Health and Social Development, Faculty of (Okanagan)
Nursing, School of
DSpace
UBCO
Werstuik, Saige M.
Master of Arts - MA
University of British Columbia
This Master’s thesis aims to determine factors that influence successful traditional wellness integration in health programming, and addresses ways to strengthen Indigenous peoples access to traditional wellness practices within the current healthcare system. According to recent data, Indigenous populations are less likely to receive adequate health care due to providers’ lack of cultural safety and awareness. Integrating traditional wellness practices within healthcare not only ensures cultural safety but also eliminates these existing inadequacies. The thesis will address this issue by addressing the research question: What are the factors that influence appropriate and Indigenized integration of traditional wellness in a culturally safe way? In addition, the objectives include 1) identifying barriers to successful integration that traditional wellness practitioners and Indigenous peoples face, 2) gathering lived experiences that highlight the strengths of current integration strategies, and 3) leveraging local Indigenous knowledges to ensure cultural safety and enhance integration for traditional wellness. The research outlined in this thesis has used an Indigenous methodology as guided by Enowkinwixw principles as an analogy to ensure Indigenized methods, such as community engagement, story work, and sharing circles. The aim of this research is to contribute to fulfilling the Truth and Reconciliation Commission: Call to Action #22 and Article 24 of the United Nations Declaration on the Rights of Indigenous Peoples. The thesis achieved these goals by outlining culturally safe and accessible traditional wellness integration strategies which have been developed for, by, and with a local Indigenous community. These findings will contribute to ensuring the continued and successful integration of traditional wellness practitioners into health and wellness programs.
TRADITIONAL WELLNESS INTEGRATION, CULTURAL SAFETY AND INDIGENIZATION STRATEGIES FOR HEALTH AND WELLNESS SERVICES by Saige M. Werstuik B.A., The University of British Columbia, 2021 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE COLLEGE OF GRADUATE STUDIES (Interdisciplinary Studies) (Community Engagement, Social Change and Equity) THE UNIVERSITY OF BRITISH COLUMBIA (Okanagan) April 2024 © Saige M. Werstuik, 2024 ii The following individuals certify that they have read, and recommend to the College of Graduate Studies for acceptance, the thesis entitled: Traditional Wellness Integration, Cultural Safety and Indigenization Strategies for Health and Wellness Services submitted by Saige M. Werstuik in partial fulfillment of the requirements for the degree of Master of Arts Dr. Laura L. Struik, Faculty of Health and Social Development Supervisor Dr. Kimberly R. Huyser, University of British Columbia (Vancouver) Co-Supervisor Dr. James Coble, Okanagan College Supervisory Committee Member Dr. Gabrielle Legault, Irving K. Barber Faculty of Arts and Social Sciences Supervisory Committee Member Dr. Peter Hutchinson, Irving K. Barber Faculty of Arts and Social Sciences University Examiner iii Abstract This Master’s thesis aims to determine factors that influence successful traditional wellness integration in health programming, and addresses ways to strengthen Indigenous peoples access to traditional wellness practices within the current healthcare system. According to recent data, Indigenous populations are less likely to receive adequate health care due to providers’ lack of cultural safety and awareness. Integrating traditional wellness practices within healthcare not only ensures cultural safety but also eliminates these existing inadequacies. The thesis will address this issue by addressing the research question: What are the factors that influence appropriate and Indigenized integration of traditional wellness in a culturally safe way? In addition, the objectives include 1) identifying barriers to successful integration that traditional wellness practitioners and Indigenous peoples face, 2) gathering lived experiences that highlight the strengths of current integration strategies, and 3) leveraging local Indigenous knowledges to ensure cultural safety and enhance integration for traditional wellness. The research outlined in this thesis has used an Indigenous methodology as guided by Enowkinwixw principles as an analogy to ensure Indigenized methods, such as community engagement, story work, and sharing circles. The aim of this research is to contribute to fulfilling the Truth and Reconciliation Commission: Call to Action #22 and Article 24 of the United Nations Declaration on the Rights of Indigenous Peoples. The thesis achieved these goals by outlining culturally safe and accessible traditional wellness integration strategies which have been developed for, by, and with a local Indigenous community. These findings will contribute to ensuring the continued and successful integration of traditional wellness practitioners into health and wellness programs. iv Lay Summary Current research and literature show that Indigenous peoples do not receive supportive health care. This is due to a lack of cultural awareness among health providers. To eliminate these gaps in knowledge and to create enhanced healthcare for Indigenous peoples, it is important to include traditional wellness practices in health programs, making options safer for Indigenous patients. While progress has been made, what contributes to successful traditional wellness integration is not well known. This thesis focuses on blending local Indigenous traditional wellness practices into healthcare, guided by community input. It explores challenges to accessing traditional wellness, gathers positive experiences, and outlines a path forward for improved access. Overall, this thesis found that getting local Indigenous community input on traditional wellness access can help ensure that health care support for Indigenous peoples is culturally safe, Indigenized and addresses the gaps in current literature and research. v Preface This thesis is an unpublished, original intellectual product of the author, S. Werstuik. The research outlined in this thesis was conducted on the unceded traditional territory of the Syilx nation; with guidance from the supervisory committee composed of Dr. Laura Struik (Supervisor), Dr. Kimberly Huyser (Co-Supervisor), Dr. James Coble (Committee Member) and Dr. Gabrielle Legault (Committee Member) alongside the Westbank First Nation Health and Wellness Department. The fieldwork reported in Chapters 3- 4 was approved by the University of British Columbia’s Behavioral Research Ethics Board certificate number H23-00424, under the title “Traditional Wellness Integration, Cultural Safety and Indigenization Strategies for Health and Wellness Services”. The research was funded through both internal awards and the British Columbia Network Environment for Indigenous Health Research Graduate Scholarship. vi Table of Contents Abstract ......................................................................................................................................... iii Lay Summary ............................................................................................................................... iv Preface .............................................................................................................................................v Table of Contents ......................................................................................................................... vi List of Illustrations ....................................................................................................................... xi List of Figures .............................................................................................................................. xii List of Abbreviations ................................................................................................................. xiii Acknowledgements .................................................................................................................... xiv Dedication ................................................................................................................................... xvi Chapter 1: Introduction ............................................................................................................... 1 1.1 Research Questions ..................................................................................................... 3 1.2 Significance and Impact .............................................................................................. 4 1.3 Positionality ................................................................................................................ 6 Chapter 2: Literature Review .................................................................................................... 10 2.1 Indigenous Health Needs and Chronic Health Disparities ....................................... 11 2.2 Defining Indigenous Traditional Wellness ............................................................... 13 2.3 Defining Indigenization for Health and Wellness Services ...................................... 18 2.4 Defining Cultural Safety ........................................................................................... 20 2.5 Historical Context ..................................................................................................... 22 2.5.1 Historical Intersectional Impacts on Traditional Wellness ................................... 25 2.5.2 Historical Interpretations of Traditional Wellness ................................................ 29 2.6 A Review of Indigenous Impacted Commissions and Declaration’s ....................... 31 vii 2.6.1 Indigenous Health Implications in the Truth and Reconciliation Commission: Calls to Action .................................................................................................................. 32 2.6.2 Indigenous Health Implications in the United Nations Declaration on the Rights of Indigenous Peoples ....................................................................................................... 35 2.7 Indigenous Self-Governance and Rights Affirmation: Pre-UNDRIP Achievements of the Westbank First Nation ................................................................................................ 38 Chapter 3: Theoretical Framework, Methodology and Methods .............................................. 40 3.1 Indigenous Methodologies ........................................................................................ 41 3.2 Indigenous Theoretical Framework: Enowkinwixw Principles ................................ 42 3.3 Recruitment ............................................................................................................... 46 3.4 Sample Demographics .............................................................................................. 50 3.5 Data Collection ......................................................................................................... 53 3.5.1 Sharing Circle Procedures..................................................................................... 56 3.5.2 Knowledge Sharing Interview Procedures............................................................ 59 3.5.3 Personal Reflection Procedures ............................................................................ 61 3.6 Data Safety Procedures ............................................................................................. 62 3.7 Data Analysis ............................................................................................................ 62 3.7.1 Inductive Thematic Findings ................................................................................ 62 3.7.2 Deductive Thematic Analysis ............................................................................... 64 3.7.3 Attributes of the Four Food Chiefs ....................................................................... 65 Chapter 4: Results ..................................................................................................................... 67 4.1 Strengths ................................................................................................................... 67 4.1.1 Access To Diverse Traditional Outlets Increases Wellness ................................. 68 viii 4.1.2 Access to Traditional Wellness Fosters Community Connection......................... 69 4.1.3 Essential Traits of Good Leadership Enhances Engagement in Traditional Wellness ............................................................................................................................ 70 4.1.4 Wellness Initiatives are Impactful When Local Teachings are Provided ............. 71 4.1.5 Current Knowledge of and Access to Land Based Knowledges are Integral to Peoples Health and Wellbeing .......................................................................................... 72 4.2 Barriers ...................................................................................................................... 73 4.2.1 Various Accessibility Issues are a Barrier to Engaging and Accessing Traditional Wellness ............................................................................................................................ 74 4.2.2 Lack of Consistency in Leadership and Programming Can Deter Engagement in Traditional Wellness Initiatives ........................................................................................ 75 4.2.3 Navigating Traditions Can Create Difficulties in Implementation of Traditional Wellness Outlets ............................................................................................................... 76 4.2.4 Historical Trauma and Stigma’s Impact Engagement and Desire to Participate in Traditional Wellness Activities and Initiatives ................................................................. 78 4.3 The Way Forward ..................................................................................................... 79 4.3.1 Fostering Collaborative Environments with Community to Allow for Growth in Traditional Practices ......................................................................................................... 