Indigenous Health Research Mentorship within Post-Secondary Institutions in Canada, the United States, Australia, and New Zealand: A Scoping Review.

Indigenous peoples have been engaged in research since time immemorial, and have always acknowledged the power of their own knowledge systems, ways of being, and approaches. However, Indigenous peoples continue to be underrepresented in health research within academic institutions. There is an increased need for Indigenous leadership in health research, including greater Indigenous autonomy, mentorship, and self-determination in health research. This scoping review aims to explore Indigenous mentorship within Indigenous health research in post-secondary institutions in Canada, the US, New Zealand, and Australia. A review of empirical studies, case studies, reviews, commentaries, and grey literature was conducted. Four databases were used: Web of Science, PubMed, Native Health, and Google Scholar. Out of 1594 articles, 11 articles met the inclusion criteria. Four overarching themes were identified: (1) reciprocity: giving back to community; (2) supporting the development of research skills to build research capacity; (3) fostering a sense of belonging; and (4) building student ownership and confidence. The findings suggest that Indigenous mentorship is vital to creating supportive research environments for Indigenous students in the area of health sciences. Indigenous mentorship holds promise to address challenges faced by Indigenous scholars within post-secondary institutions, including intellectual, social, and cultural isolation, and can help to foster greater integration of Indigenous worldviews in Western-dominated academic settings and research systems. Future research should examine place-based mentorship opportunities for Indigenous students in community-based health research environments. Fostering Indigenous mentorship in health sciences is essential for advancing the health and wellbeing of Indigenous peoples and communities.

Best Practices to Support the Self-Determination of Indigenous Communities, Collectives, and Organizations in Health Research through a Provincial Health Research Network Environment in British Columbia, Canada.

In Canada, the health research funding landscape limits the self-determination of Indigenous peoples in multiple ways, including institutional eligibility, priority setting, and institutional structures that deprioritize Indigenous knowledges. However, Indigenous-led research networks represent a promising approach to transforming the funding landscape to better support the self-determination of Indigenous peoples in health research. The British Columbia Network Environment for Indigenous Health Research (BC NEIHR) is one of nine Indigenous-led networks across Canada that supports research leadership among Indigenous (First Nations, Métis, and Inuit) communities, collectives, and organizations (ICCOs). In this paper, we share three best practices to support the self-determination of ICCOs in health research based on three years of operating the BC NEIHR: (1) creating capacity-bridging initiatives to overcome funding barriers; (2) building relational research relationships with ICCOs ("people on the ground"); and (3) establishing a network of partnerships and collaborations to support ICCO self-determination. Supporting the self-determination of ICCOs and enabling them to lead their own health research is a critical pathway toward transforming the way Indigenous health research is funded and conducted in Canada.

Structural Racism as an Ecosystem: An Exploratory Study on How Structural Racism Influences Chronic Disease and Health and Wellbeing of First Nations in Canada.

Indigenous peoples in Canada experience disproportionately higher rates of chronic disease than their non-Indigenous counterparts. Previous research has identified structural racism as a powerful determinant of health and wellbeing. Mounting evidence demonstrates that First Nations are disproportionately over-represented, compared to other Canadians, in several domains that have been used to measure structural racism in other countries. Despite growing concern of the impact of structural racism on health, there remains little empirical evidence on the impact structural racism has on chronic disease health outcomes of First Nations. This qualitative study examines the complex and intersecting ways in which structural racism can influence chronic disease health outcomes and the overall health and wellbeing of First Nations in Canada. In-depth semi-structured interviews were conducted with twenty-five participants, including subject matter experts in health, justice, education, child welfare, politics, and researchers in racism scholarship and First Nations who have lived experience with a chronic condition(s). Thematic analysis was used to analyze the data collected. Six themes on how structural racism influences chronic disease and the health of First Nations were identified: (1) multiple and intersecting pathways; (2) systems of failure, harm, and indifference; (3) impacts on access to healthcare; (4) colonial policies of structural deprivation; (5) increased risk factors for chronic disease and poor health; and (6) structural burden leading to individual-level outcomes. Structural racism creates an ecosystem that negatively impacts chronic diseases and the health of First Nations. The findings illuminate how structural racism can have micro-level influences at an individual level and can influence one's chronic disease journey and progression. Recognizing how structural racism shapes our environments may help to catalyze a shift in our collective understanding of the impact of structural racism on health.