Indigenous Health Research Monitoring, October 2025

In this issue:

Just Published

New scientific publications and articles

New publications from INSPQ

Article Summaries: Subject Areas

Prevention of infectious and chronic disease

The perspectives of young Indigenous people on chronic disease prevention programs: A systematic review of qualitative studies

Sinka, V., Kerr, M., Dickson, M., Stephens, J. H., Craig, J. C., Vastani, R. T., Hewage, A. H., Dal Grande, E., and Jauré, A. (2025). The perspectives of young Indigenous people on chronic disease prevention programs: A systematic review of qualitative studies. Journal of Adolescent Health, 77(2), 181–190.

Background

The continuing effects of colonization, intergenerational trauma and discrimination have repercussions on the lifestyle of Indigenous young people, with consequences that include higher rates of obesity and physical inactivity. Lifestyle habits take shape during adolescence and early adulthood, making this a critical period for the development of chronic disease. The risk of chronic health issues such as cardiovascular disease, diabetes, and kidney disorders increases among Indigenous young people during early adulthood. Health promotion programs have been implemented to promote health and prevent chronic disease among Indigenous youth by encouraging behavioural changes in the areas of diet and physical exercise. The effectiveness of such programs may be limited, however, if they are not adapted to the needs and priorities of Indigenous youth.

Objective   

Describe the experiences and perspectives of Indigenous youth aged 10 to 24 with respect to interventions aimed at preventing chronic disease.

Methods   

Qualitative studies published up to May 2024 looking at Indigenous youth in Western countries with similar colonial histories (Canada, Australia, New Zealand, and the United States) were included. The search strategy in various databases (MEDLINE, Embase, PsycINFO, and CINAHL) used keywords pertaining to the Indigenous populations in those countries. Primary and secondary chronic disease prevention interventions were eligible if the study described the experiences of the young Indigenous participants. The data was synthesized through thematic analysis. 

What was learned?    

An analysis of 13 studies involving 441 participants identified four key themes.

1) Safeguarding food sovereignty

Access to traditional food (food obtained locally from the natural environment and prepared with traditional knowledge) is perceived by young people as fundamental since it is a way of better understanding their culture. Moreover, young people noted the importance of meeting nutritional needs by prioritizing traditional foods, which are seen as healthier than commercial products. Young people trust Elders to share their dietary knowledge. Finally, because of limited access to some healthy food options in Indigenous communities, they believe that ensuring food security should be an integral part of health promotion programs.

2) Equipping emerging leaders with agency and power

Imparting traditional knowledge, specifically through storytelling traditions and intergenerational sharing about healthy lifestyles, could contribute to developing knowledge about health among young people. Likewise, when an initiative offers young people the opportunity to assume positions of influence and leadership and they are involved in designing and implementing the initiative, they have a sense of making a difference in their community’s wellbeing.

3) Strengthening the sociocultural fabric

Young people recognize the importance of fostering community inclusion and present the case for more local cultural and sports facilities, as well as extracurricular activities to reinforce community cohesion and collective responsibility. They also point out the value in gaining community buy-in for initiatives and note that the involvement of Elders and families plays a key role in mobilizing young people around health promotion. Finally, integrating cultural ways, especially through the transmission of Elders’ knowledge about health, is an essential part of information sharing.

4) Navigating challenges

Young people report being less engaged when they lack access to adequate information and knowledge. For example, participants in a gym-based program mentioned that many of their peers “don’t go to the gym because they don’t know what to do.” In the same vein, some young people have the impression that program health messages are somewhat diluted and fail to correctly inform them about the seriousness of chronic disease.

Limitations

The authors acknowledge that including articles exclusively in English, a majority of which are based in North America, is a limitation. In addition, only one study reported having reached data saturation. Furthermore, urban settings were excluded and the review was limited to interventions in community settings.

Culturally adapted approaches to research and intervention

Supporting the development of Inuit children in urban environments: What are the needs of Inuit families living in southern Québec?

Ouellet, L., Grandisson, M., and Fletcher, C. (2025). Supporting the development of Inuit children in urban environments: What are the needs of Inuit families living in southern Québec? Canadian Journal of Public Health.

Background

Like other Indigenous children, Inuit children in Canada display more developmental vulnerabilities at various stages than do their non-Indigenous counterparts. At a time when the Indigenous population is becoming urbanized, it is estimated that nearly one Inuk in five lives outside Nunavik. Barriers to accessing services and shortcomings in the quality of those delivered persist in urban settings. In fact, a vast majority of services are designed for the general population, while adaptations that take into consideration Indigenous needs and characteristics are limited. In order to support the Inuit in their parenting experiences and to foster the development of their children, the needs of that population must be understood.

Objectives

  • Identify the main resources and sources of support that Inuit families living in an urban setting can use to foster the healthy development of their children.
  • Better understand the needs of those families pertaining to childhood development.

