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ETHICAL SPACE FOR ENGAGING CANADIAN INDIGENOUS WOMEN IN CERVICAL SCREENING
I Zehbe, Thunder Bay Regional Research Institute, Thunder Bay , CANADA
K S Berst, Lakehead University, Thunder Bay, CANADA
J Pintar, Lakehead University, Thunder Bay, CANADA
M Maar, Laurentian University, Northern Ontario School of Medicine, Sudbury, CANADA
Background: Cervical cancer is highly preventable. In Canada, an up to 20-fold higher rate of this cancer has been reported in Indigenous women compared to the mainstream population. Cervical cancer incidence is highest in
populations where well-organized cervical screening programs have not been implemented and specifically when screening uptake or follow-up on the results of screening tests are poor.
Objectives: We hypothesize that the higher cervical cancer rate is associated with low screening compliance and a pervasive lack of access to culturally safe screening services for Indigenous women. As a foundation to the
development of culturally safe screening methods we have developed a Participatory Action research (PAR) project in Northwest Ontario based on respectful and meaningful collaboration with Indigenous women, community
health care providers and community leaders.
Methods: Being mindful of the schism that exists between Western public health approaches to cervical cancer screening and Indigenous women’s experiences thereof we borrowed Ermine’s interpretation of ethical space to
create a research dialogue on this sensitive topic with Indigenous communities. We used an iterative approach designed to continuously widen the ethical space of engagement through several cycles of increasing dialogues
with Indigenous stakeholders.
Results: Here we describe the tools and processes to create and maintain ethical space related to research on this important and sensitive subject. This resulted in the completion of a pilot study conducted in one community with
50 women and community support of nine other Indigenous communities for a large scale study involving over a thousand women.
Conclusion: This approach may serve as an example for PAR, e.g. in the context of cancer screening that can be adapted to similar research in Indigenous communities in Canada and overseas.
Declaration of interest