This paper considers the Aboriginal population in Canada (composed of First Nations, Métis and Inuit peoples) and explores the hypothesis that the degree to which traditional knowledge concepts, specifically in the area of mental health, is impacted by the extent to which a given population has achieved self-government. Additionally, from a public policy standpoint, this study – using a single case comparison methodology – examines the gap between intentions outlined in policy formulation stage guidance documents, indicating that the Canadian federal government intends to incorporate traditional knowledge to a greater degree, and evidence present at the policy implementation and budgeting stage, where it is clear that the application of the guidance does not always result in the stated outcome. By looking at similarities and differences between the case populations, this study will highlight some successes in the field of mental health policy, assess the challenges that policymakers face in the area of Aboriginal health, and offer suggestions to arrive at a place in the future where fundamental mental health disparities have been reduced for Aboriginal people in Canada.

Background: Little is known about shared decision-making (SDM) interventions with Aboriginal Peoples. Purpose: To explore Aboriginal women’s SDM needs and engage Aboriginal women in culturally adapting an SDM approach. Methods: Three studies were guided by an advisory group, ethical framework and a postcolonial theoretical lens. 1. A systematic review of the literature to identify health decision-making interventions to support Indigenous Peoples. 2. An interpretive descriptive qualitative study using individual interviews with Aboriginal women to explore decision-making needs. 3. An interpretive descriptive qualitative study to culturally adapt and usability test the Ottawa Personal Decision Guide (OPDG) to support decision making by Aboriginal women. Results: 1. The only eligible intervention study was a randomized control trial conducted in the United States with 44 Indigenous students. Compared to baseline, post-intervention the students demonstrated increased knowledge and use of a four-step decision-making process. 2. Interviews with 13 Aboriginal women supported SDM. Shared decision-making needs were represented by four major themes and presented in a Medicine Wheel framework: To be an active participant; To feel safe with care; Engagement in the decision process; Personal beliefs and community values. Supports for each of the major themes focused on the relational nature of shared decision-making. 3. Aboriginal women participated in two focus groups (n=13) or usability interviews with decision coaching (n=6). For culturally adapting the OPDG seven themes were identified: “This paper makes it hard for me to show that I am capable of making decisions”; “I am responsible for my decisions”; “My past and current experiences affect the way I make decisions”; “People need to talk with people”; “I need to fully participate in making my decisions”; “I need to explore my decision in a meaningful way”; “I need respect for my traditional learning and communication style.” Conclusions: There is little evidence on SDM interventions with Indigenous Peoples. Although Aboriginal women support SDM, they may have unmet decision-making needs. The OPDG was culturally adapted to be combined with decision coaching and needs to be evaluated.

From the Arctic to the South Pacific, Indigenous Peoples have experienced a rapid nutrition transition involving the decline of traditional/subsistence-based ways of life and the adoption of a “Western” diet that is high in saturated fats, sugar, and processed foods. This dietary shift has been paralleled by an increased prevalence of obesity, diabetes, and, other diet-related chronic diseases. In the Arctic, rapidly changing biophysical conditions, globalization, and integration into market economies are collectively challenging access to both country foods and nutritious market foods. Food security and nutrient adequacy thus remain elusive for Inuit communities of northern Canada. Premised upon the view that human well-being is predicated upon complex and dynamic interactions between ecosystems, economies, and societies, this dissertation integrates multiple lines of inquiry and scales of engagement (community, regional, and national) to further understanding of the nutrition transition among Inuit in Canada. The thesis is comprised of two sections. Section 1 bridges the often disparate fields of human nutrition and wildlife conservation by addressing key questions about the status and management of Arctic species, and the implications for Inuit food security and health. For example, caribou (Rangifer tarandus) populations across the circumpolar north are currently experiencing dramatic declines in abundance and restrictions on Inuit subsistence harvest are currently implemented for several caribou populations. Caribou, however, is the primary source of protein and several micronutrients involved in the prevention of anemia (e.g. iron zinc, copper, riboflavin, and vitamin B12) in the contemporary diet of Inuit adults. Caribou consumption is also positively associated with hemoglobin levels in Inuit adults. Section 2 considers elements of the market food system in Inuit communities. We found that the most popular market foods consumed by Inuit (e.g. sweetened beverages, added sugar, and bread) contribute significantly to total diet energy while contributing minimally to most micronutrients. Using optimization models, we have demonstrated that a nutritious diet (one meeting Health Canada dietary reference intake values) is theoretically feasible based on a mix of country food and market food, and at relatively little additional cost from current diets. However, significant deviations in patterns of food expenditure away from sweetened beverages, towards dairy, and whole fruits and vegetables would be required. Taken collectively, this thesis provides important information, as well as new tools, and approaches, for communities, wildlife conservation and public health professionals to jointly promote ecosystem and human health in a rapidly changing environment.

