Knowledge Translation and Indigenous Health

Wiradjuri et al. (2024) define knowledge translation (KT) as “the process, activities, and deliverables that convert research knowledge and findings into action: knowledge translation is ultimately what makes research matter” (Wiradjuri et al., 2024, p.61).  Integrated knowledge translation, more specifically, entails the process by which knowledge is shared from researchers to those who benefit and can utilize the knowledge learned (Ninomiya Morton et al., 2022). Effective knowledge translation (KT) and integration of KT are essential for communities to benefit from health research. However, these concepts of knowledge dissemination are maintained through a colonial context (Ninomiya Morton et al., 2022). Indigenous Peoples and communities have been practicing effective and intrinsic knowledge translation since time immemorial, well before it became an academic focus. Colonization has limited Indigenous Peoples and communities from accessing research funding, the ability to conduct, and the ability to control how Indigenous health research is presented (Ninomiya Morton et al., 2022).

In addition to Indigenous health research being underrepresented in academia, many non-Indigenous researchers are unaware of their contribution to the issue (Ninomiya Morton et al., 2022). Non-Indigenous researchers are often unaware of the colonial lens in which they view/conduct research, and are unaware and unpracticed in Indigenous research methodologies. Indigenous methodologies are crucial for effective KT of Indigenous research and need to be valued as such by the broader academic community (Kennedy Wiradjuri et al., 2024). The use of Indigenous knowledge systems is beneficial in overcoming “systemically racist colonial structures” to enhance the health and well-being of Indigenous Peoples (Kennedy Wiradjuri et al., 2024, p. 65).

In a recent systematic review, four key considerations were identified to enhance Indigenous health and wellness through knowledge translation (Morton Ninomiya et al., 2022). The first two considerations pertain to funding and accountability of researchers, while the last two pertain to practice and include (a) integrating research ethics, methods and approaches in research training and (b) research adheres to Indigenous ways of knowing and KT. While keeping these considerations in mind, strategies and tools to support effective KT with respect to mitigating cardiovascular disease risk in Indigenous women in Canada will be discussed.

                In supporting Indigenous research ethics, health research must adhere to the First Nations principles of ownership, control, access, and possession (OCAP) (First Nations Information Governance Centre, 2022). These principles outline and detail the ethical guidelines for collecting, protecting, utilizing, and disseminating First Nations health data. Additionally, the CONSIDER statement is another useful tool (Huria et al., 2019). The CONSIDER statement is a comprehensive international checklist that identifies 17 criteria for reporting on Indigenous health research, encompassing aspects such as governance, relationships, priorities, methodologies, participation, capacity, analysis, findings, and dissemination. The CONSIDER statement is highly relevant for ethical health research as it details important elements such as comprehensive community engagement, community identification of priorities, cultural safety, Indigenous worldviews, and the recognition of physical, social, economic, and political contexts. For more information on the CONSIDER statement, see Huria et al. (2019).

                Hanson and Smylie (2006) (as cited in Ellison 2014) provide a comprehensive description of how knowledge is translated within Indigenous communities. This description, known as The Knowledge Circle, can be observed in Figure 1. It helps non-Indigenous researchers understand and appreciate knowledge dissemination through an Indigenous lens. In addition to understanding the flow of knowledge through an Indigenous community, non-Indigenous researchers can recognize the benefit of using Indigenous methods to share knowledge. Morton Ninomiya et al. (2022) suggest using mixed media to share knowledge. This can include film, video, community meetings, social media, songs, music, infographics, yarning circles, arts, storytelling, being present in the community, dance, and visuals (Kennedy Wiradjuri et al., 2024).

Figure 1.

