Adapting Child Health Knowledge Translation Tools for Indigenous Communities: A Qualitative Exploration of Indigenous Healthcare Provider Perspectives (Preprint)

Abstract

Background - Our research groups have developed a number of parent knowledge translation (KT) tools to help families and caregivers understand common childhood illnesses and make informed decisions regarding when to seek urgent care. We have developed a series of videos to help parents understand how to manage common acute childhood illnesses at home and when to contact emergency healthcare services. It is unclear whether the videos in their current form and language are useful for a wider scope of populations, including Indigenous groups.

Objectives - The purpose of this study was to explore if and understand how our KT tools could be adapted for use with Indigenous communities.

Methods - Healthcare providers (HCPs) serving Indigenous families in Alberta were asked to review two of our KT tools (one on croup and one on acute otitis media), complete a demographic survey, and participate in a one-on-one semi-structured interview. HCPs were asked to reflect on the usability of our KT tools within their practice, and what cultural adaptation considerations they felt would be needed to develop KT tools that meet the needs of Indigenous clients. Audio recordings from the interviews were transcribed verbatim and analyzed for relevant themes using thematic analysis.

Results - Eighteen HCPs (15 women and 3 men) from various health professions (e.g., doctor, registered nurse, licensed practical nurse, etc.) were interviewed. Seven HCPs self-identified as Indigenous. Four key overarching themes were identified as important when considering how to adapt KT tools for Indigenous communities: accessibility, relatability, KT design, and relationship building. Access to tangible resources and personal and professional connections were considered important. Accessibility impacts the types of KT tools that can be obtained or utilized by various individuals and communities, and the extent to which they can implement recommendations given in those KT tools. Additionally, the extent to which users relate to the depictions and content within KT tools must be considered. The environments, portrayals of characters, and cultural norms and values presented within KT tools should be relevant to users to increase relatability and uptake of recommendations. Most importantly, fostering genuine and sustainable relationships with users and communities is a vital consideration for KT tool developers.

Conclusion - These findings serve to cultivate a greater understanding of the various components to consider when developing and/or culturally adapting KT tools for Indigenous families. This information will help support the effective adaptation and distribution of KT tools for use by a broad audience. Careful consideration of the themes identified in this study highlights the importance of working together with the knowledge users when developing KT tools.