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| Name | Class |
|---|---|
| Aqqiumavvik - Arviat Wellness Society | UNKNOWN |
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This study is looking at how eating more country foods affects mental health among Inuit men and women in Arviat, NU. The goal is to evaluate if eating more of these foods helps people feel less depressed or anxious, and whether being part of food-gathering and cultural activities also makes a difference.
Whether the positive effects last over time, and if getting access to these foods later (instead of right away) still helps people feel better, will also be assessed.
The primary objective of this study is to evaluate the feasibility, cultural acceptability, and potential mental health impacts, measured using PHQ-9 as part of a multi-level intervention (MLI) that integrates country foods, community wellness practices, and clinical care.
Specifically, the intervention aims to:
Improve mental health outcomes: Increased access to country foods is hypothesized to reduce depression and anxiety.
Strengthen cultural identity: Community-led wellness activities are expected to enhance cultural identity and community cohesion.
Enhance food sovereignty: Addressing systemic barriers can improve access to country foods and support culturally relevant healthcare.
Promote continuity of care: Integrating culturally grounded interventions into care plans can improve patient outcomes and overall wellness.
Secondary objectives include assessing the role of Elders in transferring cultural knowledge, identifying systemic barriers to accessing country food, and evaluating the integration of IQ principles into clinical systems. Elders are expected to facilitate social cohesion and transfer cultural knowledge, which are vital for community resilience. Policy recommendations will be explored to address systemic barriers, while the intervention's findings will inform clinical care plans to promote culturally relevant healthcare.
Ultimately, this research aims to develop community-based, culturally aligned solutions that promote resilience, improve health outcomes, and support Inuit self-determination. This study aims to create sustainable pathways for wellness and food sovereignty in Inuit communities by addressing historical injustices and systemic inequities.
Research Question(s): This study is guided by the following research questions:
How does increased access to country foods influence individual mental health outcomes, including anxiety, depression, emotional well-being, and resilience? How do community-driven food-gathering activities enhance social cohesion, cultural identity, and collective mental health within Inuit communities? What structural, systemic, and environmental barriers restrict access to Inuit country foods, and what specific policy interventions can effectively address these barriers to promote sustainable food security and mental health improvements? How do land-based and country food wellness programs integrate holistic approaches to address biological, psychological, social, and cultural determinants of mental health? What role do interdisciplinary collaborations and culturally relevant care practices play in improving access to country foods and fostering mental health equity in Inuit communities?
Hypotheses:
Increased access to country foods will improve mental health outcomes, including reduced depression and anxiety.
Community-led wellness activities will strengthen cultural identity, social bonds, and cohesion.
Access to country foods will help address systemic barriers and enhance food sovereignty while supporting culturally relevant healthcare.
Integrating culturally grounded interventions into care plans will improve continuity of care and patient outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Immediate Intervention | Other | Weekly distributions of traditional country foods (caribou, seal, Arctic char), Elder-led workshops on food preparation and cultural practices, and mental health supports through unnikkaaratiginniq and sharing circles for the first 30 days of the trial. |
|
| Delayed Intervention | Other | Participating in baseline assessments only (no guided conversations or workshops from Days 1-30). From Days 30-60, the delayed intervention group will receive the same intervention as the immediate intervention group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Traditional Country Foods | Other | Participants will receive weekly distributions of traditional foods, including caribou and fish. Guided conversations will explore changes in dietary habits, emotional well-being, and cultural connections |
| Measure | Description | Time Frame |
|---|---|---|
| Cultural Acceptability of the Intervention- Qualitative Interviews | Qualitative interviews with healthcare providers and community facilitators will explore barriers and facilitators to intervention implementation. | From enrolment to the end of treatment at 12 weeks |
