David Mykota

Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study

BackgroundCultural interventions offer the hope and promise of healing from addictions for Indigenous people.a However, there are few published studies specifically examining the type and impact of these interventions. Positioned within the Honouring Our Strengths: Culture as Intervention project, a scoping study was conducted to describe what is known about the characteristics of culture-based programs and to examine the outcomes collected and effects of these interventions on wellness.MethodsThis review followed established methods for scoping studies, including a final stage of consultation with stakeholders. The data search and extraction were also guided by the “PICO” (Patient/population, Intervention, Comparison, and Outcome) method, for which we defined each element, but did not require direct comparisons between treatment and control groups. Twelve databases from the scientific literature and 13 databases from the grey literature were searched up to October 26, 2012.ResultsThe search strategy yielded 4,518 articles. Nineteen studies were included from the United States (58%) and Canada (42%), that involved residential programs (58%), and all (100%) integrated Western and culture-based treatment services. Seventeen types of cultural interventions were found, with sweat lodge ceremonies the most commonly (68%) enacted. Study samples ranged from 11 to 2,685 clients. Just over half of studies involved quasi-experimental designs (53%). Most articles (90%) measured physical wellness, with fewer (37%) examining spiritual health. Results show benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies.ConclusionsEvidence from this scoping study suggests that the culture-based interventions used in addictions treatment for Indigenous people are beneficial to help improve client functioning in all areas of wellness. There is a need for well-designed studies to address the question of best relational or contextual fit of cultural practices given a particular place, time, and population group. Addiction researchers and treatment providers are encouraged to work together to make further inroads into expanding the study of culture-based interventions from multiple perspectives and locations.

Learner Characteristics as Predictors of Online Social Presence [Abstract]

In this study, the authors’ determined the individual learner characteristics of educators enrolled in online courses that influenced social presence (affective social communication). Findings reveal that the number of online courses taken, followed by computer‐mediated communication proficiency, are significant predictors of social presence. Recommendations for the effective use of online learning recognize that instructors must deliberately structure interaction patterns to overcome the potential lack of social presence of the medium. Similarly, quality instructional design and course development strategies need be incorporated with supportive pre‐course instructional activities provided to acquaint novice learners with online learning expectations. Cet article porte sur les experiences scolaires de jeunes africano‐canadiens. D’habitude, les chercheurs ont tendance a souligner le pietre rendement scolaire des eleves noirs ou les problemes relies a leur echec scolaire ou encore a les presenter de facon stereotypee comme des personnes bruyantes, paresseuses, portees a commettre des crimes, athletiques, demunies, dangereuses ou ayant un comportement deviant. Cet article decrit plutot des eleves noirs albertains qui reussissent bien leurs etudes en depit de conditions tres difficiles. Les donnees presentees indiquent que les facteurs comme le milieu familial et les encouragements des parents contribuent au succes scolaire.

Community Resilience Impact on Child and Youth Health Outcomes A Neighbourhood Case Study

In this study the authors investigated community resilience from the perspectives of well-defined, geographically bounded neighbourhoods and in relation to factors within them that may mediate, either positively or negatively, child and youth health outcomes. Three socially contrasting neighbourhoods with heterogeneous child health outcomes were selected for study. Within each neighbourhood, adults and 13- to 18-year-old youth were recruited for focus group interviews; in addition, key informants from the educational sector were included in the study. The results provide empirical support to a conceptual model of community resilience that integrates structural and process-related dualisms as well as risk and protective factors for child health. While presenting an integrated model of community resilience, the authors acknowledge the need for studies that further illuminate specific contributions of community and individual factors and their mechanisms in producing child and youth health outcomes.

Moderator Factors in First Nation Students at Risk for Psychosocial Problems.

In this study the authors sought to examine the determinants of psychological well-being and risk in First Nation students residing in their home community. The participant sample was drawn from students who resided in a First Nation community and were served by their tribal council in a central western province. All students, Grades 1 to 12, who were registered in a First Nation or provincial school were included. The results of the study indicate that, because academic performance continues to be such a strong predictor of psychosocial well-being, it underscores the importance of the school as an ameliorative factor in the prevention and treatment of behavioral problems. Given this finding, the authors recognize the significance of intervention as a preventive measure for all age groups and the responsibility of federal and provincial funding agencies to continue to make available appropriate educational resources to First Nation communities.

