May 25, 2013

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Knowledge Translation & Ethics

Knowledge Translation in Aboriginal Health Research

Knowledge translation (KT) is one of many terms commonly used to describe efforts to use research to fuel positive change. Often there is a gap – called the ‘know-do gap’ – between when new information is created and when this knowledge benefits the members of society. This gap is largely a feature of settler society where knowledge and action are distinct activities. In contrast, in Aboriginal knowledge traditions, knowledge is often inherently practical; the usefulness of knowledge is built-in. Aboriginal communities also have strong traditions of knowledge translation which includes oral traditions, experiential knowledge, and cross-cultural knowledge sharing.

The decision to put research to use making the world a better place is an ethical one motivated by the desire to improve the circumstances in which we human beings find ourselves. In the case of Aboriginal health research, KT is often motivated in part by the urgency of the challenges many communities face, the poorer health (on average) experienced by Aboriginal peoples compared to the general population and a desire for healthy Aboriginal communities and individuals. Western KT methods typically include journal publications and conference presentations. For example, the Centre Director and associates have been published an academic paper in the Canadian Journal of Public Health on creating knowledge translation strategies for Aboriginal research. Centre associates have also given presentations on this topic at events in Oregon, British Columbia, and Nova Scotia. Furthermore, all of CAHR’s publications are also freely available online, to encourage further dissemination of our information and to promote knowledge translation. Some of CAHR’s more recent publications are Healthy Aging Through Fall Prevention Among Older Aboriginal People and Crisis On Tap: Seeking Solutions For Safe Water For Indigenous Peoples. To access our written publications click here. Finally, CAHR maintains the Aboriginal health resource website NEARBC and circulates a weekly e-newsletter. The NEARBC site makes a myriad of Aboriginal health resources freely available to the public, all in one place, including news articles, job advertisements, videos, and an e-library of useful publications, reports, links to other resources and an Aboriginal health abstract database. Each edition of the CAHR/NEARBC e-newsletter summarizes all of the weekly updates to the NEARBC website and currently reaches approximately 1,300 subscribers. By maintaining the NEARBC website and making all of the CAHR materials freely available online, CAHR strives to close the ‘know-do gap’ by making information easily accessible and useful for scholars, researchers and Aboriginal communities who can directly translate these knowledge resources into their work.

In Aboriginal health research, KT also includes sharing research findings in meetings with participants, often held in partner communities to increase accessibility, Elders gatherings, and the joint creation of knowledge products to reflect community needs. For example, during the summer of 2010, in collaboration with six partner communities, CAHR organized a series of workshops in First Nations communities across British Columbia. At these meetings, recent and on-going research was shared as a supplement to community discussions. The meetings were located in rural communities, were free to community members, and were planned with band office staff in each of the communities so that our meetings did not overlap with other community events, to invite participants, and to ensure that community needs are met and traditions respected. By planning our KT in this manner, CAHR helped create opportunities for members of First Nations communities to access and share knowledge. CAHR has also created a documentary on water and Indigenous peoples’ health, which has been made possible by the participation of many Aboriginal and non-Aboriginal community members, academics, policy makers, and practitioners. The documentary, Crisis On Tap, is available here.

From a practical point of view, successful KT requires meaningful community involvement right from the beginning of the research project in order for the new knowledge generated to be relevant to the people it is intended to help. At times, CAHR has approached specific communities that may be interested in a particular research topic, and at others an open call has been made for community participation. Depending on the size and scope of a research project, involving communities more closely in research planning, implementation, and sharing requires commitments of time and resources from both the researcher and prospective community partners. Fortunately, funding agencies are increasingly aware of the additional resources needed for enhancing community involvement in research and have responded to this need with specific grant competitions for community-based research. A number of small grants programs also exist to support community participation in research activities. CAHR is very fortunate to have worked with dedicated members of communities across Canada, and looks forward to many opportunities for collaboration with communities in the future.

Processes which include knowledge users – such as community leaders, practitioners, policy makers, and other members of the community – throughout the research activity are called integrated knowledge translation. An integrated KT approach involves the participation of the knowledge user from the beginning of the project and also contributes to capacity building. By including the knowledge user early on in the research project, integrated KT creates opportunities for capacity-building for both the researcher and the knowledge user. Knowledge users will learn more about the research process itself, as well as about the specific research topic as they participate throughout the project. Researchers will gain a better understanding of the different uses to which their work will be put, helping them tailor the design to meet the needs of communities, and helping them develop future research that is relevant to community needs. Because it involves Aboriginal knowledge users early on, when the research is still being planned, integrated knowledge translation also creates opportunities to increase the role of Indigenous perspectives and research methods in health research.

Ethics in Aboriginal Health Research

The involvement of Aboriginal people in both research and KT is also a requirement for conducting ethical Aboriginal health research. Over the past two decades, researchers and members of Aboriginal communities (and often individuals belonging to both groups) have struggled to more clearly define the role of Aboriginal community interests throughout the research process. One such event, the Ethics Research Involving Aboriginal Peoples Workshop, was a CAHR program coordinated by NEARBC that took place in 2007. These efforts culminated in the 2008 publication of CIHR’s Guidelines for health research involving Aboriginal people. The guidelines were developed by Aboriginal researchers in collaboration with Aboriginal communities, researchers, and institutes using an existing, and widely-touted network: the Aboriginal Capacity and Developmental Research Network. The CIHR’s Institute for Aboriginal Peoples’ Health was then housed at CAHR and led by Scientific Director Dr. Jeff Reading, who was also CAHR’s director. These guidelines strongly influenced the Tri-Council Policy Statement on the ethical conduct for research involving humans, including a chapter addressing the specific needs and expectations for research involving Aboriginal people (Chapter 9). The Tri-Council Policy Statement is now the governing document for the standards of ethical health research involving First Nations, Inuit and Métis people in Canada.

The important achievement of formalized research ethics guiding interactions between researchers, institutions, and Aboriginal communities brings together the aims of government and funding agencies, research intensive institutions and Aboriginal communities. These developments are very recent, and have only just begun to change the landscape of research involving Aboriginal peoples in Canada; the future may look quite different in terms of how Aboriginal peoples are participating in or leading research that concerns their communities.

The research approach embraced by CAHR emphasizes processes through which knowledge users engage with the research team and participate in a way that acknowledges and respects the strengths of both western and traditional ways of knowing.

Links to more information on ethics in Aboriginal health research:

CAHR’s KT activities & materials: