Women-Centered and Culturally Responsive Heart Health Promotion Among Indigenous Women in Canada

Abstract

Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs.

Results of a culturally relevant, physical activity-based wellness program for urban Indigenous women in Alberta, Canada

“…PA is known to reduce cardiovascular disease, diabetes, and cancer risk and improve insulin sensitivity and blood glucose levels in people with diabetes (American Diabetes Association, 2004;World Health Organization, 2018). However, the health disparities endured by Indigenous women require tailored and culturally responsive approaches to health promotion (ACEWH, 2009;Native Women's Association of Canada, 2012;Ziabakhsh et al, 2016). A review of PA programming for Indigenous women demonstrates that such programming should be grounded in knowledge about, and appreciation for, regional Indigenous histories, cultures, and values.…”

The State of Affairs for Cardiovascular Health Research in Indigenous Women in Canada: A Scoping Review

“…In total, data from 192,678 participants were reported (not including those in which the sample size was not provided and possible duplication across articles). Sample sizes ranged from 8 71 to 38,200 63 participants. Almost all were cross-sectional (89% of articles), with few reporting on longitudinal data (11%).…”

“…The Seven Sister Healthy Heart Pilot Project was "informed by indigenous healing perspectives, transcultural nursing, and feminist theories of health and illness." 71 The project used a community approach and involved Indigenous women leaders and elders as champions of heart health who learned about and tried to improve their own personal risk factors while helping to improve the healthy living practices of their community members. 71 The program was a 2-hour weekly women-only group that ran over 8 weeks and included a talking circle, which provided each woman an opportunity to discuss issues about their personal health and well-being and share stories and knowledge.…”

“…71 The project used a community approach and involved Indigenous women leaders and elders as champions of heart health who learned about and tried to improve their own personal risk factors while helping to improve the healthy living practices of their community members. 71 The program was a 2-hour weekly women-only group that ran over 8 weeks and included a talking circle, which provided each woman an opportunity to discuss issues about their personal health and well-being and share stories and knowledge. Results from the pilot found that women in the program reported making better food choices and became more aware of the importance of regular exercise and the importance of smoking cessation.…”

“…Participants reported that the talking circle was the best part of the program. 71 No studies reported on rehabilitation services specifically targeted to Indigenous women.…”