Commemorative Report 2000-2008

Table of Contents

1.0 Message from the CIHR-IAPH Scientific Director
2.0 Profiles: CIHR and CIHR-IAPH
3.0 Advances in Health Knowledge

• 3.1 Open Research
• 3.2 Strategic Priority Research

4.0 People and Research Capacity

• 4.1 Researchers and Trainees
• 4.2 Research Resources and Collaboration
• 4.3 National and International Partnerships
• 4.4 Ethical, Legal and Social Issues

5.0 Knowledge Translation and Commercialization
6.0 Organizational Excellence

• 6.1 Institute Advisory Board
• 6.2 Staff
• 6.3 Institute Accountability

7.0 CIHR Investments in Aboriginal Health 2000-2008

CIHR is a federal agency reporting to Parliament through the Minister of Health. It was created by an Act of Parliament in June 2000 (48-49 Elizabeth II, C.6)

For further information, please contact:

Canadian Institutes of Health Research

160 Elgin Street, 9th Floor
Ottawa, Ontario K1A 0W9
Telephone: 613-941-2672
Fax: 613-954-1800
Toll Free: 1-888-603-4178
Email: info@cihr-irsc.gc.ca
Website: CIHR Website
CIHR-IAPH Website

Also available on the Web in PDF and HTML formats
© Her Majesty the Queen in Right of Canada (2008)

Catalogue No. MR21-126/2008e
ISBN 978-0-662-48911-5

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1.0 Message from the CIHR-IAPH Scientific Director

Reflecting back over the past eight years, from 2000 to 2008, the Canadian Institutes of Health Research - Institute of Aboriginal Peoples' Health (CIHR-IAPH) has made significant inroads into Aboriginal health research through its unique community-based, participatory, inter-disciplinary, and multi-pillar approach. I invite you to read this Commemorative Report as it highlights some remarkable achievements.

CIHR-IAPH was created through the CIHR Act of June 2000 and is one of 13 founding institutes of CIHR. It was the first national health research institute established in Canada dedicated solely to improving the health and well-being of Aboriginal peoples that includes First Nations, Inuit and Métis populations. In fact, CIHR-IAPH can lay claim to being the only federal health research institute of its kind in the world.

The need is urgent for this type of targeted health research institute. The health status of Aboriginal people, one of the fastest growing populations in Canada, continues to be significantly lower than other Canadians. Aboriginal people are more likely than other Canadians to have hearing, sight and speech disabilities. Aboriginal people experience significantly higher rates of diabetes and other diseases than other Canadians. Aboriginal people have a life expectancy that is six to eight years less than others. The pervasive gap in health status is unacceptable and has an impact on all other sectors in society, including social and economic.

Although much is known that helps explain the health gaps between Aboriginal and non-Aboriginal people, such as historical, socio-economic and cultural factors, more work is needed to fully understand the disparities. This is where CIHR-IAPH has stepped up to the challenge and along the way, has been guided by a series of five strategic priorities or directions.

One of its priorities has been to build capacity and infrastructure in Aboriginal health research. In Canada, the Institute has supported capacity building through several initiatives, particularly via the ACADRE (Aboriginal Capacity and Developmental Research Environments) and its successor, NEAHR (Network Environments for Aboriginal Health Research) programs. Both have contributed to the tremendous depth and breadth of health research completed or underway. Equally important, these initiatives support new researchers who are vital to the continued growth and development of the sector - after all, today's trainees are tomorrow's innovators.

It is recognized that new knowledge is generated more quickly through partnerships and information sharing. That said, one of the Institute's strategic priorities has been to develop partnerships to advance Aboriginal health research. In Canada, CIHR-IAPH has collaborated with a diverse range of non-profit and public organizations and has supported workshops, symposia and conferences related to Aboriginal health. In the global arena of indigenous health research, CIHR-IAPH is considered a leader. Partnering with health research organizations in countries such as Australia, New Zealand, Mexico and the United States and sharing knowledge with various bodies in many other countries including those in the circumpolar region (e.g., Greenland, Denmark and Norway), has had a positive impact on the quality and quantity of health research initiatives undertaken to improve the health status of indigenous populations.

Ensuring inclusion and recognition of Aboriginal values and cultures in health research has underpinned all CIHR-IAPH activities and is a strategic priority. This has led to the development of the CIHR Guidelines for Health Research Involving Aboriginal People -- a landmark document that ensures Aboriginal people are engaged fully as partners in research. This means all CIHR funded researchers must consider Aboriginal traditions, cultures and values as they conduct their work -- a practice that was not always followed in the past. The Guidelines came into force in July 2008.

Resolving critical health issues is another strategic priority for CIHR-IAPH. Although a long list of specific health conditions or diseases has been identified, the Institute recognizes that poverty is the driver of many of these conditions. In addition to focusing on specific diseases in the areas of communicable disease, chronic disease, mental health, children and youth health service issues, CIHR-IAPH is also focusing on health determinants and looking at effective intervention strategies. A further challenge is dealing with misconceptions and biases about Aboriginal people that have an impact on access to quality health care, treatment and health outcomes.

Inroads have been made by CIHR-IAPH in the area of knowledge translation, the fifth and final strategic priority. Essentially, knowledge translation occurs when knowledge is acquired through targeted research initiatives and is translated into policy and practice to benefit First Nations, Inuit, and Métis peoples across Canada. CIHR-IAPH has sponsored and attended conferences on knowledge translation, while many of its initiatives such as the ACADRE and NEAHR programs have imbedded knowledge translation strategies into their work plans. Formalizing the Institute's current and proposed knowledge translation activities into a comprehensive strategy is under review.

More details on the goals and implementation plans for these five strategic priorities can be accessed in our Five-Year Strategic Plan: 2006-2011.

The Institute's achievements identified above and many others not mentioned here were not completed in isolation. The CIHR-IAPH Institute Advisory Board has been and continues to be an indispensible and integral part of the organization. Board members have given generously of their time and expertise over the years. In addition, unwavering support from CIHR and a dedicated team of CIHR-IAPH staff have contributed to the success and stellar reputation of CIHR-IAPH at home and abroad.

I would like to take this opportunity to recognize and specially thank our Associate Director, Mr. Earl Nowgesic, RN, BScN, MHSc, for his commitment to CIHR-IAPH. From the very beginning, Mr. Nowgesic has contributed significantly to the strategic direction of CIHR-IAPH as well as managed the day to day operation of the Institute with integrity and thoroughness. Mr. Nowgesic has been an indispensable asset to this organization and its success over the past eight years.

And finally, I would like to extend my best wishes to the incoming Scientific Director and the new team that will take CIHR-IAPH to the next stage of development in Aboriginal health research. The future holds dynamic possibilities.

All my relations,

Jeff Reading, MSc, PhD, FCAHS
Scientific Director

Jeff Reading, MSc, PhD, FCAHS Scientific Director	Earl Nowgesic, RN, BScN, MHSc Associate Director
John O'Neil, BA, MA, PhD Chair, Institute Advisory Board 2000-2005	Malcolm King, PhD Chair, Institute Advisory Board 2005-2008

2.0 Profiles

Canadian Institutes of Health Research

Created by an Act of Parliament in June 2000 (48-49 Elizabeth II, C.6), the Canadian Institutes of Health Research (CIHR) is a federal agency reporting to Parliament through the Minister of Health.

CIHR is Canada's health research funding agency and supports the work of more than 11,000 researchers and trainees in universities, teaching hospitals, and research institutes across Canada within the four CIHR pillars of research: biomedical, clinical, health systems and services, and population health. Its mandate is to "excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system."

There are 13 health research institutes under the CIHR umbrella with each one focused on a particular area of health research: for example, aging, cancer, genetics, infection and immunity, and Aboriginal health.

CIHR strives to achieve strategic outcomes in three broad areas:

1. advances in health knowledge;
2. people and research capacity; and
3. knowledge translation and commercialization.

To achieve success in these areas, CIHR promotes a problem-based, multidisciplinary and collaborative approach to resolving health challenges facing Canadians.

One of the primary goals of CIHR is to improve the health status of vulnerable populations. This includes Aboriginal peoples, Canadians living in poverty, residents of northern and rural areas, immigrants and refugees, and the homeless. Children, the disabled and chronically ill, the mentally ill, seniors, those facing gender inequities, and victims of violence are also among the vulnerable.

