Nuts'a'maat shqwaluwun - Knitting ways of life with Indigenous research principles to examine preterm birth in Quw'utsun.

Abstract

Setting: The Quw'utsun Preterm Birth Study used a community-led and participatory action research methodology to investigate preterm birth in Quw'utsun, a First Nations community in Cowichan Valley, British Columbia (BC). Quw'utsun people and staff from the community's Ts'ewulhtun Health Centre partnered with the BC First Nations Health Authority, Island Health (regional health authority), and the University of British Columbia to develop Nuts'a'maat shqwaluwun (one heart, one mind), a framework for conducting research activities.

Intervention: Guided by Elders, Nuts'a'maat shqwaluwun incorporated Quw'utsun standards for research ethics by knitting together snuw'uy'ulh (ways of life), such as Stsi'elh stuhw tu Sul-hween (honour the Elders), with federal policy for ethical conduct of research involving Indigenous people. Situating the study at Cowichan Tribes strengthened the community's authority to lead.

Outcome: The framework, Nuts'a'maat shqwaluwun, fostered a research environment where we could Ti'tul'atul' tst (learn from one another). We learned to bring our knowledges together to conduct the study in ways that respected snuw'uy'ulh. This research was meaningful to Quw'utsun people because snuw'uy'ulh were respected. Our partnerships resulted in the first-ever report of preterm birth rates and risk factors among Quw'utsun people. Knowledge translation activities enhanced community access to results.

Implications: Indigenous Peoples have an inherent and legislated right to self-determination, including the right to lead research involving them. Several principles within Nuts'a'maat shqwaluwun enabled Quw'utsun people to lead this research: (1) trusting relationships; (2) respecting community-specific ways of life; (3) community ownership and access to data; and (4) training opportunities to lead research.