Koscielniak Andrew, Zur Nedden Natalie, Shergill Yaadwinder, Trudeau-Magiskan Teresa, Read Marinna, Benson Alycia, Ray Lana, Smith Andrew, McEwen Virginia, Francis Paul, Falcigno Alex, Drawson Tyler, Furlan Andrea, Mushquash Christopher, Poulin Patricia A
Indigenous Health, N'doo'owe Binesi, St. Joseph's Care Group, Thunder Bay, Canada.
Department of Anesthesiology & Pain Medicine, Ottawa Hospital Research Institute, Ottawa, Canada.
Can J Pain. 2025 Apr 4;8(2):2469213. doi: 10.1080/24740527.2025.2469213. eCollection 2024.
Indigenous Peoples in Canada experience health disparities, including higher rates of chronic pain. Many report distrust of the health system due to factors such as racial discrimination. A lack of appreciation and respect for Indigenous knowledges further contributes to feelings of alienation. In 2022-2023, we offered the first Project Extension for Community Healthcare Outcomes (Project ECHO) Indigenous Chronic Pain and Substance Use Health (ICP&SU) to health care providers interested in improving chronic pain care with and for Indigenous Peoples in Canada. The program reflects a Two-Eyed Seeing approach weaving together Indigenous and Western approaches to chronic pain and substance use health care.
We describe the development and implementation of Project ECHO ICP&SU.
Following guidance from the project Elder, we use storytelling, centered around the metaphor of weaving, to discuss the conception and implementation of Project ECHO ICP&SU. We also describe our engagement in sharing circles and ceremonies to share stories, knowledges, and lessons learned.
With strong Anishinaabe leadership, the program was implemented as intended and reached 121 health care professionals. Lessons learned included an overt recognition of the influence of different structures and institutions on programs and for a culturally safer development and evaluation frameworks for future Project ECHOs to improve care with and for Indigenous Peoples.
Project ECHO can be a vehicle to enact Truth and Reconciliation Calls to Action through weaving relationships and knowledges to create culturally safer institutions and practices to improve chronic pain, substance use health, and wellness, with and for Indigenous Peoples.
加拿大的原住民面临健康差距,包括慢性疼痛发生率较高。许多人报告称,由于种族歧视等因素,他们不信任医疗系统。对原住民知识缺乏欣赏和尊重进一步加剧了疏离感。在2022 - 2023年,我们为有兴趣改善加拿大原住民慢性疼痛护理的医疗服务提供者提供了首个社区医疗成果项目拓展计划(ECHO项目)——原住民慢性疼痛与物质使用健康项目(ICP&SU)。该项目体现了一种双重视角的方法,将原住民和西方的慢性疼痛及物质使用医疗方法交织在一起。
我们描述ECHO项目ICP&SU的开发与实施情况。
在项目长者的指导下,我们以编织的隐喻为中心,通过讲故事来讨论ECHO项目ICP&SU的构想与实施。我们还描述了我们参与分享圈和仪式以分享故事、知识和经验教训的情况。
在强大的阿尼什纳abe领导力下,该项目按计划实施,覆盖了121名医疗专业人员。吸取的经验教训包括明确认识到不同结构和机构对项目的影响,以及为未来的ECHO项目建立一个文化上更安全的发展和评估框架,以改善对原住民的护理。
ECHO项目可以成为一个载体,通过编织关系和知识来创建文化上更安全的机构和实践,以改善原住民的慢性疼痛、物质使用健康和整体健康状况,从而落实真相与和解行动呼吁。