, & Greenwood, ). This is despite calls from within the nursing profession to move away from a focus on changing individual behaviours towards providing “options” within the “cultural contexts” of clients (Basnyat, ).…”

“…There is increasing recognition that “culture” and socio‐cultural diversity within a population has critical implications for nursing practice, which is itself located within a White, Western‐centric cultural context. There have been sustained calls, under various terminology umbrellas, for broader conceptualizations of culture and cultural processes to be embedded into nursing education and on‐going learning development (Browne, ; Crawford, Stein‐Parbury, & Dignam, ; Desouza, ; Gerlach et al, ; Grant & Guerin, ; Grant & Luxford, ; Janevic, Sripad, Bradley, & Dimitrievska, ; Lynam, Loock, Scott, & Basu Khan, ; Renzaho & Oldroyd, ). The analysis presented here suggests that while these strategies are important, there remains a lack of firm, institutional commitment to supporting the comprehensive implementation of these initiatives.…”

Working together in Aboriginal health: a framework to guide health professional practice

“…This paper supports and extends previous research identifying important approaches to practice when working in Aboriginal health. Working in partnership with Aboriginal people has been stressed by multiple authors [15-20, 22, 43-45] as has the importance of getting to know an Aboriginal person before direct questioning or "getting down to business" [17,22], and considering a person's context and history when working with them [18,20,23]. Linked to this, previous research supports the finding from this study that valuing and incorporating Aboriginal expertise is beneficial [17,45], including through involving Indigenous peoples in the research process [46], is beneficial and relationship building is a fundamental element of working in Aboriginal health [17,45].…”

“…Much of this is directed at non-Aboriginal health professionals and includes guidelines [9,10], protocols [11,12], ethical principles [13] and suggested professional practices based on research and experience [14,15]. Authors highlight the need to work in partnership [16][17][18][19][20], be flexible [21], build relationships [17,21], get to know Aboriginal people [17,22] and reflect on their positions of privilege [23,24]. Programs often expand on the 'build relationships' principle to highlight that shared trust and respect are required in order to bring about sustained health change in Aboriginal communities [17,23,25,26].…”