| Cultural Acceptability of the Intervention- Participant Diaries | Participant diaries will also be used to assess the perceived cultural significance of the intervention. | From enrolment to the end of treatment at 12 weeks |
| Participant satisfaction and perceived impact on mental health | Data will also be collected through participant diaries, focusing on experiences with country food consumption, the perceived cultural significance of the intervention, and overall satisfaction with the program. REDCap surveys will collect data from participant diaries, allowing for consistent monitoring of cultural experiences and satisfaction over time. | From enrolment to the end of treatment at weeks 4, 8, and 12. |
| Mental Health Impacts | Potential mental health impacts will be measured using the Patient Health Questionnaire-9 (PHQ-9) tool at baseline. Scoring ranges from 0-27; a higher score indicates worse mental health. | Baseline (enrolment) |
| Mental Health Impacts - 4 weeks | Potential mental health impacts will be measured using the Patient Health Questionnaire-9 (PHQ-9) tool 4 weeks after enrolment. Scoring ranges from 0-27; a higher score indicates worse mental health | 4 weeks after enrolment |
| Mental Health Impacts |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of the Role of Elders in Transferring Cultural Knowledge- Workshops | Assessment of the Role of Elders in Transferring Cultural Knowledge will be evaluated through Elder-led workshops. | 12 weeks after enrolment |
| Assessment of the Role of Elders in Transferring Cultural Knowledge- Conversations |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wayne Clark, Ed.D | Contact | 7804928482 | wclark1@ualberta.ca | |
| Tibetha Kemble, PhD | Contact | 5875902693 | kemble@ualberta.ca |
| Name | Affiliation | Role |
|---|---|---|
| Wayne Clark, Ed.D | University of Alberta | Principal Investigator |
| Justin Ezekowitz, MD | University of Alberta | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Aqqiumavvik Society | Recruiting | Arviat | Nunavut | X0C 0E0 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Young, T. K. (2012). Health and disease in the Canadian North. University of Toronto Press. | ||
| 16042162 | Background | Willows ND. Determinants of healthy eating in Aboriginal peoples in Canada: the current state of knowledge and research gaps. Can J Public Health. 2005 Jul-Aug;96 Suppl 3:S32-6, S36-41. English, French. | |
| Background | Wilson, S. (2008). Research is ceremony: Indigenous research methods. Fernwood Publishing. | ||
| Background | Turner, N. J., Ignace, M. B., & Ignace, R. (2013). Traditional ecological knowledge and wisdom of Aboriginal Peoples in British Columbia. Ecological Applications, 10(5), 1275-1287. | ||
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Given the size of the study population, IPD will not be shared.
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| ID | Term |
|---|---|
| D003863 | Depression |
| D001008 | Anxiety Disorders |
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D001523 | Mental Disorders |
| D010549 | Personal Satisfaction |
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| Cultural Workshops | Behavioral | Weekly workshops led by Elders will focus on traditional country food, food preparation, and sharing practices, enhancing cultural identity and community bonds. Participants will also engage in cultural camps where they will be led by Elders in land based teachings on country food. |
|
Potential mental health impacts will be measured using the Patient Health Questionnaire-9 (PHQ-9) tool 8 weeks after enrolment. Scoring ranges from 0-27; a higher score indicates worse mental health.
| 8 weeks after enrolment |
| Mental Health Impacts | Potential mental health impacts will be measured using the Patient Health Questionnaire (PHQ-9) tool 12 weeks after enrolment. Scoring ranges from 0-27; a higher score indicates worse mental health. | 12 weeks after enrolment |
| Participant Satisfaction- Participant Diaries | Data will be collected through participant diaries that focus on experiences with country food consumption, the perceived cultural significance of the intervention, and overall satisfaction with the program at baseline. | Baseline (at enrolment) |
| Participant Satisfaction- Participant Diaries | Data will be collected through participant diaries that focus on experiences with country food consumption, the perceived cultural significance of the intervention, and overall satisfaction with the program 4 weeks after enrolment | 4 weeks after enrolment |
| Participant Satisfaction- Participant Diaries | Data will be collected through participant diaries that focus on experiences with country food consumption, the perceived cultural significance of the intervention, and overall satisfaction with the program 8 weeks after enrolment | 8 weeks after enrolment |
| Participant Satisfaction- Participant Diaries | Data will be collected through participant diaries that focus on experiences with country food consumption, the perceived cultural significance of the intervention, and overall satisfaction with the program 12 weeks after enrolment | 12 weeks after enrolment |
