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Who is research serving? A systematic realist review of circumpolar environment-related Indigenous health literature.

ABSTRACT: BACKGROUND:Addressing factors leading to health disparities in the Circumpolar North require approaches that consider and address the social determinants of health including on-going colonization. Today, colonization and related policies and processes, continue to manifest in the marginalization of Indigenous knowledge, particularly its use in research; however, Indigenous populations have moved from being research subjects to leaders and consumers of environmental health research. Given the tensions that exist between how health research is conducted, how the results are mobilized, and who has control and access to the results, we examine how peer-reviewed environment-related Indigenous health research in the Circumpolar North is serving the needs of Indigenous communities, governments, and organizations. METHODS:A modified systematic-realist literature review was conducted. Three databases were searched for peer-reviewed literature published from 2000 to 2015. Articles were included if the research focused on the intersection of the environment and health in Northern Canada and/or Alaska. A total of 960 unique records were screened for relevance, and 210 articles were analysed. RESULTS:Of these relevant articles, 19% discussed how Indigenous peoples were engaged in the research. There was a significant increase in reporting participatory, community-based methods over time; the proportion of articles reporting community-engagement varied by research topic; quantitative research articles were significantly less likely to report community-engaged methods; and most articles did not clearly report how the results were shared with the community. CONCLUSION:The results raise a number of questions for the field of Circumpolar environment-related Indigenous health research, including whether or how authors of peer-reviewed literature should (or should not) be obliged to describe how research is serving Northern Indigenous communities. The results are intended to stimulate further conversations and bridge perceived dichotomies of quantitative/qualitative, Western/Indigenous, and empirical/community driven research approaches, as well as underlying assumptions that frame health research.

SUBMITTER: Jones J

PROVIDER: S-EPMC5993119 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Who is research serving? A systematic realist review of circumpolar environment-related Indigenous health literature.

Jones Jen J Cunsolo Ashlee A Harper Sherilee L SL

PloS one 20180524 5

<h4>Background</h4>Addressing factors leading to health disparities in the Circumpolar North require approaches that consider and address the social determinants of health including on-going colonization. Today, colonization and related policies and processes, continue to manifest in the marginalization of Indigenous knowledge, particularly its use in research; however, Indigenous populations have moved from being research subjects to leaders and consumers of environmental health research. Given ...[more]

PMID: 29795554

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Project description:BackgroundAboriginal and Torres Strait Islander Australians (hereafter respectfully Indigenous Australians) claim that they have been over-researched without corresponding research benefit. This claim raises two questions. The first, which has been covered to some extent in the literature, is about what type(s) of research are likely to achieve benefits for Indigenous people. The second is how researchers report the impact of their research for Indigenous people. This systematic review of Indigenous health reviews addresses the second enquiry.MethodsFourteen electronic databases were systematically searched for Indigenous health reviews which met eligibility criteria. Two reviewers assessed their characteristics and methodological rigour using an a priori protocol. Three research hypotheses were stated and tested: (1) reviews address Indigenous health priority needs; (2) reviews adopt best practice guidelines on research conduct and reporting in respect to methodological transparency and rigour, as well as acceptability and appropriateness of research implementation to Indigenous people; and (3) reviews explicitly report the incremental impacts of the included studies and translation of research. We argue that if review authors explicitly address each of these three hypotheses, then the impact of research for Indigenous peoples' health would be explicated.ResultsSeventy-six reviews were included; comprising 55 journal articles and 21 Australian Government commissioned evidence review reports. While reviews are gaining prominence and recognition in Indigenous health research and increasing in number, breadth and complexity, there is little reporting of the impact of health research for Indigenous people. This finding raises questions about the relevance of these reviews for Indigenous people, their impact on policy and practice and how reviews have been commissioned, reported and evaluated.ConclusionsThe findings of our study serve two main purposes. First, we have identified knowledge and methodological gaps in documenting Indigenous health research impact that can be addressed by researchers and policy makers. Second, the findings provide the justification for developing a framework allowing researchers and funding bodies to structure future Indigenous health research to improve the reporting and assessment of impact over time.

Project description:Introduction: Community engagement is increasingly recognized as a critical aspect of global health. Recent years have seen an expansion of community engagement activities linked to health research, but debates and inconsistencies remain about the aims of different types of engagement, mechanisms underpinning their implementation and impact, and influential contextual factors. Greater commitment to and consistency around community engagement by health research programs, implementers and funders requires a more coherent evidence base. This realist review is designed to improve our understanding of how and why community engagement contributes to intended and unintended outcomes (including research and ethical outcomes) in different contexts. Given the breadth and diversity of the literature on community engagement in health research, the review will initially focus on malaria research in low- and middle-income countries (LMICs) and draw on wider global health literature where needed. Methods and analysis: Community engagement in practice is often a complex set of interventions. We will conduct a realist review - a theory driven approach to evidence synthesis - to provide explanations for how and why community engagement with health research produces the pattern of outcomes observed across different contexts of application. We will consolidate evidence from a range of documents, including qualitative, quantitative and mixed method studies. The review will follow several stages: devising an initial programme theory, searching evidence, selecting appropriate documents, extracting data, synthesizing and refining the programme theory, and reiteration of these steps as needed. Ethics and dissemination: A formal ethics review is not required for this literature review. Findings will be disseminated in a peer reviewed journal, through national and international conferences, and through a set of short briefings tailored for audiences with an interest in community engagement. Outputs and presentations will be informed by and feed into our network of community engagement experts. PROSPERO registration number: CRD42019125687.

