Progress Update – Action Plan: Building a healthier future for First Nations, Inuit and Métis peoples

June 21, 2017

In November 2016, CIHR announced 10 commitments to strengthen Indigenous health research in Canada, building on work that was already underway.

Over the past months, CIHR has worked closely with the First Nations, Inuit and Métis communities to address gaps in Indigenous health research, and will continue to do so in the future. CIHR is grateful for the advice and guidance of its partners in the Indigenous health research community such as the Assembly of First Nations, Inuit Tapiriit Kanatami, the Métis National Council, the Native Women’s Association of Canada, and the National Association of Friendship Centres, among others.

The successful implementation of our 10-point plan to strengthen Indigenous health research is being co-led by Dr. Carrie Bourassa, the Scientific Director of the CIHR Institute of Aboriginal Peoples’ Health and CIHR Executive Vice-President Michel Perron.

Today, on National Aboriginal Day, we are pleased to present the progress we’ve made on our commitments, while recognizing that much remains to be done.

Progress by commitment

  1. Increase its capacity to interact with Indigenous communities in a culturally appropriate manner, through the creation of a dedicated team assigned to work directly with Indigenous peoples, researchers and communities.

    CIHR has established a dedicated Indigenous Health Research Support Office. This team is responsible for supporting initiatives such as Pathways to Health Equity for Aboriginal Peoples, a major program of research focused on suicide prevention, diabetes/obesity, tuberculosis and oral health; supporting the iterative peer review process, which is designed to ensure higher success rates for applications with an Indigenous health focus; and supporting the development of policies and resources to strengthen Indigenous health research generally across CIHR.

    We know that delivering on these 10 commitments will require a concerted effort on the part of the whole organization, and to that end, we have made cultural competency and cultural humility classes available to staff, with more training opportunities to follow in the future. To build on what is being taught in these classes, last week’s employee recognition event, held during National Public Service Week, had an Indigenous theme, including Elders, a smudging ceremony, and traditional dancing and food.

  2. Ensure that the Federal Government is made aware that the membership of CIHR’s Governing Council should reflect the diversity of Canada’s Indigenous peoples.

    We recognize that Indigenous voices must be heard around the management table, and that is why we are working with our government partners to encourage the inclusion of representatives of the Indigenous community on Governing Council and other committees. As a first step, we have ensured that at least half of the membership of the Institutes Advisory Board for Indigenous Peoples’ Health is made up of representatives from the First Nations, Inuit and Métis communities, with three seats reserved for representatives of the national Indigenous organizations.

  3. Accept the definition of “Indigenous health research” as drafted by the Institute of Aboriginal Peoples’ Health in consultation with Indigenous stakeholders.

    The words we use matter, and, as a sign of respect, it is important that, when discussing Indigenous health research, we use the vocabulary favoured by First Nations, Inuit and Métis communities. We wish to thank the Indigenous stakeholders who helped our Institute of Aboriginal Peoples’ Health draft a new, more encompassing and culturally sensitive definition of “Indigenous health research.”

  4. Develop, in collaboration with the newly appointed Institutes Advisory Board on Indigenous Peoples’ Health, performance indicators to validate CIHR investments in Indigenous health research.

    With a new definition of Indigenous health research now in place, CIHR is working closely with its Institutes Advisory Board on Indigenous Peoples’ Health to refine its performance indicators. This will support our goal of being open and transparent when reporting on our progress on investing in Indigenous health research.

    CIHR has also been collaborating with the Social Sciences and Humanities Research Council (SSHRC) and Natural Sciences and Engineering Research Council (NSERC) in order to standardize the practice for collecting data on applicants’ and other stakeholders’ identities (including Indigenous identity), with the goal of gaining a better sense of participation rates across applicant and stakeholder groups.

  5. Increase its investments in Indigenous health research to a minimum of 4.6% (proportional to Canada’s Indigenous population) of CIHR’s annual budget.

    CIHR continues to take steps to ensure its investment in Indigenous health research totals 4.6% of its annual budget. For our recent Project Grant competition, all 38 applications for Indigenous health research projects went through our iterative peer review process where at least two of the reviewers had expertise in Indigenous health and wellness and who provided their written reviews through a mentorship lens.

    This resulted in 22 of the 38 Indigenous health research projects being awarded funding, with an additional 12 projects receiving one-year bridge grants, for a total investment of $16.5M.