80 4.3.2 Enhancing Access for Ease of Traditional Wellness Participation in Various Areas 82 4.3.3 Effective Strategies for Passing on Traditional Knowledge and Revitalizing Traditional Wellness Practices .......................................................................................... 83 4.4 Gender Findings ........................................................................................................ 84 ix 4.4.1 Addressing the Need for Gender Role Balance in Spaces .................................... 85 4.4.2 The Importance of Gender in Traditional Wellness ............................................. 86 4.4.3 The loss of Traditional Roles due to Imposing Western Perspectives .................. 87 4.4.4 Traditional Gender Roles Can Be Discouraging .................................................. 89 4.5 Visual Representations of Thematic Analysis .......................................................... 90 Chapter 5: Discussion ............................................................................................................... 93 5.1 Summary of Findings ................................................................................................ 93 5.2 Principle Findings ..................................................................................................... 94 5.3 Implications for Wellness, Policy, and Future Research Considerations ................. 97 5.3.1 Implications for Wellness ..................................................................................... 98 5.3.2 Implications for Policy ........................................................................................ 100 5.3.3 Future Research Considerations ......................................................................... 101 5.3.4 Gender ................................................................................................................. 102 5.3.5 Elders .................................................................................................................. 103 5.3.6 Language ............................................................................................................. 103 5.3.7 Urban Indigenous Voices .................................................................................... 104 5.4 Strengths and Limitations ....................................................................................... 105 5.4.1 Interpretation of the Results ................................................................................ 105 5.4.2 Demographic Sample and Time.......................................................................... 106 5.4.3 Methodology ....................................................................................................... 106 5.4.4 Establishing Partnerships .................................................................................... 107 5.5 Knowledge-Sharing Plan ........................................................................................ 108 5.6 Conclusion .............................................................................................................. 109 x 5.7 Final Statement ....................................................................................................... 112 Bibliography ...............................................................................................................................114 xi List of Illustrations Illustration 1 Recruitment Ad ....................................................................................................... 48 Illustration 2 Visiting on the Land with Semi-Structured Interview Participants 102 & 103 ...... 61 xii List of Figures Figure 1 Participant Demographics .............................................................................................. 50 Figure 2 Gender Demographics .................................................................................................... 51 Figure 3 Participants Experience Accessing Traditional Wellness .............................................. 52 Figure 4 Common Types of Traditional Wellness Experiences ................................................... 52 Figure 5 Four Food Chiefs Thematic Analysis ............................................................................. 92 xiii List of Abbreviations In Plain Sight Data Report (IPSDR): The In Plain Sight Data Report (2021) served as a comprehensive examination of Indigenous-specific racism and discrimination in BC health care. It is included in this thesis to provide up-to-date insights into current health disparities and to inform the overall content of the thesis. The United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP): The United Nations Declaration on the Rights of Indigenous Peoples (2007) is a globally recognized document that delineates fundamental human rights and needs. It also includes articles addressing various Indigenous health-related matters, providing valuable support to the thesis and research. Truth and Reconciliation Commission Calls to Action (TRC): The Truth and Reconciliation Commission Calls to Action (2015) consist of 94 initiatives, currently under consideration for implementation by the Canadian Government. Call to Action #22, among others, has significantly influenced the research topic and thesis. Westbank First Nation (WFN): The Westbank First Nation is a local self-governing Indigenous community of which I am a member of; WFN supported, co-created and collaborated on this research. xiv Acknowledgements I am incredibly grateful for the support I have received from the network of individuals that have surrounded me throughout my journey in completing this thesis. My heartfelt gratitude extends first and foremost to my family, with whom I had the honor to engage with during this research journey. Specifically, I wish to acknowledge my mother, Nicole, and my father, Mickey. Their continuous encouragement for me to pursue higher education has been fundamental in shaping my academic path. I admire them both for their significant achievements as individuals and for their invaluable contributions to our community. I aspire to follow in their footsteps and make a similar impact. I am always grateful to have such amazing role models as my parents. I am incredibly grateful to my Graduate committee, led by my supervisor Dr. Laura Struik, for her consistent support and guidance throughout this milestone. Dr. Struik’s confidence in my abilities served as a source of motivation throughout this process. I also want to express my appreciation to my co-supervisor, Dr. Kimberly Huyser, for her invaluable insights and expertise throughout research development. My gratitude also extends to committee members Dr. James Coble and Dr. Gabrielle Legault for their contributions that significantly shaped this research and thesis. To the Westbank First Nation (WFN) community, a constant pillar of support. Specifically, to the WFN Education Department that has been instrumental in navigating my academic endeavors. Furthermore, I am incredibly appreciative of the specific facets within WFN whom I collaborated with during my research and thesis. The WFN Health and Wellness Department provided invaluable on-the-ground insights into the community. To the WFN Youth Council xv which has been an inspiration in their generational support providing innovative knowledge. I hold immense pride in witnessing their emergence as the next generation. I would also like to extend my gratitude to the Sncəwips Heritage Museum for granting me access to a reservoir of records and providing a safe and welcoming space to delve into the history, language, and wisdom of the Westbank First Nation and Syilx community. My sincere thanks goes out to the WFN community and family members who generously shared their time, wisdom, and awareness throughout this research. Their willingness to engage in meaningful conversations and answer the questions I longed to explore has been enlightening. Finally, I express my gratitude to BC NEIHR for funding this important work and creating opportunities for Indigenous academics, such as myself, in furthering Indigenous Health and Wellness initiatives and research. This thesis selectively omits specific research findings to safeguard the sacred knowledge and teachings that are maintained within the WFN community. Nevertheless, the knowledge I gained through my research significantly enhanced my understanding as a Syilx woman, strengthening my connection to both my culture and people. Completing this thesis has been a sacred period in my personal growth, and I am grateful to those who have uplifted me throughout this time. Limləmt | Thank You xvi Dedication This thesis is dedicated to my sqilwx relatives. I honor the determination of past, present, and future sqilwx generations who are and have been tirelessly committed to revitalizing and preserving our traditional knowledges, practicing restitution, and ensuring cultural continuity. 1 Chapter 1: Introduction According to the In Plain Sight Data Report (2021), Indigenous populations are less likely to seek and receive adequate health care; 32% of respondents indicated that health providers held a lack of respect for Indigenous values and cultural practices. This appeared to be rooted in a lack of understanding from health care providers about the nature and importance of these values and practices (Johnson, p.78). To eliminate this gap in cultural understanding, health and wellness systems must work towards informing, creating and integrating Indigenized, culturally safe spaces and traditional wellness practices that are advised through lived Indigenous perspectives and voices. In relation to eliminating the health discrepancy outlined above, health and wellness systems must adhere to further implementation of Call #22 in the 2015 report of the Truth and Reconciliation Commission Calls to Action (TRC), which states, “We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients” (p.3). Therefore, it has become a priority for wellness and healing center programs to provide Indigenous modes of wellness, particularly by employing or working with a Traditional Wellness Practitioner (First Nations Health Authority, 2014). There have been advancements in defining Indigenous rights to Traditional Wellness, as seen through the further implementation of the United Nations Declaration on the Rights of Indigenous People Act (UNDRIP) as referenced through article 24, which states that “Indigenous peoples have the right to their Traditional medicines and to maintain their health practices…” (2018, p. 18). However, the lack of policy guidelines in relation to ensuring access to Traditional Wellness has been found to be a major barrier to 2 implementation (Ijaz and Boon, 2018). In addition, Ijaz and Boon bring to light that ‘the statutory regulation of traditional medicine practitioners and practices requested from a biomedical professional regulation standpoint continues to reinforce biomedicine’s disproportionate political dominance across the globe.” (p. 8). Ijaz and Boon emphasize that regulatory actions and requirements are primarily from a Western biomedical perspective and argue that this singular Westernized viewpoint lacks flexibility in recognizing or accepting Indigenous traditional processes and practices as valid. Instead, this westernized lens insists on adhering solely to biomedical standards for qualifying or verifying traditional wellness implementation when shaping policies and guidelines. This approach lacks mindfulness of traditional perspectives on wellness and the customary vetting processes that are traditionally practiced. The Westbank First Nation (WFN) Health and Wellness department and community have articulated that addressing these knowledge gaps are a priority. The WFN is an Indigenous nation situated within the Okanagan (syilx) valley with over 850 members living both on and off WFN reserve lands. The WFN is one of the few self-determining and self-governing Indigenous nations located in Canada. Therefore, in collaboration with WFN, this thesis aims to develop evidence to understand traditional wellness integration, ultimately generating Indigenous-led evidence to inform future policy and practices for integration. As a WFN member, this area of focus holds dear to my heart, I have and will continue to build a long-standing collaborative relationship with WFN to address the traditional wellness integration knowledge gap. 3 1.1 Research Questions The primary research question that this thesis will address asks, ‘What are the factors that influence appropriate and Indigenized integration of traditional wellness in a culturally safe way?’ The objectives include: 1. Identify barriers to successful integration that Traditional Wellness Practitioners and Indigenous peoples face. 2. Gather lived experiences that highlight the strengths of current access and integration strategies. 3. Leverage local Indigenous knowledge to ensure cultural safety and enhance integration for traditional wellness. With the invaluable support and input from my supervisory committee members, professors, and family, I honed this research question to its current form, ensuring its relevance and timeliness. To appropriately navigate the complexities of this vital topic, the objectives were thoughtfully crafted, seeking to shed light on its intricate nuances and multifaceted dimensions. The primary objectives of this study were to identify the barriers, strengths and way forward that support successful integration of traditional wellness, cultural safety and Indigenized practices within health care settings. Delving into the complexities of this issue to best understand the barriers, I engaged with community members, health professionals, and knowledge keepers to understand the challenges faced in embracing traditional healing practices within contemporary healthcare systems. Through candid conversations and reflective exchanges, I aimed to uncover the historical, social, and institutional obstacles that have impeded the recognition, validation, and access to Indigenous forms of wellness. 