Department of Community Health Sciences, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
Manitoba Inuit Association, Winnipeg, Manitoba, Canada.
BMJ Open. 2021 Sep 14;11(9):e052936. doi: 10.1136/bmjopen-2021-052936.
Decades of research demonstrate that First Nations, Metis and Inuit (FN/M/I) populations have differential access to diagnostic and therapeutic healthcare. Emerging evidence shows that this continues to be the case during the SARS-CoV-2 pandemic. In an effort to rectify these differences in access to care, our team, which is co-led by FN/M/I partners, will generate and distribute evidence on COVID-19 diagnostic testing and vaccination in high-priority FN/M/I populations in Manitoba, with the goal of identifying system-level and individual-level factors that act as barriers to equitable care and thereby informing Indigenous-led public health responses.
Our nations-based approach focuses on FN/M/I populations with separate study arms for each group. Linked administrative health data on COVID-19 diagnostic testing and vaccinations are available on a weekly basis. We will conduct surveillance to monitor trends in testing and vaccination among each FN/M/I population and all other Manitobans, map the geographic distribution of these outcomes by health region and tribal council, and identify barriers to testing and vaccination to inform public health strategies. We will follow the course of the pandemic starting from January 2020 and report findings quarterly.
Ethics approvals have been granted by the University of Manitoba Research Ethics Board and from each of our FN/M/I partners' organisations. Our team is committed to engaging in authentic relationship-based research that follows First Nations, Metis and Inuit research ethics principles. Our FN/M/I partners will direct the dissemination of new information to leadership in their communities (health directors, community health organisations) and to decision-makers in the provincial Ministry of Health. We will also publish in open-access journals. The study will create ongoing capacity to monitor Manitoba's pandemic response and ensure potential health inequities are minimised, with learnings applicable to other jurisdictions where detailed administrative data may not be available.
几十年来的研究表明，第一民族、梅蒂斯和因纽特人（FN/M/I）在获得诊断和治疗性医疗保健方面存在差异。新出现的证据表明，在 SARS-CoV-2 大流行期间，这种情况仍在继续。为了纠正这些在获得医疗保健方面的差异，我们的团队由 FN/M/I 合作伙伴共同领导，将在马尼托巴省的高优先级 FN/M/I 人群中生成和分发有关 COVID-19 诊断检测和疫苗接种的证据，目标是确定作为公平护理障碍的系统级和个人级因素，并为土著领导的公共卫生应对措施提供信息。
我们的基于国家的方法侧重于每个群体都有单独研究臂的 FN/M/I 人群。每周都可以获得有关 COVID-19 诊断测试和疫苗接种的链接行政健康数据。我们将进行监测，以监测每个 FN/M/I 人群和所有其他马尼托巴人的检测和疫苗接种趋势，按卫生区域和部落委员会绘制这些结果的地理分布，并确定检测和疫苗接种的障碍，以为公共卫生策略提供信息。我们将从 2020 年 1 月开始跟踪大流行的进程，并每季度报告一次结果。
马尼托巴大学伦理审查委员会和我们的每个 FN/M/I 合作伙伴组织都已批准了伦理。我们的团队致力于进行真实的基于关系的研究，遵循第一民族、梅蒂斯和因纽特人的研究伦理原则。我们的 FN/M/I 合作伙伴将负责向其社区的领导层（卫生主任、社区卫生组织）和省级卫生部的决策者传播新信息。我们也将在开放获取期刊上发表文章。该研究将持续监测马尼托巴省的大流行应对情况，并确保最大限度地减少潜在的健康不平等，同时从其他可能无法获得详细行政数据的司法管辖区中获得学习经验。