    This topic will be discussed in detail at the next meeting of the Institutes Advisory Board on Indigenous Peoples’ Health.

  6. Seek to grow these investments as research capacity and additional financial resources allow.

    CIHR launched the refresh of the Indigenous Mentorship Network Program on December 13, 2016, with an $8M investment over five years, enough to fund eight teams, including seven regional nodes (in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec and Atlantic Canada) plus an international/coordinating node. The goal of this program is to break down the barriers hindering participation of First Nations, Inuit and Métis trainees and new investigators in health research. CIHR has also begun discussions with partners around collaborative and innovative strategies to support capacity for Indigenous health research across the spectrum, from entry level (high school) to post-doctoral, including building capacity for communities to engage in research.

    In May, CIHR’s Institute of Aboriginal Peoples’ Health hosted a national gathering of graduate students in Indigenous health attended by 20 students and a new investigators meeting. At these two events, the interest in supporting scholarship using an Indigenous research paradigm was evident. In September 2017, CIHR will be supporting Indigenous new investigators, as well as Elder/youth pairs, to attend the third annual Pathways Annual Gathering, an event that brings together community members, researchers, national Indigenous organizations and CIHR staff to encourage respect for and inclusion of Indigenous Ways of Knowing in CIHR’s Indigenous health research projects, and support networking and community building.

  7. Continue working with the Reference Group on Indigenous Health Research ‎to implement iterative peer review processes for applications relevant to Indigenous health, so as to ensure better success rates for Indigenous-focused investigator-initiated grant applications.

    CIHR continues to work with the external Reference Group on Appropriate Review Practices for Indigenous Health Research  to develop an iterative peer review process. This process was used for the first time in the most recent Project Grant competition, with all Indigenous health-related applications being sent to a separate face-to-face committee where at least half of reviewers had expertise in Indigenous health and wellness and provided their written reviews through a mentorship lens.

  8. Create, with the advice of the Institutes Advisory Board on Indigenous Peoples’ Health, impactful strategic initiatives aimed at improving the health of Indigenous peoples.

    CIHR continues to look for ways to integrate Indigenous health research into its funding opportunities, and has recently earmarked funds for Indigenous components in funding opportunities for the microbiome, HIV/AIDS, maternal, reproductive and child and youth health, and improved immunization coverage, among others. The CIHR Institute of Aboriginal Peoples’ Health will be working with its community to identify other opportunities for investment.

  9. Hold annual meetings between the President of CIHR and leaders of the Assembly of First Nations, Inuit Tapiriit Kanatami, and the Métis National Council to discuss Indigenous health research priorities.

    We are committed to strengthening our relationship with the Indigenous community, including the national Indigenous organizations, and have made significant strides in building positive and collaborative relationships. For example, we have been working closely with Inuit Tapiriit Kanatami (ITK) on one of their biggest health priorities – suicide prevention. In Iqaluit in March 2017, CIHR and ITK cohosted an important international symposium on suicide prevention. CIHR is also pleased to have become a member of a Health Portfolio Table which will strengthen our ability to engage with the Métis National Council. And to make certain that we listen and hear from the community about its needs, the national Indigenous organizations will once again be participating in our third annual Pathways Gathering in September.

  10. Work with other federal research councils to develop strategies to strengthen Indigenous research capacity development through training and mentoring along the entire career continuum from undergraduate to postdoctoral levels.

    CIHR staff have joined a Tri-Agency working group convened by SSHRC to identify areas of collaboration for Indigenous research between SSHRC, CIHR and NSERC. This group will focus on strategies for capacity building, investments for improved management of Indigenous data, and administrative efficiencies to support Indigenous community-based research. CIHR is also exploring opportunities to leverage investment funds with the other Tri-Agencies to achieve the greatest impact when it comes to supporting Indigenous research.

The activities above represent the first steps CIHR is taking as an organization to strengthen Indigenous health research. The Truth and Reconciliation’s health-related Calls to Action were clear: there is a pressing need for governments to close gaps in health outcomes experienced by Indigenous peoples, recognize the value of traditional healing practices and increase the number of Indigenous peoples working in the health care field, among other urgently needed actions. CIHR is committed to doing its part to work towards reconciliation through research.

In the spirit of openness and transparency, we will be reporting on our progress towards our 10 commitments regularly, so please check back often.

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