Innovating for Transformation in First Nations Health Using Community-Based Participatory Research
Abstract
Community-based participatory research (CBPR) provides the opportunity to engage communities for sustainable change. We share a journey to transformation in our work with eight Manitoba First Nations seeking to improve the health of their communities and discuss lessons learned. The study used community-based participatory research approach for the conceptualization of the study, data collection, analysis, and knowledge translation. It was accomplished through a variety of methods, including qualitative interviews, administrative health data analyses, surveys, and case studies. Research relationships built on strong ethics and protocols to enhance mutual commitment to support community-driven transformation. Collaborative and respectful relationships are platforms for defining and strengthening community health care priorities. We further discuss how partnerships were forged to own and sustain innovations. This article contributes a blueprint for respectful CBPR. The outcome is a community-owned, widely recognized process that is sustainable while fulfilling researcher and funding obligations.
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Misconceptions that First Nations receive freebies in education and health resources have deleterious impacts to health.
“Notions that the First Nations receive all sorts of ‘freebies’ when it comes to education and health resources exist. These misconceptions have deleterious impacts to health [35].”
From Confronting Racism within the Canadian Healthcare System: Systemic Exclusion of First Nations from Quality and Consistent Care (2020) · cites this paper as [35]
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BackgroundMethodSelf-citationCommentary: Developing Relationships through Trust in Indigenous Health Research
Oster, R. T., & Lightning, P. (2022) · Healthcare policy · doi:10.12927/hcpol.2022.26825 · Cited by 16 · see citing works
“…Vol.17 No.4, 2022 [59] literature, to establish considerate, culturally sensitive, relevant and equitable research partnerships that lead to community-owned health strategies and viable benefits to Indigenous communities (Dadich et al. 2019; Kyoon-Achan et al. 2018; Wallerstein and Duran 2006).”
BackgroundOster, R. T., Bruno, G., Mayan, M. J., Toth, E. L., & Bell, R. C. (2018) · Qualitative Health Research · doi:10.1177/1049732318794205 · Cited by 15 · see citing works
Bruno, G., Bell, R. C., Parlee, B. L., Lightning, P., Bull, I., Cutknife, B., & Oster, R. T. (2022) · International Journal for Equity in Health · doi:10.1186/s12939-022-01764-8 · Cited by 14 · see citing works
Indigenous community members' views on silver diamine fluoride to manage early childhood caries
Achan, G. K., Schroth, R. J., DeMaré, D., Sturym, M., Edwards, J. M., Lavoie, J. G., Sanguins, J., Campbell, R., Chartrand, F., Bertone, M. F., et al. (2020) · Journal of Public Health Dentistry · doi:10.1111/jphd.12370 · Cited by 14 · see citing works
Self-citationAchan, G. K., Lavoie, J. G., Phillips-Beck, W., Kinew, K. A., Ibrahim, N. H. M., Sinclair, S., & Katz, A. (2019) · Healthcare policy · doi:10.12927/hcpol.2019.26069 · Cited by 13 · see citing works
“Study design A community-based participatory research framework was implemented from the conception of the study, data gathering, analysis and interpretation to knowledge dissemination (Kyoon-Achan et al. 2018).”
MethodSelf-citationWaddell-Henowitch, C. M., Herron, R., Gobeil, J., Tacan, F., Jager, M. D., Allan, J. A., & Roger, K. S. (2020) · Qualitative Health Research · doi:10.1177/1049732320960050 · Cited by 13 · see citing works
“…employed with Indigenous communities to study a variety of health and mental health experiences such as pathways to suicide (Tingey et al., 2014) to develop interventions (Kyoon-Achan et al., 2018) and to improve health outcomes (BirdNaytowhow et al., 2017; Maar et al., 2018; Munro et al., 2017).”
BackgroundBeks, H., Walsh, S., Wood, S. M., Clayden, S., Alston, L. V., Coffee, N. T., & Versace, V. L. (2024) · Australian Health Review · doi:10.1071/ah23239 · Cited by 10 · see citing works
Manitoba First Nation peoples’ use of hospital-based mental health services: trends and solutions
Lavoie, J. G., Phillips-Beck, W., Kinew, K. A., & Katz, A. (2020) · Canadian Journal of Public Health · doi:10.17269/s41997-020-00328-z · Cited by 11 · see citing works
Self-citationLavoie, J. G., Phillips-Beck, W., Kinew, K. A., Sinclair, S., Achan, G. K., & Katz, A. (2021) · International Indigenous Policy Journal · doi:10.18584/iipj.2021.12.1.10475 · Cited by 11 · see citing works
Self-citationThe use of realist approaches for health research in Indigenous communities
Bergeron, D. A., Tremblay, M., Dogba, M. J., Martin, D. H., & McGavock, J. (2021) · AlterNative An International Journal of Indigenous Peoples · doi:10.1177/1177180121996063 · Cited by 11 · see citing works
“This is a first step in working to restore a balance of power in Indigenous communities (Kyoon-Achan et al., 2018).”