CIHR - Institute of Aboriginal Peoples' Health

For almost a decade, the CIHR - Institute of Aboriginal Peoples' Health (CIHR-IAPH) has been tirelessly pursuing its goal to improve the health of Aboriginal people across Canada and globally.

The idea for establishing an institute dedicated solely to Aboriginal heath research emerged in 1999 and was developed by several Aboriginal stakeholder groups and individuals. They recognized the need for rigorous, evidence-based research that would not only serve to improve the physical, emotional, mental and spiritual health of Aboriginal people but would also engage them and respect their cultures and ways of knowing. The team of researchers also believed a dedicated institute would be an ideal vehicle to build capacity in Aboriginal health research.

CIHR was subsequently approached with a proposal to set up an institute dedicated to Aboriginal health research and in December 2000, CIHR-IAPH was launched. The Institute was the first of its kind in Canada and abroad to focus solely on Aboriginal health research. Since then, CIHR-IAPH has been instrumental in the development of several innovations - in particular, the establishment of a national network of Aboriginal health research centres, and the development and adoption of the CIHR Guidelines for Health Research Involving Aboriginal People. This was a seminal event. According to CIHR, "these guidelines offer the kind of safeguards that have long been missing for Aboriginal people participating in research."

The Institute's goal to build capacity in Aboriginal health research has been consistently gaining momentum. More than 300 new health researchers and research trainees at the undergraduate, graduate, doctoral and postdoctoral levels in Canada have been nurtured by the Institute, which has also provided continuous support for those already established. Moreover, collaborations with Aboriginal health researchers around the world have served to improve the physical and spiritual well-being of indigenous people globally.

Since its inception, CIHR-IAPH has recognized the importance of communicating with Aboriginal communities in ways that are respectful and informative. In fact, it has placed even greater weight to this activity in its second strategic plan covering the years 2006 to 2011. By building greater awareness of health research results and helping communities translate these findings into action, our knowledge of Aboriginal health and resilience has grown, and will continue to do so over the coming years among First Nations, Inuit and Métis populations.

CIHR-IAPH is grateful to its Institute Advisory Board, sometimes referred to as the "dream team," for sharing its expertise and providing direction over the past eight years and to its committed staff.

With a solid foundation from which to grow, the Institute looks forward to tackling challenges and seizing opportunities that lie ahead. CIHR-IAPH will continue building an advanced research agenda and pursuing its strategic directions in partnership with many stakeholder groups including Aboriginal communities and organizations, other health-based organizations, health researchers, postsecondary institutions, grassroots agencies, and multiple levels of government in Canada and abroad.

CIHR-IAPH public launch, October 2001, Toronto. Left to right: Dr. John O’Neil; the Honourable Allan Rock, former Federal Minister of Health; Dr. Jeff Reading.

Guiding Philosophies

CIHR-IAPH is guided in its goal to improve the health of Aboriginal people across Canada by core values that respect and engage Aboriginal communities and cultures. This goal was in the forefront of its first strategic plan covering the years 2002 to 2007 and was renewed and strengthened in its second five-year strategic plan, covering the years 2006 to 2011. With the completion of its second plan, the Institute noted, "insights and experiences gained over the last five years have led to a more focused vision and clearer articulation of [our] mission and values."

CIHR-IAPH Scientific Director Dr. Jeff Reading remarked, "In setting the course for the next five years, CIHR-IAPH has renewed its commitment to building research capacity and infrastructure in Aboriginal health research... CIHR-IAPH is well positioned to build on its achievements and work together with Aboriginal health researchers, trainees, national Aboriginal leadership and communities and governments to implement the strategic plan."

As articulated in its current strategic plan, below are the Institute's mandate, vision, mission, values, strategic priorities and directions that will guide it over the coming years.

Mandate

CIHR-IAPH supports health research that addresses the special health needs of Aboriginal peoples in Canada.

Vision

CIHR-IAPH will improve the health of First Nations, Inuit and Métis people through the assertion of Aboriginal understandings of health and by fostering innovative community-based and scientifically excellent research.

Mission

CIHR-IAPH will play a lead role in increasing the productivity and impact of Aboriginal health research by advancing capacity and infrastructure in the First Nations, Inuit and Métis communities, enhancing knowledge translation and forging partnerships with diverse communities and organizations at the regional, national and international levels.

Values

• Respect for Aboriginal peoples and traditional knowledge
• Promotion of community-based and highest-quality scientific research
• High ethical standards in approach to and conduct of research with Aboriginal peoples
• Inclusiveness, trust and openness in our work
• Partnership and collaboration

Strategic Priorities

1. Develop strategic regional, national and international partnerships to advance Aboriginal health research;
2. ensure inclusion and recognition of Aboriginal values and cultures in health research;
3. enhance capacity and infrastructure to advance Aboriginal health research;
4. resolve critical Aboriginal health issues; and
5. facilitate and evaluate translation of Aboriginal health knowledge into policy and practice.

Strategic Directions

The strategic directions guiding CIHR-IAPH have remained constant over the past eight years. But under the new five-year strategic plan for 2006-2011, a fifth was added addressing knowledge translation, while the remaining four were sharpened. "CIHR-IAPH has confirmed five strategic directions which are inextricably intertwined and together are seen as integral to advancing Aboriginal peoples' health through an advanced heath research agenda," the plan states.

Priority 1 - Develop strategic regional, national and international partnerships to advance Aboriginal health research.
Advance CIHR-IAPH's mandate by building upon established and creating new partnerships at the regional, national and international levels. The development of diverse strategic alliances with health and research organizations and governments is integral to sharing resources, brainpower and infrastructures.

Priority 2 - Ensure inclusion and recognition of Aboriginal values and cultures in health research.
Fund and promote scientifically excellent research that is grounded in Aboriginal conceptual models. Guide the development and implementation of Aboriginal health research ethical guidelines nationally.

Priority 3 - Enhance capacity and infrastructure to advance Aboriginal health research.
Develop, sustain and evolve a national network of Aboriginal health research centres. Advance research capacity through targeted funding for a new generation of investigators in Aboriginal health research.

Priority 4 - Resolve critical Aboriginal health issues.
Fund initiatives that use a health-determinants approach to identify and address priority health issues for Aboriginal peoples, working collaboratively at the regional, national and international levels.

Priority 5 - Facilitate and evaluate translation of Aboriginal health research into policy and practice.
Collaborate and partner with Aboriginal communities, researchers, key organizations and governments to facilitate development of an advanced knowledge translation agenda that incorporates Aboriginal knowledge, community-based principles and scientific research.

Over the past eight years, the Institute's mandate, vision, mission, values and strategic priorities and directions have provided a solid foundation from which to move forward. These guiding philosophies will continue propelling the Institute onward in its future growth and development.

3.0 Advances in Health Knowledge

The Role of CIHR

The vision of CIHR is to strengthen health research communities across Canada in many different disciplines and specialties. At the heart of its vision are the contributions of dedicated health research individuals: 70% of research funding awarded by CIHR is investigator driven (open competitions). Each application is peer reviewed on its scientific merit and the top ranked applications are funded regardless of which area they represent in science.

The remaining 30% is allocated for strategic research priorities, which are developed by its 13 institutes and CIHR offices, and targeted to address major health challenges. The CIHR Governing Council delegates financial authority to each Institute for managing a portion of these funds through two mechanisms:

• Institute Strategic Research Priorities: Each institute is allocated funds annually to support strategic health research in its respective area by awarding peer-reviewed grants and awards.
• Institute Support Grant: Each institute receives a support grant of $1 million annually to operate and to develop research capacity in the scientific community it represents through a wide variety of collaborative activities.

Researchers can compete for grants and awards from both the funding pool for open, investigator-initiated programs of CIHR and the Strategic Initiatives Program linked to each Institute. In this case, CIHR-IAPH.

3.1 CIHR Investigator Initiated Open Competition

Highlights

CIHR has funded a wide range of multi-year projects lasting anywhere from two to eight years in Aboriginal health research. Awards range from less than $100,000 to more than $1 million, depending on the scope of the initiatives.

Many of the applications for funding have been and continue to be reviewed by the CIHR Peer Review Committee in Aboriginal Peoples' Health, which was established in 2004-2005. It reviews applications against a set of stringent criteria with an emphasis on the integration of community-based and advanced health research methods, multi-sector partnerships, participatory research and indigenous methodologies. Investigations are also encouraged that contribute to capacity building for the advanced health research community and Aboriginal populations.

