Integrating Indigenous healing practices within collaborative care models in primary healthcare in Canada: a rapid scoping review

Abstract

ObjectivesIn November 2020, a series of reports, In Plain Sight, described widespread Indigenous-specific stereotyping, racism and discrimination limiting access to medical treatment and negatively impacting the health and wellness of Indigenous Peoples in British Columbia, Canada. To address the health inequalities experienced by Indigenous peoples, Indigenous healing practices must be integrated within the delivery of care. This rapid scoping review aimed to identify and synthesise strategies used to integrate Indigenous healing practices within collaborative care models available in community-based primary healthcare, delivered by regulated health professionals in Canada.Eligibility criteriaWe included quantitative, qualitative and mixed-methods studies conducted in community-based primary healthcare practices that used strategies to integrate Indigenous healing practices within collaborative care models.Sources of evidenceWe searched MEDLINE, Embase, Indigenous Studies Portal, Informit Indigenous Collection and Native Health Database for studies published from 2015 to 2021.Charting methodsOur data extraction used three frameworks to categorise the findings. These frameworks defined elements of integrated healthcare (ie, functional, organisational, normative and professional), culturally appropriate primary healthcare and the extent of community engagement. We narratively summarised the included study characteristics.ResultsWe identified 2573 citations and included 31 in our review. Thirty-nine per cent of reported strategies used functional integration (n=12), 26% organisational (n=8), 19% normative (n=6) and 16% professional (n=5). Eighteen studies (58%) integrated all characteristics of culturally appropriate Indigenous healing practices into primary healthcare. Twenty-four studies (77%) involved Indigenous leadership or collaboration at each phase of the study and, seven (23%) included consultation only or the level of engagement was unclear.ConclusionsWe found that collaborative and Indigenous-led strategies were more likely to facilitate and implement the integration of Indigenous healing practices. Commonalities across strategies included community engagement, elder support or Indigenous ceremony or traditions. However, we did not evaluate the effectiveness of these strategies.

Diversity of the chiropractic profession in Canada: a cross-sectional survey of Canadian Chiropractic Association members

“…Our findings support this call to action within the chiropractic profession and its educational institutions. Of note, underrepresentation of indigenous peoples within the chiropractic profession may not only reflect underlying inequity in educational opportunities but also a lack of integration of indigenous practices into communitybased chiropractic care [35] and underlying cultural and structural differences. Interestingly, despite the underrepresentation of indigenous chiropractors in our sample, we found the reported use of Canadian Indigenous language to be overrepresented.…”

Diversity of the chiropractic profession in Canada: A cross-sectional survey of Canadian Chiropractic Association Members

“…Our ndings support this call to action within the chiropractic profession and its educational institutions. Of note, underrepresentation of indigenous peoples within the chiropractic profession may not only re ect underlying inequity in educational opportunities but also a lack of integration of indigenous practices into community-based chiropractic care [30] and underlying cultural and structural differences.…”

Concerted Model of Healthcare for Awá Indigenous of Nariño, Colombia

“…Thus, the model that the Awá community has built is itself an integration of the two health systems. Corso et al point out that leadership and participation of Indigenous populations in health systems is fundamental to integrating their healing practices and the traditional Indigenous model of care within the Canadian health system [13]. The Awá people defined their version of both SDH and Renewed PHC.…”

“…Its logic is territorial rather than contractual, and it is supported by participatory planning of the work in Awá communal territories, the coordination of the MHTs and their interventions, community participation, coordination and cooperation between the two medicines (traditional and allopathic), and an administrative component that guarantees the financial sustainability of the model. Several studies report the importance of the participation of Indigenous populations in the identification of needs and the specific orientation of the health system they require [13,15].…”