Shifting paradigm from biomedical to decolonised methods in Inuit public health research in Canada: a scoping review

Abstract

BackgroundThe National Inuit Strategy on Research focuses on advancing Inuit governance in research, increasing ownership over data and building capacity. Responding to this call for Inuit self-determination in research, academic researchers should consider cultural safety in research and ways to promote Inuit-led methods.MethodsThis scoping review collated academic literature on public health research in Inuit communities in Canada between 2010 and 2022. A critical assessment of methods used in public health research in Inuit communities examined cultural safety and the use of Inuit-attuned methods. Descriptive and analytical data were summarised in tables and figures. Knowledge user engagement in the research process was analysed with thematic analysis.Results356 articles met the inclusion criteria. Much of the published research was in nutrition and mental health, and few initiatives reported translation into promotion programmes. Almost all published research was disease or deficit focused and based on a biomedical paradigm, especially in toxicology, maternal health and chronic diseases. Recent years saw an increased number of participatory studies using a decolonial lens and focusing on resilience. While some qualitative research referred to Inuit methodologies and engaged communities in the research process, most quantitative research was not culturally safe. Overall, community engagement remained in early stages of co-designing research protocols and interventions. Discussion on governance and data ownership was limited. Recent years saw emerging discussions on these issues. Knowledge user capacity-building was limited to brief training on conventional data collection methods.ConclusionsThe last decade of published public health research has not responded to the National Inuit Strategy on Research. Participatory research is gaining ground, but has not reached its full potential. A shift from biomedical to decolonised methods is slowly taking place, and public health researchers who have not yet embraced this paradigm shift should do so.

Experimental studies testing interventions to promote cultural safety, interculturality or antiracism in healthcare: protocol for a systematic review

“…55 73 74 Several literature reviews and at least ten additional PROS-PERO registrations address cultural safety. These reviews focus on describing culturally safe interventions for specific health issues, [9][10][11][12][13][14][15][16] how to improve healthcare practices (medicine, nursing, midwifery), [17][18][19][20][21][22][23] eHealth applications, 24 the presence of cultural safety in health research, 25 narrative descriptions of what cultural safety is [26][27][28][29][30][31][32] and the experiences of beneficiaries. 33 34 A limited literature on intercultural approaches to health emphasises communication issues.…”