Aidan Neill, Stephanie Montesanti, Lea Bill, Barbara S E Verstraeten, Rhonda C Bell, Richard T Oster, Arto Ohinmaa, Mike Paulden
{"title":"在加拿大西部第一民族背景下协调土著和西方卫生资源决策概念。","authors":"Aidan Neill, Stephanie Montesanti, Lea Bill, Barbara S E Verstraeten, Rhonda C Bell, Richard T Oster, Arto Ohinmaa, Mike Paulden","doi":"10.1007/s40258-025-01004-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Western health economic evaluation tools often fail to reflect the relational, collective, and holistic perspectives that underpin Indigenous concepts of health. These limitations pose challenges when applying Western measures in Indigenous contexts. The individualistic foundation of the Western definition of health and the values that inform it are significantly different from the community-based values typically found in Canadian Indigenous communities. For health economics to effectively support Indigenous health decision making, a values-based approach should initially be undertaken to identify conceptual commonalities with Western perspectives.</p><p><strong>Aims: </strong>This study aimed to develop a conceptual framework that identifies shared elements between Western and First Nations understandings of health resource decision making, with the goal of supporting the creation of culturally meaningful health outcome measures.</p><p><strong>Methods: </strong>Through a Health Economics Technical Advisory Group (HE-TAG) in Alberta, Canada, co-led by Indigenous and non-Indigenous researchers, we conducted a conceptual exploration of health resource decision making. Fourteen HE-TAG sessions held between July 2021 and June 2023 were transcribed and analyzed using a hybrid approach-combining Q methodology, thematic analysis (Braun & Clarke), and Walker and Avant's concept analysis.</p><p><strong>Data: </strong>Transcripts from 14 HE-TAG sessions provide the qualitative data upon which analysis was conducted. Sessions were held online using virtual meeting technology, and recordings were transcribed and analyzed.</p><p><strong>Results: </strong>Indigenous and Western conceptual frameworks allow for a common understanding of health resourcing. Indigenous community and culture and Western economic evaluation and social determinants of health were the four main observed themes, each of which contained two subthemes which differentiated between concepts of 'health.' Five concepts were found to resonate between Indigenous and Western themes when exploring health resource thinking: values, holism, time, resources, and context. Concepts and themes were mapped to illustrate common approaches to understanding health resource decision making.</p><p><strong>Conclusions: </strong>This Indigenous-informed research aligns concepts of resource decision making by showing the thematic backgrounds of First Nations and Western thinking, which are linked by the common concepts of values, holism, time, resources, and context. Centering future community engagement on these shared concepts while grounding them in community-generated health value sets can advance the development of novel, culturally relevant health outcome measures.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Aligning Indigenous and Western Concepts of Health Resource Decision Making in a Western Canadian First Nations Context.\",\"authors\":\"Aidan Neill, Stephanie Montesanti, Lea Bill, Barbara S E Verstraeten, Rhonda C Bell, Richard T Oster, Arto Ohinmaa, Mike Paulden\",\"doi\":\"10.1007/s40258-025-01004-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Western health economic evaluation tools often fail to reflect the relational, collective, and holistic perspectives that underpin Indigenous concepts of health. These limitations pose challenges when applying Western measures in Indigenous contexts. The individualistic foundation of the Western definition of health and the values that inform it are significantly different from the community-based values typically found in Canadian Indigenous communities. For health economics to effectively support Indigenous health decision making, a values-based approach should initially be undertaken to identify conceptual commonalities with Western perspectives.</p><p><strong>Aims: </strong>This study aimed to develop a conceptual framework that identifies shared elements between Western and First Nations understandings of health resource decision making, with the goal of supporting the creation of culturally meaningful health outcome measures.</p><p><strong>Methods: </strong>Through a Health Economics Technical Advisory Group (HE-TAG) in Alberta, Canada, co-led by Indigenous and non-Indigenous researchers, we conducted a conceptual exploration of health resource decision making. Fourteen HE-TAG sessions held between July 2021 and June 2023 were transcribed and analyzed using a hybrid approach-combining Q methodology, thematic analysis (Braun & Clarke), and Walker and Avant's concept analysis.</p><p><strong>Data: </strong>Transcripts from 14 HE-TAG sessions provide the qualitative data upon which analysis was conducted. Sessions were held online using virtual meeting technology, and recordings were transcribed and analyzed.