4 In pursuit of the second objective, I gathered lived experiences that reveal the strengths and merits of existing integration strategies. By listening attentively to the narratives of those who have experienced or facilitated successful integrations, I hoped to discern the empowering aspects of these practices. These stories will serve as inspiration illustrating the potential for traditional wellness to complement and enhance modern healthcare approaches and expand the variety of healing methods that can be available to Indigenous peoples. The third objective drew upon the wisdom and insights of local syilx knowledge to enhance the way forward. Recognizing the intrinsic connection between cultural safety and effective integration, I engaged in qualitative questions throughout my sharing circle and interview guides that enhanced my understanding of the topic. The teachings and guidance shared by the participants in this research helped shape a framework for cultural safety that not only respects and values traditions but also paves the way for informing seamless integration within healthcare systems. 1.2 Significance and Impact Incorporating traditional wellness strategies into health and wellness frameworks is linked to improved educational and health outcomes, strong cultural identity and community and family connections (Allen et. al., 2020). In a study conducted by Katz et al. (2018), Indigenous patients who had access to Indigenous-led health services that incorporated cultural safety and traditional wellness reported higher levels of satisfaction with their care (M = 8.29, SD = 1.69) compared to those who did not have access to such services (M = 6.32, SD = 2.39), t(141) = 6.87, p < .001 (p. 345-388). Overall, this access led to higher levels of patient satisfaction but also improved health outcomes for Indigenous peoples where improved satisfaction with care and access to culturally relevant services contribute to enhanced mental and emotional well-5 being, increased adherence to healthcare recommendations, and potentially better management of chronic conditions (Katz et al., 2018). This Master’s thesis study serves as a pivotal platform for advocating an Indigenous-centric approach to integrate traditional wellness practices into healthcare services, thereby fostering the seamless integration of traditional wellness within the health and wellness domain. Furthermore, the research conducted and the findings unveiled in this study hold immense significance in meeting the imperatives outlined in TRC Call to Action #22 and UNDRIP Article 24. Wherein Call # 22 advocates for community-driven health and wellness approaches that are informed by Indigenous peoples through active collaboration in eliminating existing health disparities. Concurrently, Article 24 asserts the right of Indigenous communities to maintain and access traditional health systems without discrimination, ensuring cultural safety and acknowledgment of traditional health practices. This thesis stands as a meaningful contribution towards realizing these calls to action and articles, emphasizing the importance of respecting, and incorporating Indigenous perspectives in healthcare. The study holds profound implications for overcoming current integration barriers, utilizing strengths, and improving integration practices. The findings derive their strength from collaboration with Indigenous communities and an Indigenous knowledge-gathering methodology. This research has been carefully developed for, by, and in collaboration with a local Indigenous community. As a result, this thesis represents a significant step towards fostering respect, reciprocity and trust in healthcare relationships, empowering Indigenous communities to assert their self-determination in healthcare matters. Ultimately, this research aims to foster an environment where Indigenous communities feel valued and empowered in their healthcare choices and experiences. 6 1.3 Positionality Before I dive into the thesis and research study and findings, I must first introduce myself in a sqilxw practice through my Nsyilxcən language: way̓ isxwist Saige Werstuik | Hello my name is Saige Werstuik. Kn’tl st’aʔɬqʷilnwt | I come from the place of the pines (IR#9 on Westbank First Nation Lands). ƛ ̓ ‘a?xex ƛ ̓xap Nicole naɬx Mickey Werstuik | My parents are Nicole and Mickey Werstuik. ntum támaʔ twi Gloria Faith Wilson | My maternal late grandmother is Gloria Faith Wilson. nm̓ istəm̓ qʕánaʔ twi Marsha King | My paternal late grandmother is Marsha King. ti sec isec mi pnunum ixi way̓ | I am a new learner to my language, and I am finished with my introduction. This introduction is a common and respectful practice when defining who I am. I expand to all who came before me, acknowledging the accumulated wisdom needed to bring me here today. It is important to situate myself in this aspect as a reminder that I, too, will be an ancestor to someone and everything that I do impacts not only myself but all those around me, past, present and future. This is a key aspect that I always consider and practice while navigating through my academic journey. As a syilx (Okanagan) woman, a daughter, a sister, a granddaughter, a friend, a community member, and an Indigenous scholar, I am dedicated to making a meaningful impact in the field of Indigenous health and wellness. While growing up, traditional wellness was woven into the fabric of my family’s life. Through engaging in various forms of ceremony, traditional practices and knowledge-keeping, each of these facets of traditional wisdom fostered my relation to kinship, identity and defining the philosophical meaning of the world around me. When I think of my mother, I am reminded of the kinship aspect of traditional wellness. With her Nakota Sioux and Assiniboine teachings, she taught my brother and I the significance of our roles; For example, as a Woman, my 7 Indigenous heritage on both my mother’s and father’s sides are matrilineal in practice. Therefore, there are specific roles that I must maintain and pass forward when I become a matriarch of my family one day. There are certain roles that my brother must uphold to support the matriarchs as well as the men in his life. My mother also ensured we were actively engaged in our spiritual wellness through partaking in ceremony. This meant participating in the powwow circle and supporting our community during times of need. When I think of my father, I think of the philosophy of traditional wellness and my relation to the world. Every Sunday, he would bring my brother and I up into the bush to spend time on the land, supporting our traditional wellness through providing for our family and community by hunting, gathering and preparing what has been provided by our tmixw (animals & living things) and tmxulawx (earth). My father taught us about our responsibility to the tmixw and tmxulawx as we are in a reciprocal relationship with these beings. Both of my parents’ expressions of traditional wellness helped settle me in understanding and having a well-rounded expression of who I am. Therefore, I have always treasured the wisdom held within traditional wellness and as I sought my purpose in education, my career and in life, I found solace in learning and understanding wellness. I have continually aimed to heighten my awareness of traditional wellness and Indigenizing wellness strategies by working for and with my community. I have deep connections to my community, particularly in the realms of health, health promotion, and fostering community ties. My involvement extends to my past role where I was previously a Youth and Recreation Leader for Westbank First Nation from 2016-2023. I was also the first established Health and Wellness intern for WFN in 2021. Alongside my professional career, I maintained my community efforts through volunteer work as a WFN Youth Council founding member from 2015-2022. I have experience engaging with Indigenous communities outside of 8 my own through my internship with First Nations Health Authority as the Primary Care and Traditional Wellness Co-op student. In this role I was provided the opportunity to witness the affiliations health authorities had with one another and gained insight to see what the provincial Ministry of Health was progressing through regarding access to culturally safe wellness. This insight from a health authority perspective, showcased that there is much to do from an Indigenized health point of view. From an educational standpoint, both my current and previous studies have revolved around the concept of wellness. In 2021, I successfully earned my B.A. with a major in Psychology. Following this accomplishment, I spent time reflecting on how I could best channel my dedication to the community and my passion for health and wellness. These considerations ultimately led me to apply for the IGS (Community Engagement, Social Change, and Equity) program, where I could delve deeper into the subject matter. As a result, I found myself immersed in research and working on a compelling thesis, which I am excited to share with you today. What motivates me as an Indigenous scholar and influences my research in initiating valuable change is my position as an Indigenous, woman, community member and scholar, I am driven to raise awareness on Indigenous health equity from my own lived experience, especially in light of current social and political priorities like The Truth and Reconciliation Commission Calls to Action and The United Nations Declaration on the Rights of Indigenous Peoples. My thesis aims to build a foundation of accessible traditional wellness services and Indigenized integration methods within biomedical frameworks, addressing cultural health disparities for Indigenous peoples and protecting traditional knowledge for future generations. Through this research, I strive to amplify Indigenous voices and stories by employing methodologies that are reflexive of Indigenous modes of knowledge sharing such as, sharing 9 circles, story work, personal reflections, and engaging with knowledge keepers and community members. This work allowed for a profound understanding of Indigenous in-situ lived experiences and fostered interactions that challenge the dominant narrative shaped by a westernized, patriarchal lenses. By doing this work, I hope to facilitate a meaningful dialogue in western academic and biomedical contexts, creating valuable insights and promoting positive change. 10 Chapter 2: Literature Review In this chapter, I begin examining the existing health needs and disparities experienced among Indigenous populations in Canada. Moving forward with a multifaceted definition of what traditional wellness is, and what it means to be a traditional wellness practitioner, medicine person or knowledge keeper. Furthermore, I provide succinct examples of traditional wellness, offering insights into the designated roles of traditional wellness practitioners or medicine people in their community. This is exemplified through a local syilx coming-of-age ceremony, drawn from local anthropological accounts. I delve into an in-depth examination of key terminologies essential to this research, including Traditional Wellness Integration, Cultural Safety, and Indigenization. To effectively address these challenges and promote Indigenous Traditional Wellness, I emphasize the significance of cultural safety and Indigenization in healthcare. Expanding upon these foundations, I explore the concept of Indigenous Traditional Wellness from a historical and cultural perspective, describing the effects of colonization on Indigenous people’s health. I then explain that these historical events have resulted in a decline in traditional practices and cultural heritage. In addition, the chapter moves into identifying the intersectional aspects that contributed to the loss of traditional wellness, including the impacts on women, Two-Spirit, and gender-inclusive individuals, which has led to a shift towards patriarchal societies. In revitalizing Indigenous Traditional Wellness, I highlight the need for an intersectional understanding of health and healing, recognizing the unique experiences of various Indigenous communities. Finally, I conclude by identifying current Indigenous impacted commissions and declaration initiatives aimed at implementing health-related changes for Indigenous peoples, noting both the legislative shortcomings and the anticipated tasks voiced by numerous Indigenous peoples across nations. 11 2.1 Indigenous Health Needs and Chronic Health Disparities Chronic health disparities persist among Indigenous populations in Canada when compared to their non-Indigenous counterparts, a result of the enduring impact of historical colonial ideologies and implementation of services (Joseph,2018; Johnson, 2021; Loppie & Wien, 2022; Public Health Agency of Canada, 2018). Historically, health data has either misrepresented or excluded the representation of Indigenous peoples, often narrowly focusing on disease and chronic illness without delving into broader aspects of health and wellness, particularly the impact of limited access to traditional practices (Johnson, 2021; Wilson-Raybould, 2022). The chronic health disparities confronting Indigenous communities are evident, with a notable prevalence of multiple chronic health conditions experienced by 55.3% of Indigenous populations, in contrast to their non-Indigenous counterparts at 48.5% (Loppie & Wien, 2022). This significant difference underscores the health challenges faced by Indigenous individuals (Public Health Agency of Canada, 2018). What’s more, access to both physical and mental health resources is notably lower for Indigenous communities, registering at 37.8%, while their non-Indigenous counterparts have a higher rate of 59.9% (Loppie & Wien, 2022; Public Health Agency of Canada, 2018). This discrepancy in health access further exacerbates the disparities in prevalence of multiple chronic health conditions. Importantly, the life expectancy for First Nations, Inuit, and Metis communities averages at 77.7 years, significantly lower than the 85.4 years reported for non-Indigenous populations (Loppie & Wien, 2022; Public Health Agency of Canada, 2018). Access to healthcare exacerbates these challenges, with severe shortages of primary health care physicians across Canada, further hindering Indigenous individuals’ ability to receive essential medical attention (Angus Reid Institute, 2022). In 12 conjunction to this, Indigenous populations experience higher prevalence of chronic conditions such as asthma and diabetes, and increased rates of perceived disabilities compared to non-Indigenous counterparts (Hahmann & Kumar, 2022; Hahmann et al., 2019). These figures, drawn from various studies emphasize the urgent need for targeted interventions and systemic changes to address the underlying factors contributing to