Note: from “Indigenous Knowledge and Knowledge Synthesis, Translation and Exchange (KTSE),” by C. Ellison, 2014, National Collaborating Centre for Aboriginal Health. (https://www.nccih.ca/docs/context/RPT-IndigenousKnowledgeKSTE-Ellison-EN.pdf )

                Lastly, the Indigenous Methodology of Two-Eyed Seeing. Two-Eyed Seeing is an Indigenous methodology that bridges both Western and Indigenous ways of knowing (Northern Ontario School of Medicine, 2021). Hyett et al. (2018) summarize other methodologies; however, Two-Eyed Seeing appears to be a promising approach for health research. Two-eyed Seeing has been identified as an Indigenous methodology that can effectively integrate Western approaches of evidence-based practices with Indigenous knowledge (Rogers et al., 2019).

                Although the strategies and tools discussed here are not comprehensive, they serve as a starting point from which I can help further develop my understanding of Indigenous knowledge and the practice of effective knowledge translation. As a non-Indigenous identifying health promoter, I must continue this journey to deepen my appreciation and understanding of Indigenous worldviews and knowledge, while also reflecting on my role in supporting Indigenous health and well-being.

References

Ellison, C. (2014). Indigenous knowledge and knowledge synthesis, translation and exchange (KTSE). National Collaborating Centre for Aboriginal Health. https://www.nccih.ca/docs/context/RPT-IndigenousKnowledgeKSTE-Ellison-EN.pdf

First Nations Information Governance Centre. (2022). The First Nations Principles of OCAP. https://fnigc.ca/wp-content/uploads/2022/10/FNIGC_OCAP_Brochure_New-Logo_20230608_PRINT.pdf

Hanson, P. G., & Smylie, J. (2006). Knowledge translation for Indigenous communities- A policy making toolkit. Indigenous KT Summit Steering Committee. https://www.ccnsa.ca/docs/setting%20the%20context/KT_Policy_Toolkit_Sept26%5B1%5D.pdf

Huria, T., Palmer, S.C., Pitama, S., Pitama, S., Beckert, L., Ewen, S., & Smith, L.-T. (2019). Consolidated criteria for strengthening reporting of health research involving indigenous peoples: the CONSIDER statement. BMC Medical Research Methodology, 19(173), 1-9. https://doi.org/10.1186/s12874-019-0815-8

Hyett, S., Marjerrison, S., & Gabel, C. (2018). Improving health research among Indigenous Peoples in Canada. CMAJ: Canadian Medical Association, 190(20), E616–E621. https://doi.org/10.1503/cmaj.171538

Kennedy Wiradjuri, M., Ninomiya, M. M., Ninomiya, M. M., Brascoupé Anishinabeg/Haudenausanee, S., Smylie Mѐtis, J., Calma Kungarakan Iwaidja, T., Mohamed Narrunga Kaurna, J., Stewart Taungurung, P. J., & Maddox Bagumani Modewa, R. (2024). Knowledge translation in Indigenous health research: voices from the field. The Medical Journal of Australia, 221(1), 61–67. https://doi.org/10.5694/mja2.52357 

Morton Ninomiya, M. E., Maddox, R., Brascoupé, S., Robinson, N., Atkinson, D., Firestone, M., Ziegler, C., & Smylie, J. (2022). Knowledge translation approaches and practices in Indigenous health research: A systematic review. Social science & medicine (1982), 301, 114898. https://doi.org/10.1016/j.socscimed.2022.114898 

Northern Ontario School of Medicine. (2021). An introduction to Two-Eyed Seeing (Etuaptmumk). https://www.nosm.ca/wp-content/uploads/2022/09/NOSM-CEPD-Tip-Sheet-2021-November-Two-Eyed-Seeing.pdf 

Rogers, B.J., Swift, K., van der Woerd, K., Auger, M., Halseth, R., Atkinson, D. et al. (2019). At the interface: Indigenous health practitioners and evidence-based practice. National Collaborating Centre for Aboriginal Health. https://www.nccih.ca/495/At_the_interface__Indigenous_health_practitioners_and_evidence-based_practice.nccih?id=249