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CTN 302: Visioning Health II

Indigenous, participatory evaluation and assessment of a culturally-grounded and arts-informed intervention for HIV-positive Aboriginal women

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About the study (objectives)

Visioning Health II (VHII) is an intervention research study that builds on the results of Visioning Health (VHI), a community-driven research project undertaken by, for, and with Positive Aboriginal Women. VHI indicated that research, when done with attention to Indigenous knowledges, cultural traditions, and individual and collective strengths, can increase health among participants. The study takes a salutogenic approach—an approach focusing on health rather than illness—and incorporates the creation of artistic works as part of the process towards health and cultural connectedness. The aim of the study is to use the process, activities, and orientation to Indigenous knowledge used in VHI as a health promotion intervention aimed at optimizing the wellbeing of Positive Indigenous Women living in Canada. 

Background/context

While Visioning Health II aims to take a strengths-based approach, there is no denying that HIV and related social harms affect Indigenous women more than other populations. This inequality is fundamentally linked to the on-going and cumulative impact of colonization and the social inequities that have resulted. The effects are widely felt in the form of intergenerational or historical trauma, the interruption of traditional gender roles, and the devaluing of Indigenous women. This, in turn, has led to a host of social challenges within Indigenous communities, including trauma-induced mental illness, substance use, intimate partner violence, and sexual abuse. As a result, Indigenous women experience poorer health than non-Indigenous Canadians, and this holds true in the context of HIV.

Between 1998 and 2012, females represented 47.3% of all positive HIV tests among Indigenous peoples compared to 20.1% for the general population. Between 1979 and 2006, Indigenous women made up 26.5% of reported AIDS cases among Indigenous peoples compared to 9.1% for non- Indigenous  women. Positive Indigenous women are more likely than non-Indigenous women with HIV to be diagnosed and to initiate antiretroviral therapy (ART) at later stages; to test positive for HIV during prenatal testing; to start ART later in pregnancy; and to have shorter time to mortality.

To address these inequities in health and health access, Indigenous and allied scholars have highlighted the importance of timely access to gender sensitive and culturally relevant programs and services, including access to traditional medicines and ceremonies. They also highlight the importance of research that identifies individual and community-level health-promoting factors, including strengths and assets. Finally, they emphasize the critical importance of culturally grounded interventions and intervention research “to define the models of good practice that will enable our communities to achieve their goals of health equity.” VH II is designed to meet these criteria and test the effectiveness of the culturally grounded VH intervention on the wellness of positive Indigenous women living in different regions of Canada.

Study Approach (methodology)

The VH II research design is structured around the ‘nesting’ concept in which a descriptive research study is embedded within an intervention research study and each of the research sites provides data for both. Specifically, VHII will gather qualitative data from Positive Indigenous Women about health, gender, and culture using culturally-grounded and arts-informed methods, while using both qualitative and quantitative methods to assess the implementation and potential health outcomes of VH as an intervention. Due to geographic dispersion and in order to ensure close partnership with local Aboriginal AIDS service organizations and to fully engage participants, a Community Research Coordinator, a Positive Indigenous Woman Mentor, and an Elder or Traditional Knowledge Keeper will support activities in each regional site. A National Coordinator and a Post-Doctoral Fellow, with assistance from a Research Assistant, will oversee and ensure continuity across sites, supported by the Working Team (Loppie, Masching, Peltier and Prentice) and a National Knowledge Keeper (Wanda Whitebird), who will receive direction from a PAW Council.

Eligibility criteria

  • HIV-positive Indigenous women (including two-spirit and transwomen)
  • 18 years old or older
  • Speak and understand English

Additional Information

If you have any questions about your rights as a research participant, you can contact the Human Research Ethics Office at the University of Victoria, ph. 250-472-4545 or email ethics@uvic.ca.

If you have any questions or comments about this study, you can contact Charlotte Loppie, Faculty, HSD School of Public Health and Social Policy, University of Victoria, at 250-472-5450 OR Renée Masching, Canadian Aboriginal AIDS Network, at 902.433.0900 or reneem@caan.ca.

Participating Sites

British Columbia
Red Road HIV/AIDS Network

Alberta
Shining Mountain Living Community Services

Saskatchewan
All Nations Hope Network
Circle of Courage

Manitoba
Ka Ni Kanichihk Inc. (Aboriginal Women Responding
to the AIDS Crisis in Manitoba)

Ontario
PACE (People Advocating for Change)
Oahas

Quebec
Native Women’s Shelter of Montreal

Atlantic Canada
Healing Our Nation

 

Principal Investigators

Charlotte Loppie
University of Victoria
Professor – School of Public Health and Social Policy, Human and Social Development
University of Victoria
PO Box 1700, STN CSC, Victoria, BC V8W 2Y2
Tel: 250-472-5451
Email: loppie@uvic.ca

Doris Peltier
Canadian Aboriginal AIDS Network
National Coordinator – Visioning Health II, 113 – 154 Willowdale Drive, Dartmouth, NS, B2V 2W4
Tel: (450) 672-8753
Email: dorpeltier@yahoo.ca

Tracey Prentice
University of Victoria Postdoctoral Fellow – School of Public Health and Social Policy, Human and Social Development
University of Victoria
PO Box 1700, STN CSC, Victoria, BC V8W 2Y2
Tel: 613-745-6517
Email: tracey.prentice@gmail.com

Renee Masching
Canadian Aboriginal AIDS Network
Director of Research & Policy – 113 – 154 Willowdale Drive, Dartmouth, NS B2V 2W4
Tel: (902) 433-0900
Email: ReneeM@caan.ca

Catherine Worthington
University of Victoria
Associate Professor
School of Public Health and Social Policy, B202e, Human and Social Development University of Victoria
PO Box 1700, STN CSC, Victoria, BC V8W 2Y2
Tel: 250-472-4709
Email: worthing@uvic.ca

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