these persistent health inequalities faced by Indigenous populations in Canada. Indigenous peoples are faced with unique barriers that negatively affect Indigenous determinants of health, which are entrenched in experiences of colonialism, exclusion, and racism (Public Health Agency of Canada, 2020). The health status disparities between Indigenous communities and other segments of the Canadian population stem from historical processes of colonization, oppression, and the traumatic legacy of Indian Residential Schools, compounded by persisting discrimination and racism within healthcare settings (Joseph, 2018; Johnson, 2021; Public Health Agency of Canada, 2020). Historical and modern colonial impacts, exemplified by the aforementioned examples, and coupled with the forced displacement of Indigenous communities to inhospitable and inaccessible reserve lands (Joseph, 2018; Yangzom et al., 2020) have resulted in a disruption of access to traditional foods, practices and adequate public health (Joseph, 2018). Consequently, Indigenous people experience significant health disparities compared to their non-Indigenous counterparts as a result. However, the study on Factors that influence the decision to vape among Indigenous youth reveals a positive correlation between Indigenous youth’s well-being and their cultural affiliation and engagement (Struik et al., 2022). Specifically, Indigenous youth in the study indicated that engaging in traditional wellness (e.g., beading, walking the land), were protective of engaging in risky health behaviors like vaping (Struik et al.). This study 13 underscores the significance of engagement with and access to traditional outlets as a means of enhancing wellness. It is evident that health and well-being is intricately tied to the historical, political, economic, and social circumstances into which one is born. The enduring ramifications of land dispossession, erosion of language and cultural resources, and the curtailment of self-determination have profoundly impacted the health trajectory of Indigenous peoples in Canada (Joseph, 2018; Johnson, 2021; Public Health Agency of Canada, 2020; Wilson-Raybould, 2022). Racism, discrimination, and social exclusion further exacerbate the situation, impeding Indigenous peoples access to culturally safe care and perpetuating healthcare disparities (Johnson, 2021; Wilson-Raybould, 2022). Hence, recognizing and addressing these Indigenous determinants of health, rooted in historical injustices and ongoing systemic barriers, is fundamental to advancing the health and well-being of First Nations, Inuit, and Métis populations within the Canadian healthcare landscape. 2.2 Defining Indigenous Traditional Wellness According to Decolonization & Healing: Indigenous Experiences in the United States, New Zealand, Australia and Greenland, traditional wellness encompasses holistic health practices directed at improving the mental, physical, spiritual, and emotional well-being of Indigenous communities by integrating Indigenous methods of health and wellness into available wellness structures (Archibald, 2006). It emphasizes the interconnectedness of all living beings and recognizes the importance of maintaining a reciprocal relationship with the natural world (Archibald, 2006). It has been found that incorporating elements of traditional medicines sourced from the land or specific territories that Indigenous individuals are from mutually reinforce 14 traditional wellness client’s connection with the land; allowing an opportunity to engage with specific land-based cultural teachings (Kirmayer, Brass & Tait, 2000). Traditional healing and medicines integrate local Indigenous worldviews and perspectives on health and well-being, creating an enhanced well-being overall (Archibald, 2006; Katz et al., 2018; Public Health Agency of Canada, 2020). It is important to note that these perspectives differ among Indigenous peoples, with each people holding their own unique and autonomous culture and understanding of traditional healing and practices. What remains crucial is that traditional healing and practices play a significant role in reinforcing a vital aspect of Indigenous identity and cultural survival, as it reflects the values, beliefs, and practices that have been passed down through generations. (Kirmayer, Brass, & Tait, 2000, p. 260-289). In the context of this study and thesis, Traditional Wellness Integration refers to the incorporation or amalgamation of Indigenous traditional practices into health programs, aiming to establish comprehensive and inclusive health practices. For instance, the Wellbriety program advocates for cultural healing by integrating the seven sacred teachings [love, respect, honesty, bravery, wisdom, truth, and humility] into recovery programs for addiction and substance use (Pathways Health and Wellness Programs, 2021). Similarly, alternative healing approaches in healthcare involve the utilization of local traditional medicines, engagement in ceremonial practices, seeking guidance from Elders, and participation in land-based activities (Pathways Health and Wellness Programs 2021). As this chapter unfolds, I aim to delve deeper into defining traditional wellness integration and elucidating its implementation methods within healthcare. 15 Within traditional wellness, as previously mentioned, a key component in relaying traditional wholistic practices is through a trained traditional healer, practitioner, medicine person, knowledge keeper or elder (Archibald, 2006; Kirmayer, Brass & Tait, 2000). To provide an overarching definition and understanding of how a traditional wellness healer, practitioner or knowledge keeper is defined, Linda Archibald further explains as follows: “[Traditional healers] are well versed in multifaceted elements such as leading, hunting, creating, gathering, fishing, understanding kinship bonds, and is a person who has a strong connection to the earth. [A traditional healer], views what is biomedically referred to as illnesses as rather an imbalance or disharmony with nature instead of an inherent problem or disease. These healers are connected to spirit and have a vast understanding of dream interpretation. These healers facilitate ceremonies and provide naturopathic healing.” (Archibald, 2006, p. 52-53). It’s crucial to acknowledge the distinctions among terminologies used to convey the specific roles of traditional wellness practitioners, knowledge keepers, and medicine people. It is also important to acknowledge that the selection process and definition for a traditional wellness practitioner, medicine person or knowledge keeper differs among Indigenous nations. In keeping with the context of my thesis, I will be using local definitions to describe these different roles, which are presented below. Traditional wellness practitioners are specifically recognized individuals within their communities possessing healing abilities, perceptiveness, respectful relationships, and deep cultural knowledge (Archibald, 2006). They undergo training by esteemed Elders, knowledge keepers, medicine people and other traditional wellness practitioners to preserve and transmit their community and nations ceremonies, medicines, languages, and traditional healing practices 16 (Kirmayer, Brass & Tait, 2000; Archibald, 2006). These practitioners adeptly address spiritual, mental, emotional, and physical concerns through sacred ceremonies (First Nations Health Authority, 2014; Archibald, 2006). Additionally, traditional wellness practitioners’ wellness plans encompass land-based activities, traditional foods, and plant medicines (First Nations Health Authority, 2014). Knowledge keepers are often considered to be ‘Elders in Training,’ and possess traditional teachings passed on from other traditional wellness practitioners, Elders, and medicine people along with their own personal experiences and teachings (First Nations Health Authority, 2014). Knowledge keepers are dedicated to sharing the wisdom that has been bestowed upon them (First Nations Health Authority, 2014). Knowledge keepers may conduct ceremonies and can also collaborate closely with traditional wellness practitioners (First Nations Health Authority, 2014). In relation to medicine people, I will provide a local example among the Syilx people. The traditional choice would often be a ƛ̓aʕkwilx (pronounced phonetically as KL-Ah-K-Qw-EEL-H), most closely translated to mean ‘medicine person’. It’s important to note that variations in pronunciation and written forms of this term exist across different regions within the syilx Okanagan Valley. Referring to an interview I had with participant Coralee Miller, who has provided their permission and has requested to be referred to by name throughout the thesis and findings, is a docent for the sncewips heritage museum, Coralee describes their understanding of the selection process for traditional medicine people within the syilx community through reflections of teaching’s they learned throughout time: “So traditionally to be considered a ƛ̓aʕkwilx (medicine person) or be chosen to be trained. Most of the time you were Stimiyaʔ (Two-Spirit) someone who possessed 17 the perspectives and the powers of both male and female. This is someone who works with medicine and they work with all the practitioners. They can deliver a baby, they can make something that will help you with a rash or they can engage in ceremonies that help bring you back from the other side or they help you to get to the other side. They can commune with spirits and they have spirit helpers. So you can be man or woman or in between to do medicine, but the first step first always had to be the coming of age ceremony. You couldn’t be a proper ƛ̓aʕkwilx unless you went through the four days of fasting and getting your vision. I could be wrong, but this is what I was taught. If you don’t have that integral step, then it’s really hard for you to do your job.” (Participant 119-Miller, Community Member). As Coralee describes the integral step in becoming or being selected as a medicine person from a syilx perspective, it’s worth considering the anthropological understanding and evidence of local syilx practices about coming-of-age ceremonies which can be gleaned from the documented accounts of Franz Boas and James Teit (1927), providing a basic insight into the composition and significance of these practices. Boaz and Teit observed that considerable emphasis was placed on the mental preparation involved in the ceremony, where success was contingent on individuals focusing their minds intensely on their desires. The suppression of intense emotions was deemed crucial. The youth were required to attain a state of calm expectancy, during which the guardian spirit would reveal itself, often through various facets or a song. An integral aspect of the youth’s coming-of-age involved daily cold-water baths. These baths served to toughen the youth, making them strong and resilient in the face of cold conditions. Additionally, the practice was believed to promote overall health, immunity from colds and illnesses, and a quick recovery from injuries. (Boas and Teit, 1927). In the course of 18 these ceremonies, the guardian spirit played a pivotal role in guiding the youth’s life path, ultimately shaping their designated role within the community (Boas and Teit, 1927). Consequently, these coming-of-age experiences, as Coralee describes, served as crucial moments wherein medicine people discovered their purpose. It is also important to note that this anthropological evidence and perspective of the syilx coming-of-age ceremony stems from a non-Indigenous lens focused from a westernized perspective translated to fit the anthropological views of their time. To gain a deeper insight into the spiritual and intersectional dimensions of these ceremonies, I’ve yet to explore them in their entirety due to a lack of direct experience. However, I’m aware that these revered practices persist, overseen by knowledgeable Elders who facilitate their conduction. As far as my current knowledge extends, these coming-of-age practices frequently take place on the land, involving youth seclusion in specific sacred areas across the territory. The precise locations remain undisclosed to honor their sacredness and safeguard their integrity. Regrettably, numerous sacred sites have suffered disturbance, mistreatment, and destruction due to tourism, climate change, and general culturally motivated aggressions and vandalism from people who encounter these sacred areas. While I haven’t received permission to disclose these areas, I am aware of a few specific places where these ceremonies traditionally occur. 2.3 Defining Indigenization for Health and Wellness Services In this section, I will describe best practices that are aimed at engaging Indigenous peoples in ways that both support and reflect traditional wellness, while also respecting specific Indigenous autonomous perspectives on health. In other words, I will be defining Indigenization of health practices. 19 Indigenization embodies integrating Indigenous knowledge, values, practices, and perspectives within various spheres, such as education, healthcare, and social services (Smith, 2019). It involves acknowledging and respecting Indigenous worldviews, traditions, languages, and governance systems within institutional frameworks (Jones & Johnson, 2020). Indigenization transcends mere inclusion, emphasizing a transformative shift towards recognizing and empowering Indigenous cultures and communities (Smith, 2019). In the context of health and wellness services, Indigenization pertains to incorporating Indigenous traditional healing practices, ceremonies, and holistic approaches within healthcare systems (Adams et al., 2021). It involves creating culturally safe environments that honour and integrate Indigenous healing modalities, recognizing the interconnectedness of spiritual, mental, emotional, and physical health (Jones & Johnson, 2020). Indigenization in healthcare underscores the importance of collaboration and partnerships with Indigenous communities to co-create culturally responsive and relevant healthcare services (Adams et al., 2021, p. 118). Currently known practices of cultural health integration includes using traditional medicines, ceremonies, and land-based healing activities within healthcare delivery and employing culturally specific healing methods, such as sweat lodge ceremonies or smudging rituals, into treatment plans (Smith, 2019; Williams & Brown, 2020) Moreover, practicing these forms of integration fosters respectful and reciprocal relationships between healthcare providers and Indigenous communities, promoting cultural safety and mutual understanding in healthcare settings (Williams & Brown, 2020). Consider this study by Marsh (2018), that highlighted the positive outcomes of integrating Indigenous traditional healing practices into what Marsh refers to as the ‘Western 20 Treatment Model Seeking Safety’. The ‘Western Treatment Model Seeking Safety’ is a specialized therapy model created to tackle trauma and substance use issues frequently utilized in mental health and addiction treatment contexts in Western settings. This integration notably led to reduced intergenerational trauma, alleviated symptoms, and diminished substance use disorders. The study by Marsh (2018), primarily focused on qualitative evidence, specifically examining the impact of the sweat lodge ceremony within traditional healing practices. Participants reported significant improvements in their spiritual and emotional well-being directly linked to their participation in this ceremony. This study highlights the transformative potential of integrating Indigenous traditional healing practices within healthcare. 