Project description:BackgroundGeographic access to food may affect dietary choices and health outcomes, but the strength and direction of associations may depend on the operationalization of exposure measures. We aimed to systematically review the literature on up-to-date evidence on the association between food environment exposures based on Global Positioning System (GPS) and diet-related and cardiometabolic health outcomes.MethodsThe databases PubMed, Embase.com, APA PsycInfo (via Ebsco), Cinahl (via Ebsco), the Web of Science Core Collection, Scopus, and the International Bibliography of the Social Sciences (via ProQuest) were searched from inception to October 31, 2022. We included studies that measured the activity space through GPS tracking data to identify exposure to food outlets and assessed associations with either diet-related or cardiometabolic health outcomes. Quality assessment was evaluated using the criteria from a modified version of the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. We additionally used four items from a quality assessment tool to specifically assess the quality of GPS measurements.ResultsOf 2949 studies retrieved, 14 studies fulfilled our inclusion criteria. They were heterogeneous and represent inconsistent evidence. Yet, three studies found associations between food outlets and food purchases, for example, more exposure to junk food outlets was associated with higher odds of junk food purchases. Two studies found associations between greater exposure to fast food outlets and higher fast food consumption and out of three studies that investigated food environment in relation to metabolic outcomes, two studies found that higher exposure to an unhealthy food environment was associated with higher odds of being overweight.ConclusionsThe current and limited evidence base does not provide strong evidence for consistent associations of GPS-based exposures of the food environment with diet-related and cardiometabolic health outcomes.

Project description:The pervasive nature and colonial foundations of neoliberalism has significant ramifications for Indigenous health, globally. Not only does neoliberalism undermine Indigenous collectivist values by emphasising personal autonomy, but the exploitation of natural resources has unique implications for Indigenous wellbeing. Therefore, this scoping review aims to synthesise evidence that articulates the impacts of neoliberalism on global Indigenous health inequities. Two reviewers searched PubMed, Embase, Scopus, Web of Science, and ProQuest Central to identify records eligible for inclusion. The search was not restricted by geographic location or language. Using principles of qualitative meta-aggregation, generative mechanism summaries and illustrations were extracted from each of the included articles, synthesised into broader categories, then considered in the context of neoliberal ideologies. The systematic search identified 9952 unique records, of which 38 fully satisfied the inclusion criteria. Findings represented 23 Indigenous communities across 12 countries and considered the impacts of neoliberalism across 16 health outcomes. Eighty-eight generative mechanisms of neoliberalism and 12 generative mechanisms of resistance were extracted from the included articles and mapped against four core principles of neoliberalism: competitive and private markets, reduced public expenditure on infrastructure, personal autonomy, and deregulation that facilitates economic activity. Overwhelmingly, neoliberalism has manifest impacts, through various pathways, on poor health outcomes and experiences for Indigenous communities included in this review. Importantly, Indigenous communities continue to resist the impacts of neoliberalism through advocacy, reclamation of traditional practices, and opposition to industrial development. Consideration and investigation of neoliberal structures and ideologies must become common practice in health equity scholarship. Actors within neoliberal societies must resist dominant epistemological, ontological, and praxiological stances that reinforce the supremacy of colonial values and subalternation of Indigenous ways of knowing, being, and doing to begin effectively addressing Indigenous health inequities.

Project description:IntroductionParticipatory research involving community engagement is considered the gold standard in Indigenous health research. However, it is sometimes unclear whether and how Indigenous communities are engaged in research that impacts them, and whether and how engagement is reported. Indigenous health research varies in its degree of community engagement from minimal involvement to being community-directed and led. Research led and directed by Indigenous communities can support reconciliation and reclamation in Canada and globally, however clearer reporting and understandings of community-led research is needed. This scoping review assesses (a) how and to what extent researchers are reporting community engagement in Indigenous health research in Atlantic Canada, and (b) what recommendations exist in the literature regarding participatory and community-led research.MethodsEleven databases were searched using keywords for Indigeneity, geographic regions, health, and Indigenous communities in Atlantic Canada between 2001-June 2020. Records were independently screened by two reviewers and were included if they were: peer-reviewed; written in English; health-related; and focused on Atlantic Canada. Data were extracted using a piloted data charting form, and a descriptive and thematic analysis was performed. 211 articles were retained for inclusion.ResultsFew empirical articles reported community engagement in all aspects of the research process. Most described incorporating community engagement at the project's onset and/or during data collection; only a few articles explicitly identified as entirely community-directed or led. Results revealed a gap in reported capacity-building for both Indigenous communities and researchers, necessary for holistic community engagement. Also revealed was the need for funding bodies, ethics boards, and peer review processes to better facilitate participatory and community-led Indigenous health research.ConclusionAs Indigenous communities continue reclaiming sovereignty over identities and territories, participatory research must involve substantive, agreed-upon involvement of Indigenous communities, with community-directed and led research as the ultimate goal.

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Who is research serving? A systematic realist review of circumpolar environment-related Indigenous health literature.

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Who is research serving? A systematic realist review of circumpolar environment-related Indigenous health literature.

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