Supporting Positive Learning Experiences for Veterinary Students on Rotations in Remote Indigenous Communities in Canada.

Many health care programs in medicine, nursing, social work, and physiotherapy include practicum rotations near the end of students' studies. Increasingly, veterinary education programs also offer community-based rotations in underserved or remote communities. While these opportunities in veterinary medicine provide many learning benefits, they can also be stressful if the students do not feel adequately supported. The purpose of this study was to explore how veterinary students are and can be supported during rotations in remote Indigenous communities in Canada. Annually, four veterinary students from the University of Calgary Faculty of Veterinary Medicine travel with a small veterinary team to five communities in the Northwest Territories, Canada. During the 4-week rotation, students spend 2.5 weeks providing veterinary services to companion animals in these communities. In this study, 11/20 veterinary students who participated in this rotation between 2015 and 2020 completed online surveys. Results from this study suggest that participants of the rotation often felt welcomed and supported by the communities they served and were well supported by and connected to the members of the veterinary team. Findings are applicable across community-based veterinary student learning experiences and highlight the importance of building relationships with the communities being served, picking the right team, and implementing debriefing and decompressing activities during downtime.

Reflecting on the use of Etuaptmumk/Two-Eyed seeing in a study examining hospital-based Indigenous wellness services in the Northwest Territories, Canada.

Etuaptmumk/Two-Eyed Seeing (E/TES) is a Mi'kmaw guiding principle that emphasises the importance of bringing together the strengths of Indigenous knowledges and Western knowledges to improve the world for future generations. Since its introduction to the academic community, E/TES has been taken up more frequently in Indigenous health research. However, as it is increasingly used, Elders and scholars have affirmed that it is at risk of being watered down or tokenised. This article reports on how E/TES was used in a community-engaged research study that examined hospital-based Indigenous wellness services in the Northwest Territories, Canada. As a living, relational, and spiritual principle, E/TES was used in the study in three interrelated ways. E/TES: (1) guided the study ontologically, shaping the research team's conceptualisation of knowledge and knowledge generation; (2) informed the research team's approach to relationship-building; and (3) guided reflexivity amongst team members. By reporting on how E/TES was used in the study, and critically reflecting on the strengths and challenges of the approach, this article seeks to contribute to growing scholarship about how E/TES is characterised and taken up in Indigenous health research.

Elucidating the sustainability of 700 y of Inuvialuit beluga whale hunting in the Mackenzie River Delta, Northwest Territories, Canada.

Beluga whales play a critical role in the subsistence economies and cultural heritage of Indigenous communities across the Arctic, yet the effects of Indigenous hunting on beluga whales remain unknown. Here, we integrate paleogenomics, genetic simulations, and stable δ13C and δ15N isotope analysis to investigate 700 y of beluga subsistence hunting in the Mackenzie Delta area of northwestern Canada. Genetic identification of the zooarchaeological remains, which is based on radiocarbon dating, span three time periods (1290 to 1440 CE; 1450 to 1650 CE; 1800 to 1870 CE), indicates shifts across time in the sex ratio of the harvested belugas. The equal number of females and males harvested in 1450 to 1650 CE versus more males harvested in the two other time periods may reflect changes in hunting practices or temporal shifts in beluga availability. We find temporal shifts and sex-based differences in δ13C of the harvested belugas across time, suggesting historical adaptability in the foraging ecology of the whales. We uncovered distinct mitochondrial diversity unique to the Mackenzie Delta belugas, but found no changes in nuclear genomic diversity nor any substructuring across time. Our findings indicate the genomic stability and continuity of the Mackenzie Delta beluga population across the 700 y surveyed, indicating the impact of Inuvialuit subsistence harvests on the genetic diversity of contemporary beluga individuals has been negligible.

Awareness and perceptions of contaminants in the Dehcho and sahtú regions of the Northwest Territories.