BackgroundInfluentialCanada First Nations Strengths in Community-Based Primary Healthcare
Kyoon Achan, G., Eni, R., Phillips-Beck, W., Lavoie, J. G., Kinew, K. A., & Katz, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192013532 · Cited by 10 · see citing works
Self-citationMcEachern, L. W., Harris, S., Valaitis, R., Watson, A., Yessis, J., Zupko, B., & Hanning, R. M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315878 · Cited by 8 · see citing works
“The journey of the LC in Upper Skeena reflects this—at many times in the process work had to be done to develop relationship and overcome a lack of trust between the two groups that co-exist in the community, before food work could be addressed [14,27].”
BackgroundValaitis, R. F., McEachern, L. W., Harris, S., Dick, T., Yovanovich, J., Yessis, J., Zupko, B., Corbett, K. K., & Hanning, R. M. (2022) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2021-0780 · Cited by 8 · see citing works
Phillips-Beck, W., Kyoon-Achan, G., Lavoie, J. G., Krueger, N., Kinew, K. A., Sinclair, S., Ibrahim, N., & Katz, A. (2019) · International Indigenous Policy Journal · doi:10.18584/iipj.2019.10.4.8334 · Cited by 13 · see citing works
Self-citationBouchard, K., Perry, A. F., West-Johnson, S., Rodon, T., & Vanchu-Orosco, M. (2020) · International Journal of Community Well-Being · doi:10.1007/s42413-020-00088-1 · Cited by 9 · see citing works
Walsh, K., Carroll, B., MacFarlane, A. E., O’Donovan, D. T., & Cush, P. (2022) · Qualitative Health Research · doi:10.1177/10497323221100346 · Cited by 8 · see citing works
“…(e.g., Participatory Learning Action) that support participatory approaches (Flemig & Osborne, 2019), with many targeting marginalized populations (Kyoon-Achan et al., 2018; O’Reilly-de Brún et al., 2018), and some considering the specific position of older people (Hallett et al., 2017; Rudnicka…”
BackgroundLavoie, J. G., Stoor, J. P., Cueva, K., Akearok, G. H., Rink, E., Larsen, C. V. L., & Gladun, E. F. (2022) · International Indigenous Policy Journal · doi:10.18584/iipj.2022.13.1.10928 · Cited by 8 · see citing works
“Indigenous nations have expressed an interest in leading research that addresses their own information needs, and directly benefits their communities (Dedats'eetsaa: Tłı ̨chǫ Research & Training Institute, 2017; Eriksen et al., 2021; Kovach, 2009; Kukutai & Taylor, 2016; Kyoon-Achan et al., 2018).”
BackgroundSelf-citationPeterson, M., Rosing, A., Rink, E., Schure, M. B., Haggerty, J. H., Reimer, G. A., & Larsen, C. V. L. (2025) · International Journal of Circumpolar Health · doi:10.1080/22423982.2025.2473181 · Cited by 7 · see citing works
“Community-based participatory research (CBPR) is a framework to improve social and health equity that has grown in popularity across Arctic geographies in the past two decades, especially to benefit Indigenous communities [1–4].”
Occupational transaction in support of miyupimaatisiiun (wellness): Eeyou/Eenou community voices
Lévesque, M. C., Kutcher, A., Roy, L., Linton, P., Trapper, L., Torrie, J. E., & MacDonald, M. E. (2023) · Journal of Occupational Science · doi:10.1080/14427591.2022.2132999 · Cited by 6 · see citing works
“The methods used in this community-level research flowed from the community-based participatory research (CBPR) approach (Israël, 1998; Kyoon-Achan et al., 2018) adopted in our broader IAMP developmental evaluation (Lévesque et al.”
MethodAchan, G. K., Schroth, R. J., DeMaré, D., Sturym, M., Sanguins, J., Chartrand, F., Campbell, R., Edwards, J., Lavoie, J. G., & MOFFATT, M. E. K. (2021) · AlterNative An International Journal of Indigenous Peoples · doi:10.1177/11771801211016873 · Cited by 6 · see citing works
“…and maintain trust throughout the research relationship, part of which was respecting community ethics and protocols, and encouraging community ownership of the research process to create culturally grounded interventions (Christopher et al., 2008; Kyoon-Achan et al., 2018; Walters et al., 2020).”