As per its mandate, the committee considers the following types of research: disciplinary and interdisciplinary approaches to Aboriginal health; Aboriginal health services, policy development and knowledge translation; Aboriginal world views of health and well-being that includes balancing mental, physical, spiritual and emotional aspects; and exploration of indigenous knowledge, traditional medicine and spiritual health. Also considered is research in the areas of ethical, cultural, mental, physical, social, psychological, spiritual, environmental, genetic determinants and/or aspects of illness and wellness in Aboriginal populations.

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CIHR Aboriginal Peoples' Health Peer Review Committee Membership 2004-2007*

The CIHR Aboriginal Peoples' Health Peer Review Committee was created in 2004 as a permanent standing peer review committee to review applications in Aboriginal health research.

The committee members for competitions from 2004-2007* included:

Valerie Gideon, PhD (Chair)*
Assembly of First Nations

David Newhouse, PhD (Scientific Officer)*
Trent University

Neil Andersson, MD, MPhil (Invitee, 2005-2006)
CIETcanada, Ottawa

Laura Arbour, MD*
University of British Columbia

Cheryl Bartlett, PhD
University College of Cape Breton

Annette Browne, RN, PhD*
University of British Columbia

Sharon Bruce, PhD
University of Manitoba

Lorne Stanley Clearsky, MD*
University of Manitoba

Christopher Fletcher, PhD
University of Alberta

Christopher Furgal, PhD*
Université Laval

Katherine Gray-Donald, PhD
McGill University

Marcia Hills, RN, PhD
University of Victoria

Bonnie Jeffrey, PhD
University of Regina

Harriet Kuhnlein, RN, PhD
McGill University

Roderick Michael McCormick, PhD*
University of British Columbia

Gina Muckle, PhD (Invitee, 2005-2006)
Université Laval

Cora Voyageur, PhD
University of Calgary

Dennis Wardman, MD
Health Canada, First Nations and Inuit Health Branch

Cora Weber-Pillwax, PhD
University of Alberta

Cornelia Wieman, MD
University of Toronto

Noreen D. Willows, PhD (Invitee - 2005-2006)
University of Alberta

Kue Young, MD, DPhil
University of Toronto

*Members of fall 2007 Peer Review Committee - Aboriginal Peoples’ Health

Professional affiliations of the members are shown as current to their term. Some invitees for specific competitions are not included in this list.

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The following table of selected CIHR-sponsored Aboriginal health research projects demonstrates a commitment to support research that not only contributes to improving the health and well-being of Aboriginal communities but also to building capacity in the health research sector.

Study Title	Duration	Amount*
The Sandy Lake health and diabetes project: Understanding and addressing metabolic syndrome, diabetes and associated complications in Aboriginal Canadians	2001-2002 to 2008-2009	$1.6 million
MCRP, lipid oxidation and homocysteine as risk factors for diabetes, vascular disease and complications among Aboriginal Canadians	2002-2003 to 2004-2005	$160,000
Access issues for Aboriginal people seeking primary care services in an urban centre	2003-2004 to 2006-2007	$246,000
Inuit health in transition study	2004-2005 to 2006-2007	$210,000
Early identification of rheumatoid arthritis in Canadian First Nations	2005-2006 to 2008-2009	$404,000
The social environment and the health of First Nations women and men	2005-2006 to 2008-2009	$256,000
Completing the circle: End of life health care with Aboriginal families	2005-2006 to 2008-2009	$209,000
The determinants of tuberculosis transmission in the Canadian-born population of the prairie provinces	2005-2006 to 2008-2009	$501,000
Health and wellness in Saddle Lake First Nation: Promoting self-care for the prevention and treatment of diabetes and kidney failure	2006-2007 to 2008-2009	$113,000
From risk factors to culturally sensitive interventions: A programmatic approach to Aboriginal suicide	2006-2007 to 2008-2009	$478,000
Community led reduction of domestic violence in Aboriginal communities: Rebuilding from resilience	2007-2008 to 2008-2009	$676,000
Leaving for the city: An assessment of cultural, social, health and economic dimensions of Manitoba First Nations relocating to urban centres to access medical care	2007-2008 to 2008-2009	$97,000
Progression and management of chronic kidney disease among First Nations people	2008-2009	$76,000

* The amounts are rounded.

3.2 CIHR-IAPH Strategic Priority Research

The Role of CIHR-IAPH

CIHR-IAPH actively participates in the CIHR Strategic Priority Research initiative and through this funding envelop has supported a diversity of activities over the years. When determining which applications to fund, CIHR-IAPH is guided by its philosophies, as outlined in the previous section of this report. It is also guided by the highest standards -- all research proposals must meet rigorous international scientific standards of excellence -- as demonstrated by the highlights listed below.

Highlights

 

• CIHR-IAPH funded the first ever Survey Research Centre for Aboriginal Health based in Winnipeg, Manitoba in 2001-2002. Producing data that is culturally relevant, statistically valid, and comparable continues to be the centre's main goals. All surveys reflect distinct Aboriginal social and cultural realities and are respectful of Aboriginal principles around data and research governance -- ownership, control, access and possession.
• A global health research initiative was funded by CIHR-IAPH in 2002-2003 involving several key players including CIHR, six other CIHR institutes, the Canadian International Development Agency, Health Canada, and the International Development Research Centre. Jointly, they supported an international team of researchers from Greenland/Denmark, the United States, Russia and Canada that was granted funds for a long-term research program designed to improve the health of Inuit people.
• As one of the first federal research granting agencies in Canada to fund community-based research projects, CIHR-IAPH supported six community based research initiatives in 2003-2004 across the country. The Institute also funded nine new scholars in Aboriginal health research who conducted studies in a variety of areas including intergenerational trauma of First Nations Peoples and the health effects of mould exposure in Aboriginal housing in British Columbia. Two senior research fellows were granted funds to conduct research into the history of Aboriginal health and medicine.
  
  In the same year, three principal investigators were awarded funds for their comparative studies which explored global health issues impacting indigenous people in other parts of the world including Australia and New Zealand. Research initiatives to examine obesity and end-of-life care (palliative) were also awarded funding. In partnership with two other CIHR institutes, CIHR-IAPH funded two separate projects: one was designed to assess the role of individual, workplace and community social supports, while the other explored health issues of marginalized Canadians using a transdisciplinary approach.
• The Aboriginal Peoples' Health Peer Review Committee was established in 2004-2005 to ensure Aboriginal health research is approached as a unique research area requiring specialized expertise. Another six community based research projects were funded by CHIR-IAPH, while five new scholars were awarded opportunities in Aboriginal health research. In partnership with the CIHR Institute of Population and Public Health, CIHR-IAPH supported a global study examining indicators for health promotion with indigenous peoples.
• CIHR-IAPH continued supporting research in 2005-2006 characterized as multi-pillar, inter-disciplinary and participatory at the community level. Several new research opportunities were provided to emerging Aboriginal health research scholars. The 20-member Aboriginal Peoples' Health Peer Review Committee was actively engaged in reviewing applications from CIHR-IAPH Strategic Initiatives and CIHR open competitions.
• In 2006-2007, CIHR-IAPH funded 20 new research projects and awards via competitions in six broad categories including:
  1. new researchers in Aboriginal health;
  2. Aboriginal community-based research;
  3. Aboriginal health and human resources in community-based research;
  4. CIHR open competition;
  5. CIHR fellowship awards; and
  6. suicide prevention targeting Aboriginal people.
  Additionally, CIHR supported two key Aboriginal health research projects: one on eating as a social practice and the other on tuberculosis.
• In 2007-2008, CIHR-IAPH awarded an operating grant to researchers at the University of Ottawa for a two-year study in Aboriginal women's health, titled Improving access to preventive early childhood services for urban Aboriginal families: A participatory research study. The Institute, in partnership with the Assembly of First Nations, the First Nations Information Governance Committee and the CIHR Institute of Human Development and Child and Youth Health, awarded operating grants to two research teams to analyze data from the First Nations Regional Longitudinal Health Survey. The research teams set out to explore the prevalence of asthma in Aboriginal communities and the health of First Nations infants and possible related impacts on families and communities. CHIR-IAPH continued partnering with other lead CIHR institutes by providing support for research in the areas of cancer, arthritis and HIV/AIDS.

