Kennedy Andrea, Sehgal Anika, Szabo Joanna, McGowan Katharine, Lindstrom Gabrielle, Roach Pamela, Crowshoe Lynden Lindsay, Barnabe Cheryl
Faculty of Health, Community and Education, Mount Royal University, Calgary, AB, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Health Educ J. 2022 Jun;81(4):423-438. doi: 10.1177/00178969221088921. Epub 2022 Apr 7.
A strengths-based lens is essential for the pursuit of health equity among Indigenous populations. However, health professionals are often taught and supported in practice via deficit-based approaches that perpetuate inequity for Indigenous peoples. Deficit narratives in healthcare and health education are reproduced through practices and policies that ignore Indigenous strengths, disregard human rights, and reproduce structural inequalities. When strengths are recognised it is possible to build capacities and address challenges, while not losing sight of the structural factors impacting Indigenous peoples' health.
In this paper, we examine Indigenous strengths-based approaches to policy and practice in healthcare and health professions education when delivered alongside teachings shared by Elders from the Cree, Blackfoot and Métis Nations of Alberta, Canada.
Literature and Elders' teachings were used to shift strengths-based approaches from Western descriptions of what might be done, to concrete actions aligned with Indigenous ways.
Four pointers for future action adopting a strengths-based approach are identified: enacting gifts - focusing on positive attributes; upholding relationality - centring good relationships; honouring legacy - restoring self-determination; and reconciling truth - attending to structural determinants of health.
Identified directions and actionable strategies offer a promising means to advance Indigenous health equity through strengths-based actions that change existing narratives and advance health equity.
基于优势的视角对于在原住民群体中追求健康公平至关重要。然而，医疗专业人员在实践中常常通过基于缺陷的方法来接受教导和获得支持，这种方法使原住民长期处于不平等状态。医疗保健和健康教育中的缺陷性叙述通过忽视原住民优势、无视人权并重现结构性不平等的实践和政策得以延续。当优势得到认可时，就有可能建设能力并应对挑战，同时不忽视影响原住民健康的结构性因素。
在本文中，我们研究了在与加拿大阿尔伯塔省克里族、黑脚族和梅蒂斯族长老分享的教义一同传授时，医疗保健和卫生专业教育中基于原住民优势的政策和实践方法。
利用文献和长老的教义，将基于优势的方法从西方对可能采取措施的描述转变为与原住民方式相一致的具体行动。
确定了采用基于优势方法的未来行动的四个要点：发挥天赋——关注积极属性；维护关系性——以良好关系为核心；尊重遗产——恢复自决权；调和真相——关注健康的结构性决定因素。
确定的方向和可采取行动的策略提供了一种有前景的手段，通过基于优势的行动来推进原住民健康公平，这些行动改变现有叙述并促进健康公平。
