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Engaging for Change


As part of the road to reconciliation with Indigenous peoples in Canada, it is important to address the challenges facing Indigenous people in the health care system. Engagement between the authors and Indigenous health professionals working in Southwestern Ontario identified a number of problems experienced by Indigenous peoples in the health system. 

  • There is lack of culturally safe and compassionate care for Indigenous peoples living in London, Ontario

  • There is lack of engagement of mainstream health care organizations around Indigenous peoples’ health in London, Ontario

  • There is limited if any coordination between mainstream and Indigenous run health services,

  • Priority service areas are cancer care, mental health, emergency, maternal health and diabetes care, based on high levels of need and particular challenges in these areas.


Research Aims

  • To complete a situational analysis to identify gaps and promising practices

  • To increase awareness among care providers of issues in care provisions for Indigenous peoples

  • To assess ways to improve attitudes, knowledge and skills among health care providers

  • To provide an evidence base to inform improvements in services for Indigenous peoples across hospital and community based health systems.



Qualitative research questions explored:

  • attitudes, knowledge and skills in working with Indigenous patients and families;

  • positive and negative experiences; 

  • challenges for patients and providers; 

  • referrals between Indigenous-run health and healing services; 

  • training they have had or would like to have on cross-cultural care; 

  • resources they would need to provide better services for their Indigenous patients. 



The results of this study demonstrated that care providers were aware of a wide range of barriers faced by Indigenous people in health services, from stereotypes held by providers that compromised quality care, to a lack of knowledge or discussion about the traditional and community-based health and healing services that Indigenous people were accessing. Respondents also noted that Indigenous peoples tend not to articulate their health issues to physicians, and often do not get the range of services that would be considered standard practice. 

Wylie, L., & McConkey, S. (2019). Insiders' insight: Discrimination against Indigenous peoples through the eyes of health care professionals. Journal of Racial and Ethnic Health Disparities, 6 (1):37–45

Click here to read the publication.

Mobilizing Narratives to End Colonial Legacies

The stories of racism, discrimination, culturally unsafe practices and poor treatment of Indigenous peoples in Canada represent a collective experience of colonialism, and not just as something of the past. Colonialism continues to shape everyday experiences of all Indigenous people in Canada. 


Storytelling and narratives that share the effect of legacies of colonialism can expose the need for change, and activate that change in societal values, behaviours and beliefs, institutional and organizational practices, and policies. 


We are embarking on a shared journey of how narratives are used to make meaningful change in and around London, including Chippewa of the Thames, Oneida of the Thames, and Muncey Delaware communities. 


We will share stories that can and will change the past, present and future experiences of Indigenous people. 



Improving Diabetes Care in First Nations Communities 

TransFORmation of IndiGEnous PrimAry HEAlthcare Delivery (FORGE AHEAD) Research Program


To develop and evaluate community-driven, culturally relevant, primary healthcare models that enhance chronic disease management and appropriate access to available services in First Nations communities


  1. Assess the current healthcare delivery, funding models, and best practices used in First Nation Communities in Canada

  2. Assess community and clinical readiness to address and adopt chronic disease care measures

  3. Enhance patient access to available community resources for chronic disease care management

  4. Implement and evaluate community and clinical quality improvement initiatives, including cost analysis of activities, to improve chronic disease management

Develop sustainment strategies and scale-up toolkit for improved chronic disease management in First Nations Communities


  1. Community-based participatory research approach that honours and reflects the communities as full partners in all aspects of the research program

  2. Integrated knowledge translation and culturally appropriate processes to ensure cultural and intellectual integrity

  3. Honour the Ownership, Control, Access, and Possession (OCAP®) Principles by FNIGC

  4. Incorporation of the Expanded Chronic Care Model, including the inter-relationships between individual, community, population, and system factors in chronic disease prevention and care

Series of inter-related progressive projects to systematically facilitate participation in the program and engender local healthcare transformation

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