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  1. Article ; Online: Towards attainment of Indigenous health through empowerment

    Cheryl Barnabe

    BMJ Global Health, Vol 6, Iss

    resetting health systems, services and provider approaches

    2021  Volume 2

    Abstract: Colonial policies and practices have introduced significant health challenges for Indigenous populations in commonwealth countries. Health systems and models of care were shaped for dominant society, and were not contextualised for Indigenous communities ...

    Abstract Colonial policies and practices have introduced significant health challenges for Indigenous populations in commonwealth countries. Health systems and models of care were shaped for dominant society, and were not contextualised for Indigenous communities nor with provision of Indigenous cultural approaches to maintain health and wellness. Shifts to support Indigenous health outcomes have been challenged by debate on identifying which system and service components are to be included, implementation approaches, the lack of contextualised evaluation of implemented models to justify financial investments, but most importantly lack of effort in ensuring equity and participation by affected communities to uphold Indigenous rights to health. Prioritising the involvement, collaboration and empowerment of Indigenous communities and leadership are critical to successful transformation of healthcare in Indigenous communities. Locally determined priorities and solutions can be enacted to meet community and individual needs, and advance health attainment. In this paper, existing successful and sustainable models that demonstrate the empowerment of Indigenous peoples and communities in advocating for, designing, delivering and leading health and wellness supports are shared.
    Keywords Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216
    Subject code 390 ; 360
    Language English
    Publishing date 2021-02-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Patient complexity assessment tools containing inquiry domains important for Indigenous patient care

    Anika Sehgal / Cheryl Barnabe / Lynden Lindsay Crowshoe

    PLoS ONE, Vol 17, Iss 8, p e

    A scoping review.

    2022  Volume 0273841

    Abstract: Patient complexity assessment tools (PCATs) are utilized to collect vital information to effectively deliver care to patients with complexity. Indigenous patients are viewed in the clinical setting as having complex health needs, but there is no existing ...

    Abstract Patient complexity assessment tools (PCATs) are utilized to collect vital information to effectively deliver care to patients with complexity. Indigenous patients are viewed in the clinical setting as having complex health needs, but there is no existing PCAT developed for use with Indigenous patients, although general population PCATs may contain relevant content. Our objective was to identify PCATs that include the inquiry of domains relevant in the care of Indigenous patients with complexity. A scoping review was performed on articles published between 2016 and 2021 to extend a previous scoping review of PCATs. Data extraction from existing frameworks focused on domains of social realities relevant to the care of Indigenous patients. The search resulted in 1078 articles, 82 underwent full-text review, and 9 new tools were identified. Combined with previously known and identified PCATs, only 6 items from 5 tools tangentially addressed the domains of social realities relevant to Indigenous patients. This scoping review identifies a major gap in the utility and capacity of PCATs to address the realities of Indigenous patients. Future research should focus on developing tools to address the needs of Indigenous patients and improve health outcomes.
    Keywords Medicine ; R ; Science ; Q
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Critically examining health complexity experienced by urban Indigenous peoples in Canada by exploring the factors that allow health complexity to persist

    Cheryl Barnabe / Rita Henderson / Sara Scott / Adam Murry / Anika Sehgal / Lynden (Lindsay) Crowshoe

    BMJ Open, Vol 13, Iss

    a qualitative study of Indigenous patients in Calgary, Alberta

    2023  Volume 10

    Abstract: Objectives This study aims to identify and critically examine the components of health complexity, and explore the factors that allow it to exist, among urban Indigenous peoples in Canada.Design Qualitative exploration with relational conversations ... ...

