Kandasamy Sujane, Vanstone Meredith, Oremus Mark, Hill Trista, Wahi Gita, Wilson Julie, Davis A Darlene, Jacobs Ruby, Anglin Rebecca, Anand Sonia Savitri
Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont.
CMAJ Open. 2017 May 18;5(2):E411-E416. doi: 10.9778/cmajo.20160077.
Women play important roles in translating health knowledge, particularly around pregnancy and birth, in Indigenous societies. We investigated elder Indigenous women's perceptions around optimal perinatal health.
Using a methodological framework that integrated a constructivist grounded-theory approach with an Indigenous epistemology, we conducted and analyzed in-depth interviews and focus groups with women from the Six Nations community in southern Ontario who self-identified as grandmothers. Our purposive sampling strategy was guided by a Six Nations advisory group and included researcher participation in a variety of local gatherings as well as personalized invitations to specific women, either face-to-face or via telephone.
Three focus groups and 7 individual interviews were conducted with 18 grandmothers. The participants' experiences converged on 3 primary beliefs: pregnancy is a natural phase, pregnancy is a sacred period for the woman and the unborn child, and the requirements of immunity, security (trust), comfort, social development and parental responsibility are necessary for optimal postnatal health. Participants also identified 6 communal responsibilities necessary for families to raise healthy children: access to healthy and safe food, assurance of strong social support networks for mothers, access to resources for postnatal support, increased opportunities for children to participate in physical activity, more teachings around the impact of maternal behaviours during pregnancy and more teachings around spirituality/positive thinking. We also worked with the Six Nations community on several integrated knowledge-translation elements, including collaboration with an Indigenous artist to develop a digital story (short film).
Elder women are a trusted and knowledgeable group who are able to understand and incorporate multiple sources of knowledge and deliver it in culturally meaningful ways. Thus, tailoring public health programming to include elder women's voices may improve the impact and uptake of perinatal health information for Indigenous women.
在原住民社会中，女性在传播健康知识，尤其是围绕怀孕和分娩的知识方面发挥着重要作用。我们调查了年长的原住民女性对最佳围产期健康的看法。
我们采用了一种将建构主义扎根理论方法与原住民认识论相结合的方法框架，对安大略省南部六国社区中自认为是祖母的女性进行了深入访谈和焦点小组讨论，并进行了分析。我们的目的抽样策略由一个六国咨询小组指导，包括研究人员参与各种当地聚会以及通过面对面或电话向特定女性发出个性化邀请。
我们与18位祖母进行了3次焦点小组讨论和7次个人访谈。参与者的经历集中在三个主要信念上：怀孕是一个自然阶段，怀孕对女性和未出生的孩子来说是一个神圣的时期，免疫、安全（信任）、舒适、社会发展和父母责任的要求对于最佳产后健康是必要的。参与者还确定了家庭养育健康孩子所需的6项共同责任：获得健康和安全的食物、确保为母亲提供强大的社会支持网络、获得产后支持资源、增加儿童参与体育活动的机会、增加关于孕期母亲行为影响的教导以及增加关于灵性/积极思考的教导。我们还与六国社区合作开展了几个综合知识转化项目，包括与一位原住民艺术家合作制作一个数字故事（短片）。
年长女性是一个值得信赖且知识渊博的群体，她们能够理解并整合多种知识来源，并以具有文化意义的方式进行传播。因此，调整公共卫生项目以纳入年长女性的声音，可能会提高原住民女性围产期健康信息的影响力和接受度。