2.4 Defining Cultural Safety Cultural safety is an essential concept in healthcare that emphasizes the importance of creating an environment where individuals feel safe, respected, and valued for their unique cultural identities (First Nations Health Authority, 2014). For Indigenous peoples, cultural safety is particularly critical as they have historically experienced discrimination and mistreatment in healthcare settings, as previously outlined. Cultural safety refers to involving, recognizing, and respecting the unique experiences, histories and cultures of Indigenous peoples and incorporating these aspects into policies, programs, and practices to promote greater equity and inclusion (First Nations Health Authority, 2014). Cultural safety empowers Indigenous peoples and communities by placing their knowledge, values, and decision-making processes at the forefront (Marion et al., 2010). Consider this example of how Indigenous peoples have maintained and revitalized traditional wellness through Indigenized cultural safety frameworks. Marion et al. (2010) 21 provide context for ten years of experience in the development of traditional healing services in Traditional Anishinaabe Healing in a Clinical Setting: The Development of an Aboriginal Interdisciplinary Approach to Community-based Aboriginal Mental Health Care. The authors suggest that the development of traditional healing protocols and inter-professional education for providers and community members offers a basis for successfully integrating Western and traditional healing practices in a clinical mental health setting that supports holistic health and well-being. Marion et al. (2010) highlight the interdisciplinary approach to successfully integrating traditional wellness into health care is grounded in the concept of the medicine wheel, which is an Anishinaabe model of holistic health that considers the physical, emotional, mental, and spiritual aspects of an individual’s well-being. Marion et al. explain that the medicine wheel is a foundational concept in Anishinaabe culture, representing a framework for understanding the interconnectedness of all things. The interdisciplinary approach used in the study recognized that mental health and well-being go beyond treating symptoms or illnesses; it involves addressing the whole person and their relationship to the broader community and environment (Marion et al., 2010). This approach prioritized integrating traditional Anishinaabe healing practices, such as traditional medicines, ceremonies, and teachings, alongside Western mental health practices (Marion et al., 2010). By doing so, the study recognized the importance of cultural safety and responsiveness in mental health care for Indigenous peoples and acknowledged the unique ways in which traditional healing practices can support holistic health and well-being. However, the Anishinaabe framework employed in the study is unique to the Anishinaabe nation and cannot be generalized as a one-size-fits-all approach to integrating traditional wellness practices. Instead, this study offers an example of how researchers and community members can collaborate to develop an Indigenized model that integrates traditional healing practices in a culturally safe and 22 respectful manner that is reflective of the specific healing practices of a particular nation. It is crucial to acknowledge the differences between each nation and their wellness knowledge, which will be discussed in the following sections. Therefore, it is imperative to foster a profound appreciation for the distinctive knowledge systems within each Indigenous nation while prioritizing respect to prevent the imposition of broad western health perspectives onto Indigenous communities. 2.5 Historical Context The history of Indigenous traditional wellness is one that has been typically overlooked and undermined. Only recently has traditional wellness garnered more attention due to the implementation of Indigenous impacted declarations and commissions among many other international and national policies and laws. In this section, I will provide a historical examination of the ways in which Indigenous peoples’ health and traditional wellness have been affected, from historical acts of health misconduct perpetrated against Indigenous peoples, to the intersections of health and wellness on Indigenous men, women, Two-Spirit and gender-inclusive identities, as well as the mistranslations and misinterpretations of Indigenous traditional wellness practices within healthcare, and the barriers that are currently being faced. The loss of traditional wellness and cultural practices among Indigenous peoples can be attributed largely to the impacts of colonization and the enforcement of the Indian Act (Joseph, 2018). The history of health misconduct begins with biological warfare in 1763, a movement that was led by the British under, Jeffrey Amherst, who used blankets exposed to smallpox as germ warfare in an attempt to subdue the First Nations resistance led by Obwandiyag (Pontiac) (Spaulding & Foster-Sanchez, 2020). The legacy of this biological tactic resulted in an epidemic that carried on for generations throughout Indigenous nations across what is now called Canada. 23 Later in history, the enforcement of the Indian Act of 1876 came underway, where the intersections of Indigenous health are encroached upon in multiple ways. For example, through the creation of reserves (1876-present day), and the assimilation tactics enforced in Residential Schooling (1884-1996) (Joseph, 2018). More specifically, with the creation of reserves in 1876, seasonal gathering practices throughout traditional territories of many Indigenous nations were limited to government sanctioned plots of land that included only a segment of Indigenous people’s ancestral territories was retained, often being distant from their traditional lands (Joseph, 2018). The reserve system imposed on bands resulted in the loss of land, limiting Indigenous peoples’ capacity to engage in traditional practices such as hunting, trapping, fishing, and harvesting to sustain themselves. The shortage of traditional foods, coupled with the introduction of foreign food items, shifts in lifestyle, and susceptibility to European viruses and diseases, contributed to the weakening of Indigenous immune systems, rendering them more susceptible to malnourishment and diseases (Joseph, 2018). The assimilation system of residential schools from 1884-1996 led to the displacement of countless Indigenous youth and children from their home territories from the young ages of three to sixteen (Joseph, 2018). Throughout the history of residential schooling, children were taken from this world in overwhelming numbers. This loss was due to a multitude of factors including disease, exposure to the elements during escape attempts; countless forms of abuse, self-inflicted harms and severe malnourishment (Joseph, 2018). Disturbingly, Indigenous youth and children were not only removed from these schools but were also transferred to ‘Indian hospitals’, created to address concerns among white settlers about the contagious nature of tuberculosis (Wilson-Raybould, 2022). Simultaneously, these Indigenous children were subjected to medical research and experimentation, primarily aimed at advancing treatments for the settler population (Wilson-24 Raybould, 2022). The widespread practice of experimenting on Indigenous peoples subjected numerous individuals from these communities to such tests. However, the research findings did not disclose the fact that these experiments were conducted on Indigenous populations, preventing non-Indigenous individuals from knowing the subjects involved when contributing to these findings. This resulted in a significant gap in the history of healthcare representation for Indigenous peoples of which we still see today brought forward in the recent In Plain Sight Data Report (2021). Current disparities in traditional wellness access, highlighted by the In Plain Sight Data Report (2021), have been intricately linked to historical injustices, particularly the longstanding misrepresentation of Indigenous peoples in health data. For example, it was noted that the use of disaggregated data has historically been employed in the healthcare system to the disadvantage of Indigenous peoples, frequently reinforcing stereotypes that depict them as inferior, vulnerable, and afflicted by illness and mortality (Johnson, 2021). Such historical misrepresentation has perpetuated systemic barriers, contributing to the reluctance of Indigenous populations to seek health services (Johnson, 2021). Correspondingly, due to the gross negligence of Indigenous peoples’ health throughout colonial history, Indigenous populations declined, giving rise to apprehension surrounding the continuation of traditional health practices and engagement with the healthcare system, ultimately leading to a substantial gap in the preservation of cultural heritage (Monkman, 2017). Consequently, Monkman (2017) explains that there is a pressing need to address these issues comprehensively, ensuring that traditional wellness initiatives are informed by a nuanced understanding of Indigenous values and cultural practices. This approach is vital for contributing to an environment of trust, respect, and equitable access to holistic healthcare solutions (First Nations Health Authority, 2014). 25 2.5.1 Historical Intersectional Impacts on Traditional Wellness The historical factors outlined in the previous passage have had a profound impact on the preservation of Indigenous cultural heritage, including traditional wellness practices. Similarly, in this section, I will explore the intersectional aspects that have contributed to the loss and evolution of traditional wellness, including the effects of denying women Status, the imposition of the elected chief and band council system, forced and voluntary enfranchisement, the banning of cultural ceremonies, language restrictions, and the prohibition of practicing traditional religion, all of which continue to impact Indigenous traditional wellness today (Joseph, 2018). In matrilineal communities, the maternal line can determine cultural and social responsibilities or group membership. This highlights the significance of the mother’s role in shaping family connections and heritage (Baskin, 2020). Matrilineal practices have long been a foundational aspect of many Indigenous nations. Prior to European contact, and the subsequent profound disturbance to the traditional lifestyle of Indigenous communities, women were central to the family. Women were revered in communities and had roles within government, spiritual ceremonies, and were generally respected for their sacred gifts (Joseph, 2018). In traditional Indigenous ceremonies, women played important roles as keepers of wisdom, and were responsible for teaching children about the qualities of a good leader, resolving conflicts within the community, and healing their communities (Baskin, 2020). Additionally, women and grandmothers were tasked with introducing ceremonies to the community, and training other women to carry out these teachings for future generations (Baskin, 2020). The grandmothers also taught women about their roles in the protection and care around men during times of healing, battle, or hunting (Baskin, 2020). 