The development and dissemination of health messaging is a critical component of reducing health disparities. Participants (n = 87) from a human biomonitoring study in six Dene communities responded to a survey about health communication regarding contaminants. The survey included questions on awareness of health messages and risk perceptions related to country foods and contaminants. The vast majority of participants reported eating country foods (99%) and heard that country foods had beneficial nutrients (90%). Seventy per cent of respondents had heard or seen messages about fish with high levels of mercury, and 60% had concerns about the safety or quality of country foods they consumed. Respondents who reported decreasing the number of fish they ate since hearing the messages about fish and mercury had lower (p = 0.04) mercury concentration in hair, compared to those who had not heard the messages. However, no differences in hair mercury were observed for respondents who reported to have changed their fishing location, chosen smaller fish or eaten less predatory fish since hearing the messages. Results indicate the need to examine reasons for self-reported behaviour changes, in addition to awareness. The conclusions of this study can inform the development of messaging and risk management decisions about contaminants within Indigenous populations.

Can remotely sensed catchment to lake area ratios predict mercury levels in subarctic fishes?

Mercury concentrations ([Hg]) in fish reflect a complex array of interacting biogeochemical and ecological variables. In northern regions where fish are a critical subsistence food, understanding and predicting fish [Hg] can be particularly difficult, largely due to a paucity of comprehensive data associated with the logistical challenges of field sampling. Building on previous work where we elucidated causal relationships between fish [Hg] and a variety of catchment, water quality, and ecological variables in subarctic lakes, we investigated whether using only ratios of catchment area to lake area (CA:LA) can predict [Hg] in northern freshwater fish species. As CA:LA can be sensed remotely, they may be more feasible and practical to obtain than field data in far northern regions. Our study included thirteen remote lakes that represent a CA:LA gradient of 6.2-423.5 within an ∼66,000 km2 subarctic region of Northwest Territories, Canada. We found that size-standardized [Hg] in three widespread fish species, including Lake Whitefish (Coregonus clupeaformis), Walleye (Sander vitreus), and Northern Pike (Esox lucius), were significantly and positively related to CA:LA (p < 0.007, r2 = 67-80%), indicating higher fish [Hg] in smaller lakes surrounded by relatively larger catchments. Our findings provide compelling evidence that remotely sensed CA:LA can be used to predict [Hg] in northern fishes and aid in prioritizing understudied and subsistence fishing lakes of the Canadian subarctic for [Hg] monitoring programs.

Land-Based Retreats as a Method for Building Enabling Environments for HIV Prevention with Northern and Indigenous Adolescents in the Northwest Territories, Canada: Mixed-Methods Findings.

The Northwest Territories (NWT), Canada has high rates of sexually transmitted infections (STI) that elevate HIV acquisition risks. We conducted a mixed-methods study to explore the potential of land-based peer leader retreats (PLR) in building HIV prevention enabling environments among Northern and Indigenous youth in the NWT. PLRs are grounded in Indigenous principles and ways of knowing, acknowledging the land as a physical, spiritual, emotional, and intellectual being with the potential to facilitate (re)connection to culture, community, and self. We conducted one-week PLRs between 2016 and 2021 with adolescents aged 13-17 in the NWT. PLRs addressed HIV/STIs, safer sex, and gender equity. We conducted post-retreat focus groups (FGs) and pre/post-retreat surveys with youth participants (n = 353), and post-retreat FGs with PLR facilitators (n = 252). We applied thematic analysis to FGs and assessed pre/post-retreat changes in HIV/STI knowledge and safer sex efficacy (SSE) using paired sample t-tests. We assessed factors associated with post-test SSE and HIV/STI knowledge using multivariable linear regression. Youth participants (n = 353; mean age: 14.5, standard deviation [SD]: 1.3) were mostly Indigenous (71%) and women (66%). Participant narratives revealed PLRs enhanced technical communication (e.g., correct condom use). There were significant post-retreat HIV/STI knowledge increases; change score increases were lower for Indigenous participants. Qualitative narratives described how PLRs fostered transformative communication (e.g., sexual consent). There were significant post-retreat increases in SSE, and these were lower among men and sexually diverse (vs. heterosexual) participants. Land-based PLRs offer the potential to build technical and transformative communication to facilitate HIV prevention with youth in Canada's North.

Developing an alcohol strategy for the Northwest Territories: Evaluating global research evidence against rural and remote realities.