Assessment of the Role of Elders in Transferring Cultural Knowledge will be evaluated through guided unikkaaqatiginniq conversations. |
| 12 weeks after enrolment |
| Systemic Barriers to Accessing Country Food- Interviews | Evaluation of systemic barriers to accessing country food will be done via interviews with health care providers who provide care to Inuit within the region. | 12 weeks after enrolment |
| Systemic Barriers to Accessing Country Food- Participant Diaries | Evaluation of systemic barriers to accessing country food will be done via qualitative analysis of participant diaries. | 12 weeks after enrolment |
| Systemic Barriers to Accessing Country Food- Discussions | Evaluation of systemic barriers to accessing country food will be done via insights from Circle discussions with participants. | 12 weeks after enrolment |
| Integration of IQ principles into clinical systems- Participant Diaries | Evaluation of the integration of IQ principles into clinical systems will be done via qualitative analysis of participant diaries. Recommendations will be made to the Government of Nunavut and the Nunavut Health Authority based on this analysis into how IQ principles can be incorporated across the health care and clinical systems. | Once between 12-24 weeks after enrolment |
| Integration of IQ principles into clinical systems- Discussions | Evaluation of the integration of IQ principles into clinical systems will be done via insights from Circle discussions with participants. Recommendations will be made to the Government of Nunavut and the Nunavut Health Authority based on this analysis into how IQ principles can be incorporated across the health care and clinical systems. | Once between 12-24 weeks after enrolment |
| Integration of IQ principles into clinical systems- Interviews | Evaluation of the integration of IQ principles into clinical systems will be done via interviews with health care providers who provide care to Inuit within the region. Recommendations will be made to the Government of Nunavut and the Nunavut Health Authority based on this analysis into how IQ principles can be incorporated across the health care and clinical systems. | Once between 12-24 weeks after enrolment |
| Aqqiumavvik - Arviat Wellness Society | Not yet recruiting | Arviat | Nunavut | X0C0E0 | Canada |
| Background |
| Tagalik, S. (2011). Inuit Qaujimajatuqangit: The role of Indigenous knowledge in supporting wellness in Inuit communities. National Collaborating Centre for Aboriginal Health. https://www.nccih.ca/docs/context/FS-InuitQaujimajatuqangitWellness-EN.pdf |
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| Background | Santos Dunn, C., Yazzie, M., & Tsosie, R. (2023). Colonial legacies, food sovereignty, and health inequities among Indigenous peoples. Indigenous Policy Journal, 34(1), 1-18. |
| Background | Rink, E. (2019). Intergenerational trauma and resilience among Indigenous youth: A multi-level intervention model. Journal of Adolescent Health, 65(6), 782-789. https://doi.org/10.1016/j.jadohealth.2019.07.014 |
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| 28776115 | Background | Marmot M. Social justice, epidemiology and health inequalities. Eur J Epidemiol. 2017 Jul;32(7):537-546. doi: 10.1007/s10654-017-0286-3. Epub 2017 Aug 3. |
| Background | Louis, R. P. (2007). Can you hear us now? Voices from the margin: Using Indigenous methodologies in geographic research. Geographical Research, 45(2), 130-139. https://doi.org/10.1111/j.1745-5871.2007.00443.x |
| Background | LaLonde, C. E., Richmond, C. A., & McGregor, D. (2023). Food security, cultural continuity, and Indigenous health in Canada: The critical role of community initiatives. Canadian Journal of Public Health, 114(1), 45-54. https://doi.org/10.17269/s41997-022-00669-0 |
| Background | Kovach, M. (2009). Indigenous methodologies: Characteristics, conversations, and contexts. University of Toronto Press. |
| Background | Kazdin, A. E. (2021). Research design in clinical psychology (5th ed.). Cambridge University Press. |
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| Background | Healey Akearok, G., Tagalik, S., & Healey, J. (2024). Integrating Inuit Qaujimajatuqangit in clinical trials: A decolonizing approach to mental health research. Canadian Indigenous Health Review, 4(1), 32-50. |
| Background | Healey Akearok, G., Tagalik, S., & Healey, J. (2019). Inuit knowledge and its role in health promotion: Lessons from Nunavut for community-based interventions. Arctic, 72(3), 273-285. https://doi.org/10.14430/arctic69064 |
| Background | First Nations Information Governance Centre. (2014). Ownership, Control, Access and Possession (OCAP®): The path to First Nations information governance. First Nations Information Governance Centre. |
| 21753059 | Background | Egeland GM, Johnson-Down L, Cao ZR, Sheikh N, Weiler H. Food insecurity and nutrition transition combine to affect nutrient intakes in Canadian arctic communities. J Nutr. 2011 Sep;141(9):1746-53. doi: 10.3945/jn.111.139006. Epub 2011 Jul 13. |
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