“If you understand you cope better with it”: the role of education in building palliative care capacity in four First Nations communities in Canada

• Published in: BMC Public Health
• Main Authors: Holly Prince, Shevaun Nadin, Maxine Crow, Luanne Maki, Lori Monture, Jeroline Smith, Mary Lou Kelley
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2019
• Subjects: First Nations; Aboriginal; Indigenous; Palliative care; Education; Community development; Public aspects of medicine; RA1-1270; Canada
• Online Access: https://doi.org/10.1186/s12889-019-6983-y; https://doaj.org/article/9c23ef1005324ce19fc5b02181421e2c

Abstract Background In Canada, there is a growing need to develop community-based, culturally appropriate palliative care for Indigenous people living in First Nations communities. The public health approach to palliative care, which emphasizes community-based initiatives, is especially relevant in First Nations communities because care is grounded in their distinct social and cultural context. Central to the public health approach are educational strategies that strengthen communities’ capacity to care for their vulnerable members as they die. This paper presents community-based research conducted with First Nations communities in Canada that aimed to assess and address local palliative care educational needs to improve community capacity in palliative care. Methods Participatory action research (PAR) was conducted with four First Nations communities in Canada over a six-year period (2010–2016). The research occurred in three phases. Phase 1: focus groups, interviews and surveys were employed to assess community specific needs and resources. Phase 2: recommendations were developed to guide the PAR process. Phase 3: educational resources were created to address the identified educational needs. These resources were implemented incrementally over 4 years. Ongoing process evaluation was employed, and revisions were made as required. Results Educational needs were identified for patients, families, community members and internal and external health care providers. A wide and comprehensive range of educational resources were created to address those needs. Those culturally appropriate educational resources are available in a very accessible and useable workbook format and are available for use by other Indigenous people and communities. Conclusions This research provides an example of the public health approach and offers implementation strategies around palliative care education. This paper contributes to the international literature on the public health approach to palliative care by presenting a case study from ...