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  • Systematic Review
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Indigenous participation in pediatric Indigenous health research in Canada: a systematic review

Pediatric Research volume 93, pages 1800–1809 (2023)Cite this article

Abstract

For health inequities to be successfully addressed through health research, it is necessary for researchers to strive for genuine engagement with stakeholders. Indigenous people provide critical perspectives in Indigenous health research. The objective of this review was to systematically review the existing pediatric Indigenous health research in Canada to determine the prevalence of Indigenous participation. Embase, MEDLINE, Cochrane Library were searched on April 15, 2017 and updated on July 16, 2020. A total of 798 studies focused on the health of Indigenous children ≤18 in Canada were included, of 17,752 abstracts screened in English and French. A total of 46.1% of articles indicated Indigenous participation, increasing over time. Organization/government was the most common form of Indigenous participation (62.8%) and Indigenous researcher as author was least common (10.9%). Participation by child age, geography and topic area varied. The most common category of topic researched was nutrition, lifestyle and anthropometrics. Indigeneity of researchers was determined by self-identification in the papers and may be an underestimate. Although improving over time, less than half of studies about Indigenous children in Canada included Indigenous participation in their execution. Journals and funding bodies must ensure fulsome participation of Indigenous people in research focused on Indigenous children.

Impact

  • Indigenous participation in pediatric Indigenous health research is critical to producing ethical relevant and actionable results.

  • This review describes the status of Indigenous participation in this body of work in Canada.

  • This review highlights areas of concern and strength to improve the practices and ethics of medical researchers in this area, thereby increasing relevance of pediatric Indigenous health research to communities.

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Fig. 1: PRISMA 2020 flow diagram.
Fig. 2: Indigenous participation in Canadian pediatric Indigenous health research by decade.
Fig. 3: Neurological, behavior, mental health subcategory participation (n = 155).
Fig. 4: Nutrition, lifestyle and anthropometrics subcategory participation (n = 183).
Fig. 5: Distribution of health topics within decade categories.

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Data availability

All data generated or analyzed during this study are included in this published article and its Supplementary information files.

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Funding

This project has no funding to declare. S.M.’s research work is supported by a Hamilton Health Sciences Early Career Award and the McMaster University Ronald Barr Professorship in Pediatric Oncology.

Author information

Authors and Affiliations

  1. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada

    Sarah Hyett & Stacey Marjerrison

  2. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Sarah Hyett

  3. Indigenous Undergraduate Summer Research Scholars Program, McMaster University, Hamilton, ON, Canada

    Josha Rafael

  4. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada

    Josha Rafael & Raven Mancini

  5. Indigenous Health, Faculty of Health Science, McMaster University, Hamilton, ON, Canada

    Bernice Downey

  6. School of Nursing & Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada

    Bernice Downey

  7. Indigenous Women’s Heart & Brain Health Research Chair, Heart & Stroke Foundation and Canadian Institute of Health Research, Ottawa, ON, Canada

    Bernice Downey

  8. Indigenous Field of Study, Wilfred Laurier University Faculty of Social Work, Waterloo, ON, Canada

    Eric Lickers

  9. Department of Pediatrics, McMaster University, Hamilton, ON, Canada

    Stacey Marjerrison

  10. McMaster Children’s Hospital, Hamilton, ON, Canada

    Stacey Marjerrison

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Contributions

This work was a collaboration between Indigenous and non-Indigenous researchers. Both Indigenous and non-Indigenous authors were included in the process of evaluating articles, writing, and high-level expertise. The initial idea for the work was proposed by two non-Indigenous authors, one junior (S.H.) one senior (S.M.). A junior Indigenous researcher was invited to join the review team (R.M.), as well as a senior Indigenous researcher (B.D.) who provided high-level feedback on what datapoints would be helpful and realistic to collect. This same author contributed to appropriate interpretation of the data and review of the manuscript. Later, two additional junior Indigenous researchers (E.L. and J.R.) joined the review team. One of these junior researchers (J.R.) participated extensively in decision making around methodological issues. S.H. conceptualized and designed the study, lead the acquisition, analysis and interpretation of the data, drafted the initial manuscript, and reviewed and revised the manuscript. Self-location statement: I approach this work from a white settler lens. I grew up in Brantford, Ontario on the Haldimand Tract, which is currently only 5% of the original land promised to Six Nations as part of the Haldimand Treaty. In my professional and personal life, I have had the privilege of working with and learning from Indigenous community members and scholars from many nations, in many different contexts, and I work to stay accountable in all aspects of my life to these personal and professional ties. I understand that as a settler I am not an expert on what Indigenous communities want or need, and I will make mistakes regardless of my intentions. As such, I continually work to partner with those who are experts and recommend all other settler-researchers do the same. I hope to continue developing into a researcher deserving of the trust of the partners I am accountable to and can act as a resource to support my Indigenous colleagues in this work. J.R. conceptualized and designed the study, contributed to acquisition, analysis and interpretation of the data, and reviewed and revised the manuscript critically for important intellectual content. Self-location statement: I am a nêhiyaw iskwêw (Cree woman) and my community is Saddle Lake Cree Nation. I grew up primarily in Vancouver, BC and would spend time visiting my father, brothers and sisters, nieces and nephews, aunts, uncles, and cousins in Saddle Lake. Exploitive research of Indigenous peoples has been taking place for decades. My community, and particularly my step-father who went to residential school and was a victim of nutritional experimentation, have not been exempt. My background and my desire to ensure that research with the most vulnerable populations is connected to the communities it is working with propelled me to engage in this research. B.D. contributed to the conceptualization of the study, interpretation of the data and reviewed and revised the manuscript critically for important intellectual content. R.M. contributed to acquisition and analysis of the data and reviewed and revised the manuscript critically for important intellectual content. E.L. contributed to acquisition and analysis of the data and reviewed and revised the manuscript critically for important intellectual content. Self-location statement: I am an Indigenous man with a mixed background, including Mohawk, Seneca, and British ancestry. I grew up In Brantford, Ontario which is where the Mohawk institute was located that some of my family members attended as a residential school and later as a day school. I completed my Master of Social Work degree at Wilfrid Laurier University in the Indigenous Field of Study program to reclaim knowledge of Indigenous concepts of wellness and methods of healing. I use this framework in my current job as a social worker in the education sector. S.M. conceptualized and designed the study, guided and supervised the acquisition and analysis of the data, interpreted the data, and reviewed and revised the manuscript critically for important intellectual content. Self-location statement: I am a pediatric oncologist and researcher, of white settler background. I grew up in Eastern Ontario, in close proximity to Akwesanse, and presently make my home in Hamilton, in the region bound by the Dish with One Spoon Wampum Agreement. My research work is fueled by the inequities I observe in my clinical practice, including the disparate outcomes for Indigenous children with cancer in Canada. I have been fortunate to learn from and collaborate with many First Nations, Inuit and Métis scholars and neighbors through my research work, as well as through creating welcoming clinical spaces at the McMaster Children’s Hospital, developing opportunities for learners through the McMaster University Post-Graduate Medical Education Indigenous Health Council, and the Pediatric Oncology Group of Ontario Indigenous Children with Cancer Initiative. I aspire to continuing to work alongside Indigenous partners, for so long as I can contribute in a good way.

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Correspondence to Stacey Marjerrison.

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Hyett, S., Rafael, J., Downey, B. et al. Indigenous participation in pediatric Indigenous health research in Canada: a systematic review. Pediatr Res 93, 1800–1809 (2023). https://doi.org/10.1038/s41390-022-02361-9

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