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ABORIGINAL HEALING AND WELLNESS STRATEGY
Phase lll - LONGITUDINAL STUDY - Final Report
Joint Management Committee Approved, March 25, 2009

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From the Executive Summary

... Clients are accessing AHWS programs and services to meet a variety of needs. Most clients (94.2%) stated that they chose the AHWS program because it was best suited to meet their needs and that the program made a difference in their lives (94.9%). AHWS-funded programs were reported as best suited for clients because: the program respected their cultural heritage (92.6%); and, the program had a positive impact on their understanding of Aboriginal culture (85.5%). Improvements in Aboriginal health were reported with eighty-six percent (86%) of clients rating their health as “good” or “excellent” after using AHWS-funded programs, whereas only sixty percent (60.2%) rated their health as “good” or “excellent” prior to their involvement with the program. Clients are seeking services that go beyond physical health and although physical care (28.1%) was the leading service clients are seeking; clients are accessing programs and services that address all other areas (emotional – 24.2%, spiritual – 22.0%, and mental – 21.7%) of wholistic health and healing.

Clients reported on the benefits of their involvement of AHWS programming which included: providing support in making healthy lifestyle choices (91.1%); increased access to traditional health providers or traditional supports (80.9%); assisted and supported Aboriginal identity of clients (75.1%); increased access to other health care services (74.2%); and, increased client access to primary health care (49.4%).

Ninety-four percent (93.6%) of clients report that involvement in AHWS programs resulted in learning something new and eighty percent (79.8%) of clients indicated that the program has assisted and been supportive in helping clients change behaviours. Clients report that this has a ripple effect to the family, with ninety-five percent (95%) of clients indicating that their involvement with the program will result in a stronger, healthier family. Eighty percent (79.8%) of clients indicate that the program has had an impact on other family members. Clients report that this also extends to the community and nation, as they report that their experiences at an AHWS program can or has already impacted other community members (77.8%) and their nation (63%).

The Aboriginal Circle of Care, which was identified in Phase l of the Longitudinal Study, referred to the way that AHWS programs and services provide a supportive/caring and trusting environment and continues to be evident in this phase. The highest frequency of clients surveyed (42.1%) indicated that they have been involved with AHWS programs for more than five years, which is evidence of the long-term commitment that is required to begin to see some changes/results in the health and healing of Aboriginal people. Key informants consistently reported on how AHWS clients are increasingly accessing services that have life changing affects, specifically the cultural component to programming and its impact on health and healing. Some key informants from Aboriginal Health Access Centres and Healing Lodges reported that they have reached capacity and now have  waiting lists for their programs and services.

AHWS programs have also proved to be helpful for clients seeking assistance with family violence. Twenty-three percent (22.9%) of clients surveyed indicated that they have sought assistance from the AHWS-funded program for matters involving violence. With ninety percent (89.7%) of these clients indicating that the AHWS funded program had helped them in dealing with the violence issue. Ninety-five (94.9%) of clients feel these impacts will result in a stronger, healthier family and eighty-five percent (85%) of clients felt their involvement in the program resulted in a reduction of family violence. While these findings show the positive impact on clients who access services for family violence key informants expressed the need for more focus on the issue of family violence. Since the original vision of the Strategy was to specifically  address family violence, key informants expressed concern that this issue has become overshadowed by a focus on primary health care and that family violence is being inadequately addressed.

Some of the positive changes that occurred regarding health and healing, as reported by clients, included: leaving an abusive relationship; eating healthier foods; increasing physical activity; interacting more with people; moving into a healthier home; taking more responsibility for their own health; and, taking more responsibility for lifestyle. As a result clients report improvements in levels of happiness, balance in their lives, social supports, stress levels and sleep habits.

AHWS programs have also provided opportunities for networking as key informants discussed their involvement in Committees within their municipality and at the provincial level. This type of networking provides opportunities for collaboration between Aboriginal communities and government. In addition, AHWS has been integral in the development of a pool of skilled Aboriginal workers, many of whom become leaders and role models in the communities. Key informants also revealed that the integration of services provides a positive impact on communities through activities such as: relationships with other agencies in the community; support of political organizations; and, co-sponsoring programs and activities with other agencies and across communities in order to meet the needs of clients.

In conclusion, it appears that AHWS is meeting its objectives in the areas of: improving Aboriginal health, promotion of networking and community development and integration. The cultural revitalization observed in communities as clients participate in AHWS programs and services is a key component to the health and healing of clients. While AHWS clients report satisfaction with the current services to promote family healing, key informants repeatedly noted that this is an area within the Strategy where there should be more of a priority, especially for programs to support family healing in a future Phase lV.

Recommendations for Phase lV include: a review of the governance structure of the AHWS – which includes the development of a strategic plan to address issues of family violence; funding – budget equity and wage parity with mainstream government-funded agencies and programs; more services to deal with family violence; attracting more Aboriginal Health Care Professionals to work at AHWS sites; apprenticeship programs with Elders to ensure that knowledge is passed down to the next generation; additional programs to support youth and seniors; additional services to deal with the incidence of diabetes and cancer in communities.

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Table of Contents

Acknowledgments 3
Executive Summary 5

1. BACKGROUND 9

1.1 Aboriginal Healing and Wellness Strategy (AHWS) 9

2. CULTURAL FOUNDATION OF THE AHWS 12

2.1 Wholistic Health and Healing 12
2.2 The Healing Continuum 13
2.3 The Life Cycle 15

3. INTRODUCTION 16

3.1 Overview of the AHWS Longitudinal Study, Phase lll (2005 – 2008) 16
3.2 The AHWS Research Framework 17
3.3 Culture Based Indicators 18

4. LIMITATIONS OF THE RESEARCH 21

5. METHODOLOGY 25

5.1 Longitudinal Study Research Questions 25
5.2 Research Design 25
5.3 Participants 26
5.4 Research Tools 27
5.5 Procedure 28

6. FINDINGS: PHASE lll LONGITUDINAL STUDY, 2005 - 2008 37

6.0 Introduction to findings 37
6.1 Profile of AHWS respondents 38
6.2 Is AHWS inclusive of all members of the community across the life cycle? 43
6.3 Clients decision to use AHWS programs 46
6.4 What kinds of programming along the healing continuum is needed to address issues clients are presenting with? 50
6.5 Impact of AHWS funded programs on clients 52
6.6 Do AHWS programs meet the physical, mental, emotional and spiritual needs throughout the lifecycle? 57
6.7 What is the effect of AHWS structures and processes on Aboriginal Relationships? Relationships between individuals, families, organizations and communities? 59
6.8 What are the structural elements that may either facilitate or create barriers to accessibility of the AHWS program and/or service? 66
6.9 Clients future use of AHWS programs 72
6.10 Where do clients go after participating in the AHWS program and/or service? 74

7. DISCUSSION OF THE VISION AND MANDATE OF THE AHWS 75

7.1 Is AHWS meeting its objectives and how? 75
7.2 Is AHWS addressing needs throughout the lifecycle? 87