Methods

This qualitative descriptive study was part of the participatory community research project Qanuikkat Siqinirmiut?, a study aimed at describing the health and wellbeing of Inuit living in southern Québec.

A non-probability network sampling strategy (posters, social media, and the network of contacts of the research team and its partners) was used to recruit Inuit participants. To qualify, participants had to identify as Inuit, be parents of at least one child under the age of 18, be at least 16 years old, and have lived in southern Québec for a minimum of 6 months.

A thematic analysis of semi-structured interviews (conducted in French or English, online or in person) was undertaken. The preliminary results were initially presented to members of the urban Inuit community, and the same was done with the final results and conclusions. Those meetings were aimed at validating the results, correcting cultural inaccuracies and eliciting community knowledge.

What was learned? 

Meetings were held with a total of 13 Inuit, including 12 women. Eleven participants lived in or near Montréal. Four were students, suggesting that they were in the city for their studies rather than having settled permanently.

With respect to services and resources, two categories emerge from the recorded discourses: 1) family, friends and other community members, and 2) a variety of organizations. In addition to organizations specific to the Indigenous community (such as Native Friendship Centres), more general organizations (such as those serving LGBTQ+ families) were also named. However, participants reported encountering barriers when trying to access services. These included, for example, unfamiliarity with the services offered, lack of transportation, and non‑Inuit staff who is not aware of the Inuit context. These results show the need to create services specifically designed for Inuit families living in southern Québec in collaboration with members of that community. Furthermore, the authors propose facilitating access to information concerning existing services that target the Inuit.

As for needs, the results of the analysis show that supporting the development of Inuit children living in southern Québec requires more than just acquiring skills. Participants spoke of issues in meeting their basic needs and in being able to develop in a safe family environment. The need to have access to culturally safe environments that support the transfer of the Inuit cultural heritage and language was also identified. Finally, participants spoke of the need for opportunities to socialize their children and receive an education sensitive to their context.

Limitations

The authors mention the small sample size due to constraints of geographical dispersion and logistical considerations. They also note that the interviews could not be held in Inuktitut because a qualified interpreter was not available. One participant mentioned that she would have been more comfortable in her own language. Finally, the three authors point out that they are not Inuit, hence their efforts to validate the approach and results with members of the urban Inuit community.

Lifestyles and health behaviours/h2>

Experiences, impacts, and perspectives of recreational cannabis use among Indigenous communities: A scoping review

Zentner, D., Dobischok, S., DeGrace, S., Wen, R. A., and Wendt, D. C. (2025). Experiences, impacts, and perspectives of recreational cannabis use among Indigenous communities: A scoping review. Psychology of Addictive Behaviors, 39(4), 354–364.

Background

Despite their history of resilience, Indigenous populations face many risk factors influenced by discrimination and colonial oppression that contribute to the use of cannabis. Indigenous young people begin to use cannabis at an earlier age than their non-Indigenous counterparts. Cannabis use is associated with a number of social and behavioural consequences (e.g., lower academic results, professional difficulties, the use of other drugs, antisocial behaviour, as well as the risk of psychosis, anxiety and depression). The Indigenous population is also more vulnerable because of the social inequalities they face.

Objective

Gather and organize existing data on cannabis use in Indigenous populations in order to describe emerging themes and future avenues for research.

Methods

A scoping review was conducted of articles published between 2005 and February 2020 that specifically address cannabis use by Indigenous populations living on or off reserve in Canada or the United States. The research strategy included keywords pertaining to Indigenous peoples and cannabis use adapted to each database (APA PsycINFO, Scopus, and Medline). The selected literature was subjected to a thematic analysis.

What was learned? 

A total of 152 documents (149 peer-reviewed articles, one book chapter, and two commentaries) were included. A majority of the studies took place in the United States, had a quantitative design and included comparisons between ethnocultural groups.

Prevalence and patterns of cannabis use (n = 54)

The results indicate that cannabis use increases over time and that young people start using cannabis before alcohol. Moreover, early use of cannabis is associated with increased use later in life, as well as with a higher probability of developing cannabis use disorder. Some studies that controlled for socioeconomic characteristics found no statistically significant difference in the frequency of cannabis use between Indigenous participants and the non‑Indigenous population.

Protective (n = 29) and risk (n = 42) factors

Certain family characteristics act as protective factors against cannabis use. These include living in a two-parent household, parental supervision and parental disapproval for the use of cannabis. Further protective factors include strong community and cultural engagement, Indigenous spiritual beliefs and a strong Indigenous identity.

Other family and social characteristics prove to be risk factors: exposure to drugs in the family, arguments with parents, parental violence, family dysfunction during childhood, weak parental attachment, dissatisfaction with family life and psychoactive substance use by peers. On the individual level, cannabis use is associated with favourable attitudes towards substance use, sensation seeking, easy access to psychoactive substances, recent stressful events, violence at school, experience with abuse, feeling unsafe in the neighbourhood, fragile mental health, suicidal ideation and poor overall health.