4.0 People and Research Capacity

One of the cornerstones of both CIHR and CIHR-IAPH is capacity building. Over the past eight years, CIHR has increased its investments in capacity building for all 13 health research institutes under its mandate, leading to a significant rise in the number of health researchers granted funding for their peer-reviewed proposals. Canadians across the country are benefiting from the knowledge acquired through these initiatives.

Aboriginal health research is an important part of this trend, due, in large part, to the efforts of CIHR-IAPH and its advanced health research agenda. The Institute has proudly mentored increasing numbers of Aboriginal health researchers by providing opportunities for more than 300 new scholars and trainees at the undergraduate, graduate, doctoral and postdoctoral levels. CIHR-IAPH has also demonstrated consistent support for several established researchers (refer to Section 7.0 CIHR Investments in Aboriginal Health for more details.)

All along, and equally important, CIHR-IAPH has ensured Aboriginal communities have been involved closely in capacity building. As a result, working relationships between the Aboriginal health community and academic health researchers have grown more comfortable and collaborative. The successes listed below are the outcomes of these philosophies.

4.1 Researchers and Trainees

The next generation of Aboriginal health researchers, Dr. Jeff Reading and the 2007 CIHR-IAPH Scientific Director’s Award of Excellence recipients. From left to right: Julie Bull, Amanda Ritchie, Treena Delormier and Christopher Mushquash.

Highlights

 

• The ACADRE -- Aboriginal Capacity and Developmental Research Environments -- Program was rolled out in 2001-2002 with four regional ACADRE centres located in: Winnipeg, Manitoba; Edmonton, Alberta; Regina, Saskatchewan; and Ottawa, Ontario. All were affiliated with a major university in their respective city. The purpose of the ACADRE initiative was to build capacity by developing researchers and providing continued support for scientific careers in Aboriginal health research. That same year, the National Network for Aboriginal Mental Health Research was launched. Co-funded by CIHR-IAPH and the CIHR Institute of Neurosciences, Mental Health and Addiction, the network began addressing critical mental health needs of Aboriginal people in rural and urban settings. Several other major initiatives were introduced including the New Emerging Teams (NET) Grant Program and the CIHR Training Initiative in Health Research. Several new Requests for Proposals (RFP) were posted that were aligned with CIHR-IAPH research priorities such as child and youth health promotion, management of diabetes, and accident and injury prevention. In its pursuit to build capacity, the Institute hosted two national gatherings of graduate student researchers.
• In 2002-2003, the ACADRE network was expanded to include four additional regional centres located at universities in: Halifax, Nova Scotia; Quebec City, Quebec; Toronto, Ontario; and Vancouver, British Columbia. In addition, research grants were awarded to three other principal investigators who explored ways to improve access to appropriate health services for marginalized groups. Initiatives supporting new investigators and Aboriginal community-based research were also offered.
• By 2007-2008, it became evident a greater and sustained emphasis was needed to ramp-up the number of Aboriginal health researchers that were well trained in the sciences and skilled and responsive to working with Aboriginal communities. Sparked by these and other emerging needs, the ACADRE program was officially closed on September 30, 2007 and was replaced by the Network Environments for Aboriginal Health Research (NEAHR) initiative.

The federal government demonstrated its commitment to NEAHR with an official announcement at the University of Manitoba on January 22, 2008 of a $15.8 million three-year grant through CIHR. On behalf of the Minister of Health Tony Clement, Parliamentary Secretary for Health Steven Fletcher noted "Aboriginal people should get the health care they need, when they need it."

Building on the work of the ACADRE initiative, key elements of the NEAHR program include: enhancing and developing relationships between universities and First Nations, Métis and Inuit communities and organizations; supporting research that has a direct impact on Aboriginal people such as child health and development, population health, and health services; and training graduate students across the country working in a broad range of health issues such as mental health and addiction, nutrition, diabetes, northern health issues, tobacco control and Aboriginal youth suicide.

Full grants were awarded to nine NEAHR centres located at the following locations across Canada:

1. University of British Columbia, Vancouver, British Columbia
2. University of Alberta, Edmonton, Alberta
3. University of Saskatchewan, Regina, Saskatchewan
4. University of Manitoba, Winnipeg, Manitoba
5. CIETcanada/University of Ottawa, Ottawa, Ontario
6. University of Toronto, Toronto, Ontario
7. Université Laval, Quebec City, Quebec
8. Sir Mortimer B. Davis - Jewish General Hospital, Montreal, Quebec
9. Dalhousie University, Halifax, Nova Scotia

As well, a planning grant was awarded to Dalhousie University to establish a multi-disciplinary network environment focusing on Aboriginal mental health and addictions research.

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Network Environments for Aboriginal Health Research

NEAHR is supported by the Aboriginal Health Research Networks Secretariat (AHRNetS), the coordinating body for the nine centres and is located at Six Nations Polytechnic Institute, Six Nations of the Grand River Territory, Ontario, Canada. Its responsibilities include:

• enhancing coordination and communication among the nine NEAHR centres, Aboriginal health research networks, including students and researchers, national Aboriginal health organizations and international indigenous health research networks;
• coordinating events such as meetings of the principle investigators and coordinators/ directors and the annual gathering of students;
• disseminating information related to Aboriginal health research using communication and knowledge transfer strategies; and
• engaging in advocacy activities on Aboriginal health research matters.

(Sidebar quote)

"Through this investment by CIHR, we have the opportunity to build on the groundwork established through the CIHR-ACADRE grant, wherein we have achieved some significant successes in the development of research capacity in our communities," said Dr. Catherine Cook, Principal Investigator, NEAHR grant, University of Manitoba.

(Sidebar quotes from two emerging researchers funded by ACADRE Ottawa)

"Seed funding from the Ottawa ACADRE was essential to develop a full grant application to carry out [my] research on sexual violence, HIV/AIDS and Aboriginal women. This is an unexplored area of work, even though Aboriginal women make up almost half the HIV/AIDS figures for the Aboriginal population. Since it is such a sensitive topic, we have taken great care to keep risk of harm to study participants very low. The Ottawa ACADRE funding was key in this regard, as it gave us the time to fully design a suitable methodology. I hope that our work will help protect Aboriginal women in particular, as we strive to take greater hold of the Aboriginal HIV/AIDS epidemic. We will build on the OCAP (Ownership, Control, Access and Possession) principles to make sure it is the Aboriginal population that steers the research process and releases the findings in a way that contributes to understand and tackle these issues."

- Kevin Barlow, Mi'Kmaq from the Indian Island First Nation in New Brunswick

"I am so very grateful for the ACADRE [Ottawa] program, which has enabled me to do a doctoral degree internationally with Charles Sturt University in Australia. My work is on Native American youth risk and resilience. Specifically, my doctoral thesis explores Blackfoot youth risks in Southern Alberta."

- Paula Du Hamel Yellow Horn, Algonquin and Blackfeet (mother) and Métis (father)

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4.2 Research Resources and Collaboration

Workshops, symposia and conferences

Over the past eight years, CIHR-IAPH has supported a wide variety of workshops, symposia and conferences directly related to Aboriginal health -- from events on child and youth health and cardiovascular disease to suicide, dental hygiene, inner city health and diabetes. Through these and other similar activities, CIHR-IAPH promoted partnerships and public engagement. In total, more than 50 events were supported by the Institute over the past eight years, in addition to holding several town hall meetings across the country during its formative years to introduce CIHR-IAPH to Aboriginal communities and researchers across the country.

As an invited speaker at key regional, national and international events, Dr. Reading's role as the public face of CIHR-IAPH has been instrumental in knowledge translation, partnership development, collaborating with key stakeholders and engaging communities. Among Dr. Reading's many responsibilities, he remained committed to reaching out to audiences across Canada and internationally. Over the past eight years, he spoke at more than 80 regional and national conferences and some 65 international events.

International indigenous health meeting participants, Ottawa, March 2002. Left to right: Earl Nowgesic, CIHR-IAPH; Jacinta Elston, Australia; Dr. Sue Crengle, New Zealand; Michael Bird, United States; Dr. Maria del Consuelo Garcia Andrade, Mexico; Dr. Jeff Reading, CIHR-IAPH.