    Abstract Objectives This study aims to identify and critically examine the components of health complexity, and explore the factors that allow it to exist, among urban Indigenous peoples in Canada.Design Qualitative exploration with relational conversations.Setting Calgary, Alberta, Canada.Participants A total of nine urban Indigenous patients were recruited from a multidisciplinary primary healthcare clinic that serves First Nations, Métis and Inuit peoples. Recruitment and data collection took place between September and November 2021.Results Thematic analysis revealed three main themes, namely: sources of health complexity, psychological responses to adversity, and resilience, strengths, and protective factors. Key sources of health complexity arose from material resource disparities and adverse interpersonal interactions within the healthcare environment, which manifest into psychological distress while strengths and resilience emerged as protective factors.Conclusion The healthcare system remains inapt to address complexity among urban Indigenous peoples in Canada. Healthcare violence experienced by Indigenous peoples only further perpetuates health complexity. Future clinical tools to collect information about health complexity among urban Indigenous patients should include questions about the factors defined in this study.
    Keywords Medicine ; R
    Subject code 360
    Language English
    Publishing date 2023-10-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: A scoping Review of tools used to assess patient Complexity in rheumatic disease

    Kara Hawker / Cheryl Barnabe / Claire E.H. Barber

    Health Expectations, Vol 24, Iss 2, Pp 556-

    2021  Volume 565

    Abstract: Abstract Objective Patients with rheumatic diseases often have multiple comorbidities which may impact well‐being leading to high psychosocial complexity. This scoping review was undertaken to identify complexity measures/tools used in rheumatology that ... ...

    Abstract Abstract Objective Patients with rheumatic diseases often have multiple comorbidities which may impact well‐being leading to high psychosocial complexity. This scoping review was undertaken to identify complexity measures/tools used in rheumatology that could help in planning and coordinating care. Methods MEDLINE, EMBASE and CINAHL were searched from database inception to 14 December 2019 using keywords and Medical Subject Headings for “care coordination”, “complexity” and selected rheumatic diseases and known complexity measures/tools. Articles describing the development or use of complexity measures/tools in patients with adult rheumatologic diagnoses were included regardless of study design. Included articles were evaluated for risk of bias where applicable. Results The search yielded 407 articles, 37 underwent full‐text review and 2 were identified during a hand search with 9 included articles. Only 2 complexity tools used in populations of adult patients with rheumatic disease were identified: the SLENQ and the INTERMED. The SLENQ is a 97‐item patient needs questionnaire developed for patients with systemic lupus (n = 1 study describing tool development) and applied in 5 cross‐sectional studies. Three studies (a practice article, trial and a cross‐sectional study) applied the INTERMED, a clinical interview to ascertain complexity and support coordinated care, in patients with rheumatologic diagnoses. Conclusions There is limited information on the use of patient complexity measures/tools in rheumatology. Such tools could be applied to coordinate multidisciplinary care and improve patient experience and outcomes. Patient contribution This scoping review will be presented to patient research partners involved in co‐designing a future study on patient complexity in rheumatic disease.
    Keywords Care coordination ; Rheumatoid Arthritis ; Rheumatology ; Systemic Lupus Erythematosus ; Medicine (General) ; R5-920 ; Public aspects of medicine ; RA1-1270
    Subject code 005
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher Wiley
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Anti-racism in CanMEDS 2025

    Kannin Osei-Tutu / Nathalie Duchesne / Cheryl Barnabe / Lisa Richardson / Saleem Razack / Brent Thoma / Jerry M Maniate

    Canadian Medical Education Journal (2023)

    2023  

    Keywords Education (General) ; L7-991 ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher Canadian Medical Education Journal
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Equity, diversity, inclusion, and social justice in CanMEDS 2025

    Cheryl Barnabe / Kannin Osei-Tutu / Jerry M Maniate / Saleem Razack / Brian M Wong / Brent Thoma / Nathalie Duchesne

    Canadian Medical Education Journal (2023)

    2023  

    Keywords Education (General) ; L7-991 ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher Canadian Medical Education Journal
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Access, Relationships, Quality and Safety (ARQS)

    Cheryl Barnabe / Pamela Roach / Meagan Ody / Paige Campbell / Adam Murry / Andrea Kennedy / Stephanie Montesanti / Lynden Crowshoe / Melissa Scott / Esther Tailfeathers

    BMJ Open Quality, Vol 12, Iss

    a qualitative study to cocreate an Indigenous patient experience tool for virtual primary care

    2023  Volume 4

    Abstract: Background Perspectives from Indigenous peoples and their primary care providers about the quality and impacts of virtual primary care for Indigenous patients are currently limited. This study engaged Indigenous patients and their primary care providers, ...

