Access to land and nature as health determinants: a qualitative analysis exploring meaningful human-nature relationships among Indigenous youth in central Canada.

BACKGROUND: Human relationships with and connections to nature and the "land" are a commonly accepted Social Determinant of Health. Greater knowledge about these relationships can inform public health policies and interventions focused on health equity among Indigenous populations. Two research questions were explored: (1) what are the experiences of meaningful human-nature relationships among Indigenous youth within central Canada; and (2) how do these relationships function as a determinant of health and wellness within their lives. METHODS: Drawing from three community-based participatory research (CBPR) projects within two urban centers in Saskatchewan and Manitoba, the integrated qualitative findings presented here involved 92 interviews with 52 Indigenous youth that occurred over a period of nine years (2014-2023). Informed by "two-eyed seeing," this analysis combined Indigenous Methodologies and a Constructivist Grounded Theory approach. RESULTS: Our integrative analysis revealed three cross-cutting themes about meaningful human-nature relationships: (1) promoting cultural belonging and positive identity; (2) connecting to community and family; and (3) supporting spiritual health and relationships. The experiences of young people also emphasized barriers to land and nature access within their local environments. DISCUSSION: Policies, practices, and interventions aimed at strengthening urban Indigenous young peoples' relationships to and connections with nature and the land can have a positive impact on their health and wellness. Public Health systems and healthcare providers can learn about leveraging the health benefits of human-nature relationships at individual and community levels, and this is particularly vital for those working to advance health equity among Indigenous populations.

Intersectionality of Resilience: A Strengths-Based Case Study Approach With Indigenous Youth in an Urban Canadian Context.

By bringing together two important areas of contemporary health research-resilience among Indigenous youth and intersectionality theory-this study advances an intersectionality of resilience framework that exposes intersecting forms of oppression within inner city urban contexts, while also critically reframing intersectionality to include strength-based perspectives of overlapping individual, social, and structural resilience-promoting processes. Drawing on Indigenous methodologies, a "two-eyed seeing" approach, and Stake's case study methodology involving multiple data sources (i.e., four sharing circles, 38 conversational interviews, four rounds of photovoice, and naturalistic interactions that occurred with 28 youth over an entire year), this qualitative study outlines three intersecting processes that facilitate youth resilience and wellness in various ways: (a) strengthening cultural identity and family connections; (b) engagement in social groups and service to self and community; and (c) practices of the arts and a positive outlook. In the end, implications for research, clinical practice, and health or community interventions are also discussed.

Land and nature as sources of health and resilience among Indigenous youth in an urban Canadian context: a photovoice exploration.

BACKGROUND: Population and environmental health research illustrate a positive relationship between access to greenspace or natural environments and peoples' perceived health, mental health, resilience, and overall well-being. This relationship is also particularly strong among Canadian Indigenous populations and social determinants of health research where notions of land, health, and nature can involve broader spiritual and cultural meanings. Among Indigenous youth health and resilience scholarship, however, research tends to conceptualize land and nature as rural phenomena without any serious consideration on their impacts within urban cityscapes. This study contributes to current literature by exploring Indigenous youths' meaning-making processes and engagements with land and nature in an urban Canadian context. METHODS: Through photovoice and modified Grounded Theory methodology, this study explored urban Indigenous youth perspectives about health and resilience within an inner-city Canadian context. Over the course of one year, thirty-eight in-depth interviews were conducted with Indigenous (Plains Cree First Nations and Métis) youth along with photovoice arts-based and talking circle methodologies that occurred once per season. The research approach was also informed by Etuaptmumk or a "two-eyed seeing" framework where Indigenous and Western "ways of knowing" (worldviews) can work alongside one another. RESULTS: Our strength-based analyses illustrated that engagement with and a connection to nature, either by way of being present in nature and viewing nature in their local urban context, was a central aspect of the young peoples' photos and their stories about those photos. This article focuses on three of the main themes that emerged from the youth photos and follow-up interviews: (1) nature as a calming place; (2) building metaphors of resilience; and (3) providing a sense of hope. These local processes were shown to help youth cope with stress, anger, fear, and other general difficult situations they may encounter and navigate on a day-to-day basis. CONCLUSIONS: This study contributes to the literature exploring Indigenous youths' meaning-making process and engagements with land and nature in an urban context, and highlights the need for public health and municipal agencies to consider developing more culturally safe and meaningful natural environments that can support the health, resilience, and well-being of Indigenous youth within inner-city contexts.

Performing Pimâtisiwin: The Expression of Indigenous Wellness Identities through Community-based Theater.