OBJECTIVES: This paper outlines the engagement process that was used to develop the Northwest Territories Alcohol Strategy, based on a recommendation by the developers of the Canadian Alcohol Policy Evaluation report, and how this informed the final actions in the strategy. METHODS: A literature review, four targeted engagement activities, and iterative validation by advisory groups and community and Indigenous leadership were used to evaluate, modify, or reject the original recommendations and develop the final actions that were included in the NWT Alcohol Strategy. RESULTS: There are fourteen original CAPE recommendations, four of which had already been implemented in the Northwest Territories before the development of the strategy. On completion of the process, four recommendations had already been implemented in the NWT. Two recommendations were included in the strategy without changes, two were adapted for use in the strategy, and six were not included. One stand-alone alcohol policy measure was created and included. CONCLUSION: Alcohol strategies are dependent on a variety of contextual factors. Developers need to take into consideration the unique geography, political climate, and cultural context of the region for which they are being developed, in order to produce a strategy that is applicable, acceptable, and feasible at the community level.

RéSUMé: OBJECTIFS: Cet article présente la méthodologie de projet utilisée pour élaborer la Stratégie sur l'alcool des Territoires du Nord-Ouest (TNO), basée sur un ensemble de recommandations formulées par les auteurs du rapport d'évaluation des politiques canadiennes sur l'alcool (CAPE). Il présente également les orientations et actions finales de la stratégie. MéTHODES: Une analyse documentaire, un dispositif de concertation multi-canal, ainsi qu'une validation itérative par des groupes consultatifs, des représentants des populations locales et autochtones ont été utilisées pour évaluer, modifier ou rejeter les recommandations originales et élaborer les actions finales à inclure dans la Stratégie sur l'alcool des TNO. RéSULTATS: Le CAPE comprend quatorze recommandations d'origine, dont quatre étaient déjà en vigueur dans les TNO avant l'élaboration de la stratégie. À l'issue du processus, quatre recommandations avaient déjà été mises en œuvre dans les TNO. Deux recommandations ont été incluses dans la stratégie sans modifications, deux ont été adaptées pour être mises en œuvre dans la stratégie, et six n'ont pas été incluses. En outre, une politique indépendante de quantification a été créée et incluse. CONCLUSION: Les stratégies en matière d'alcool dépendent de divers facteurs contextuels. Les concepteurs doivent tenir compte de la singularité géographique, du climat politique et du contexte culturel de la région pour laquelle elles sont élaborées, afin de rendre la stratégie applicable, acceptable et réalisable pour la population.

Nature Prescriptions and Indigenous Peoples: A Qualitative Inquiry in the Northwest Territories, Canada.

Nature prescription programs have become more common within healthcare settings. Despite the health benefits of being in nature, nature prescriptions within the context of Indigenous Peoples have received little attention. We therefore sought to answer the following question: What are circumpolar-based physicians' and Indigenous Elders' views on nature prescribing in the Northwest Territories, Canada? We carried out thirteen semi-structured interviews with physicians between May 2022 and March 2023, and one sharing circle with Indigenous Elders in February 2023. Separate reflexive thematic analysis was carried out to generate key themes through inductive coding of the data. The main themes identified from the physician interviews included the importance of cultural context; barriers with nature prescriptions in the region; and the potential for nature prescriptions in the North. Reflections shared by the Elders included the need for things to be done in the right way; the sentiment that the Land is not just an experience but a way of life; and the importance of traditional food as a connection with Nature. With expanding nature prescription programs, key considerations are needed when serving Indigenous communities. Further investigation is warranted to ensure that nature prescriptions are appropriate within a given context, are inclusive of supporting Land-based approaches to health and wellbeing, and are considered within the context of Indigenous self-determination.

Prevalence of cannabis use and the frequency, types, and sources of cannabis products used in northern remote territories of the Canadian legal cannabis market.

