W3 - Lewis: Increasing Response Rates on Face-to-Face Surveys with Indigenous Communities

Background and Context

  • Participants: Pictou Landing First Nation (PLFN) Native Women’s Group (NWG) collaborated with academic researchers to address health issues.

  • History of Environment: Boat Harbour served as a traditional resource area for the Mi’kmaq community and has been environmentally degraded by industrial waste for 50 years, raising health concerns in the community.

  • Objective: Share lessons from a community-based participatory research (CBPR) project that successfully achieved a 59% response rate on a household-level environmental health survey.

  • Trust Issues: Historical mistrust in academic research due to broken promises and lack of community-driven research prior to this effort.

Methods: Community-Based Participatory Research (CBPR)

  • CPBR Principles:

    • Engaged the NWG as equal partners in the research process.

    • Focused on collective decision-making, enhancing mutual respect and understanding.

    • Highlighted the importance of flexibility concerning community needs and timelines.

Survey Development and Execution

  • Survey Design:

    • Included 297 questions, combining existing surveys and new culturally relevant ones.

    • Emphasized the community’s perceptions of health encompassing physical, mental, emotional, and spiritual dimensions.

    • Engendered community buy-in by involving NWG members in the development process, ensuring cultural relevance.

  • Training of Community Surveyors:

    • Hired and trained 13 Mi’kmaq community researchers (RAs) for data collection, enhancing local involvement and credibility.

  • Debriefings: Regular debriefing meetings allowed the research team to dynamically adapt the survey process based on community feedback.

Key Lessons Learned

  1. Culturally Appropriate Approaches:

    • Developed a survey protocol that respected Indigenous cultural practices, including methods of consent (verbal rather than written).

    • Emphasized surveys that captured environmental health issues relevant to traditions and cultural practices, such as harvesting wild foods.

  2. Engagement Strategies:

    • Used door-to-door outreach targeting female heads of households, recognizing women's crucial role in family health discussions.

    • Implemented community information dissemination techniques, including Facebook and face-to-face meetings.

  3. Incentives and Response Rates:

    • Initially considered no compensation but later introduced a lottery for gift cards as appreciation for participation, which may have helped increase response rates.

    • Maintained an ongoing dialogue about the survey’s relevance to combat survey fatigue, a common issue in Indigenous communities.

  4. Inclusivity in Data Collection:

    • Allowed multiple household members to participate independently, respecting the diversity of voices within family structures.

    • Included provisions for conducting surveys in flexible settings and times based on respondents' availability.

  5. Continual Reflection and Adaptation:

    • Fostered a continuous evaluation process throughout the project to refine methods based on community feedback and changing circumstances.

    • Acknowledged the necessity for flexibility in timelines and processes to accommodate community dynamics.

Conclusion

  • Significance of Relationships: Building trust and rapport with the community is imperative for successful CBPR.

  • Broader Implications: This case demonstrates how respectful, community-driven methods can enhance health survey participation in Indigenous populations, providing a model for future research efforts.

  • Recommendations for Future CBPR Projects:

    • Engage meaningfully with communities and incorporate their feedback throughout the research process.

    • Address not only health data needs but also the cultural significance of the research topics at hand.

    • Promote engagement with academic and grassroots institutions to ensure research serves community priorities.

  • Participants: The Pictou Landing First Nation (PLFN) Native Women’s Group (NWG), which comprises women from the community with a shared goal of enhancing health outcomes, partnered with academic researchers to tackle critical health disparities that affect their population. This collaboration was designed to utilize the research expertise of academics while prioritizing and respecting the lived experiences, perspectives, and needs of Indigenous women, ensuring their voices were heard and integrated throughout the research process.

  • History of Environment: Boat Harbour has a rich history as a traditional resource area essential to the Mi’kmaq community, providing natural resources and cultural significance for generations. However, this area has suffered from extensive environmental degradation due to toxic industrial waste for over half a century, resulting in serious ecological damage and adverse health impacts on the local population. Community members have reported alarming increases in chronic diseases, psychological distress, and a general decline in well-being, raising urgent health concerns and a compelling need for thorough environmental health assessments and interventions aimed at revitalizing the community's health and environment.

  • Objective: The project's main goal was to share critical insights and lessons learned from a community-based participatory research (CBPR) initiative that achieved an impressive 59% response rate on a comprehensive household-level environmental health survey. This survey aimed to measure the impacts of environmental conditions on health and capture the community’s perspectives regarding these issues, thereby empowering the residents through active participation in research that concerns their health and environment.

  • Trust Issues: There exists a profound historical context of mistrust towards academic research within the PLFN community, predominantly due to past experiences where research efforts led to unmet promises and a lack of involvement in decision-making processes. These failures have fostered deep-seated skepticism towards external researchers and academic institutions. Recognizing this, the CBPR project focused heavily on establishing transparency and fostering genuine collaboration with the community, aiming to rebuild trust and improve engagement. The project emphasized the importance of honoring the community's autonomy and ensuring that research efforts served their interests and addressed their specific health concerns.