BackgroundInfluentialSelf-citationAchan, G. K. (2021) · International Journal of Indigenous Health · doi:10.32799/ijih.v16i1.33207 · Cited by 5 · see citing works
Liamputtong, P., & Rice, Z. S. (2021) · Springer eBooks · doi:10.1007/978-3-030-48277-0_25-2 · Cited by 5 · see citing works
Jacquez, F., & Vaughn, L. M. (2025) · Journal of Participatory Research Methods · doi:10.35844/001c.140734 · Cited by 4 · see citing works
Our People, Our Health: Envisioning Better Primary Healthcare in Manitoba First Nation Communities
Achan, G. K., Phillips-Beck, W., Kinew, K. A., Lavoie, J. G., Sinclair, S., & Katz, A. (2021) · International Indigenous Policy Journal · doi:10.18584/iipj.2021.12.1.13561 · Cited by 4 · see citing works
Self-citationSyeda, M. M., Fournie, M., Ibanez, M. C., & Crooks, C. V. (2021) · American Journal of Evaluation · doi:10.1177/1098214021997574 · Cited by 4 · see citing works
“According to CBPR principles, relevant community stakeholders become coresearchers within their organizations (Kyoon-Achan et al., 2018).”
BackgroundAjaps, S., & Mbah, M. F. (2022) · World sustainability series · doi:10.1007/978-3-031-12326-9_4 · Cited by 4 · see citing works
Skeie, K. B., van Leersum, C. M., & Oftedal, E. M. (2025) · Journal of Responsible Innovation · doi:10.1080/23299460.2025.2477348 · Cited by 3 · see citing works
Liamputtong, P., & Rice, Z. S. (2022) · Springer eBooks · doi:10.1007/978-3-030-48277-0_25-3 · Cited by 3 · see citing works
Pandya, R. E., Aurbach, E. L., Burns, K., Chalk, A. M., Crocker, E., Dosemagen, S., Hanson, B., Lyon, L., Mealey, T., Renoe, S. D., et al. (2023) · doi:10.22541/essoar.167768122.22544063/v1 · Cited by 3 · see citing works
Qualitative genomic research with Indigenous peoples: a scoping review of participatory practice
Ehman, M., Caron, N. R., Montour, L., & Regier, D. A. (2024) · BMJ Global Health · doi:10.1136/bmjgh-2024-015377 · Cited by 2 · see citing works
First Nations’ hospital readmission ending in death: a potential sentinel indicator of inequity?
Lavoie, J. G., Phillips-Beck, W., Kinew, K. A., Achan, G. K., & Katz, A. (2020) · International Journal of Circumpolar Health · doi:10.1080/22423982.2020.1859824 · Cited by 2 · see citing works
Self-citationBeyond Care: Validating a First Nations Mental Wellness Framework
Achan, G. K., Ibrahim, N. H. M., Eni, R., Phillips-Beck, W., Lavoie, J. G., Kinew, K. A., & Katz, A. (2021) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2021-005 · Cited by 2 · see citing works
Self-citationLiamputtong, P., & Rice, Z. S. (2022) · Springer eBooks · doi:10.1007/978-3-030-89594-5_25 · Cited by 2 · see citing works
Avila, M. M., Vining, C. B., Allison‐Burbank, J. D., & Velez, C. M. (2022) · Health Equity · doi:10.1089/heq.2022.0091 · Cited by 2 · see citing works
“Community-based participatory research methodologies hold promise for conducting ethical research with vulnerable populations such as the Abenaki.(15)”
BackgroundIdentifying training needs of healthcare providers to implement caries risk assessment
Olatosi, O. O., Schroth, R. J., DeMaré, D., Manigque, M., Mittermuller, B.-A., Edwards, J., Yerex, K., Wong, P. D., Lavoie, J., Sanguins, J., et al. (2025) · Frontiers in Oral Health · doi:10.3389/froh.2025.1641307 · Cited by 1 · see citing works
Self-citationContextualizing Indigenous approaches to trauma-informed care in social work practice
Bhat, N., Mehliqa, U., Paul, F. A., & Bashir, A. (2025) · Journal of Ethnic & Cultural Diversity in Social Work · doi:10.1080/15313204.2025.2524351 · Cited by 1 · see citing works
“Likewise, Kyoon-Achan et al. (2018) show that CBPR is effective for the harmonization of culturally relevant Indigenous healing practices and modern mental health care.”