The performing arts can be a powerful means of wellness, identity exploration, and positive social representation for Indigenous young people. In this article, we outline the results of a year-long collaborative study that explored Indigenous young peoples' relationships between the performing arts, wellness, and resilience. Twenty in-depth interviews were conducted with 10 Cree and Métis youth about their participation in the Circle of Voices theater program at the Gordon Tootoosis Nik̄an̄iw̄in Theatre in Saskatoon, Saskatchewan, Canada. A strength-based analysis focused on performing pimâtisiwin, that is, how young people learn to enact, protest, and play with a wide range of social identities, while also challenging racially stereotyped identities often imposed on them within inner-city environments. This research critically engages performative theory to more readily understand aspects of Indigenous youth identity and wellness and offers new empirical and methodological directions for advancing Indigenous youth wellness in urban settings.

"Just because they aren't human doesn't mean they aren't alive": The methodological potential of photovoice to examine human-nature relations as a source of resilience and health among urban Indigenous youth.

Photovoice has been widely used as a participatory visual research methodology within the social sciences and health research. Given photovoice's critical and pedagogical potential, its advancement within Indigenous resilience and health research has been particularly prevalent. However, it has largely failed to problematize the concept of 'voice' to the extent of theorizing and engaging with the 'voices' of other kinds of life with consequences for theory and method. In this paper we re-examine the methodological potential and utility of photovoice methods to include other-than-human 'voices' during the empirical study of place-making, human-nature relations, and resilience and health. We analyze photo-narratives from a community-based, participatory research project involving Indigenous youth in Saskatoon, Saskatchewan in order to revisit 1) what we did to produce those images and 2) what we saw and heard in images. Our results suggest that when photovoice methods consider a relational and affective understanding of subjective reality during research practice, they have the capacity to capture and handle other-than-human 'voices'. Accordingly, we discuss future directions when adapting photovoice methods for the study of environmental repossession and dispossession within contested contexts of and encounters with methodological complexity, uncertainty, and emergence.

Re-imagining miyo-wicehtowin: Human-nature relations, land-making, and wellness among Indigenous youth in a Canadian urban context.

Relationships to land and nature have long been recognized globally as a central Indigenous determinant of health. As more Indigenous peoples migrate to larger urban centers, it is crucial to better understand how these relationships are maintained or function within urban spaces. This article outlines the results of a year-long collaborative study that qualitatively explored Indigenous young peoples' connections between "land," nature, and wellness in an urban Canadian context. Thirty-eight semi-structured interviews were conducted with 28 Cree and Métis Indigenous youth living within Saskatoon, Saskatchewan. A strength based analysis focused on re-imagining miyo-wicehtowin; that is, the processes of youths' self-determination and agency that build positive human-nature relationships and enact "land-making" amidst their urban spaces. This research critically engages environmental dispossession and repossession to more readily consider decolonizing land-based approaches to health and wellness among urban contexts. Future empirical and methodological directions for exploring human-nature relationships in urban health research are also offered.

Being and Becoming a Helper: Illness Disclosure and Identity Transformations among Indigenous People Living With HIV or AIDS in Saskatoon, Saskatchewan.

Saskatoon has nearly half of the diagnoses of HIV in Saskatchewan, Canada, with an incidence rate among Indigenous populations within inner-city contexts that is 3 times higher than national rates. Previous research does not adequately explore the relations between HIV vulnerabilities within these contexts and the experiences of illness disclosure that are informed by identity transformations, experiences of stigma, and social support. From an intersectionality framework and a constructivist grounded theory approach, this research involved in-depth, semistructured interviews with 21 Indigenous people living with HIV and/or AIDS in Saskatoon, both male and female. In this article, we present the key themes that emerged from the interviews relating to experiences of HIV disclosure, including experiences of and barriers to the disclosure process. In the end, we highlight the important identity transformation and role of being and becoming a "helper" in the community and how it can be seen as a potential support for effective community health interventions.

"I Have Strong Hopes for the Future": Time Orientations and Resilience Among Canadian Indigenous Youth.

In this article, we demonstrate how concepts of time and the future inform processes of resilience among Indigenous adolescents within an urban Canadian context. This study employed a modified grounded theory methodology by conducting 38 qualitative interviews with 28 Indigenous youth (ages 15-25) over the course of 1 year. The analysis revealed complex processes of and navigations between moments of distress and strategies for resilience. The distressing contexts in which Indigenous youth often find themselves can impact the development of their concepts of time and limit their abilities to conceptualize a future. A future time orientation (FTO) emerged as central to processes of resilience and was supported by (a) nurturing a sense of belonging, (b) developing self-mastery, and