Enigok Project

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Enigok 2010-11 Project Discussing Ethics & Benefits of Research Assembly of Manitoba Chiefs Health Information Research Governance Committee and Chiefs Task Force on Health

AMC Chiefs in Assembly 1996 - Mandated AMC-Health Information Research Governance Committee (AMC- HIRGC) as the First Nations research ethics board to: Oversee Regional Health Survey (RHS, 2001-2002) Review research proposals 2007 - Amended the AMC constitution to support research for self-determination. Research must be done with First Nations and follow: Free Prior Informed Consent; First Nations OCAP Principles First Nations have Ownership, Control, Access and Possession of their own data and; First Nations Ethical standards.

Enigok* 2010 and beyond to engage MFNs, Elders, leaders, researchers thru circles of discussions to: Promote Research by and with Manitoba First Nations according to fundamental FN principles Engage researchers in learning their goals & concerns and in sharing FNs priorities & standards Gain ideas how to make AMC HIRGC a more effective Regional Ethics Board for MFNs * Enigok is Ojibway for cheering us on: work hard, sturdy, use all your effort!

Enigok project partners AMC applied for a grant on behalf of Assembly of Manitoba Chiefs (AMC) Health Information Research Governance Committee (HIRGC) and the Chiefs Task Force on Health (CTFoH). Partners include University of Manitoba Faculty of Medicine: Dr. Sharon MacDonald, Director, Community Health Sciences Dr. Cathy Cook, Associate Dean, Faculty of Medicine, interim Director of First Nations, Metis and Inuit Health, and Principal Investigator, NEAHR @ UM. Dr. Brenda Elias, co-director, Manitoba First Nations Centre for Aboriginal Health Research (MFN CAHR), and assistant professor, CIHR New Investigator Dr. Michael Hart, co-director, Manitoba First Nations Centre for Aboriginal Health Research (MFN CAHR), Assistant Professor, Faculty of Social Work Tracy Scott, M.N., Knowledge Liaison, Saint Elizabeth Health Care, including @YourSide Colleague online training and knowledge exchange system with FNs. Funding is from Canadian Institutes for Health Research (CIHR) and Network Environment for Aboriginal Health Research (NEAHR) at UM (AMC is part of NEAHR partnership).

We invite you to join us: Learn about MFN Chiefs 3 conditions for research with First Nations: FREE PRIOR INFORMED CONSENT FIRST NATIONS PRINCIPLES OF OCAP FIRST NATIONS ETHICAL PRINCIPLES

Free Prior Informed Consent Consent (agreement) to participate in research requires both community and individual consent Key Questions to ask: Does the research involve a significant # of FN? Does the research involve 1 FN, or more? (If one or a group of communities in a Tribal Council area, individual community or TC Council protocols prevail. Consent must be: free (voluntary no pressure); prior (before any info collected), and informed (FN and person needs to know what research purpose, methods, use would be ahead of participation).

FIRST NATIONS PRINCIPLES OF OCAP O- OWNERSHIP C- CONTROL A- ACCESS P- POSSESSION Originally coined in 1998 as OCA OCAP is fundamentally tied to: self-determination self-governance First Nations governments, like other governments, need data on their people the preservation and development of First Nations cultures. OCAP allows a community to make decisions regarding why, how and by whom information is collected, used and shared for research, evaluation and planning purposes.

OCAP : Ownership Relationship of First Nations to their cultural knowledge/ data/ information; Community/group owns information collectively just as individuals own their personal information; Distinct from possession (stewardship). - First Nations Centre, National Aboriginal Health Organization http://www.naho.ca/firstnations/

OCAP: Control maintain, regain control in all areas of their lives includes research, information and data control over all aspects and stages of research and information management projects and processes that impact them. This includes generating or validating research questions that are meaningful and important to FN. extends to resources, policy, review processes, formulation of conceptual frameworks, data management etc. 9

OCAP: Access ACCESS First Nations: must have access to information, data about themselves and their communities, wherever it is held. manage and make decisions regarding access to their collective information. - First Nations Centre, National Aboriginal Health Organization http://www.naho.ca/firstnations/ 10

OCAP: Possession POSSESSION Possession (stewardship) is a mechanism to assert, protect ownership. When FN data is in the possession of others (e.g. government, universities), there is a risk of breach or misuse. Especially when trust is lacking between owner and possessor. - First Nations Centre, National Aboriginal Health Organization http://www.naho.ca/firstnations/ 11

The Regional Longitudinal Health Survey (RHS) Background Our Survey, Our Voice, Our Reality In the mid-1990s RHS was designed and developed by First Nations Health Directors from across Canada, including the late Audrey Leader of Pinaymootang First Nation, then AMC Health Director. RHS was carried out in 1997/98 (pilot), 2002/03 (baseline) and 2008/2010 The RHS data reflects the principles of OCAP as developed by First Nations First Nations Ownership, Control, Access, and Possession of their data.

2002/03 RHS Harvard University Project on American Indian Economic Development Independent evaluation of RHS 2002-03 by Harvard found: Compared to other national surveys of Indigenous people around the world, the 2002/2003 RHS was unique in the world, due to: First Nations ownership of the research process from design to reporting. Explicit incorporation of First Nations values and OCAP into the research design. Intensive collaborative engagement of First Nations people and their representatives at each stage of the research process. Consistently praised for Sampling Design, Data Collection, and Data Analysis and Dissemination. 13

First Nations Ethical Standards 63 First Nations in Manitoba are peoples of several indigenous nations Cree, Dakota, Dene, Ojibway, OjiCree. We each have our own views and ideas within our own languages. In March 2005, Elders from our nations in MB met in workshop on research ethics and agreed: Research is a relationship based on respect and it takes time to build trust.

Overall Protocol Contact and engage AMC/Community/FN partner prior to/or at the idea or draft stage of research proposal Draft proposal, if possible involve partners in design, consider feedback Finalize proposal Submit proposal to AMC HIRGC/Community/Tribal Council obtain letter of support University Research Ethics Board Maintain communication/consultation/ engagement through entire research process

ACCOUNTABILITY TO MANITOBA FIRST NATIONS Researchers and research teams first and foremost consult, dialogue, report data/findings, and be accountable to their First Nation partners/leaders/community prior to any publication. AMC-HIRGC is accountable to the Chiefs Task Force on Health (CTFoH). CTFoH are mandated by and accountable to the Chiefs in Assembly First Nation partners/leaders/community have right to dissent First Nations partners/leaders/community have right to be acknowledged or participate in authorship depending on role in research.

Have your say What rules or guidelines do you think should be set for researchers?

For Additional Information: Go to the AMC website at www.manitobachiefs.com or sign up for an @YourSide Colleague account at : http://www.atyourside.ca/fni/fni_index.html to access background documents such as: Upcoming Enigok activities OCAP & Free Prior Informed Consent RHS 2002-2003 Regional Report FNIGC & National RHS 2002-2003 Report AMC-HIRGC mandate and membership Traditional Code of Ethics & RHS Code of Ethics First Nations Ethical Principles Research Collaboration Agreement Template Links to Other Review Ethics Boards etc

Miigwech Mahsi Ekosani Wopida! For more information, please contact AMC: Dr. Kathi Avery Kinew, Manager Research & Social Dev t Leona Star, Researcher/Policy Analyst Leanne Gillis, Administrative Assistant AMC Mainline: 204-956-0610 or 1-888-324-5384 kathiaverykinew@manitobachiefs.com lstar@manitobachiefs.com lgillis@manitobachiefs.com *Photo credit: Scott Benesiinaabandan