26 However, the Indian Act mandate of forced enfranchisement, which denied status to Indigenous women from 1869 to 1985, had devastating effects on both Indigenous women and their communities. This mandate warped social dynamics among many nations. Indigenous women in colonial Canada encountered challenges in gaining recognition as individuals who identified as both Indigenous and as women (Joseph, 2018). This resulted in Indigenous women being forcefully excluded from leadership and other pivotal roles that they once held. Not only this but Indigenous women were prevented from holding positions in office or gaining the right to vote until 1960 (Jospeh, 2018). As a result, a patriarchal societal shift occurred, which still exists today in some Indigenous communities (Monkman, 2017). One example of this societal shift can be seen through the declaration of the banning of the potlatch and rendering other cultural ceremonies as illegal (1884-1951) (Joseph, 2018). In the article by Lenard Monkman (2017), where he interviewed Philip Brass a traditional knowledge keeper from Peepeekisis First Nation in Saskatchewan. Brass Stated, ‘Patriarchal culture exists around ceremonies today because during the time of the ceremonial ban, men would tell the agents that they were going “hunting,” when in reality, they were practicing ceremonies in the bush. Men had more freedom to leave the reservation than women. Ceremonies were being practiced with only men in attendance. After doing that for 70 years, the ceremonies became very male-centric’(Monkman, 2017). While patriarchal shifts were further cemented through the imposition of the elected chief and band council system, the impact was not necessarily liberating for Indigenous men. As Joseph (2018) notes, the chiefs were given restricted authority that did not align with their previous responsibilities, further diminishing their leadership and disempowering them. A chief’s 27 decision-making powers were reduced to eight specific mandates, one of which included the care of public health (Joseph, 2018). In this regard, their role essentially became one of administering the Indian Act rather than upholding their traditional responsibilities. In conjunction with these patriarchal aspects of creating disparities among traditional and cultural wellness retention, Two-Spirit, and gender-inclusive individuals have also been impacted by historical trauma and ongoing discrimination, which has had a significantly negative affect on their health and wellness. Two-Spirit is a term many Indigenous communities use to describe diverse gender identities, gender expressions, gender roles, and sexual orientations (Qmunity, 2013). Two-Spirit people are sacred individuals through their cultural and traditional roles within ceremonial practices (Qmunity, 2013). Two-Spirit peoples were and are regarded as respected members of their communities and were/are often assigned revered positions, such as matchmakers, healers, and counsellors, among many other roles (Hunt & Holmes, 2015). In the process of colonization, there has been an effort to eliminate the existence of Two-Spirit individuals (Hunt & Holmes, 2015). The prohibition of practicing traditional religion in 1940 led to western religious values and belief systems to be imposed on Indigenous people (Joseph, 2018). The enforced religious perspectives condemned any sexual or gender diversity and the societal roles people who identified as such held within Indigenous communities (Joseph, 2018; Hunt & Holmes, 2015). These religious perspectives led to an exclusion of Two-Spirit and gender-inclusive identities from many Indigenous cultures, which have resulted in the loss of traditional healing knowledges that may have been more inclusive of gender and sexual diversity, and further exacerbated health disparities for these individuals (Joseph, 2018; Smith et al., 2019). The recognition and inclusion of Two-Spirit and gender-inclusive identities in traditional wellness practices can help to address 28 these disparities and support the health and wellness of all Indigenous peoples. It is therefore essential to gain insight from gender inclusive and Two-Spirit individuals to ensure that gender inclusive lives are not erased from public health discourse (Hunt, 2016, p.12). Currently, healthcare takes a new form of discrimination through outdated Indian Act mandates. Status individuals and Non-Status individuals as defined under the Indian Act differ in eligibility to certain health benefits. Specifically, Status Indians are deemed access to certain health care benefits and health insurance that are covered by the federal government of Canada or the First Nation Organization/Nation that Status individuals are enrolled in (First Nations Health Authority, 2014). If an Indigenous individual does not carry Indian Status, these individuals are categorized as Non-Status. Many Non-Status Indigenous peoples in Canada can trace their lack of Status back to the forced and voluntary enfranchisement policies that were imposed upon Indigenous peoples as previously mentioned. The Indian Act’s enfranchisement provisions that were mandated from 1876-1985, were designed to encourage assimilation and reduce the financial burden on the federal government by decreasing the number of Indigenous peoples with status (Joseph, 2018). This was achieved through several means, including the act of denying women status, pursuing a higher education, through the enrollment in the military, and even by withholding the right to vote in federal elections (Joseph, 2018). Non-Status individuals do not have access to the same benefits and insurance eligibilities as Status individuals (First Nations Health Authority, 2014). As a result, many Non-Status Indigenous peoples in Canada may not have access to healthcare coverage, which is often an out-of-pocket expense. It must also be considered that enfranchisement policies were exclusory of the enfranchised Indigenous peoples. The enfranchisement policies, while seemingly granting specific rights or privileges, were discriminatory and exclusionary, particularly towards 29 Indigenous individuals who were required to give up their Indigenous identity or had it forcibly taken away to obtain such rights. Despite ostensibly offering certain so called “benefits”, these policies did not genuinely or equitably include Indigenous peoples. Enfranchised Indigenous peoples were to abandon their traditional and cultural beliefs and were displaced from families and places of living, which also held cultural knowledges. Therefore, it is crucial to consider the access to healthcare for both Non-Status and Status individuals, as there are still many barriers that must be addressed (First Nations Health Authority, 2014). 2.5.2 Historical Interpretations of Traditional Wellness Indigenous relational identities to healthcare are complex, and it is crucial to accurately represent our knowledge and histories to address Indigenous relations to healthcare effectively. Additionally, it is important to recognize when Indigenous knowledges are being mistranslated and misinterpreted to prevent further loss of traditional wellness practices. For example, the 20th century was marked by a surge in researching Indigenous cultures, conducted by external non-Indigenous parties. These initial qualitative studies employed extractive research methods, resulting in the disenfranchisement of those studied and the misinterpretation and extraction of knowledge from these Indigenous communities (Kovach, 2021). As an example of how Indigenous wellness knowledge has been misinterpreted, consider Abraham Maslow’s Hierarchy of Needs Theory (1943). Abraham Maslow’s Hierarchy of Needs Theory was influenced by the time he spent with the Blackfoot people, which he developed as an ethical space concept (Blackstock, 2009). In the concept of an ethical space, a framework is established where knowledge systems can engage with one another through mutual respect, kindness, generosity, and adherence to fundamental values and principles (Pritchard, 2020). Maslow’s theory assumes 30 that understanding human needs is crucial to personal well-being, however his considerations misalign with the ethical space concept fundamentals as Maslow believed that some needs were more important than others and valid across cultures. Indigenous scholars suggest that Maslow’s final model does not fully incorporate Blackfoot or Indigenous perspectives, such as ancestral knowledge, spirituality, and community (Blackstock, 2009). The structure of the hierarchy model itself was misinterpreted as a triangle, however, the Blackfoot belief is not a triangle; rather, it is a tipi where they believe tipis reach to the sky (Blackstock, 2009). Cindy Blackstock refers to this as the Breath of Life Theory which considers a holistic nature and more expansive concept of time and dimension of reality of which the tipi represents human needs that are non-hierarchal and advocates for balance between the personal and the collective (Blackstock, 2009). In contrast, Maslow’s translation as the Hierarchy of Needs centralizes individualism and removes the individual from the context of community and spirituality (Blackstock, 2009). Cindy Blackstock’s Breadth of Life Theory emphasizes the significance of comprehensively understanding Indigenous knowledge systems instead of reducing them to a generalized Western scientific perspective (Blackstock, 2009). This approach acknowledges the holistic nature of Indigenous wellness practices, which encompass spiritual, emotional, physical, and mental health (Blackstock, 2009). By valuing Indigenous knowledge systems and learning Indigenous perspectives relating to health, we can work towards successful and culturally safe traditional wellness integration. Indigenous traditional wellness practices have a rich history that dates back thousands of years. However, with the arrival of Eurocentric ideologies and the implementation of the Indian Act in 1876, many of these practices were suppressed, and Indigenous peoples were forced to assimilate into Western principles. These strict regulations imposed on Indigenous peoples, resulted in a 31 loss of culture and traditional wellness knowledges and worldviews, which led to negative impacts on Indigenous peoples’ health and well-being. It is imperative to recognize the foundational causes of traditional and cultural losses stemming from the enduring consequences of colonialism. Progress in healing can only be achieved when we address the persistent systems of oppression that not only perpetuate these issues but also overlook their underlying origins. Restorative efforts must extend beyond individualized perspectives on health and well-being, focusing on communal healing that transcends these limitations. By integrating these practices, there can be adequate acknowledgement of the resilience and wisdom of Indigenous communities and create a more inclusive and holistic healthcare system that can better serve all members of our diverse society. In Jody Wilson-Raybould’s (2022) work, True Reconciliation: How to be a Force for Change, she underscores the importance of understanding the historical and ongoing missteps that the healthcare system has and continues to enact towards Indigenous peoples and communities. Wilson-Raybould emphasizes that these systemic shortcomings are deeply embedded within health systems and institutions and the lack of consideration of these histories or worldviews in dismantling these current health discrepancies. Wilson-Raybould further states that this lies at the heart of racism and privilege, signifying that social structures and institutions are constructed in manners that marginalize Indigenous peoples, making their participation more challenging and hindering the creation of culturally supportive or safe environments (2022). 2.6 A Review of Indigenous Impacted Commissions and Declaration’s In this section, I will review the current Indigenous impacted commissions and declarations that attempt to acknowledge and integrate Indigenous autonomy practices within the Canadian government. These legislative measures represent an essential step towards 32 recognizing the value of Indigenous traditional knowledge and practices in the context of contemporary healthcare. Moreover, the incorporation of Indigenous traditional wellness practices into legislation also signifies a commitment to addressing the historical injustices that have been perpetuated in health settings onto Indigenous populations. These commissions, declarations, laws, acts and policies are a foundational step towards rectifying past wrongs and fostering a more equitable and just society. The revitalization of traditional wellness practices and cultural traditions within healthcare has undeniable political contexts, as well as historical; intertwined with the assertion of Indigenous rights and the recognition of intrinsic Indigenous values and perspectives (Henderson, 2008). Before revitalization, there must first be an understanding of where the current Indigenous impacted commissions and declarations lies in recognizing Indigenous rights. Indigenous communities have long worked to uphold our rights to practice our own wellness methods and preserve cultural traditions that promote overall well-being. This section delves into the journey towards upholding these rights, with a particular focus on the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), the Truth and Reconciliation Commission: Calls to Action (TRC), and how each can make an impact on Canadian legislation, especially within the context of healthcare. 2.6.1 Indigenous Health Implications in the Truth and Reconciliation Commission: Calls to Action The connection between the Truth and Reconciliation Commission: Calls to Action and Canadian law and policy can be traced through the implementation of The Indian Residential Schools Settlement Agreement, a historic class-action settlement initiated in 2007, marking the largest settlement in Canadian history (Government of Canada, 2021). An integral component of this agreement, aimed at holding Canada accountable, was the establishment of the Truth and 33 Reconciliation Commission of Canada. This commission was tasked with fostering reconciliation among former students, their families, communities, and all Canadians (Government of Canada, 2021). Guided by Schedule "N" of the Settlement Agreement, the Truth and Reconciliation Commission operated under key principles that directed its crucial work (Government of Canada, 2021). Within the Truth and Reconciliation Commission: Calls to Action, each section articulates specific calls for accountability from the Canadian government. For example, in the health section, numerous calls advocate for government support and legal responsibilities in prioritizing funding for the co-creation of culturally competent programming, curricula, and training (Truth and Reconciliation Commission, 2015). Many Calls to Action within the document emphasize the need for continued Nation-to-Nation relationships with Indigenous communities. These relationships should be founded on the recognition of rights, respect, cooperation, and partnership in the formulation of laws, acts, and policies addressing Indigenous issues (Truth and Reconciliation Commission, 2015). Furthermore, it is stressed that these legislative efforts should be implemented and acknowledged at national, international, and constitutional levels, as well as within modern treaties (Truth and Reconciliation Commission, 2015). In the realm of health, the government and various jurisdictions are required to investigate both current and historical misconducts. Additionally, progress reports should be provided, and long-term trends on health indicators must be assessed (Truth and Reconciliation Commission, 2015). Lastly, recognition of the value of Indigenous healing practices is mandated, and Indigenous communities should be granted autonomy over these practices (Truth and Reconciliation Commission, 2015). This comprehensive approach underscores the 34 interconnectedness of the Truth and Reconciliation Commission with Canadian law and policy, aiming to address historical injustices and promote meaningful reconciliation. Since its recognition in 2015, the Truth and Reconciliation Commission: Calls to Action has made progress on only thirteen of the