OBJECTIVE: The Cannabis Policy Study in the Territories (CPST) is an annual repeat cross-sectional study aiming to evaluate the impacts of cannabis legalization in the Canadian territories (Yukon, Northwest Territories, and Nunavut), where there is a paucity of data on cannabis use. This current study's objective was to describe the 2022 CPST, including methods, population prevalence estimates of cannabis use, and legal cannabis sources and perceptions in the territories. METHODS: The 2022 CPST includes 2462 respondents (aged 16 +) residing in the territories who either use or do not use cannabis. Respondents were recruited through mail-push-to-web invitations sent via licensed mailing lists, sampling from a near census of households in the territories. Population-weighted indicators of cannabis use are described. RESULTS: Past 12-month cannabis use was self-reported by 46.1%, and 21.8% self-reported daily/almost daily use. The most commonly used product types among past 12-month consumers were dried flower (73.4%), edibles (59.0%), and vape oils (35.7%). On average, 74.8% of cannabis products used in the past 12 months were from legal sources, though legal sourcing varied by product type (54.4‒92.2%). Cannabis consumers reported favourable perceptions of legal compared to illegal cannabis products regarding quality, convenience, and safety, but a lesser extent for price. CONCLUSION: Cannabis use is highly prevalent in the territories, particularly daily/almost daily use, and legal market penetration is high despite region remoteness. Following cannabis legalization, monitoring cannabis use prevalence and patterns in remote regions is important for informing the development of harm reduction and prevention initiatives that consider the unique needs of these regions.

RéSUMé: OBJECTIF: L'Étude sur les politiques relatives au cannabis dans les territoires (Cannabis Policy Study in the Territories ‒ CPST) est une étude transversale annuelle qui a pour but d'évaluer les répercussions de la légalisation du cannabis dans les territoires canadiens (Yukon, Territoires du Nord-Ouest et Nunavut), où il existe peu de données sur la consommation de cannabis. L'objectif de la présente étude était de décrire l'étude CPST de 2022, y compris la méthodologie, les estimations de la prévalence de la consommation de cannabis au sein de la population, ainsi que les sources et les perceptions du cannabis vendu légalement dans les territoires. MéTHODES: L'étude CPST menée en 2022 a consisté à interroger 2 462 personnes âgées de 16 ans et plus qui résident dans les territoires. Les répondants incluent des personnes qui consomment du cannabis et d'autres qui n'en consomment pas. Les répondants ont été recrutés au moyen d'invitations envoyées par la poste à partir de listes d'envoi autorisées. Les échantillons ont été effectués à partir d'un quasi-recensement des ménages qui résident dans les territoires. Les indicateurs pondérés en population de la consommation de cannabis sont décrits. RéSULTATS: Au cours des 12 derniers mois, le pourcentage d'autodéclarations de consommation de cannabis était de 46,1 %, et 21,8 % des répondants ont déclaré consommer quotidiennement ou presque. Les produits les plus couramment utilisés par les consommateurs au cours des 12 derniers mois étaient les fleurs séchées (73,4 %), les produits comestibles (59,0 %) et les huiles de vapotage (35,7 %). En moyenne, 74,8 % des produits de cannabis consommés au cours des 12 derniers mois provenaient de sources légales, bien que l'approvisionnement légal varie selon le type de produit (de 54,4 % à 92,2 %). Les consommateurs de cannabis ont déclaré percevoir favorablement les produits de cannabis vendus légalement comparativement aux produits vendus illégalement en ce qui a trait à la qualité, à la commodité et à la sécurité, mais dans une moindre mesure en matière de prix. CONCLUSION: La consommation de cannabis est très répandue dans les territoires, en particulier la consommation quotidienne ou presque quotidienne. De plus, la pénétration du marché des produits vendus légalement est élevée malgré l'éloignement des régions. À la suite de la légalisation du cannabis, la surveillance de la prévalence et des tendances de consommation du cannabis dans les régions éloignées fournit des renseignements importants pour l'élaboration d'initiatives de réduction des méfaits et de prévention qui tiennent compte des besoins uniques de ces régions.

The Arctic marine soundscape of the Amundsen Gulf, Western Canadian Arctic.