</p><p><strong>Results: </strong>Indigenous and Western conceptual frameworks allow for a common understanding of health resourcing. Indigenous community and culture and Western economic evaluation and social determinants of health were the four main observed themes, each of which contained two subthemes which differentiated between concepts of 'health.' Five concepts were found to resonate between Indigenous and Western themes when exploring health resource thinking: values, holism, time, resources, and context. Concepts and themes were mapped to illustrate common approaches to understanding health resource decision making.</p><p><strong>Conclusions: </strong>This Indigenous-informed research aligns concepts of resource decision making by showing the thematic backgrounds of First Nations and Western thinking, which are linked by the common concepts of values, holism, time, resources, and context. Centering future community engagement on these shared concepts while grounding them in community-generated health value sets can advance the development of novel, culturally relevant health outcome measures.</p>\",\"PeriodicalId\":8065,\"journal\":{\"name\":\"Applied Health Economics and Health Policy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-09-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Applied Health Economics and Health Policy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40258-025-01004-4\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ECONOMICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Applied Health Economics and Health Policy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40258-025-01004-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
Aligning Indigenous and Western Concepts of Health Resource Decision Making in a Western Canadian First Nations Context.
Background: Western health economic evaluation tools often fail to reflect the relational, collective, and holistic perspectives that underpin Indigenous concepts of health. These limitations pose challenges when applying Western measures in Indigenous contexts. The individualistic foundation of the Western definition of health and the values that inform it are significantly different from the community-based values typically found in Canadian Indigenous communities. For health economics to effectively support Indigenous health decision making, a values-based approach should initially be undertaken to identify conceptual commonalities with Western perspectives.
Aims: This study aimed to develop a conceptual framework that identifies shared elements between Western and First Nations understandings of health resource decision making, with the goal of supporting the creation of culturally meaningful health outcome measures.
Methods: Through a Health Economics Technical Advisory Group (HE-TAG) in Alberta, Canada, co-led by Indigenous and non-Indigenous researchers, we conducted a conceptual exploration of health resource decision making. Fourteen HE-TAG sessions held between July 2021 and June 2023 were transcribed and analyzed using a hybrid approach-combining Q methodology, thematic analysis (Braun & Clarke), and Walker and Avant's concept analysis.
Data: Transcripts from 14 HE-TAG sessions provide the qualitative data upon which analysis was conducted. Sessions were held online using virtual meeting technology, and recordings were transcribed and analyzed.
Results: Indigenous and Western conceptual frameworks allow for a common understanding of health resourcing. Indigenous community and culture and Western economic evaluation and social determinants of health were the four main observed themes, each of which contained two subthemes which differentiated between concepts of 'health.' Five concepts were found to resonate between Indigenous and Western themes when exploring health resource thinking: values, holism, time, resources, and context. Concepts and themes were mapped to illustrate common approaches to understanding health resource decision making.
Conclusions: This Indigenous-informed research aligns concepts of resource decision making by showing the thematic backgrounds of First Nations and Western thinking, which are linked by the common concepts of values, holism, time, resources, and context. Centering future community engagement on these shared concepts while grounding them in community-generated health value sets can advance the development of novel, culturally relevant health outcome measures.
期刊介绍:
Applied Health Economics and Health Policy provides timely publication of cutting-edge research and expert opinion from this increasingly important field, making it a vital resource for payers, providers and researchers alike. The journal includes high quality economic research and reviews of all aspects of healthcare from various perspectives and countries, designed to communicate the latest applied information in health economics and health policy.
While emphasis is placed on information with practical applications, a strong basis of underlying scientific rigor is maintained.