Highlights

 

• In 2001-2002, CIHR-IAPH engaged key publics and shared knowledge via a number of regional, national and international events. Dr. Reading delivered a presentation at an influential meeting sponsored by the National Council on Ethics in Human Research in Toronto, Ontario, titled Protection of Human Participants in Research - Exploring the Challenge. The Institute initiated or sponsored several workshops, symposia and conferences across the country of relevance to Aboriginal health research. Dr. Reading played a pivotal role in heightening awareness of Aboriginal health research through his participation in many of these events.
• In 2002-2003, Dr. Reading delivered the keynote address at the fourth annual Amyot Lecture series in Ottawa. At this time, CIHR-IAPH called for a review and revision of an existing code of ethics for research involving Aboriginal people in the Tri-Council Policy Statement on Ethical Conduct for Research Involving Humans. These initial discussions eventually led to the development and adoption by CIHR of guidelines on ethical conduct for research involving Aboriginal people. Moreover, the guidelines are now serving as a basis for continued discussions by the Tri-Council.
• By engaging increasing numbers of Aboriginal communities, health research experts, academics, community workers, non-profit organizations, students, and governments throughout 2003-2004, CIHR-IAPH inched closer to reaching one of its overriding goals, the elimination health disparities between Aboriginal and non-Aboriginal populations. Dr. Reading travelled extensively throughout Canada participating in workshops, symposia and conferences. CIHR-IAPH extended its outreach activities even further by sponsoring a wide range of workshops, symposia and conferences on health research issues relevant to Aboriginal people: for example, dental hygiene, child and youth health, cardiovascular disease epidemiology, and alcohol and illicit drugs.
• In October 2003, the International Network of Indigenous Health Knowledge and Development held its inaugural conference in Townsville, Australia. Since then, Dr. Reading and CIHR-IAPH staff have maintained their involvement with the Network.
• In 2004-2005, once again, Dr. Reading developed and reinforced collaborations across the country and internationally by attending workshops and encouraging new Aboriginal health research initiatives. In December 2004, for example, Dr. Reading participated in the meeting themed: Indigenous Peoples' Right to Health: Did the International Decade of Indigenous People make a Difference? which was held in London, England. The second International Decade of the World's Indigenous People began in January 2005. Additionally, CIHR-IAPH supported a wide range of events on a wide spectrum of Aboriginal health research issues including literacy and health research, and the fourth annual national gathering of graduate students and community members interested in Aboriginal health research.
• In 2005-2006, CIHR-IAPH remained committed to engaging diverse stakeholders in Aboriginal health research regionally, nationally and internationally and to supporting health research events directly related to Aboriginal health including global health and knowledge translation.
• In 2006-2007, CIHR-IAPH continued supporting priority setting workshops on a wide array of topics including homelessness, ethics, gender-based analysis, community-based HIV/AIDS research and northern Aboriginal health. Dr. Reading delivered some 20 presentations across Canada and abroad including Russia, Chile and Australia.
• In 2007-2008, CIHR-IAPH supported many events on critical topics including community-campus partnerships, circumpolar populations and cancer, end-of-life care for Aboriginal communities, effects of resource extraction in Aboriginal communities and Aboriginal children's oral health.

4.3 National and International Partnerships

Partnerships facilitate many things: knowledge exchange, sharing of best practices, and leveraging funding resources. To this end, CIHR-IAPH has continued creating new opportunities in Aboriginal health research through its relationships with others.

And when appropriate, the Institute has entered into bilateral or multilateral Memorandums of Understanding (MOU) with national and international agencies and organizations. Typically, these MOUs support a variety of research activities and generate funding opportunities.s

With these efforts, CIHR-IAPH has become a leader in collaboration at the national and international levels, as well as regionally.

Interagency Meeting on Indigenous Health Research - National Health and Medical Research Council of Australia (NHMRC), Health Research Council of New Zealand (HRC), National Institutes of Health (NIH), Fogarty International Center (FIC) and Canadian Institutes of Health Research (CIHR), September, 2005, Vancouver, Canada. Top row left to right: Ian Potter, Assistant Deputy Minister, First Nations and Inuit Health Branch, Health Canada; Allan Pettigrew, CEO NHMRC; Alan Bernstein, President and CEO, CIHR; Jeff Reading, Scientific Director, CIHR-IAPH; Jacinta Elston, Australia; Laura Commanda, CIHR-IAPH; Ian Anderson, Professor, Australia; Suzette Dos Santos, CIHR. Bottom row left to right: Mick Hoare, NHMRC; Sharon Hrynkow, Assistant Director, NIH FIC; Bruce Scoggins, CEO, HRC; Aroha Hudson, Chair, HRC Maori Health Committee; Robin Hill, Director, Knowledge Creation Programs, CIHR; Malcolm King, Chair, CIHR-IAPH Institute Advisory Board; Joanne Baxter, HRC Maori Health Committee.

Highlights

 

• In 2001-2002, CIHR-IAPH jump started its intensive outreach agenda to form partnerships in Aboriginal health research by creating solid regional, national and international networks of Aboriginal health researchers and organizations. Partnerships were started with several CIHR institutes on variety of projects, ranging from cardiovascular and respiratory health and diabetes to fetal alcohol syndrome/fetal alcohol effects and inner city health. National partnerships were sealed with the Canadian Tobacco Control Research Initiative and Obesity Canada, among others. International health research organizations in Australia, Mexico, New Zealand, and the United States partnered with CIHR and CIHR-IAPH on several initiatives. A Memorandum of Understanding was signed by the chief executive officers of CIHR, the National Health and Medical Research Council of Australia and the Health Research Council of New Zealand to cooperate on health research for indigenous populations. The Health Secretariat of the United Mexican States and CIHR signed a Letter of Intent to develop "health research, research training, clinical training and knowledge translation based on equality, reciprocity and mutual benefit." Notably, the busy inaugural year set the pace for the next seven years.
• The Institute continued creating and maintaining partnerships in Canada and abroad in 2002-2003. CIHR-IAPH and the National Aboriginal Health Organization formalized their working relationship by signing a Memorandum of Understanding which laid out how the two groups would work together on projects. Collaborations with several CIHR institutes, Aboriginal health organizations and communities were strengthened. Existing international partnerships and collaboration agreements were maintained and new ones fostered.
• CIHR-IAPH, in partnership with the Natural Health Products Directorate of Health Canada, supported a unique research initiative in 2003-2004 assessing traditional medicine in Cree communities in the battle against diabetes. This project showcased the fact that indigenous people have much to contribute to the field of health research. The Institute and the CIHR Ethics Office continued their review of an ethics code on research involving Aboriginal people. Collaborations with other CIHR institutes resulted in research initiatives on suicide prevention and immunization. Collaborating on rural and northern health research initiatives has been a priority for CIHR-IAPH and as such, the Institute joined the CIHR Rural and Northern Health Research Strategic Initiative which involved a team of CIHR institutes and a tri-agency working group with members from CIHR, the Social Sciences and Humanities Research Council and the National Sciences and Engineering Research Council. Its mission was to advance research and knowledge translation that strengthened the health and health systems of rural and northern Canadians. Through this collaboration, two research projects were approved in fiscal 2003-2004 -- a community health survey on aging and mental health and an investigation to better understand and address the impacts of the physical and social environments on rural and northern health.
• A complex and innovative tri-country research program was launched 2004-2005 known as the International Collaborative Indigenous Health Research Partnership on Resilience. The international agreement included CIHR, the National Health and Medical Research Council of Australia and the Health Research Council of New Zealand. Eight Aboriginal health researchers in Canada were awarded funds to participate in the cross-border project.
  
  A pioneering agreement was signed by CIHR and the U.S.-based National Institutes of Health in 2004-2005 to foster collaboration on health research issues of priority to the American Indian, the Alaska Native and Canadian First Nations, Inuit and Métis people. Significant progress was made towards creating a set of guidelines for Aboriginal health researchers funded by CIHR. The Institute continued its partnerships with several CIHR institutions.
• The pioneering tri-country research initiative on indigenous health disparities and resiliency was expanded in 2005-2006 - grants were awarded to support three new Aboriginal health research programs.
  
