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Building Resilience and Community Capacity: the Sachigo Lake Wilderness Emergency Response Education Initiative

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Building Resilience and Community Capacity: the Sachigo Lake Wilderness Emergency Response Education Initiative BUILDING RESILIENCE AND COMMUNITY CAPACITY: THE SACHIGO LAKE WILDERNESS EMERGENCY RESPONSE EDUCATION INITIATIVE by Jeffrey Curran A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science (MSc) in Interdisciplinary Health The School of Graduate Studies Laurentian University Sudbury, Ontario, Canada © Jeffrey Curran, 2014 THESIS DEFENCE COMMITTEE/COMITÉ DE SOUTENANCE DE THÈSE Laurentian Université/Université Laurentienne School of Graduate Studies/École des études supérieures Title of Thesis Titre de la thèse BUILDING RESILIENCE AND COMMUNITY CAPACITY: THE SACHIGO LAKE WILDERNESS EMERGENCY RESPONSE EDUCATION INITIATIVE Name of Candidate Nom du candidat Curran, Jeffrey Degree Diplôme Master of Science Department/Program Date of Defence Département/Programme Interdisciplinary Health Date de la soutenance April 17, 2014 APPROVED/APPROUVÉ Thesis Examiners/Examinateurs de thèse: Dr. Stephen Ritchie (Co-supervisor/Co-directeur de thèse) Dr. John Lewko (Co-supervisor/Co-directeur de thèse) Dr. Aaron Orkin (Committee member/Membre du comité) Approved for the School of Graduate Studies Dr. David VanderBurgh Approuvé pour l’École des études supérieures (Committee member/Membre du comité) Dr. David Lesbarrères M. David Lesbarrères Dr. Mary Lou Kelley Director, School of Graduate Studies (External Examiner/Examinatrice externe) Directeur, École des études supérieures ACCESSIBILITY CLAUSE AND PERMISSION TO USE I, Jeffrey Curran, hereby grant to Laurentian University and/or its agents the non-exclusive license to archive and make accessible my thesis, dissertation, or project report in whole or in part in all forms of media, now or for the duration of my copyright ownership. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also reserve the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. I further agree that permission for copying of this thesis in any manner, in whole or in part, for scholarly purposes may be granted by the professor or professors who supervised my thesis work or, in their absence, by the Head of the Department in which my thesis work was done. It is understood that any copying or publication or use of this thesis or parts thereof for financial gain shall not be allowed without my written permission. It is also understood that this copy is being made available in this form by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner. ii Abstract The Sachigo Lake Wilderness Emergency Response Education Initiative represented a partnership between Sachigo Lake First Nation in northern Ontario Canada, and medical professionals and university researchers from outside the community. This study was one component of a larger community-based participatory research program to develop locally relevant first response training to address the isolation from emergency healthcare in Sachigo Lake. The aim of this qualitative study was to complete a formative evaluation to understand how a five-day comprehensive training course implemented in May 2012: (a) met the local needs of Sachigo Lake; and (b) fostered resilience and community capacity. The results of this study describe the unique features of delivering first aid training in a remote context and illustrate the intrapersonal and interpersonal impacts of the program. Health promotion through community- based first aid education is a model with potential to improve emergency care in the absence of formal emergency medical services. Keywords: Community-based participatory research; rural and remote health; health promotion; Indigenous health; first aid; resilience; community capacity. iii Acknowledgments I would like to thank the community of Sachigo Lake First Nation for their support and involvement in this program. The program would not have been possible without the hard work of all the people involved. The Chief and Council, community members, staff of the local Health authority, staff of the Isaac Barkman Memorial Nursing Station, and staff of the local detachment of the Nishnawbe-Aski Police Service donated their valuable time and expertise to collaborate in the development, implementation, and evaluation of the Sachigo Lake Wilderness Emergency Response Education Initiative. I would like to thank Jackson Beardy for his extensive support and guidance, as well as Margaret Hudson, Laureen Kaminawaish, and Jennifer McKay for their time and expertise as research partners throughout the research process. I would also like to acknowledge my supervisory committee (Stephen Ritchie, Aaron Orkin, David VanderBurgh, and John Lewko) for their extensive support and guidance in the development of this study and document, as well as Rachel Jamieson, Calen Sacevich, and Baijayanta Mukhopadhyay for their support and participation in the evaluation. Furthermore, I would like to thank Mary Lou Kelly for her involvement as external reviewer and providing constructive feedback on the final document. The Sachigo Lake Wilderness Emergency Response Education Initiative received funding from the Institute of Aboriginal People’s Health of the Canadian Institutes of Health Research, and the Northern Ontario Academic Medical Association. iv Table of Contents Abstract .................................................................................................................................................. iii Acknowledgments ............................................................................................................................... iv Table of Contents .................................................................................................................................. v List of Tables .......................................................................................................................................... vi List of Figures ...................................................................................................................................... vii List of Appendices ............................................................................................................................. viii Executive Summary ............................................................................................................................. ix Chapter 1: Introduction ...................................................................................................................... 1 1.1 Access to Healthcare in the Far North of Ontario .......................................................................... 2 1.2 The State of First Nations’ Health in Ontario .................................................................................. 4 1.3 Emergency Response Program Potential ......................................................................................... 6 1.4 Locally Appropriate Health Promotion Challenges ...................................................................... 9 1.5 The Multidimensional Concept of Health and Associated Factors ....................................... 11 1.6 Sachigo Lake Wilderness Emergency Response Education Initiative ................................. 13 1.7 Resilience and Community Capacity ............................................................................................... 18 1.8 Purpose ..................................................................................................................................................... 20 Chapter 2: Methods ........................................................................................................................... 23 2. 1 Methodological Framework ............................................................................................................. 23 2.2 Reflexivity ................................................................................................................................................ 28 2.3 Ethics ......................................................................................................................................................... 31 2.4 Population and Sample ....................................................................................................................... 33 2.5 Primary Data Collection ...................................................................................................................... 36 2.6 Follow-Up Data Collection .................................................................................................................. 42 2.7 Data Analysis .......................................................................................................................................... 43 2.8 Research Rigour .................................................................................................................................... 47 Chapter 3: Results .............................................................................................................................. 49 3.1 Meeting Local Needs ............................................................................................................................. 50 3.2 Program Outcomes ............................................................................................................................... 74 Chapter 4: Discussion
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