Correlation with the use of other substances (n = 22)

The literature suggests the existence of various polydrug profiles (alcohol use, nicotine addiction and the use of other illicit drugs such as cocaine and methamphetamine).

Correlation with mental health disorders (n = 10) or other health consequences (n = 5)

Suicidal behaviour, depression, anxiety, emotional issues, post-traumatic stress disorder and psychotic problems are all associated with cannabis use. Moreover, Indigenous drivers injured in a traffic accident tend to present a higher level of cannabis in their body than do non-Indigenous drivers.

Interventions (n = 11)

Preventing alcohol use also reduces cannabis use. Some studies report that culturally adapted interventions should be prioritized, and one in particular showed decreased cannabis use among young people following a brief intervention.

Legalization of cannabis (n = 6)

Research into the legalization of cannabis and Indigenous populations shows that a criminal history for possession, production and selling of cannabis affects Indigenous populations disproportionately. Studies underscore the absence of significant collaboration between Indigenous communities and the various levels of government in developing laws and frameworks pertaining to cannabis.

Other categories

Other research themes emerge from the literature, including studies looking at hereditary factors associated with cannabis use (n = 5), use in specific subgroups such as pregnant women (n = 9) and attitudes towards cannabis (n = 2).

Limitations

Only three databases were searched for this scoping review, which also does not reflect post‑pandemic trends given that the selected articles were published before February 2020. Finally, given the large volume of sources identified, the full text of only 10% of publications was examined by all three research assistants to establish the reliability of the selection process.

Cultural safety

Values in health and health care for Indigenous people globally: An umbrella review

Coe, L. J., Dimitropoulos, Y., Mealings, K., Barnes, D., and McMahon, C. M. (2025). Values in health and health care for Indigenous people globally: An umbrella review. Medical Journal of Australia, 223(6), 320–325.

Background

Precolonial Indigenous health practices developed over millennia and are based on a holistic concept of health that draws on Indigenous ways of knowing, being, and doing. At the same time, Western health concepts used in planning healthcare and services do not always adequately meet the needs of Indigenous populations. Globally, emphasis is increasingly placed on a value-based healthcare system (a management model aimed at optimizing the ratio of patient results to costs) and on integrating Indigenous worldviews in planning, delivering, and evaluating services.

Objective

To review and synthesize the global evidence regarding what Indigenous people value in health and healthcare.

Methods

The collaborative yarning method was used during in-depth discussions between Indigenous and non-Indigenous researchers throughout the process of reviewing the literature. The goal was to engage meaningfully and respectfully in exchanging and sharing perspectives and ideas through reflecting, storytelling, speaking and deep listening. This umbrella review based on the Joanna Briggs Institute protocol looked at 25 literature reviews published between 2000 and 2024, primarily in Australia, New Zealand, the United States, and Canada. The articles were screened for duplicates using Covidence and a thematic analysis conducted with the Nvivo software. With the help of Indigenous partners, the research team developed a conceptual framework and a tool to measure community healthcare.

What was learned? 

A distinction emerged from the literature between the Western concept of health based on the individual, biology, and disease-centred care and the Indigenous concept rooted in culture. For Indigenous peoples in the selected studies, health is based on cultural determinants such as identity, connection to the land and community, spirituality, and traditional healing methods.

The analysis brought to light several themes about what is valued in Indigenous healthcare.

  1. Decolonized and holistic systems of care: To foster engagement in care, it needs to be based on Indigenous health concepts rather than duplicating dominant colonial structures.
  2. Culturally safe health services and care: Careful attention must be given to ensuring that patients feel respected, understood and safe in receiving services.
  3. Indigenous and culturally aware non-Indigenous health workforce: The presence of Indigenous care providers or of non-Indigenous staff trained to be culturally aware fosters patient trust, the relevance of care and patient engagement in the services provided. Health organizations managed by and for Indigenous people respond to their needs.
  4. Accessibility: Care must be geographically, financially, linguistically and culturally accessible.
  5. Communication, trust and rapport building: Effective communication without the use of jargon and taking time to build trust can help caregivers better know and understand the patient, including their family and social dynamics.

The authors conclude that racism and intergenerational trauma linked to colonization constitute barriers for Indigenous populations trying to access care. This in turn generates negative experiences that perpetuate mistrust of the health system and contribute to social inequalities in health.

Limitations

The selected reviews and quality of primary sources were not evaluated using an Indigenous quality appraisal tool. However, the authors’ position statement was used to evaluate Indigenous engagement in the selected studies. Finally, Indigenous health knowledge, perspectives and storytelling are situated outside of the realm of academia in which this study took place.