  CIHR-IAPH pursued new opportunities for Aboriginal health researchers through a variety of collaborative relationships with other CIHR institutes, including community-based research projects exploring HIV/AIDS and addictions to illicit drugs, alcohol, tobacco and cross-addictions. A grant to study suicide prevention in Aboriginal communities was provided through a partnership involving CIHR-IAPH, the CIHR Institute of Neurosciences, Mental Health and Addiction and the First Nations and Inuit Health Branch of Health Canada.
• A Memorandum of Understanding was signed in 2006-2007 by the Assembly of First Nations, the First Nations Information Governance Committee and CIHR-IAPH to support collaboration, research, and knowledge translation activities with the First Nations Regional Longitudinal Health Survey, the only national survey developed and managed by First Nations governance bodies. This partnership represented an historic opportunity for First Nations organizations and Aboriginal health researchers to work in partnership to develop knowledge that meets both high standards of academic rigour and relevance to First Nations communities.

As a fledgling health research institute in December 2000, CIHR-IAPH adopted a proactive outreach agenda, in line with its strategic research priority to forge partnerships and share knowledge. This direction has never wavered. CIHR-IAPH has always viewed collaborative relationships, alliances and partnerships as one way to ensure Aboriginal health research is relevant to Aboriginal communities.

CIHR and NIH sign historic agreement on September 20, 2004. Left to right: Ian Potter, MSc, Assistant Deputy Minister, First Nations and Inuit Health Branch, Health Canada; Jeff Reading, PhD, Scientific Director, CIHR-Institute of Aboriginal Peoples' Health; Alan Bernstein, O.C., PhD, FRSC, President and Chief Executive Officer, CIHR; Elias A. Zerhouni, MD, Director, National Institutes of Health (NIH) (USA); Sharon Hrynkow, PhD, Assistant Director, Fogarty International Center (USA); Charles W. Grim, DDS, MHSA, Director, Indian Health Services (USA).

4.4 Ethical, Legal and Social Issues

A key part of the CIHR mandate is to promote, assist, and undertake health research that meets the highest standards of ethics. In line with this goal, the CIHR Ethics Office, in partnership with CIHR-IAPH, developed a set of guidelines that profoundly impact all CIHR-funded research across Canada involving Aboriginal people, as well as influencing health research involving indigenous peoples around the world.

Highlights

 

• In March 2007, the CIHR Governing Council approved the ground-breaking CIHR Guidelines for Health Research Involving Aboriginal People -- the result of a partnership between CIHR-IAPH and the CIHR Ethics Office and extensive consultations with key Aboriginal groups across the country. The ACADRE network (now known as NEAHR) played a pivotal role in these consultations. International guidance was sought from New Zealand, Australia and the United States for their expertise in developing indigenous health research codes.
  
  Three years in the making beginning in March 2004, the guidelines ensure Aboriginal people are engaged fully as partners in CIHR-funded research and balance the pursuit of scientific excellence with Aboriginal values and traditions. Without them, researchers run the risk of not taking Aboriginal traditions, culture and spiritual values into account in the course of their work.
• National and regional communications and education initiatives were developed and implemented in 2007-2008 to ensure all partners engaged in Aboriginal health research, from individual health researchers to institutions and Aboriginal communities, fully understand the scope and implications of the Guidelines. The groundbreaking work respects Aboriginal "ways of knowing" and "will increase the efficacy of research for and with Aboriginal people," says Dr. Reading. They will be evaluated once every four years to ensure their usefulness.
• Notably, the CIHR Guidelines for Health Research Involving Aboriginal People came into force on July 1, 2008 and encourage integrated knowledge translation in Aboriginal health research funded by CIHR.

---

(Sidebar quote)

"The guidelines acknowledge the value of Aboriginal life views and the legitimacy of Aboriginal people asserting those views in the context of research funded by CIHR. The guidelines promote respectful engagement and call upon researchers to enter into partnerships with communities starting at the planning phase to ensure that the proposed research is mutually beneficial, aligned with community interests and consistent with the culture and traditions of the local community. The guidelines promote the use of a research agreement to formalize the relationship between researcher and community. The agreement should detail such issues as data and sample stewardship, secondary use of samples and intellectual property rights, which in the past have been troublesome long after the research has concluded. Biological samples 'on loan' to researchers is a novel concept introduced to deal respectfully and appropriately with cultural and spiritual beliefs about the body and its constituent parts that previously were barriers to research. The guidelines include best practices examples, a step-by-step procedure for engaging the community throughout the research project and a sample research agreement."

- Doris Cook, MPH, Akwesasne Mohawk Territory, Cornwall, Ontario, Canada
Ms. Cook is one of the chief architects of the Guidelines and was formerly Project Manager, Aboriginal Ethics Policy Development, CIHR and CIHR-IAPH.

Source: Canadian Journal of Diabetes, September 2007, page 198

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CIHR Approves Guidelines for Aboriginal Health Research March 2007. Left to right: Jeff Reading, PhD, FCAHS, Scientific Director, CIHR-Institute of Aboriginal Peoples' Health; Burleigh Trevor-Deutsch, PhD, LLB, Director, Ethics Office, CIHR; Dr. Alan Bernstein, O.C., PhD, FRSC, President and Chief Executive Officer, CIHR; Cornelia Wieman, MD, FRCPC, CIHR Governing Council; Harvey Chochinov, MD, PhD, FRCPC, CIHR Governing Council.

CIHR Aboriginal Ethics Working Group

The development of the guidelines was driven by the CIHR Aboriginal Ethics Working Group which led an intense, two-year consultation, deliberation, education and outreach process.

Members of the CIHR Aboriginal Ethics Working Group

Larry Chartrand, LLB, LLM (Co-Chair)
Francine Romero, PhD (Co-Chair)
Laura Arbour, MD
Kelly Bannister, PhD
Ed Borchert
Fern Brunger, PhD
Jeff Corntassel, PhD
Veronica Dewar
Shaun Haines, PhD
Phyllis Kinoshameg
Dawn Martin-Hill, PhD

5.0 Knowledge Translation and Commercialization

Knowledge translation is about moving knowledge into action. According to CIHR, knowledge translation is closing the gap between what we know and what we do. Two types of knowledge translation have been identified:

1. the end-of-grant knowledge translation where the researcher(s) develop and implement a plan for making potential users aware of the knowledge that has been gained from the project; and
2. knowledge translation that is integrated with or embedded in the research process.

CIHR Research and Knowledge Translation Committee

The CIHR Research and Knowledge Translation Committee is composed of 13 Scientific Directors, the Vice-President of Research and Knowledge Translation, the Director of Ethics, the Executive Vice-President, the Chief Financial Officer, and the President. The committee develops, implements and reports on CIHR's research and knowledge translation strategy in accordance with the CIHR Act and the overarching strategic directions set out by the Governing Council. It also makes recommendations to the Council on resource allocation.

Highlights

 

• CIHR-IAPH recognized the importance of sound knowledge translation activities from the start. In 2001-2002, for example, the Edmonton-based ACADRE training centre developed a list of foundation principles to facilitate and encourage knowledge translation. Included in the list were the following principles:
  1. All research will be collaborative rather than competitive and enhance the health of Aboriginal communities.
  2. Aboriginal communities will be full partners in research programs, from beginning to conclusion.
  3. Knowledge will be jointly collected, created and owned by all research partners.
  The ultimate goal for this ACADRE centre and for all other activities and organizations operating under the auspice of CIHR-IAPH was to accelerate the benefits of Aboriginal health research to build a stronger health care system for First Nations, Métis and Inuit communities.
• Knowledge translation was the main theme for an international conference organized by a CIHR-IAPH advisory board member in 2002-2003. Peer reviewed articles prepared by both Dr. Reading and the CIHR-IAPH Associate Director Earl Nowgesic were published in professional journals.
• In partnership with CIHR and the CIHR Institute of Nutrition, Metabolism and Diabetes, CIHR-IAPH supported in 2003-2004 a four-phase study titled Knowledge translation and indigenous knowledge, which was designed to weave together indigenous knowledge and Western scientific health research. With information gleaned from the study, the research team planned to develop, implement and evaluate various knowledge translation models that could be used by Aboriginal communities. Dr. Reading authored or co-authored four major papers on Aboriginal health research which were disseminated through various channels to reach their target audiences.
• CIHR-IAPH signed a two-year collaboration agreement with the National Aboriginal Health Organization in 2004-2005 to collaborate on knowledge translation activities including the planning of a national knowledge translation conference in Aboriginal health.
• CIHR-IAPH maintained its commitment throughout 2005-2006 to working with Aboriginal stakeholders to understand indigenous "ways of knowing" and develop methodologies for effective knowledge translation. In March 2006, the Institute supported the inaugural Indigenous Knowledge Translation Summit held at the First Nations University in Regina, Saskatchewan. The event brought together Aboriginal people, academics, and national and government stakeholders who began formulating a consensus on effective indigenous knowledge translation in Canada. Key organizers of the summit included the Indigenous Peoples Heath Research Centre, Health Canada, the Saskatchewan Heath Research Foundation, the National Aboriginal Health Organization, along with CIHR-IAPH. Plans were underway to synthesize the knowledge translation activities of the eight ACADRE centres across Canada. Dr. Reading contributed to the literature on Aboriginal health research as a co-author of three published peer reviewed articles.
• A new and dedicated strategic priority was added to the updated CIHR-IAPH five-year (2006-2011) strategic plan on knowledge translation -- to facilitate and evaluate translation of Aboriginal health knowledge into policy and practice. The Institute began a number of activities in 2006-2007 to meet this priority: for example, creating and implementing national and international agreements on knowledge translation with key stakeholders and funding health research projects that include or focus on knowledge translation. As well, consideration was given to develop a formal CIHR-IAPH strategy for knowledge translation. A guest editorial column by Dr. Reading was published in the Canadian Medical Association Journal (April 2006).
• In 2007-2008, CIHR-IAPH continued its knowledge translation activities from the previous years: specifically, creating and implementing national and international agreements on knowledge translation with key stakeholders and funding health research projects that include or focus on knowledge translation. Additionally, CIHR-IAPH worked under the direction of its advisory board to develop the groundwork for a knowledge translation strategy in Aboriginal health research.