The underwater soundscape, a habitat component for Arctic marine mammals, is shifting. We examined the drivers of the underwater soundscape at three sites in the Amundsen Gulf, Northwest Territories, Canada from 2018 to 2019 and estimated the contribution of abiotic and biotic sources between 20 Hz and 24 kHz. Higher wind speeds and the presence of bearded seal (Erignathus barbatus) vocalizations led to increased SPL (0.41 dB/km/h and 3.87 dB, respectively), while higher ice concentration and air temperature led to decreased SPL (-0.39 dB/% and - 0.096 dB/°C, respectively). Other marine mammals did not significantly impact the ambient soundscape. The presence of vessel traffic led to increased SPLs (12.37 dB) but was quieter at distances farther from the recorder (-2.57 dB/log m). The presence of high frequency and broadband signals produced by ice led to increased SPLs (7.60 dB and 10.16 dB, respectively).

Deep-water first occurrences of Ediacara biota prior to the Shuram carbon isotope excursion in the Wernecke Mountains, Yukon, Canada.

Ediacara-type macrofossils appear as early as ~575 Ma in deep-water facies of the Drook Formation of the Avalon Peninsula, Newfoundland, and the Nadaleen Formation of Yukon and Northwest Territories, Canada. Our ability to assess whether a deep-water origination of the Ediacara biota is a genuine reflection of evolutionary succession, an artifact of an incomplete stratigraphic record, or a bathymetrically controlled biotope is limited by a lack of geochronological constraints and detailed shelf-to-slope transects of Ediacaran continental margins. The Ediacaran Rackla Group of the Wernecke Mountains, NW Canada, represents an ideal shelf-to-slope depositional system to understand the spatiotemporal and environmental context of Ediacara-type organisms' stratigraphic occurrence. New sedimentological and paleontological data presented herein from the Wernecke Mountains establish a stratigraphic framework relating shelfal strata in the Goz/Corn Creek area to lower slope deposits in the Nadaleen River area. We report new discoveries of numerous Aspidella hold-fast discs, indicative of frondose Ediacara organisms, from deep-water slope deposits of the Nadaleen Formation stratigraphically below the Shuram carbon isotope excursion (CIE) in the Nadaleen River area. Such fossils are notably absent in coeval shallow-water strata in the Goz/Corn Creek region despite appropriate facies for potential preservation. The presence of pre-Shuram CIE Ediacara-type fossils occurring only in deep-water facies within a basin that has equivalent well-preserved shallow-water facies provides the first stratigraphic paleobiological support for a deep-water origination of the Ediacara biota. In contrast, new occurrences of Ediacara-type fossils (including juvenile fronds, Beltanelliformis, Aspidella, annulated tubes, and multiple ichnotaxa) are found above the Shuram CIE in both deep- and shallow-water deposits of the Blueflower Formation. Given existing age constraints on the Shuram CIE, it appears that Ediacaran organisms may have originated in the deeper ocean and lived there for up to ~15 million years before migrating into shelfal environments in the terminal Ediacaran. This indicates unique ecophysiological constraints likely shaped the initial habitat preference and later environmental expansion of the Ediacara biota.

Developing plant functional groups to identify changes in functional composition and diversity in a dryland river experiencing artificially sustained flows.

Land use and climate changes are driving significant shifts in the magnitude and persistence of dryland stream surface flows. The impact of these shifts on ecological functioning is largely unknown, particularly where streams have become wetter rather than drier. This study investigated relationships between hydrologic regime (including surface water persistence, differences in groundwater depth and altered flooding dynamics) with plant traits and riverine vegetation functional composition. Our study system was a previously ephemeral creek in semi-arid northwest Australia that has received groundwater discharge from nearby mining operations for >15 years; surface flows are now persistent for ∼27 km downstream of the discharge point. We aimed to (i) identify plant functional groups (FGs) associated with the creek and adjacent floodplain; and (ii) assess their distribution across hydrological gradients to predict shifts in ecological functioning in response to changing flow regimes. Seven FGs were identified using hierarchical clustering of 40 woody perennial plant species based on morphometric, phenological and physiologic traits. We then investigated how FG abundance (projective foliar cover), functional composition, and functional and taxonomic richness varied along a 14 km gradient from persistent to ephemeral flows, varying groundwater depths, and distances from the stream channel. Dominant FGs were (i) drought avoidant mesic trees that are fluvial stress tolerant, or (ii) drought tolerant xeric tall shrubs that are fluvial stress intolerant. The drought avoidant mesic tree FG was associated with shallow groundwater but exhibited lower cover in riparian areas closer to the discharge (persistent surface flows). However, there were more FGs and higher species richness closer to the discharge point, particularly on the floodplain. Our findings demonstrate that quantifying FG distribution and diversity is a significant step in both assessing the impacts of mine water discharge on riverine ecosystems and for planning for post-mining restoration.

