Health in the North: Phase 2 - Case study on the community health service needs of Tuktoyaktuk and mapping back to CAN/CSA-Z1630-17.
Principal Investigator: Leyenaar, Matthew (1)
Licence Number: 16486
Organization: St. Lawrence College/ McMaster University
Licensed Year(s): 2019
Issued: Feb 05, 2019
Project Team: Dr. Christopher Ashton (Co-Investigator, CSA Group/Harbourfront Health Group), Karrie Loynachan (Co-Investigator, St. Lawrence College), Julianne Chow (Research Team, CSA Group), Iva Vasileski (Research Team, CSA Group), Melanie Pinatton (Research Team, CSA Group)

Objective(s): To conduct a community health needs assessment via field work in Tuktoyaktuk.

Project Description: The purpose of this project is for a small team to conduct a community health needs assessment via field work in Tuktoyaktuk, and use the combined qualitative information from participatory community engagement sessions and quantitative data from published statistics to determine the adaptability of this Standard as a model guideline for specific rural application of a community paramedicine (cp) program in Tuktoyaktuk.

The primary goals of the project are:
1) to continue ongoing engagement and partnerships with Indigenous communities, health organizations, primary care teams, paramedic associations, and regulatory bodies;
2) to establish a baseline community health assessment for Tuktoyaktuk and use the findings from stakeholder consultations to determine how a community paramedicine service could address the health service challenges identified; and,
3) to develop a case study and framework for a community paramedicine program for the hamlet of Tuktoyaktuk that is based on the guidance set forth in CAN/CSA-Z1630.

This project involves a qualitative and quantitative study of the community of Tuktoyaktuk. The quantitative research will be accomplished by looking at publicly available data on websites including the NWT Bureau of Statistics, the Canadian Institute of Health Information, and other government websites.

The qualitative aspect of this project involves information gathered through interviews and discussion group sessions with participants in Tuktoyaktuk. Participants represent the wider perspective of anyone who could be impacted by a potential CP program in Tuktoyaktuk and provides a process to articulate and justify their concerns and start to explore solutions for community-based health care decision-making and action.

The qualitative data collection process will be driven by community member participation and is intended to be dynamic so as to best reflect the sensitivity of the researchers to the desires and needs of the community. The exploratory work performed in the first phase of this project was highly informative in providing insights into broad themes that the community wished to articulate. While the research team will remain flexible in the approach based on the input and direction that is received from community members, the team have some preconceptions in terms of the methodology that will be used. For example, the Canadian Standards Association (CSA) includes a checklist for the development of a community paramedicine program that will serve as a starting point for testing the applicability of the Standard to the community. We anticipate there will be items in the checklist and in the Standard that will require adaptation. Based on this premise, we expect to gather further qualitative and quantitative information about the rationale for adaptation. Descriptive statistics of publicly available data - sources may include the NWT Bureau of Statistics, the Canadian Institute of Health Information, and other government websites - will be used to identify characteristics of the population health of the community. The qualitative aspect of the research will illuminate community health desires and priorities, and as such, the Standard can be understood and revised as necessary, from a community-driven perspective.

A simplified checklist for the development of a CP program will be used to frame the collection of qualitative data. The PAR approach will focus on working with others to address issues and solve problems as they become identified through the checklist. Data collected will be analyzed using thematic analysis to generate common themes. The PAR will be comprised of conducting in-person and telephone key informant interviews and focus groups (as arranged by the community) with community leaders, members, elders, local health organizations, first responders, youth, and health departments, and will be conducted in Tuktoyaktuk.

The research methodology includes a participatory action research (PAR) approach to information gathering and data collection. Community members, elders, first responders, health service providers, and youth will be engaged in dialogue about the current health service needs in Tuktoyaktuk and what community residents identify as potential solutions for improving overall population health.

This project will consolidate qualitative findings and quantitative data to produce a case study on the community health needs assessment of Tuktoyaktuk and determine if there is a need for a community paramedicine program to help address these service gaps. The research findings will be disseminated to community leaders and elders in Tuktoyaktuk for education and use as a resource for community planning. The research report can also be shared with local service providers and other health partners. There could be economic benefits of establishing a community paramedicine program if the community determines that this service is needed. It would also create a more cohesive first responder service for Tuktoyaktuk, and has the potential to lead to overall health improvements from having access to timely, community-based health and transportation services, so that community members can continue to live productive and healthy lives.

Results of the study report will be made in a format that is publicly available on the CSA Group website and the link to the report will be shared with Tuktoyaktuk. The free link to the report will be sent to Tuktoyaktuk's community leaders to distribute to their members (and project participants). Results will also be shared with the Department of Health and Social Services, the Inuvialuit Regional Corp., and Health Canada.

The fieldwork for this study will be conducted from February 1, 2019 to March 31, 2019.