ninety-four Calls to Action (Reconciliation Education, 2023). Out of the thirteen Calls to Action that have been specified as ‘completed’ to date, only one specifically addresses healthcare, namely, Call to Action #24. However, the caveat is that this Call to Action is not yet completed; it remains ‘in progress’ as of fall 2023 (Reconciliation Education, 2023). Call to Action #24 underscores the need for Canadian medical and nursing schools should mandate that every student undergo a course addressing Indigenous health concerns. This course should encompass topics such as the history and repercussions of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties, and Indigenous rights, along with teachings and practices of Indigenous communities. Fulfilling this objective will require practical training in intercultural competency, conflict resolution, human rights, and anti-racism (Truth and Reconciliation Commission, 2015). Within the Truth and Reconciliation Commission: Calls to Action, there are six specific Calls to Action (calls 18-24) that address various critical aspects concerning the health and well-being of Indigenous peoples in Canada. However, one can argue that the TRC in its entirety provides an intersectional and holistic outlook on basic health needs that foster healthy living conditions called for by Indigenous peoples; from child welfare, education, justice, language and culture among many others. In addition, the health segment of the TRC establishes various measurable goals that support bridging the health outcome gaps between Indigenous and non-Indigenous communities, such as addressing the jurisdictional issues concerning Métis, Inuit, and off-reserve Indigenous peoples, 35 advocating for distinct health care measures for these communities. One of the pivotal calls influencing this research and thesis is Call #22, which I have alluded to and defined previously, that emphasizes the recognition of the value of integrating Indigenous healing practices into the Canadian healthcare system. Furthermore, there’s a call for increased representation of Indigenous professionals in the healthcare field, their retention in Indigenous communities, and the provision of cultural competency training for all healthcare professionals (Truth and Reconciliation Commission of Canada, 2015). Enacting each of these Calls to Action holds the promise of significantly improving healthcare for Indigenous peoples in Canada. 2.6.2 Indigenous Health Implications in the United Nations Declaration on the Rights of Indigenous Peoples One of the thirteen completed Calls to Action included the adoption of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). In 2021, Canada nationally committed to implementing the UNDRIP (Government of Canada, 2023) developing an action plan to implement of all 46 articles by 2028 (Government of Canada, 2023). UNDRIP is currently in the consultation stages of implementation, which means that no actions or articles have been legally enacted until consultation is completed. As an Indigenous individual viewing the UNDRIP, I firmly believe that these rights have always been an integral part of our Indigenous ways of knowing and being. As Indigenous peoples, we possess an inherent connection to our traditions and wellness practices that doesn’t require validation through external declarations or reaffirmation by outside colonial nations. Our cultural identity is intertwined with these rights, making them an fundamental part of who we are. However, it is important to acknowledge that the formal recognition of these rights, such as 36 through the declaration, does hold significance. By establishing these principles in an international and national context, it places a level of accountability on nation states to respect and protect our rights. This can be seen as a means for these states to adhere to their own legal frameworks while hopefully respecting the autonomy and self-determination of our Indigenous communities. In the events leading to the curation of the UNDRIP, Indigenous peoples have demanded recognition of these rights since colonial contact. These rights are as Henderson (2008) states, “Indigenous teachings and legal traditions… that have lived on in the consciousness of peoples who were oppressed by colonization; they were passed from one generation to another through stories, art, and ceremonies so that each people could restore them at the right time and transform them into the declaration” (p. 11). In essence, the declaration reinforces our rights to resilience and our ability to navigate the intricate landscape of contemporary society, all while preserving our distinct identities as well as acknowledging the long-overdue agency and recognition as peoples. The UNDRIP, echoing call to action #22, affirms in several articles the entitlement of Indigenous peoples to conserve, revitalize, and transmit their cultural heritages, encompassing historical, current, and future dimensions. This involves safeguarding their histories, languages, oral traditions, philosophies, arts, and scientific knowledge, including resources, medicines, designs, sports, and performing arts (Henderson, 2008; United Nations General Assembly, 2007). Henderson further explains that, regarding the principles underlying these rights, the General Assembly supported the worldwide consensus recognizing the entitlement of Indigenous peoples to personal integrity and health (Henderson, 2008). It was also affirmed that Indigenous peoples possess the entitlement to traditional medicines and the preservation of their health 37 practices. This includes the conservation of crucial medicinal plants, animals, and minerals (Henderson, 2008). While the rest of Canada began to enact the UN Declaration on the Rights of Indigenous Peoples (UNDRIP) in 2021, British Columbia took an early step by provincially adopting the UNDRIP in 2019, known as the Declaration on the Rights of Indigenous Peoples Act (DRIPA) (British Columbia Declaration on the Rights of Indigenous Peoples Act, 2019). This provincial legislation solidifies five crucial aspects of the UNDRIP in BC, setting the stage for its adoption across the rest of the country. Sections 3-7 of the DRIPA overview and outline the provincial government’s commitment to aligning UNDRIP principles, articles, and laws with existing provincial legislation (British Columbia Declaration on the Rights of Indigenous Peoples Act, 2019). In addition, DRIPA mandates the development and implementation of a comprehensive action plan, legally bound to be completed between 2022 and 2027 (British Columbia Declaration on the Rights of Indigenous Peoples Act, 2019). Regular reporting and monitoring of progress are integral components of this initiative. The DRIPA allows flexibility for the province to engage in agreements with a broader range of Indigenous governments and jointly exercise statutory decision-making authority allowing for more tailored and autonomous action to be made (British Columbia Declaration on the Rights of Indigenous Peoples Act, 2019). It is encouraging to witness tangible progress, albeit at a baseline level. The provincial adoption of the UNDRIP through DRIPA marks a crucial milestone, ensuring that progress not only occurs but is also consistently upheld by the government. 38 2.7 Indigenous Self-Governance and Rights Affirmation: Pre-UNDRIP Achievements of the Westbank First Nation Prior to the official affirmation of the UNDRIP in 2007, Indigenous communities, like the Westbank First Nation (WFN), had already made significant strides towards self-governance and rights affirmation. In 2005, WFN notably achieved status as one of Canada’s few self-determining and self-governing Nations. Their Self-Government Agreement, ratified by Membership on May 24, 2003, was implemented on April 1, 2005, through the Westbank First Nation Self-Government Act (Westbank First Nation, 2023). The WFN and the Government of Canada established a Self-Government Agreement, building upon an Agreement-in-Principle from July 13, 1998, with the aim of delineating a Final Agreement for self-governance. This agreement acknowledges the inherent right of self-government as an existing Aboriginal right under Section 35 of the Constitution Act, 1982. Despite potential differing legal interpretations regarding the scope of this right, the Agreement outlines specific arrangements for various jurisdictions for the implementation of self-government by WFN on Westbank Lands (Westbank First Nation, 2005). “Westbank First Nation has never ceded, surrendered, or in any way relinquished their lands or title and continues to assert its interests and exercise its aboriginal rights over the traditional territory” (Westbank First Nation 2016, p. 6). Aligned with the rights articulated in the UNDRIP mentioned earlier, the WFN Constitution outlines in sections 3.1 to 3.4 that WFN: …shall work to promote a healthy and prosperous future to ensure the continued existence of Westbank as a strong political, social and cultural community. Westbank honours its connection to the land, resources and elements of the 39 natural world that provide for its Members’ physical and spiritual needs. Westbank recognizes its responsibility to protect the land and her resources for future generations. Westbank Members value the need to respect, protect and promote their heritage, culture and traditions understanding that their traditions and practices change and that they continue to develop contemporary expressions of those traditions and practices (Westbank First Nation 2016, p. 7). Engaging with the WFN community in this master’s research was crucial given their continuous efforts in paving a path for Indigenous communities toward autonomy and self-determination. Their example serves as a testament to how an Indigenous community endeavors to actualize and integrate their inherent rights, aligning with legal calls to reinforce access to traditional wellness. The WFN underscored the significance of this research as part of their ongoing commitment to enhancing and preserving the community’s well-being. As a member of the Westbank First Nation, it was imperative for me to engage in this work with my community to honor and validate the fundamental values I hold as a member. This effort contributes an Indigenous perspective to the necessary and essential work that demands attention and action, addressing both the broader societal context and the community-level impacts as informed by the literature reviewed in this chapter. The forthcoming chapter explores the research study I conducted within Westbank First Nation, emphasizing the utilization of localized Indigenous knowledge to ensure cultural safety and strengthen the integration of traditional wellness practices. This master’s thesis was dedicated to implementing Indigenous methodologies and practices informed by traditional knowledge within the community. 40 Chapter 3: Theoretical Framework, Methodology and Methods This chapter delves into the utilization of Indigenous methodologies and methods, centering on the application of a localized Indigenous theoretical framework known as Enowkinwixw (En-OW-Kin-Wee-H) to facilitate community engagement within the Westbank First Nation. Enowkinwixw finds its roots in the syilx Captikʷɬ (oral history) of ‘How Food Was Given’, embodying four levels of collaboration: identifying generational standpoints, collaborative visioning, addressing obstacles, and achieving consensus and solidarity (Armstrong, 2009). In this chapter, I describe how these principles were strategically aligned with the research objectives, specifically focusing on better understanding traditional wellness integration practices in a culturally appropriate manner within the syilx community. I also describe my research methods, which involved employing sharing circles and knowledge-sharing interviews and employing a felt embeddedness approach as conceptualized by Catungal (2017), entails examining social phenomena through a lens that emphasizes individuals’ subjective experiences and emotions within the intricate web of their lived environments and social contexts that encourage personal reflection and fosters community involvement. Additionally, this chapter outlines the purposive sampling technique utilized for participant recruitment. Importantly, this chapter elucidates the careful approach taken in the storage and safekeeping of the gathered data, emphasizing its pivotal role in supporting subsequent data analysis practices and processes. The chapter also provides an overview of the inductive thematic process, unveiling high-level and lower-level category themes that articulate participants’ voices regarding strengths, barriers, and ways forward that lead toward meaningful integration of traditional wellness. This segment lays the groundwork for the subsequent deductive thematic analysis. 41 The deductive thematic analysis takes the lower-level themes and aligns them with the thematic framework of the Four Food Chiefs attributes. This process explores their connection to advancing traditional integration, respecting the Enowkinwixw theoretical practice of equitable collaboration, informed by the Four Food Chiefs story. This comprehensive overview encapsulates the methodology that was crucial to the successful execution of this research study within the Westbank First Nation community. 3.1 Indigenous Methodologies As illustrated by Margaret Kovach (2021), Indigenous methodologies encapsulate unique research approaches rooted in Indigenous epistemologies, ethics, community, and self. These methodologies are distinguished by their grounding in Indigenous thought, contextual relevance, and ethical considerations, offering a distinct lens for research that respects Indigenous knowledge systems and centering Indigenous worldviews in the research process (Kovach, 2021). My understanding of Indigenous methodologies stems not only from academic sources heavily influenced by Kovach’s Indigenous Methodologies, Characteristics, Conversations, and Contexts (2021), but also from personal experiences and understandings of the theoretical framework and methodology I utilized within this research, that of Enowkinwixw. Initially, when looking for guidance in shaping this research, I began by drawing inspiration from Participatory Action Research (PAR) methods, Two-Eyed Seeing approaches, and Community-Based Research (CBR) methodologies. I was driven to integrate specific methods—such as interviews, sharing circles, and story work—commonly employed within these frameworks. Congruently, also considering integrating aspects of Enowkinwixw, a traditional syilx consensus-building practice (Armstrong, 2009), into my research. After collaborating with my committee, professors, classmates, and supervisors led me to conclude 42 that a wholly Indigenous methodology would be the most suitable for every aspect of my intended research, as opposed to frameworks influenced by or integrated with Westernized modes of thought, such as the above PAR, CBR, and Two-Eyed Seeing approaches. Consequently, the Enowkinwixw theoretical framework heavily informed the research methodology. This decision aligned with my research objective of adhering to local Indigenous practices, providing a familiar framework for engagement within the WFN community. 