Peer and land-based approaches for fostering empowering and healthy relationships with Indigenous and northern young people in the Northwest Territories.

Indigenous and Northern women in Canada experience high rates of intimate partner violence (IPV), and this is particularly true in the Northwest Territories (NWT). Adolescents are also at increased risk of IPV, which has far-reaching, lifelong effects. Indigenous youth are particularly vulnerable to IPV due to ongoing effects of intergenerational trauma caused by colonialism, racism and residential school legacies. We explored attitudes towards IPV and the healthy relationship knowledge, skills, and experiences among participants of Fostering Open eXpression among Youth (FOXY) and Strength, Masculinities, and Sexual Health (SMASH) Peer Leader Retreats in the NWT. Multi-method approaches included quantitative surveys youth completed before and immediately following retreats. Quantitative analysis from retreats (2018-2021) included 240 participants aged 12-19 (mean age 14.5) who reported ever having an intimate partner. Most were from the FOXY program (64.2%), Indigenous (69.6%) and heterosexual (66.4%). Qualitative methods included Focus Group Discussions (FGD) (n = 69) conducted with peer leaders and apprentices (n = 311) and youth and adult staff (n = 14 FGDs, n = 165 participants). We thematically analysed FGDs to explore healthy relationship knowledge and skills, alongside paired t-tests to examine pre/post retreat changes in attitudes towards IPV. Qualitative findings suggest that leadership and embodied learning were effective in equipping youth with violence prevention and healthy relationship skills. While young women were committed to sharing knowledge and skills about healthy relationships in their communities, young men resonated with values of respect and appreciated support to identify and express emotions. Participants across programmes demonstrated their belief that healthy intimate relationships have communal, relational and intergenerational benefits. Quantitatively, we found a statistically significant reduction in attitudes accepting of IPV among young women, but no changes were noted among young men. Findings contribute to emergent evidence on strengths-based, culturally-responsive IPV prevention programming. Components of effective IPV prevention programming with young men merit further exploration.

Patient-planetary health co-benefit prescribing in a circumpolar health region: a qualitative study of physician voices from the Northwest Territories, Canada.

BACKGROUND: Despite climate change being described as a code red for humanity, health systems have been particularly slow in both climate mitigation and adaptation responses. The effects of climate change on health and health systems will not be felt equally, with underserved and marginalised communities disproportionately impacted. The circumpolar region is warming at 3-4 times the global rate, amplifying already existing socioeconomic barriers and health inequities, with particular amplified effects for the substantial Indigenous population in the area. OBJECTIVES AND SETTING: We therefore sought to explore perspectives of physicians around patient-planetary health (P-PH) co-benefit prescribing in a circumpolar region in the Northwest Territories (NWT), Canada, known to be one of the ground zero levels for climate change. METHODS: Thirteen semi-structured physician interviews were carried out in the NWT region between May 2022 and March 2023 using purposive sampling. Interviews were transcribed verbatim and reflexive thematic analysis was carried out to identify key themes. RESULTS: There were three main themes identified including (1) current healthcare system does not support planetary health, (2) supporting patient-planetary health is currently difficult for clinicians and (3) considering change in the NWT to support patient-planetary health. Participants noted key opportunities to move planetary health forward, with the NWT having the potential to be an innovative model for planetary health-informed change for other health systems. CONCLUSION: The NWT health system has unique features due to its rural and remote nature and smaller population base. Despite this, our study identified some key opportunities for advancing P-PH co-benefit efforts. The identified opportunities may be considered in future intervention, organisational change and policy-making efforts with potential relevance in other settings.

