Open Collections

Abstract

Persistent health disparities between Indigenous peoples and non-Indigenous peoples underscore the urgency for culturally safe and trauma-informed healthcare. Despite efforts to increase cultural safety in healthcare, Indigenous populations continue to experience systemic racism when accessing healthcare services. To address these concerns, social workers at Province Health Care (PHC) with input from PHC’s Indigenous Wellness and Reconciliation (IWR) team partnered with the University of British Columbia to develop and implement an Indigenous cultural safety educational initiative with primary healthcare social workers. Throughout 2023, eight educational workshops were offered to primary healthcare social workers. A quasi-experimental mixed methods design-based approach was used to evaluate the educational initiative. Information about the educational workshop was distributed through the Social Work email listserv. Social worker participation was voluntary (N = 46), with non-attendees forming the control group (n = 10) and workshop attendees forming the intervention group (n = 36). Independent samples t-tests were conducted to examine the difference in perceived knowledge in Indigenous cultural safety between the control and intervention group. Within the intervention group, independent samples t-tests were conducted to compare perceived knowledge of Indigenous cultural safety before and after attending the educational workshops. Open-ended responses about the educational workshops were analyzed through content analyses. Although the most appropriate way to assess Indigenous cultural safety is through service users’ perspectives on whether they feel safe within the care provided, this was not feasible due to ethical and resource constraints. This study focuses on the efficacy of the training workshop through social worker’s self reflections on their own knowledge and practice skills, rather than measuring practice outcomes. A participants reported witnessing interpersonal racism or discrimination at work directed at Indigenous racialized service users and/or their family/friends (n = 19, 44.2%). Over half (n = 24, 55.8%) indicated that institutional racism was somewhat prevalent in their health care work setting and almost a quarter (n = 9, 21%) indicated racism was very/extremely prevalent. While the intervention group scored higher across half of the domains of Indigenous cultural safety compared to the control group, statistical significance was not reached. All participants in the intervention group scored higher post-workshop across all domains, with the overall mean score and five specific areas of practice reaching statistical significance. Three broad themes were identified from participants’ open-ended responses: (a) teaching and learning approaches, (b) structural support for training, and (c) strengths and challenges of the workshop format. These themes highlighted the importance of tailored pedagogical approaches, supportive organizational structures, and practical considerations in workshop implementation. The study findings suggest the potential of this educational initiative in enhancing cultural safety and trauma-informed care for Indigenous service users among healthcare social workers. Structural supports such as protected time for training emerged as critical facilitators. However, further research is needed to understand healthcare users' perspectives. While this initiative represents progress in addressing healthcare disparities for Indigenous peoples, ongoing efforts and research are essential for sustained improvements in practice.