Searching for ‘Best’ Practices in Aboriginal Health Programming & Service Delivery in Alberta Marcy Burka-Charles, MSc Calgary Health Region
Mar 19, 2016
Searching for ‘Best’ Practices in Aboriginal Health Programming
& Service Delivery in Alberta
Marcy Burka-Charles, MScCalgary Health Region
AcknowledgementThis geographic area to be thetraditional territory of the Mi’kmaqpeople from… Mainland Nova Scotia Cape Breton Island
Overview Background Project Activities Evaluation Methodology Key Results
Background Partners:
6 Regional Health Authorities (RHAs)
Steering Committee: RHA representatives Govern project activities
Provincially Funded: Aboriginal Health Strategy
Project Fund
cont. Background Objectives:
Establish a base-line inventory of ‘best’ practices Assess ‘effectiveness’ of RHA funded projects
(1999 – 2005)
Significance: Future funding models Future research agenda
Project Activities2. Literature Review
3. Model Consensus
1. Inventory
n = 82 (1999 - 2005)
community health initiatives
‘Best’ practice…. n = 100 periodicals & non-periodicals
No universal definition
a strategy, activity, approach, or program found to be effective through research, evaluation, &/or experience
Models reviewed were primarily euro-centric & concentric. Most published models omitted culture & spirituality as ‘best’ practice attributes
Better Practice Model Three-phase model
Incorporates Indigenous & Western health ideologies
Synthesizes evidence from both research & practice
FlexibleSource: Cameron et al (2001).
Evaluation Methodology1. Scope of Review
Broad Subjects: Aboriginal Albertans
2. Data Sources Literature Review Document Review Focus Group Interviews (FGIs)
3. Analysis Better Practice Criteria (3 categories) Thematic Analysis
4. Recommendations Practice Research
Model ModificationsData Sources
Literature Review Document Review FGIs
• Effectiveness Criteria: assess selection bias, study design, blinding, confounders, data collection methods, non- responders, etc.
• Limitations:
• Scope of review too broad
• Solution:
• extract examples of better practices from document review
• apply criteria to future literature review
• Plausibility Criteria: assesses program/service potential vs. effectiveness
• Practicality Criteria: assesses affordability, availability, & compatibility
• Attributes applied = 16
• Limitations:
• Report gathering was challenging (18/82)
• no information on need, synergy, sustainability, etc.
• Solution:
• Draft FGI questions
• Plausibility Criteria: questions posed to fulfill information gap from document review (Q 1-4)
• Purposeful Sampling: questions posed (Q 5-6)…
1. What is a ‘best’ or ‘better’ practice?
2. What facilitates it?
3. What hinders it?
• Face Validity Check:
• Stage 1: Respondents
• Stage 2: St. Committee
Key Results – Document ReviewA) Recommended & Promising Practices1. Develop cohesive partnerships2. Hire Aboriginal Health Liaisons & Case Workers3. Incorporate Indigenous language & traditions4. Evaluation
B) ‘To be tracked’ Practices1. Hiring protocols2. Placement of Aboriginal health programs in RHAs
cont. Key Results - FGIsA ‘better’ practice…1. Collaboration2. Education 3. Paradigm shift 4. Research
cont. Key Results - FGIsFacilitators to a ‘better’ practice…1. Formal agreements2. Theoretical approach3. Health system changes4. Champions
cont. Key ResultsBarriers to a ‘better’ practice…1. Inaccurate health statistics2. Institutional culture3. Politics4. Multi-level deficits
cont. Key ResultsMulti-level deficitsincluded… Lack of…
Common vision, mission, goals
Human resources Fiscal resources Time Cultural competence
& safety
Additional Acknowledgements Funding Organization
Alberta Health & Wellness, Alberta Government
Steering Committee & Co-Authors Phillip Burke (Alberta Health & Wellness) Lorraine Deschambeau (Aspen Health Region) Brett Hodson (Calgary Health Region) Malcolm King (ACADRE, University of Alberta) Barb Olsen & Tracy Lee (David Thompson Health Region) Keltie Paul (Northern Lights Health Region) Karoline Phillip (Chinook Health Region) Adrienne Wiebe (Capital Health Region)
Thank You!