Human immunodeficiency virus prevention outcomes associated with arts-based sexual health workshop participation among Northern and Indigenous adolescents in the Northwest Territories, Canada.

BACKGROUND: Contextually tailored, arts-based HIV prevention strategies hold potential to advance adolescent sexual health and wellbeing. We examined HIV prevention outcomes associated with arts-based sexual health workshop participation with Northern and Indigenous adolescents in the Northwest Territories (NWT), Canada. METHODS: An Indigenous community-based youth agency delivered arts-based workshops in school settings to adolescents aged 13-18 in 24 NWT communities. Pre and post-test surveys included socio-demographic characteristics, sexually infections (STI) knowledge, HIV/STI risk perception, sexual relationship equity, condom use self-efficacy, and safer sex efficacy (SSE). Latent change score models were conducted to assess pre-post differences and factors associated with these differences. RESULTS: Among participants (n = 344; mean age 14.3 years, SD: 1.3; Indigenous: 79%) most (66%) had previously attended this workshop. Latent change score models revealed a significant and large effect size for increased STI knowledge (ß = 2.10, SE = 0.48, p < .001) and significant and small effect sizes for increased HIV/STI risk perception (ß = 0.24, SE = 0.06, p < .001) and SSE (ß = 0.16, SE = 0.07, p = .02). The largest increases across several outcomes occurred with first time workshop participants; yet previous workshop participants continued to report increases in HIV/STI risk perception and SSE. CONCLUSION: Arts-based HIV prevention approaches show promise in advancing STI knowledge, risk perception, and SSE with Northern and Indigenous youth.

Nudging policymakers on gendered impacts of policy.

Despite the proliferation of nudge research in the last few decades, very little published work aims to nudge the behavior of policymakers. Here we explore the impact of a well-established nudge on policymakers in the Northwest Territories of Canada. In a pre-registered randomized controlled trial, we emailed an invitation to policymakers (N = 263) to attend an online briefing on gendered impacts of policy. In the treatment condition (N = 133), the invitation contained personal stories of two women whose lives were disproportionally impacted by public policies more than men. In the control condition (N = 130), the invitation did not contain such stories. After the briefing, we sent all participants in both conditions a link to a public pledge that they could sign. The pledge was to lead and advocate for equity-oriented policymaking. Contrary to our prediction, there was a small backfiring effect where policymakers in the treatment condition (3.0%) were less likely to attend the briefing than the control condition (7.7%). However, two policymakers (1.5%) in the treatment condition signed the public pledge compared to one (0.8%) in the control condition. The current findings reveal the limits of using personal stories as a nudge to influence policymakers. We discuss insights gained from this experiment and follow-up debriefings with policymakers on how to improve future behavioral interventions designed to nudge policymakers.

Envisioning Indigenous and biomedical healthcare collaboration at Stanton Territorial Hospital, Northwest Territories.

Background: To improve the quality of care for Indigenous patients, local Indigenous leaders in the Northwest Territories, Canada have called for more culturally responsive models for Indigenous and biomedical healthcare collaboration at Stanton Territorial Hospital.Objective: This study examined how Indigenous patients and biomedical healthcare providers envision Indigenous healing practices working successfully with biomedical hospital care at Stanton Territorial Hospital.Methods: We carried out a qualitative study from May 2018 - June 2022. The study was overseen by an Indigenous Community Advisory Committee and was made up of two methods: (1) interviews (n = 41) with Indigenous Elders, patient advocates, and healthcare providers, and (2) sharing circles with four Indigenous Elders.Results: Participants' responses revealed three conceptual models for Indigenous and biomedical healthcare collaboration: the (1) integration; (2) independence; and (2) revisioning relationship models. In this article, we describe participants' proposed models and examine the extent to which each model is likely to improve care for Indigenous patients at Stanton Territorial Hospital. By surfacing new models for Indigenous and biomedical healthcare collaboration, the study findings deepen and extend understandings of hospital-based Indigenous wellness services and illuminate directions for future research.

Permafrost thaw induces short-term increase in vegetation productivity in northwestern Canada.