    Abstract Background Perspectives from Indigenous peoples and their primary care providers about the quality and impacts of virtual primary care for Indigenous patients are currently limited. This study engaged Indigenous patients and their primary care providers, resulting in four domains being established for an Indigenous patient experience tool for use in virtual primary care. In this paper, we explore the development and finalisation of the Access, Relationships, Quality and Safety (ARQS) tool.Methods We re-engaged five Indigenous patient participants who had been involved in the semistructured interviews that established the ARQS tool domains. Through cognitive interviews, we tested the tool statements, leading to modifications. To finalise the tool statements, an Indigenous advisory group was consulted.Results The ARQS tool statements were revised and finalised with twelve statements that reflect the experiences and perspectives of Indigenous patients.Discussion The ARQS tool statements assess the four domains that reflect high-quality virtual care for Indigenous patients. By centring Indigenous peoples and their lived experience with primary care at every stage in the tool’s development, it captures Indigenous-centred understandings of high-quality virtual primary care and has validity for use in virtual primary care settings.Conclusion The ARQS tool offers a promising way for Indigenous patients to provide feedback and for clinics to measure the quality and safety of virtual primary care practice on the provider and/or clinic level. This is important, as such feedback may help to promote improvements in virtual primary care delivery for Indigenous patients and more widely, may help advance Indigenous health equity.
    Keywords Medicine (General) ; R5-920
    Subject code 390
    Language English
    Publishing date 2023-11-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Community engagement approaches for Indigenous health research

    Cheryl Barnabe / Chu Yang Lin / Adalberto Loyola-Sanchez / Elaine Boyling

    BMJ Open, Vol 10, Iss

    recommendations based on an integrative review

    2020  Volume 11

    Abstract: Objective Community engagement practices in Indigenous health research are promoted as a means of decolonising research, but there is no comprehensive synthesis of approaches in the literature. Our aim was to assemble and qualitatively synthesise a ... ...

    Abstract Objective Community engagement practices in Indigenous health research are promoted as a means of decolonising research, but there is no comprehensive synthesis of approaches in the literature. Our aim was to assemble and qualitatively synthesise a comprehensive list of actionable recommendations to enhance community engagement practices with Indigenous peoples in Canada, the USA, Australia and New Zealand.Design Integrative review of the literature in medical (Medline, Cumulative Index to Nursing and Allied Health Literature and Embase) and Google and WHO databases (search cut-off date 21 July 2020).Article selection Studies that contained details regarding Indigenous community engagement frameworks, principles or practices in the field of health were included, with exclusion of non-English publications. Two reviewers independently screened the articles in duplicate and reviewed full-text articles.Analysis Recommendations for community engagement approaches were extracted and thematically synthesised through content analysis.Results A total of 63 studies were included in the review, with 1345 individual recommendations extracted. These were synthesised into a list of 37 recommendations for community engagement approaches in Indigenous health research, categorised by stage of research. In addition, activities applicable to all phases of research were identified: partnership and trust building and active reflection.Conclusions We provide a comprehensive list of recommendations for Indigenous community engagement approaches in health research. A limitation of this review is that it may not address all aspects applicable to specific Indigenous community settings and contexts. We encourage anyone who does research with Indigenous communities to reflect on their practices, encouraging changes in research processes that are strengths based.
    Keywords Medicine ; R
    Subject code 360 ; 306
    Language English
    Publishing date 2020-11-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Participant-reported effect of an Indigenous health continuing professional development initiative for specialists

    Cheryl Barnabe / Raheem B. Kherani / Tom Appleton / Valerie Umaefulam / Rita Henderson / Lynden Crowshoe

    BMC Medical Education, Vol 21, Iss 1, Pp 1-

    2021  Volume 8

    Abstract: Abstract Background Health outcomes of Indigenous patients are impacted by culturally unsafe specialty care environments. The ‘Educating for Equity (E4E)’ program is a continuing professional development (CPD) intervention which incorporates skill-based ... ...

