Factors influencing the provision of care for Inuit in a mainstream residential addiction rehabilitation centre in Southern Canada, an instrumental case study into cultural safety
Abstract Background Provision of culturally safe care has been proposed to address health inequity, including in the areas of mental health and addiction. The factors that influence the provision of culturally safe care remain understudied. This paper explores the factors influencing the efforts of...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-06-01
|
| Series: | Substance Abuse Treatment, Prevention, and Policy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13011-021-00387-6 |
| _version_ | 1819119936740524032 |
|---|---|
| author | Julie Lauzière Christopher Fletcher Isabelle Gaboury |
| author_facet | Julie Lauzière Christopher Fletcher Isabelle Gaboury |
| author_sort | Julie Lauzière |
| collection | DOAJ |
| description | Abstract Background Provision of culturally safe care has been proposed to address health inequity, including in the areas of mental health and addiction. The factors that influence the provision of culturally safe care remain understudied. This paper explores the factors influencing the efforts of a mainstream residential addiction rehabilitation centre to provide culturally appropriate and quality care for Inuit. Methods An instrumental case study was conducted, informed by ethnographic and creative research methods. Over 700 h of participant observation were carried out between March 2018 and January 2020, in addition to qualitative semi-structured interviews (34 participants) and/or member-checking activities (17 participants) conducted with a total of 42 individuals: 20 Inuit residents, 18 clinical/specialized staff, and 4 clinical/administrative managers. An interpretive thematic analysis was performed to examine the factors that may influence the provision of culturally safe care for Inuit residents. Results Ten categories of interrelated factors were identified and classified according to whether they relate to individual, programmatic, organizational, or systemic levels. These categories covered: (1) residents’ and staff’s life experiences; (2) personal and relational qualities and skills; (3) the model of care; (4) model flexibility; (5) ways in which relational aspects were considered; (6) sensitivity of the organization towards the population served; (7) human resources and professional development issues; (8) social climate; (9) political, relational, and funding climate; and (10) legislative, regulatory, and professional environment. While system-level factors generally had a negative effect on experiences of cultural safety, most factors at other levels had both favourable and unfavourable effects, depending on the context and dimensions examined. Conclusions The results offer insight into the interplay between the challenges and barriers that mainstream organizations face when working with Inuit, and the opportunities and enablers that organizations can build on to improve their services. This paper contributes to a better understanding of the challenges and opportunities to providing culturally safe addiction programs to Inuit within a complex intervention setting. It concludes by highlighting some areas for improvement to advance cultural safety in this context. |
| first_indexed | 2024-12-22T06:12:42Z |
| format | Article |
| id | doaj.art-786a85eddb87479bb478911111788aa4 |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-12-22T06:12:42Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-786a85eddb87479bb478911111788aa42022-12-21T18:36:11ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2021-06-0116111510.1186/s13011-021-00387-6Factors influencing the provision of care for Inuit in a mainstream residential addiction rehabilitation centre in Southern Canada, an instrumental case study into cultural safetyJulie Lauzière0Christopher Fletcher1Isabelle Gaboury2Département de médecine de famille et de médecine d’urgence, Université de SherbrookeDépartement de médecine sociale et préventive, Université LavalDépartement de médecine de famille et de médecine d’urgence, Université de SherbrookeAbstract Background Provision of culturally safe care has been proposed to address health inequity, including in the areas of mental health and addiction. The factors that influence the provision of culturally safe care remain understudied. This paper explores the factors influencing the efforts of a mainstream residential addiction rehabilitation centre to provide culturally appropriate and quality care for Inuit. Methods An instrumental case study was conducted, informed by ethnographic and creative research methods. Over 700 h of participant observation were carried out between March 2018 and January 2020, in addition to qualitative semi-structured interviews (34 participants) and/or member-checking activities (17 participants) conducted with a total of 42 individuals: 20 Inuit residents, 18 clinical/specialized staff, and 4 clinical/administrative managers. An interpretive thematic analysis was performed to examine the factors that may influence the provision of culturally safe care for Inuit residents. Results Ten categories of interrelated factors were identified and classified according to whether they relate to individual, programmatic, organizational, or systemic levels. These categories covered: (1) residents’ and staff’s life experiences; (2) personal and relational qualities and skills; (3) the model of care; (4) model flexibility; (5) ways in which relational aspects were considered; (6) sensitivity of the organization towards the population served; (7) human resources and professional development issues; (8) social climate; (9) political, relational, and funding climate; and (10) legislative, regulatory, and professional environment. While system-level factors generally had a negative effect on experiences of cultural safety, most factors at other levels had both favourable and unfavourable effects, depending on the context and dimensions examined. Conclusions The results offer insight into the interplay between the challenges and barriers that mainstream organizations face when working with Inuit, and the opportunities and enablers that organizations can build on to improve their services. This paper contributes to a better understanding of the challenges and opportunities to providing culturally safe addiction programs to Inuit within a complex intervention setting. It concludes by highlighting some areas for improvement to advance cultural safety in this context.https://doi.org/10.1186/s13011-021-00387-6Indigenous peoplesInuitSubstance use treatmentCultural safetyCultural competenceHealth equity |
| spellingShingle | Julie Lauzière Christopher Fletcher Isabelle Gaboury Factors influencing the provision of care for Inuit in a mainstream residential addiction rehabilitation centre in Southern Canada, an instrumental case study into cultural safety Substance Abuse Treatment, Prevention, and Policy Indigenous peoples Inuit Substance use treatment Cultural safety Cultural competence Health equity |
| title | Factors influencing the provision of care for Inuit in a mainstream residential addiction rehabilitation centre in Southern Canada, an instrumental case study into cultural safety |
| title_full | Factors influencing the provision of care for Inuit in a mainstream residential addiction rehabilitation centre in Southern Canada, an instrumental case study into cultural safety |
| title_fullStr | Factors influencing the provision of care for Inuit in a mainstream residential addiction rehabilitation centre in Southern Canada, an instrumental case study into cultural safety |
| title_full_unstemmed | Factors influencing the provision of care for Inuit in a mainstream residential addiction rehabilitation centre in Southern Canada, an instrumental case study into cultural safety |
| title_short | Factors influencing the provision of care for Inuit in a mainstream residential addiction rehabilitation centre in Southern Canada, an instrumental case study into cultural safety |
| title_sort | factors influencing the provision of care for inuit in a mainstream residential addiction rehabilitation centre in southern canada an instrumental case study into cultural safety |
| topic | Indigenous peoples Inuit Substance use treatment Cultural safety Cultural competence Health equity |
| url | https://doi.org/10.1186/s13011-021-00387-6 |
| work_keys_str_mv | AT julielauziere factorsinfluencingtheprovisionofcareforinuitinamainstreamresidentialaddictionrehabilitationcentreinsoutherncanadaaninstrumentalcasestudyintoculturalsafety AT christopherfletcher factorsinfluencingtheprovisionofcareforinuitinamainstreamresidentialaddictionrehabilitationcentreinsoutherncanadaaninstrumentalcasestudyintoculturalsafety AT isabellegaboury factorsinfluencingtheprovisionofcareforinuitinamainstreamresidentialaddictionrehabilitationcentreinsoutherncanadaaninstrumentalcasestudyintoculturalsafety |