Over the past several decades, various trends in vegetation productivity, from increases to decreases, have been observed throughout Arctic-Boreal ecosystems. While some of this variation can be explained by recent climate warming and increased disturbance, very little is known about the impacts of permafrost thaw on productivity across diverse vegetation communities. Active layer thickness data from 135 permafrost monitoring sites along a 10° latitudinal transect of the Northwest Territories, Canada, paired with a Landsat time series of normalized difference vegetation index from 1984 to 2019, were used to quantify the impacts of changing permafrost conditions on vegetation productivity. We found that active layer thickness contributed to the observed variation in vegetation productivity in recent decades in the northwestern Arctic-Boreal, with the highest rates of greening occurring at sites where the near-surface permafrost recently had thawed. However, the greening associated with permafrost thaw was not sustained after prolonged periods of thaw and appeared to diminish after the thaw front extended outside the plants' rooting zone. Highest rates of greening were found at the mid-transect sites, between 62.4° N and 65.2° N, suggesting that more southernly sites may have already surpassed the period of beneficial permafrost thaw, while more northern sites may have yet to reach a level of thaw that supports enhanced vegetation productivity. These results indicate that the response of vegetation productivity to permafrost thaw is highly dependent on the extent of active layer thickening and that increases in productivity may not continue in the coming decades.

Yellowknife: Canada's First Circumpolar Family Medicine Residency Site.

PROBLEM: Canada's Northwest Territories (NWT), like other regions in the circumpolar north primarily inhabited by Indigenous peoples, faces challenges in recruiting and retaining physicians. Communities in this vast, diverse region depend largely on external medical professionals for health care. Consequently, these communities receive discontinuous medical care from physicians who lack local knowledge and are available only temporarily. The shortage of physicians for people residing in northern Canada requires a sustainable, long-term solution. APPROACH: The authors describe establishing Canada's first circumpolar family medicine residency training site in Yellowknife, NWT. The site was launched in 2020 as a partnership between the University of Alberta, Alberta Health Services, and 3 local health authorities in the NWT. The residency site, which bases residents in the local community, is expected to positively impact family physician recruitment and retention by allowing residents to build connections with local communities and identify as a northern physician. OUTCOMES: As of fall 2022, 4 residents had trained with the Yellowknife family medicine residency site. Two of these 4 residents graduated in 2022, both of whom plan to continue practicing medicine in the NWT. Residents have positively influenced medical care in the NWT, providing care in close to 20 small and remote communities. The presence of residents decreased appointment wait-times for some teams by as much as 60%, improved primary care screening, and enabled the provision of medical services at critical times. Furthermore, their presence has fostered academic spirit in the medical communities and had a positive impact on the communities as a whole. NEXT STEPS: The authors provide key insights and lessons learned from the establishment of the remote residency site. To develop and improve the site, continuous program evaluation is planned.

Exploring uptake of HIV/STI knowledge and safer sex-efficacy in an arts-based sexual health workshop among Northern and Indigenous adolescents in the Northwest Territories, Canada.

ABSTRACTLimited research has evaluated sexual health promotion projects with adolescents living in Arctic regions. The study objective was to examine changes in STI knowledge and safer sex efficacy among youth in the Northwest Territories (NWT), Canada who participated in arts-based sexual health workshops. We used a pre/post-test design with a convenience sample of students aged 13-18 years recruited from 17 NWT communities. We conducted summary statistics and comparisons between pre and post-test scores using paired t-tests. Among participants (n = 610), we found statistically significant increases in STI knowledge overall (mean difference = 3.9; p < 0.001) and across gender and age stratifications. There were statistically significant increases in safer sex efficacy overall (mean difference = 0.9, p < 0.001), across genders, and among participants: aged <15 years, in rural communities, reporting food insecurity, reporting dating violence, and Indigenous youth. No statistically significant differences in safer sex efficacy were observed among participants who were aged ≥15, sexually active, reporting consistent condom use, and using drugs/alcohol. Findings signal the promise of youth-targeted, arts-based sexual health workshops for improving STI knowledge and safer sex efficacy among adolescents in the NWT. Further research can explore how safer sex efficacy may be shaped by age, substance use, and sexual experience to inform tailored interventions.