Indigenous Women's Resistance of Colonial Policies, Practices, and Reproductive Coercion.

This analysis of urban Indigenous women's experiences on the Homeland of the Métis and Treaty One (Winnipeg, Manitoba, Canada), Treaty Four (Regina, Saskatchewan, Canada), and Treaty Six (Saskatoon, Saskatchewan, Canada) territories illustrates that Indigenous women have recently experienced coercion when interacting with healthcare and social service providers in various settings. Drawing on analysis of media, study conversations, and policies, this collaborative, action-oriented project with 32 women and Two-Spirit collaborators demonstrated a pattern of healthcare and other service providers subjecting Indigenous women to coercive practices related to tubal ligations, long-term contraceptives, and abortions. We foreground techniques Indigenous women use to assert their rights within contexts of reproductive coercion, including acts of refusal, negotiation, and sharing community knowledge. By recognizing how colonial relations shape Indigenous women's experiences, decision-makers and service providers can take action to transform institutional cultures so Indigenous women can navigate their reproductive decision-making with safety and dignity.

Reclaiming Our Spirits: Development and Pilot Testing of a Health Promotion Intervention for Indigenous Women Who Have Experienced Intimate Partner Violence.

Indigenous women are subjected to high rates of multiple forms of violence, including intimate partner violence (IPV), in the context of ongoing colonization and neo-colonization. Health promotion interventions for women who experience violence have not been tailored specifically for Indigenous women. Reclaiming Our Spirits (ROS) is a health promotion intervention designed for Indigenous women living in an urban context in Canada. In this paper, we describe the development of the intervention, results of a pilot study, and the revised subsequent intervention. Building on a theory-based health promotion intervention (iHEAL) showing promising results in feasibility studies, ROS was developed using a series of related approaches including (a) guidance from Indigenous women with research expertise specific to IPV and Indigenous women's experiences; (b) articulation of an Indigenous lens, including using Cree (one of the largest Indigenous language groups in North America) concepts to identify key aspects; and (c) interviews with Elders (n = 10) living in the study setting. Offered over 6-8 months, ROS consists of a Circle, led by an Indigenous Elder, and 1:1 visits with a Registered Nurse, focused on six areas for health promotion derived from previous research. Pilot testing with Indigenous women (n = 21) produced signs of improvement in most measures of health from pre- to post-intervention. Women found the pilot intervention acceptable and helpful but also offered valuable suggestions for improvement. A revised intervention, with greater structure within the Circle and nurses with stronger knowledge of Indigenous women's experience and community health, is currently undergoing testing. © 2017 Wiley Periodicals, Inc.

Perceptions and experiences of health care professionals and staff with animal-assisted interventions in health care settings: a qualitative systematic review protocol.

OBJECTIVE: The objective of this review is to examine the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. INTRODUCTION: Animal-assisted interventions are applied in the areas of health, education, and human services to help improve individuals' health and wellness. The positive effects of animal-assisted interventions on individuals have been shown in multiple health disciplines, from pediatrics to long-term care, and include outcomes such as decreased feelings of loneliness and increased feelings of support. The increase of animal-assisted interventions in human health has initiated growing research on health care professionals' perceptions and experiences of these interventions. No current qualitative systematic reviews have focused solely on health care professionals' and staff's perceptions of animal-assisted interventions. Conducting such a review will advance understanding of how these providers perceive and engage with animal-assisted interventions as well as their influence and role in coordinating these interventions. INCLUSION CRITERIA: This review will consider qualitative primary studies that address the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. METHODS: Nine bibliographic databases will be systematically searched for published and unpublished studies by employing a three-step search strategy. Studies published from database inception to present and in English will be considered. Two reviewers will independently appraise the studies and extract qualitative data using the standardized JBI critical appraisal and data extraction instruments. Findings from the review will be categorized according to similarity in meaning, and categories will be subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021258909.

Outcomes of a controlled trial with visiting therapy dog teams on pain in adults in an emergency department.