6.0 Organizational Excellence

CIHR-IAPH has been supported in achieving its objectives through the efforts of its Institute Advisory Board, CIHR-IAPH and CIHR staff, and the CIHR Governing Council, particularly Dr. Malcolm King (June 2001 to June 2004) and Dr. Cornelia Wieman (March 2007 to present).

6.1 Institute Advisory Board - Membership since December 2000

CIHR-IAPH has accomplished a great deal since 2000 largely due to the guidance and insight of its Institute Advisory Board (IAB). Because all board members are experts in various aspects of Aboriginal health research or related disciplines, together their wisdom has steered the Institute forward at an incredible pace, particularly in the areas of capacity building, research program development, and partnership expansion. All IAB members for all CIHR institutes must go through a rigorous application process before being invited to join.

Below, is a list of all individuals who have belonged to the CIHR-IAPH advisory board since 2000 and who have graciously given their time when needed and advice when asked.

Institute Advisory Board member Marlene Brant-Castellano, O.C., O.Ont., and Her Excellency the Right Honourable Adrienne Clarkson, Governor General of Canada at the investiture ceremony of the Order of Canada, September, 2005.

Members from December 2000 to present*

Judith G. Bartlett, MD, CCFP, December 2000 - August 2006

• Associate Director, Centre for Aboriginal Health Research, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba
• Family Physician, Aboriginal Health and Wellness Centre of Winnipeg

John Kim Bell, BMus, OC, December 2000 - August 2003

• President, National Aboriginal Achievement Foundation

Michael Bird, MSW, MPH, December 2000 - August 2005

• Executive Director, The National Native American AIDS Prevention Centre

Marlene Brant-Castellano, BA, BSW, MSW, December 2000 - August 2006

• Professor Emeritus, Department of Native Studies, Trent University

Michael Chandler, PhD, September 2006 - present

• Distinguished Investigator, CIHR and Distinguished Scholar, Michael Smith Foundation for Health

Éric Dewailly, MD, PhD, December 2000 - August 2005

• Chairperson to the Nunavik Nutrition and Health Committee
• Board Member, Laval University Inuit ACADRE; Nasivvik Centre for Inuit Health and Changing Environments

Bernice Downey, RN, BScN, September 2005 - present

• Consultant, Mino a ya win Consulting

Willie Ermine, MEd, September 2007 - present

• Assistant Professor, First Nations University of Canada
• Ethicist/Researcher, Indigenous Peoples' Health Research Centre (IPHRC)

Steven Graham, BSc (Pharm.), PhD, September 2006 - present

• Director of Outreach and Interventions, Canadian Optimal Prescribing and Utilisation Service (COMPUS), Canadian Agency for Drugs and Technologies in Health (CADTH)

Margo Greenwood, PhD, September 2006 - present

• Professor, University of Northern British Columbia
• Research Lead, National Collaborating Centre on Aboriginal Health, Public Health Agency of Canada

Minnie Grey, September 2003 - August 2005

• Chairperson to the Nunavik Nutrition and Health Committee
• Board Member, Laval University Inuit ACADRE; Nasivvik Centre for Inuit Health and Changing Environments
• Negotiator, Makivik Corporation

Eber Hampton, EdD, PhD, December 2000 - August 2004

• President, First Nations University of Canada

Robert Hegele, MD, December 2000 - August 2003

• Director, J.P. Robarts Research Institute, University of Western Ontario

Richard Jock, BA, MEd, December 2000 - August 2007

• Chief Executive Officer, Assembly of First Nations

Malcolm King, PhD, September 2004 - present (Chair, September 2005 to present)

• Professor, Division of Pulmonary Medicine, Department of Medicine, University of Alberta

Lawrence Kirmayer, MC, FRCPC, September 2004 - present

• Professor and Director, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University
• Director, Culture and Mental Health Research Unit, Department of Psychiatry, Sir Mortimer B. Davis Jewish General Hospital, Montreal

Ann Macaulay, MD, CCFP, FCFP, September 2003 - present

• Scientific Director, Kahnawake Schools Diabetes Prevention Project, Centre for Research and Training
• Associate Professor, Family Medicine, McGill University

Barney Masuzumi, December 2000 - August 2003

• Member, National Council on Ethics and Research

Rod M. McCormick, BA, BEd, MA, PhD, December 2000 - August 2005

• Associate Professor, Department of Educational and Counselling Psychology, Special Education, Faculty of Education, University of British Columbia

Lynn McIntyre, MD, MHSc, FRCPC, December 2000 - August 2005

• Dean, Faculty of Health Professions, Dalhousie University

Judy Mill, RN, PhD, September 2005 - present

• Director, PAHO/WHO Collaborating Centre for Nursing and Mental Health, Faculty of Nursing, University of Alberta

Michael E.K. Moffatt, MSc, MD, FRCPC, December 2000 - August 2004

• Head, Department of Paediatrics & Child Health, University of Manitoba

Cameron Mustard, ScD, December 2000 - August 2003

• Scientific Director, Institute for Work and Health, Toronto
• Associate Professor, Department of Public Health Sciences, University of Toronto

John O'Neil, BA, MA, PhD, December 2000 - August 2007 (Chair, December 2000 to June 2005)

• Chair, Department of Community Health Sciences, University of Manitoba

Ian Potter, BA, MSc, December 2000 - present

• Assistant Deputy Minister, First Nations and Inuit Health Branch, Health Canada

Francine Romero, PhD, MPH, September 2003 - present

• Epidemiologist, Northwest Portland Area Indian Health Board (USA)

Bronwyn Shoush, BSc, LLB, December 2000 - August 2005

• Director, Aboriginal Justice Initiatives Unit, Alberta Justice Department

Janet Smylie, MD, MPH, CCFP, September 2004 - present

• Associate Professor, Department of Public Health Sciences, University of Toronto
• Research Scientist, Centre for Research on Inner City Health, St. Michael's Hospital, Toronto

Isaac Sobol, MD, CCFP, MHSc, September 2005 - present

• Chief Medical Officer of Health, Nunavut

Lisa Sterling, MA, PhD, September 2005 - present

• Special Advisor and Director of Aboriginal Affairs, Office of the Vice-President, Simon Fraser University

Gail Valaskakis, PhD, September 2003 - July 2007

• Director of Research, Aboriginal Healing Foundation

Stanley Vollant, MD, FRCSC, September 2007 - present

• Director, Aboriginal Health Program, Faculty of Medicine, University of Ottawa

Fred Wien, PhD, September 2007 - present

• Professor, School of Social Work, Dalhousie University

* Past members professional affiliations are stated current to their term on the CIHR-IAPH IAB; "present" indicates until March 2008.

Dr. Gail Valaskakis (1939-2007), Distinguished Professor Emeritus, Concordia University; Director of Research, Aboriginal Healing Foundation; National Aboriginal Achievement Award recipient (2002). Photo Credit: Aboriginal Healing Foundation.