A scoping review of Indigenous community-based research practices, guidelines, and ethical standards
Toombs, E., Skov, B., Campbell, M., Lund, J. I., & Mushquash, C. J. (2025) · Canadian Journal of Public Health · doi:10.17269/s41997-025-01090-w · Cited by 1 · see citing works
Liamputtong, P., & Rice, Z. S. (2021) · Springer eBooks · doi:10.1007/978-3-030-48277-0_25-1 · Cited by 1 · see citing works
Buchanan, Z. V., Hopkins, S. E., Ryman, T. K., Austin, M. A., Wiener, H. W., Tiwari, H. K., Klejka, J. A., Boyer, B. B., & Fohner, A. E. (2024) · Public Health · doi:10.1016/j.puhe.2024.04.010 · Cited by 1 · see citing works
Bergeron, D. A., Murillo, F., & Gaboury, I. (2020) · Revista Estomatológica Herediana · doi:10.20453/reh.v30i1.3743 · Cited by 1 · see citing works
“El desarrollo de un lenguaje común sin terminología compleja permitiría asimismo minimizar los malentendidos entre los actores y favorecer los intercambios (11).”
BackgroundAchan, G. K., Schroth, R. J., Sanguins, J., Campbell, R., DeMaré, D., Sturym, M., Edwards, J., Bertone, M. F., Dufour, L., Hai‐Santiago, K., et al. (2021) · Promotion de la santé et prévention des maladies chroniques au Canada · doi:10.24095/hpcdp.41.1.02f · Cited by 1 · see citing works
Oster, R. T., Toth, E. L., & Bell, R. C. (2019) · doi:10.21203/rs.2.17085/v1
“This finding also emphasizes the need for collaboration and partnership in attempts to improve Indigenous health, which has been suggested time and time again through recent research [11-13, 45, 46].”
BackgroundResultJock, B., Haroz, E. E., Chamoun, L., Maudrie, T. L., Redmond, L. C., & Gittelsohn, J. (2025) · Current Developments in Nutrition · doi:10.1016/j.cdnut.2025.104569
RetractedRuben, A., Paul, J., Makowsky, M. J., Jones, C. A., & Sadowski, C. A. (2025) · International Journal of Qualitative Methods · doi:10.1177/16094069251324960
“…2017); 3) it can be used to create Indigenous health programs, creating desire (strength)-based research (Allen et al., 2021; Hulen et al., 2019; Kyoon-Achan et al., 2018), and 4) to build capacity (Gokiert et al., 2017; Jernigan, 2010; Kyoon-Achan et al., 2018; Sanchez-Pimienta, 2021; Tobias…”
Shwed, A., Finlay, L., Holliday, P., Brar, K., Lambrecht, M., Giroux, E. E., Shaikh, M., Skinner, C., Hoekstra, F., Sibley, K. M., et al. (2026) · Research Involvement and Engagement · doi:10.21203/rs.3.rs-8713739/v1
Saint-Charles, J., Simon, A., Druetz, T., & Ravel, A. (2026) · International Journal of Circumpolar Health · doi:10.1080/22423982.2026.2671508
Patient- and Public-Led Research – How Is It Defined and Practiced: A Scoping Review
Wang, E., Truong, L., Hassan, N., Quershi, E., Merry, K., Lowthian, T., Lin, M., Oelke, N. D., Gainforth, H. L., Curran, J., et al. (2026) · Journal of Patient Experience · doi:10.1177/23743735261462611 · Cited by 1 · see citing works
- Authors
- Kyoon-Achan, G., Lavoie, J., Avery Kinew, K., Phillips-Beck, W., Ibrahim, N., Sinclair, S., & Katz, A.
- Affiliations
- University of Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba (CA)
- First Nations Health and Social Secretariat of Manitoba (CA)
- Corresponding author
- Katz, Alan
- Venue
- Qualitative Health Research
- Publisher
- SAGE Publications
- Published
- 2018-02-27
- Volume
- 28
- Issue
- 7
- Pages
- 1036-1049
- ISSN
- 1049-7323 (ISSN-L)
- 1552-7557
- OpenAlex
- W2788817076
- Cited by
- 69
- References
- 78
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 3 · 2023: 4 · 2022: 14 · 2021: 14 · 2020: 11 · 2019: 7 · 2018: 3
- FWCI
- 9.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Qualitative Health Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institute of Aboriginal Peoples Health (292821)
- Topics
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Health Sciences › Health Professions › General Health Professions › Community Health and Development
- Social Sciences › Sociology and Political Science › Participatory Visual Research Methods
- Keywords
- community-based participatory research, First Nations health, Indigenous health, research collaboration, knowledge translation, research ethics, health priorities
- MeSH terms
- Communication, Community Participation, Humans, Indians, North American, Leadership, Manitoba, Motivation, Organizational Innovation, United States, United States Indian Health Service, Trust, Cultural Competency, Community-Based Participatory Research, Capacity Building
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