Imagining Indigenized Futures: Multi-Eyed Seeing and Decolonialism in Integrative Health Equity.

BACKGROUND

Integrative health efforts typically offer clinical services of Western and non-Western origin in a biomedical context. Indigenous communities and other minoritized populations would benefit from improved equity efforts in integrative healthcare.

OBJECTIVE

As an approach to improve healthcare for Kānaka 'Ōiwi (Native Hawaiians), we explore multi-eyed seeing, an elaboration on two-eyed seeing, emphasizing decolonialism and adaptive use of healing traditions from multiple cultural backgrounds. We also discuss the ways multi-eyed seeing may be used to address challenges to integrative health inequities.

METHODS

Using the transformative paradigm and community-based participatory action research, we conducted 1 focus group and 38 in-depth interviews. Data were analyzed using grounded theory, a decolonial intersectionality method, ho'omana i nā leo (empowering the voices), and thematic analysis. To triangulate data, recruitment targeted 3 categories: mental and behavioral health providers who primarily serve Kānaka 'Ōiwi (n = 12), Kanaka 'Ōiwi clients who experienced depressive symptoms (n = 19), and Kanaka 'Ōiwi cultural leaders (n = 10).

RESULTS

Three primary themes emerged, suggesting that multi-eyed seeing: 1) supports Indigenous wellbeing at multiple levels; 2) necessitates unique spaces for healthcare and healing; 3) may illuminate similarities across cultures and underlying mechanisms for healing and health. Findings also include 2 secondary themes, 1 describing the potential role of multi-eyed seeing in idiographic and transdiagnostic approaches to behavioral and integrative healthcare and another describing potential barriers to multi-eyed seeing.

CONCLUSIONS

By drawing upon strengths of Indigenous, Western, Eastern, and other pathways to wellbeing, a synergistic weaving may be stronger than the sum of its parts. At the levels of ontology, epistemology, axiology, and praxis, multi-eyed seeing provides approaches to equity in integrative healthcare. We offer critical reflections and analyses of the processes that may uplift the work of multi-eyed seeing as a decolonial approach and invite dialogue around this concept for future exploration.