Institute Advisory Board Meetings

Typically, the CIHR-IAPH IAB meets at least twice a year at various locations across Canada to discuss current and emerging issues and to plan future strategic directions for the Institute. In addition, the CIHR-IAPH IAB participates in a variety of joint meetings with other CIHR institutes and the Aboriginal health research community. Specifically:

• June 9, 2003 - Montreal, Quebec: First Joint Meeting with the CIHR Institute of Neurosciences, Mental Health and Addiction
• June 7, 2005 - Toronto, Ontario: First Joint meeting with the CIHR Institute of Health Services and Policy Research IAB
• August 30-31, 2005 - Banff, Alberta: Joint meeting with CIHR-IAPH and CIHR staff for a strategic planning retreat
• July 12, 2006 - Halifax, Nova Scotia: First Joint Meeting of CIHR-IAPH IAB and the ACADRE Network
• March 13, 2007 - Edmonton, Alberta: First Joint Meeting with the CIHR Institute of Human Development, Child and Youth Health IAB
• September 20, 2007 - Toronto, Ontario: Second Joint Meeting of the CIHR-IAPH IAB and the Aboriginal Health Research Networks

6.2 Staff

The day to day operation of CIHR-IAPH is carried out by a committed team based at the host institution, and at CIHR in Ottawa. CIHR-IAPH was located at the University of Toronto from 2000 to 2004 and at the University of Victoria from 2004 to 2008.

CIHR-IAPH Staff

University of Victoria
Jeff Reading, MSc, PhD, FCAHS
Scientific Director

Earl Nowgesic, RN, BScN, MHSc
Associate Director

Namaste Marsden, BA, LLB
Senior Advisor

Mary Hum-Wan
Office Manager

CIHR - Ottawa
Cynthia Stirbys, MA
Acting Assistant Director, Partnerships, Knowledge Translation, and International Relations

Jacques Dalton, BA
Institute Project Officer

Andrea Aiabens, BA
Summer Student

Past Staff

Dawn Bruyere, RN, BA, MScN
Senior Research Analyst and Project Manager (2003-2004)

Linda Day, MA
Senior Research Analyst and Project Manager (2002-2003)

Elizabeth Estey, BA
Summer Student (2006-2007, 2008)

Katherine Gofton, BA
Research Officer (2003-2004)

Catherine Hodgins, BSc, MBA, CHE
Programs Manager (2005)

Trudy Jacobs
Senior Secretary (2000-2004)

James Makokis
Summer Student (2002)

Natasha Pelletier
Summer Student (2006)

Jewel Peters
Administrative Assistant (2004)

Velten Pilger, BA
Programs Manager (2005-2006)

Sittanur Shoush, BSc
Special Projects Support (2001-2002)

Emanuela Tura, BSc
Research Assistant (2006)

In Ottawa
Amy Bombay, MSc
Summer Student (2007)

Laura Commanda, MSW
Assistant Director (2000-present; on leave 2007-2008)

Doris Cook, MPH
Project Manager, Aboriginal Ethics Policy Development (2003-2007)

Allison Forsythe, MA
Junior Project Officer (2006-2007)

Karine Lemay
Project Officer (2005-2006)

Kanata Maracle, BA
Summer Student (2007)

Lynne Renaud
Project Officer (2005-2006)

Gwendoline Simard, BSc
Project Officer (2005-2006)

Ginette Thomas, BA, MA
CIHR Institute Liaison (2001-2002)

Dr. Jeff Reading, a professor at the University of Victoria, Faculty of Human and Social Development, divides his time between CIHR-IAPH and his research activities as the Director of the Centre for Aboriginal Health Research at the University of Victoria.

Dr. Reading was presented with a National Aboriginal Achievement Award in March 2008. Award recipients are recognized for their knowledge, expertise and "for their significant contributions to the greater society." Dr. Reading has played a central role in nurturing the growth of Aboriginal health research in Canada and globally. He has also ensured Aboriginal communities are equal partners in research through his leading role in the development and adoption in 2007-2008 of the CIHR Guidelines for Health Research Involving Aboriginal People.

Dr. Reading holds a number of voluntary professional appointments with diverse health groups including: the Canadian Heart Health Strategy Steering Committee, the Canadian Academy of Health Sciences, and the Public Health Agency of Canada Advisory Council for National Collaborating Centres.

Dr. Malcolm King and Dr. Jeff Reading, at the National Aboriginal Achievement Awards, March 2008, Toronto. Dr. Jeff Reading received an Aboriginal Achievement Award in Health.

Staff Development

Annual performance reviews have been undertaken on a regular basis for all full-time CIHR-IAPH staff providing them with valuable feedback and with professional development opportunities. Yearly staff retreats, generally held off-site, have facilitated team building and organizational planning.

6.3 Institute Accountability

While CIHR-IAPH has moved forward with its goal driven activities, the Institute has been conscious of the need for stakeholder accountability and transparency. Preparing for and evaluating programs and procedures has been a mainstay for CIHR-IAPH.

Highlights

 

• CIHR-IAPH has consistently recognized the importance of strategic planning within the context of accountability. To this end, the Institute went through two intensive strategic planning exercises involving its staff and advisory board, CIHR, along with other stakeholder groups such as its ACADRE network. Two, five-year strategic plans were produced, the first in 2001 and the second in 2006, which were used as benchmarks to help assess progress in meeting goals.
• In 2002-2003, CIHR began developing a common evaluation framework for its 13 institutes based on common elements such as activities and outcomes and sought advice from CIHR-IAPH on the matter. Additionally, the Institute began developing its own evaluation framework, with guidance from CIHR, to assess its progress.
• An evaluation of the ACADRE network was initiated in 2003-2004. The review, conducted by outside experts, examined the effectiveness, relevance and efficiency of the ACADRE model.
• In 2004-2005, the Institute worked towards completing the ACADRE review and began preparing for the CIHR mid-term evaluation scheduled for implementation the following year. Mandated by CIHR's governing legislation, the mid-term evaluation led into the five-year review. All CIHR institutes completed similar reviews.
• The five-year review was completed in 2005-2006 by an international review panel of research experts which examined the success of each institute and CIHR as a whole in achieving its mandate.
• 2006-2007 was a vital year for CIHR-IAPH. The Institute initiated the Canadian Review of the International Collaborative Indigenous Health Research Partnership. Results and recommendations made by the external evaluators are being considered for implementation.
  
  Released in June 2006, the CIHR Year 5 International Review Panel Report 2000-2005 gave favourable reviews to CIHR-IAPH for its leadership and capacity building initiatives. An overall recommendation made by the International Review Panel for CIHR-IAPH was to "maintain the present policy settings and strategy." No changes were recommended to the status or mandate of CIHR-IAPH.
• The flagship ACADRE program officially ended on September 30, 2007 and was replaced by NEAHR on October 1, 2007. CIHR-IAPH commissioned a final evaluation of the ACADRE program which focused on outcomes. The report was completed in November 2007 and concluded the ACADRE program made substantial gains in capacity building since it began in 2001. Overall, the program achieved its goals of including Aboriginal communities in advisory and governance bodies, communicating effectively with regional stakeholders and communities, and recruiting and supporting trainees to health research at the undergraduate, Master's, doctoral and post-doctoral levels.

7.0 CIHR Investments in Aboriginal Health 2000-2008

Notes:

1. CIHR Expenditures overall used to derive the CIHR Investments in Aboriginal Health as a Percentage of Overall CIHR Expenditures include the flow-through funds for the Canada Research Chairs, Networks of Centres of Excellence, and the Centres of Excellence for Commercialization and Research (2007-08 only) programs.
2. CIHR Investments in Aboriginal Health per fiscal year include the IAPH Investments in Strategic Initiatives.
3. The CIHR expenditures for CIHR Investments in Aboriginal Health figures were derived through a keyword search of the CIHR database for grants and awards related to IAPH research.
4. It is not possible to determine the proportion of a project's expenditures that are relevant to a specific research area or population. Therefore project expenditures can be reported multiple times across several CIHR institutes as estimated expenditures relevant to their areas of research. It would therefore be inappropriate to add up similar numbers from all Institutes to determine CIHR's overall support of health research. Certainly, such a process would lead to a figure that exceeds CIHR's total budget.