CONTEXT: Pain is a primary reason individuals attend an Emergency Department (ED), and its management is a concern. OBJECTIVES: Change in symptoms and physiologic variables at 3 time points pre-post a ten-minute St. John Ambulance therapy dog team visit compared to no visit in ED patients who experienced pain. DESIGN, SETTING AND PARTICIPANTS: Using a controlled clinical trial design, pain, anxiety, depression and well-being were measured with the Edmonton Symptom Assessment System (revised version) (ESAS-r) 11-point rating scales before, immediately after, and 20 minutes post- therapy dog team visit with Royal University Hospital ED patients participating in the study (n = 97). Blood pressure and heart rate were recorded at the time points. Control data was gathered twice (30 minutes apart) for comparison (n = 101). There were no group differences in age, gender or ethnicity among the control and intervention groups (respectively mean age 59.5/57.2, ethnicity 77.2% Caucasian/87.6%, female 43.6% /39.2%, male 56.4%/60.8%,). INTERVENTION: 10 minute therapy dog team visit in addition to usual care. MAIN OUTCOME MEASURES: Change in reported pain from pre and post therapy dog team visit and comparison with a control group. RESULTS: A two-way ANOVA was conducted to compare group effects. Significant pre- post-intervention differences were noted in pain for the intervention (mean changeint. = -0.9, SD = 2.05, p = .004, 95% confidence interval [CI] = [0.42, 1.32], ηp2 = 04) but not the control group. Anxiety (mean changeint. = -1.13, SD = 2.80, p = .005, 95% CI = [0.56, 1.64], ηp2 = .04), depression (mean changeint. = -0.72, SD = 1.71, p = .002, 95% CI = [0.39, 1.11], ηp2 = .047), and well-being ratings (mean changeint. = -0.87, SD = 1.84, p < .001, 95% CI = [0.49, 1.25], ηp2 = .07) similarly improved for the intervention group only. There were no pre-post intervention differences in blood pressure or heart rate for either group. Strong responders to the intervention (i.e. >50% reduction) were observed for pain (43%), anxiety (48%), depression (46%), and well-being (41%). CONCLUSIONS: Clinically significant changes in pain as well as significant changes in anxiety, depression and well-being were observed in the therapy dog intervention compared to control. The findings of this novel study contribute important knowledge towards the potential value of ED therapy dogs to affect patients' experience of pain, and related measures of anxiety, depression and well-being. TRIAL REGISTRATION: This controlled clinical trial is registered with ClinicalTrials.gov, registration number NCT04727749.

A Commentary about Lessons Learned: Transitioning a Therapy Dog Program Online during the COVID-19 Pandemic.

In 2015, the University of Saskatchewan PAWS Your Stress Therapy Dog program partnered with St. John Ambulance for therapy dog teams to visit our campus and offer attendees love, comfort and support. We recognized at the start of the COVID-19 pandemic that students, staff and faculty may require mental health support, particularly with the challenges of isolation and loneliness. In response, our team transitioned from an in-person to a novel online format at the start of the COVID-19 pandemic. We designed online content for participants to (1) connect with therapy dogs and experience feelings of love, comfort and support as occurred in in-person programming, and (2) learn about pandemic-specific, evidence-informed mental health knowledge. Our unique approach highlighted what dogs can teach humans about health through their own care and daily activities. From April to June 2020, we developed a website, created 28 Facebook livestreams and 60 pre-recorded videos which featured therapy dogs and handlers, and cross-promoted on various social media platforms. Over three months, first a combined process-outcome evaluation helped us determine whether our activities contributed to the program's goals. A subsequent needs assessment allowed us to elicit participant preferences for the program moving forward. This commentary reflects on these findings and our teams' collective experiences to share our key lessons learned related to program personnel needs, therapy dog handler training and support requirements, and online programming prerequisites. This combined understanding is informing our current activities with the virtual program and should be of interest to other therapy dog programs transitioning online.

The Efficacy of a Health Promotion Intervention for Indigenous Women: Reclaiming Our Spirits.

Indigenous women globally are subjected to high rates of multiple forms of violence, including intimate partner violence (IPV), yet there is often a mismatch between available services and Indigenous women's needs and there are few evidence-based interventions specifically designed for this group. Building on an IPV-specific intervention (Intervention for Health Enhancement After Leaving [iHEAL]), "Reclaiming Our Spirits" (ROS) is a health promotion intervention developed to address this gap. Offered over 6 to 8 months in a partnership between nurses and Indigenous Elders, nurses worked individually with women focusing on six areas for health promotion and integrated health-related workshops within weekly Circles led by an Indigenous Elder. The efficacy of ROS in improving women's quality of life and health was examined in a community sample of 152 Indigenous women living in highly marginalizing conditions in two Canadian cities. Participants completed standard self-report measures of primary (quality of life, trauma symptoms) and secondary outcomes (depressive symptoms, social support, mastery, personal agency, interpersonal agency, chronic pain disability) at three points: preintervention (T1), postintervention (T2), and 6 months later (T3). In an intention-to-treat (ITT) analysis, Generalized Estimating Equations (GEE) were used to examine hypothesized changes in outcomes over time. As hypothesized, women's quality of life and trauma symptoms improved significantly pre- to postintervention and these changes were maintained 6 months later. Similar patterns of improvement were noted for five of six secondary outcomes, although improvements in interpersonal agency were not maintained at T3. Chronic pain disability did not change over time. Within a context of extreme poverty, structural violence, and high levels of trauma and substance use, some women enrolled but were unable to participate. Despite the challenging circumstances in the women's lives, these findings suggest that this intervention has promise and can be effectively tailored to the specific needs of Indigenous women.

"I Got to Know Them in a New Way": Rela(y/t)ing Rhizomes and Community-Based Knowledge (Brokers') Transformation of Western and Indigenous Knowledge.

Drawing on three culturally specific research projects, this paper examines how community-based knowledge brokers' engagement in brokering knowledge shaped the projects' processes. Informed by Deleuze and Guattari's (1987) conceptualization of the "rhizome," we discuss how community knowledge brokers' engagement in open research-creation practices embrace the relational foundation of Indigenous research paradigms in contrast to mainstream Western research practices that are engaged as linear, objective, and outcome-oriented activities. In turn, we offer propositions for building team environments where open research-creation practices can unfold, informing a periphery of shared space for Indigenous and Western paradigms.