Cette thèse a pour but d’analyser l’émergence et l’évolution de différents discours portant sur la sécurité et la souveraineté arctiques au Canada, pendant la décennie 2000-2010. Notre regard portera plus précisément sur le discours du Grand Nord assiégé. Une de nos questions de recherche fut de comprendre comment des évaluations optimistes et pessimistes du portrait sécuritaire arctique au Canada se sont traduites dans les discours sécuritaires arctiques tenus par différents acteurs politiques canadiens au cours de la décennie 2000-2010. De plus, une deuxième question de recherche se demandera si des groupes de la société civile canadienne ont été à même de formuler des idées sécuritaires alternatives à celles défendues par le gouvernement canadien. Pour ce faire, nous réaliserons une analyse de contenu qualitative de trois différents acteurs politiques canadiens : le gouvernement fédéral, les médias, plus particulièrement les textes d’opinion dans les quotidiens canadiens, et les groupes inuits. Une attention particulière sera portée à trois crises de souveraineté ayant éclaté durant cette période : la crise de l’île de Hans (été 2005), celle du sous-américain USS Charlotte (hiver 2005-2006) et la crise du drapeau russe sous le pôle nord (été 2007). Nos conclusions nous indiquent que le discours pessimiste a été exprimé en tout premier lieu dans les médias canadiens avant d’être inséré dans la rhétorique gouvernementale en 2005. De plus, les menaces étatiques vont davantage mobiliser les différents acteurs politiques canadiens étudiés que les menaces non-étatiques. La menace russe en particulier a été utilisée pour justifier des mesures additionnelles de défense de la souveraineté canadienne en Arctique. Sur notre deuxième question de recherche, nous pouvons observer que la société civile canadienne a été capable d’exprimer des idées sécuritaires alternatives. Par contre, les idées dominantes du continentalisme et du nationalisme ont guidé la politique étrangère canadienne pendant une bonne partie de la décennie, l’internationalisme libéral étant marginalisé par la prédominance de celles-ci. De plus, les groupes inuits ont été les plus à même de formuler des conceptualisations alternatives de la sécurité et de la souveraineté arctiques au Canada.

Cette thèse vise à démystifier comment de jeunes Inuit font l’expérience de la vie à Ottawa. Les résultats révèlent que les participants à cette étude se positionnent et négocient leurs interactions d’après les relations qu’ils entretiennent avec les différents acteurs de leur environnement. En vue de leur maintien et équilibre, ces relations sont en constante négociation. Afin de se sentir mieux en ville, ils y aménagent des zones de confort mobiles, se créent de « miniunivers » inuit et s’ouvrent aux mondes urbains. Les jeunes Inuit profitent aussi de leur présence à Ottawa pour mieux se positionner par rapport au monde inuit, en (re)trouvant un bien-être personnel et en acquérant les outils et connaissances nécessaires pour contribuer à leur collectivité. Ils y développent notamment leur leadership par l’entremise de rencontres avec d’autres jeunes Inuit et autochtones et s’activent au sein même de la ville d’Ottawa à la transformation des réalités inuit. / This research seeks to demystify how Inuit youth experience living in Ottawa. Results reveal that, throughout their urban experiences, youth position themselves and negotiate their interactions according to their coexistence with the different elements of their environment. This relationship is constantly adjusting; it pushes them to alter their life in order to feel more comfortable in the city, develop their inner strengths and contribute to the collective effort in Ottawa. By creating comfort zones, finding Inuit spaces and exploring urban resources, the burden of balancing such different lifestyles is greatly mitigated. Inuit youth use their presence in the city to reorient their position within the Inuit world. By building self-confidence and developing skills which permit them to contribute to their community, they also develop leadership. These skills allow them to actively participate in the transformation of Inuit realities while living in Ottawa.

This thesis addresses food security and road development in Tuktoyaktuk (population 995), a primarily Inuvialuit (Indigenous, Inuit) community in the western Canadian Arctic. Initially, I had hoped to conduct interviews in Tuktoyaktuk to better understand how the new Inuvik-to-Tuktoyaktuk Highway (ITH), opened in 2017 (the first highway to the Arctic Ocean) had affected food security in Tuktoyaktuk. This plan was interrupted. // INTERRUPTION \\ --THIS THESIS HAS BEEN INTERRUPTED \\ What do we do when our plans are forced to change? How do we react, adapt, and overcome these changes? How do we reflect on such interruptions? These questions are the underlying essence of this thesis and they reflect my experience of engaging in Arctic community-based research during the COVID-19 pandemic. This thesis presents two articles that are a result of many interruptions. The first (1) is an econometric evaluation of the cost of food before and after the opening of the ITH and the subsequent rescission of the Nutrition North Canada federal food subsidy program to the now road-accessible community of Tuktoyaktuk. The results suggest a significant increase in market basket prices which can be attributed to the opening of the highway and the subsidy loss (+CAD$44, SE = 16.77, p = 0.02). This research is the first to document the impacts of highway development on food prices in Arctic Indigenous communities. The second (2) is a co-authored methods piece about friendship, reciprocity, and reconciliation between two young women; a 17 year old Inuvialuit journalist and myself, a 25 year old Québécoise Master’s student, navigating research for the first time and during the pandemic. In the process, we reflect on what reconciliation means to us and provide recommendations for Arctic community-based research in a post-pandemic world. // BREAK. BREAK. THIS THESIS IS AN INTERRUPTION \\ In form and content, this thesis offers a reflection on the process of conducting and writing about research, juxtaposing qualitative (at times creative) and quantitative methods under a community-based research framework for working with Inuit.

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