A scoping study of cultural interventions to treat addictions in Indigenous populations: methods, strategies and insights from a Two-Eyed Seeing approach

BackgroundThis paper describes the methods, strategies and insights gained from a scoping study using a “Two-Eyed Seeing” approach. An evolving technique, Two-Eyed Seeing respects and integrates the strengths of Indigenous knowledge and Western sciences, often “weaving back and forth” between the two worldviews. The scoping study was used to inform a tool for measuring the impact of culturally based addictions treatment services on wellness in Indigenous populations. It formed part of a three-year study, Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment. The scoping study identified and mapped literature on cultural interventions in addictions treatment, and described the nature, extent and gaps in literature.MethodsUsing a Two-Eyed Seeing approach, we adapted, applied and enhanced a common framework of scoping studies. In the end stage of the scoping review process, an Ad Hoc Review Group, led by our project Elder, reviewed and interpreted Indigenous and Western understandings within the mapped information. Elements of the scoping study were joined with results from community focus groups with staff at treatment centres.ResultsTwo-Eyed Seeing contributed differently at each stage of the scoping study. In early stages, it clarified team expertise and potential contributions. At the mid-point, it influenced our shift from a systematic to a scoping review. Near the end, it incorporated Western and Indigenous knowledge to interpret and synthesize evidence from multiple sources.ConclusionsThis paper adds to the collective work on augmenting the methodology of scoping studies. Despite the challenges of a Two-Eyed Seeing approach, it enables researchers using scoping studies to develop knowledge that is better able to translate into meaningful findings for Indigenous communities.

Honoring Indigenous culture-as-intervention: Development and validity of the Native Wellness AssessmentTM

ABSTRACT There is a need for Indigenous-centered research to appraise culture’s role in wellness. Researchers described the development and validity of the Native Wellness Assessment (NWATM). The NWA has culture-as-intervention at its apex. Wellness, culture, and cultural intervention practices (CIPs) are explored from an Indigenous perspective. Indigenous clients completed matching self-report and observer versions of the NWA at three time points during addictions treatment. Statistically and psychometrically, the NWA content and structure performed well, demonstrating that culture is an effective and fair intervention for Indigenous peoples with addictions. The NWA can inform Indigenous health and community-based programs and policy.

Implementing paraprofessional strength-based early intervention home visitations.

The purpose of the present study is to evaluate the implementation process for Parenting Plus, an early intervention program in a rural, western Canadian health district. Parenting Plus, as modeled after Hawaii Healthy Start, provides strength-based paraprofessional home visitations to overburdened parents of newborns. The general inductive approach guided the studies design and the methods used for data collection and analysis. Semi-structured in-depth interviews were conducted with health care practitioners and focus groups with program participants were held until theoretical saturation was achieved for both. Recommendations for policy and practice address the need for intersectoral involvement as crucial to a strength-based pilot projects success. Future research needs not only to look at the mode of service delivery but also, more importantly, at how the characteristics of the home visitor can effect change in the participant and what level of experience or education (paraprofessional or professional) is best suited to a particular client population.

Rural Canadian Youth Exposed to Physical Violence

Exposure to physical violence is an unfortunate reality for many Canadian youth as it is associated with numerous negative psychosocial effects. The study aims to assist in understanding resilience in rural Canadian youth exposed to physical violence. This is accomplished by identifying the importance of protective factors, as measured by the Resiliency Scale for Children and Adolescents (RSCA), and physical violence exposure, when used together, in predicting disruptive behavior, depression, and posttraumatic stress. Results indicate positive emotional reactivity is more important in protecting youth from developing psychological symptoms than sense of mastery and sense of relatedness. Differences between the effect of hearing reports, witnessing, and being victim to violence as well as differences between male and female youth were found. The study adds to the research on physical violence exposure, protective factors, and internalizing/externalizing problems in rural youth, with implications for implementing school-based programs.

Determinants of Psychosocial Disorders in Cultural Minority Children

What is culture? According to Miller (1993), culture is a shared way of looking at the world, a coherent framework of meaning in which individuals make their lives. It is a “social fact,” a collective or group property that individuals experience as both external and constraining. Culture marginalizes some ways of acting and legitimizes others; culture is not simply “our” way of experiencing the world, it is also the “right way.” It is a moral order, inculcating a moral commitment to “our way” in its members. The socialization process ensures that collective standards of conduct are internalized by members, that is, that society’s ways become “my” way (Miller, 1993).

Violence Exposure and Victimization Among Rural Adolescents

Violence exposure is a serious public health concern for adolescents in schools today. Violence exposure can be quite severe and frequent with multiple acts of indirect and direct victimization having lasting effects on the physical, emotional, and intellectual well-being of adolescents. The purpose of the present study is to examine the rates of violence exposure and the relative risk for multiple exposures among adolescent youth living in rural communities. Results confirm that adolescents who live in rural areas were frequent victims of violence exposure and that males were more likely to be the victims than females. Moreover, the relative risk for multiple exposures either indirectly, directly, or in combination reveal that in all instances amplification of risk occurs. The study is an important first step in understanding the rates of violence exposure and victimization experienced by adolescent youth in rural Canada with implications for school-based programming presented.