    Abstract Abstract Background Health outcomes of Indigenous patients are impacted by culturally unsafe specialty care environments. The ‘Educating for Equity (E4E)’ program is a continuing professional development (CPD) intervention which incorporates skill-based teaching to improve Indigenous patient experiences and outcomes in healthcare interactions. Methods The E4E program was delivered to rheumatologists in two phases, each delivered as experiential learning workshops where participants engaged with and applied course content within an interactive format focusing on real-time feedback. The phase 1 workshop focused on skill development of E4E Framework concepts and principles. Phase 2 concentrated on building capacity for teaching of E4E content. Evaluation of the program’s effectiveness was through longitudinal responses to the Social Cultural Confidence in Care Survey (SCCCS), self-reported strategies employed to address social issues and improve therapeutic relationships, engagement with teaching others, and satisfaction with the program. Results Two cohorts of participants have participated in the program (n = 24 Phase 1, n = 10 Phase 2). For participants completing both phases of training, statistically significant improvements were observed in exploring social factors with patients, gaining knowledge and skills related to cultural aspects of care, improved communication and relationship building, and reflections on held stereotypes. Strategies to address social issues and build therapeutic relationships remained consistent throughout participation, while the training enhanced exploration and confidence to ask about cultural and traditional practices, and stronger communication strategies for exploring beliefs, expectations, social barriers, and residential school impacts on health. Participants reported feeling prepared to teach Indigenous health concepts to others and subsequently lead teaching with residents, fellows, and allied health professionals. Satisfaction with the delivery and content of the workshops ...
    Keywords Indigenous populations ; Arthritis ; Continuing professional development ; Cultural competency ; Cultural safety ; Special aspects of education ; LC8-6691 ; Medicine ; R
    Subject code 300
    Language English
    Publishing date 2021-02-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Creating space for Indigenous healing practices in patient care plans

    Lindsey Logan / Jacinta McNairn / Shelley Wiart / Lynden Crowshoe / Rita Henderson / Cheryl Barnabe

    Canadian Medical Education Journal, Vol 11, Iss

    2020  Volume 1

    Abstract: Background: The Truth and Reconciliation Commission of Canada’s Calls to Action ask that those who can effect change within the Canadian healthcare system recognize the value of Indigenous healing practices and support them in the treatment of Indigenous ...

    Abstract Background: The Truth and Reconciliation Commission of Canada’s Calls to Action ask that those who can effect change within the Canadian healthcare system recognize the value of Indigenous healing practices and support them in the treatment of Indigenous patients. Methods: We distributed a survey to the Canadian Rheumatology Association membership to assess awareness of Indigenous healing practices, and attitudes informing their acceptance in patient care plans. Results: We received responses from 77/514 members (15%), with most (73%) being unclear or unaware of what Indigenous healing practices were. Nearly all (93%) expressed interest in the concept of creating space for Indigenous healing practices in rheumatology care plans. The majority of support was for the use in preventive or symptom management strategies, and less as adjuncts to disease activity control. Themes identified through qualitative analysis of free-text responses included a desire for patient-centered care and support for reconciliation in medicine, but with a colonial construct of medicine, demonstration of an evidence bias, and hierarchy of medicines. Conclusions: Overall, respondents were open to the idea of inclusion of Indigenous healing practices in patient’s car plans, emphasizing importance for patient empowerment and patient-centered care. However, they cited concerns that provide the indication for further learning and reconciliation in medicine.
    Keywords Education (General) ; L7-991 ; Medicine (General) ; R5-920
    Subject code 390
    Language English
    Publishing date 2020-03-01T00:00:00Z
    Publisher Canadian Medical Education Journal
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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