3.2 Indigenous Theoretical Framework: Enowkinwixw Principles Key to guiding my research was following in the ways of Enowkinwixw, pheonetically pronounced as (En-OW-Kin-Wee-H), as outlined by Jeanette Armstrong within her dissertation chapter “The Four Chiefs Enowkinwixw Discourse” (2009, p.175-192). The term Enowkinwixw which is written in nsyilxcən in various formats and varies in pronunciation throughout the territory such as naʕʷqnwixʷ, will be referred to in this thesis and written as Enowkinwixw. In this thesis the term Enowkinwixw works from the definition outlined by Armstrong, as a “traditional consensus-building listening process, that derives from the word Eníowkin… from the high language of the Okanagan people and has its origin in a philosophy perfected to nurture voluntary cooperation, an essential foundation for everyday living. The term is based on a metaphorical image created by the three syllables that make up the Okanagan word. The image is of liquid being absorbed drop by single drop through the head (mind). It refers to coming to understanding through a gentle integrative process.” (p. 175). ‘The [Eníowkin] procedure is a process which is always guided by four levels of collaboration. These four levels include 1) identification of each generational standpoint on the topic, 2) visioning through a collaborative group-mind process, 3) analysis then takes place to address any obstacles to the common vision, and 43 finally 4) consensus and solidarity through establishing a short-to-long term approach to achieve the objectives that have been identified (p. 176). The syilx people have a rich tradition of Enowkinwixw, which has been passed down through the Captikʷɬ (oral history) of ‘How Food Was Given’. The Captikʷɬ takes us back to a time when only animals inhabited the earth, and among them were The Four Food Chiefs - Chief Black Bear, Chief Spring Salmon, Chief Saskatoon Berry, and Chief Bitterroot. Each food chief represented an element of governance, structure, and intergenerational knowledge, and collectively these Food Chiefs embodied the principles of culture, action, community, and sustainability. In the Captikʷɬ, the Four Food Chiefs are informed that ‘the people to be’ (humans/stl’sqilwx) are coming, and they must prepare for this change. Through a process of collaboration, they decide to pledge themselves as food or means of survival for the people to be. This decision was not made until each food chief had agreed collectively to support the people to be. Had they not done so, humans/stl’sqilwx would not exist today. The syilx people honor the sacrifice of the Four Food Chiefs by passing on their knowledge of how to interact with the world through the practice of Enowkinwixw. When it comes to integrating traditional wellness with the syilx community, it is essential to follow the principles of the Four Food Chiefs and enact localized consensus-building practices. By doing so, we can ensure that traditional wellness is practiced in an honorable way that aligns with syilx people’s principles of being. The principles of Enowkinwixw closely align with the core elements of Indigenous methodologies, as outlined by Kovach (2021). Kovach emphasizes that for an Indigenous research methodology to be accurately classified as such, it must be firmly grounded in Indigenous ways of knowing, theory, ethics, storytelling, and community (Kovach, 2021). The 44 Enowkinwixw process exemplifies these essential tenets by being inherently connected to Okanagan ontology, utilizing a metaphorical image that underscores an integrative understanding (Armstrong, 2009). The Enowkinwixw theoretical framework is used as an analogy that guided the research process to ensure equitable collaboration and ensure that the research and thesis echoes the key aspects of Indigenous epistemology and ethics, emphasizing a holistic approach to knowledge and storytelling—an engagement essential to quality Indigenous research methodologies (Armstrong, 2009; Kovach, 2021). Moreover, leveraging this local traditional consensus practice seemed most fitting for as Westbank First Nation participants of this research already had an in depth understanding and experience with practicing Enowkinwixw because Westbank First Nation utilizes The Four Food Chiefs as a governance framework for the nation, and the rollout of services and strategic planning sessions are determined by the Four Food Chief principles. This theoretical framework is grounded in the understanding of how syilx peoples have traditionally used stories as vessels for passing along teachings, medicines, and practices to promote social cohesion, which is showcased through the practice of Enowkinwiwx. Storytelling has been tightly bound with Indigenous societies’ understanding of knowledge transfer, where narrative functions as an intergenerational transmission of knowledge (Kovach, 2021). Stories have personal and social meanings that engender Indigenous knowledge creation as demonstrated in the Four Food Chief’s story (Kovach, 2021; Armstrong, 2009). Stories are considered a gift, and their significance in research cannot be overstated (Archibald, 2019; Kovach, 2021; Armstrong, 2009). The Enowkinwixw process of collaboration has guided and influenced in an analogous aspect of approaching and carrying out the research process from start to finish; Enowkinwixw 45 practices were integrated within various methods such as sharing circles, knowledge sharing interviews, and follow-up feedback sessions. In this vein, the four levels of collaboration have been defined in the research through the following: 1) Identification of each generational standpoint on the topic. This first level has been established through engaging various intergenerational participants in sharing circles, story-work, knowledge sharing interviews, etc. 2) Visioning through a collaborative group-mind process is determined with community engagement practices such as utilizing localized methods that are attuned to the needs of community members. This second level was established through utilizing the Four Food Chiefs as a method of reflecting on the topic through the use of interview and sharing circle questions alongside personal reflection exercises. 3) Analysis then takes place to address any obstacles to the common vision. This third level was established through ensuring that the outcomes of the research align with what has been brought forward by community members through these integrative processes, such as ongoing feedback from the WFN Health and Wellness department, from participants and through presentations of the findings to the WFN community. 4) Consensus and solidarity through establishing a short-to-long term approach to achieve the objectives that have been identified in the research. In addressing the fourth objective of achieving consensus and solidarity for the research, I have engaged in both formal and informal communication with WFN. Through formal letters of support and ongoing conversations, I aim to establish a long-term approach that aligns with WFN’s values and objectives. As a result, I intend to provide the finished thesis and research findings to WFN, granting them full ownership of the results. This ensures that WFN can utilize the findings to 46 inform and enhance their programs and services according to the community’s needs and aspirations. By fostering this collaborative partnership, this research carries significant potential to create meaningful and lasting impacts on traditional wellness integration within the WFN community. 3.3 Recruitment Participants for this study informed three sharing circles and four knowledge-sharing interviews were found using a purposive sampling technique to fully address the research question at hand (Campbell et al., 2020). The choice to employ a purposive sampling technique, as advocated by Campbell et al. (2020), is justified by the specific research objectives and the need to select participants deliberately based on their unique characteristics, experiences, or expertise that align with the study’s focus. Purposive sampling allows for a targeted and intentional selection of participants who can provide rich and relevant insights, enhancing the depth and relevance of the research findings (Campbell et al., 2020). This approach is particularly suitable as the recruitment process targeted four specific groups that reflect the first objective of Enowkinwixw of including multi-generational stand-points (Armstrong, 2009). Specifically, this study purposively gained perspectives from 1) community members: Status and Non-Status, gender inclusive, youth, and Elders; 2) current traditional wellness clients; 3) Traditional Wellness Practitioners and Knowledge Keepers, and finally, 4) wellness coordinators/providers. Each of these groups were targeted to facilitate cohesion and promote discussions concerning the key factors influencing the integration of traditional wellness, which aligns with Enowkinwixw’s second objective of a collaborative group-mind process with the participants engaged. 47 For engaging with and recruiting specific groups such as the Health and Wellness team and the youth for sharing circles, I distributed consent forms and research details to key contacts via email and physical copies. These contacts included the WFN Health and Wellness Executive Assistant and the Manager of Youth and Recreation. They played a crucial role in recruiting and disseminating information to potential sharing circle attendees, such as members of the youth council and health and wellness department employees, as they held contact details for these specific individuals. Directly collaborating with and distributing consent forms and information to these primary contacts was essential for the recruitment process of these groups. This approach aimed to ensure and uphold ethical standards, safeguarding the privacy and confidentiality of both the WFN organization and the university while engaging with WFN employees and WFN youth. However, for prospective community interviewees and community sharing circle participants, I was able to directly correspond with each prospective interviewee and community sharing circle participant as their personal contact information was provided to me either through direct correspondence as per their outreach in interest from the recruitment ad or established connections via in-person interactions. To reach potential community participants, recruitment ads (see Illustration 1.1) were collaboratively developed with the WFN Health and Wellness Director and Executive Assistant and shared through multiple channels. The WFN Health and Wellness Executive Assistant circulated these ads posting printed copies on the WFN community bulletin board and WFN smymay (a community and organizational social network platform), directing interested individuals to contact me via my UBCO email. 48 Illustration 1 Recruitment Ad Upon contacting me, interested prospective community participants received comprehensive study information, including the study objectives, consent form, and a demographic questionnaire. Participants were encouraged to review these materials, seek clarification, or voice any concerns. Participants were asked to provide their consent either by submitting a signed physical copy of the informed consent documents or by sending an email statement clearly stating their willingness to participate. The distribution of the consent and research materials was provided to participants within a timeframe ranging from one month to a minimum of two weeks before each sharing circle or interview session. During this period, individuals were requested to carefully review and provide their informed consent. Ideally, they were encouraged to return the consent forms at least one week before the scheduled sharing circle or interview session. This allowed ample time for participants to reconsider their involvement in the session or to seek clarification by reviewing and asking questions if needed. Alternatively, participants also had the option to fill out the form at the commencement of our sharing circle or interview session if preferred. Additionally, 49 participants were encouraged to complete a brief demographic questionnaire, capturing data such as age and gender, both before their participation and, if needed, during the sharing circle or interview session itself. Once consent was obtained, participants were then scheduled for sharing circle sessions or given the choice of in-person or online interviews at a time and location convenient for them. To ensure the effectiveness of this process, I diligently followed up with each participant one week prior to the scheduled interview and on the day before the interview was scheduled to proceed. This approach not only served to confirm the interview details, including the date, time, and location, but also afforded participants the opportunity to reschedule or decline if necessary. Furthermore, I consulted with the Elders Coordinator to gather the perspectives of community Elders. Unfortunately, despite multiple planned endeavors including unforeseen illness prior to a sharing circle and the disruptive impact of wildfires that not only displaced myself but also affected numerous members, along with scheduling differences, a hard decision was made to move forward without the valuable insights of the Elders committee. This decision was made to adhere to the relevant and limiting research and thesis timeframe set out in the Interdisciplinary program. Regarding the demographic data collection process, the information gathered from participant questionnaires was meticulously transferred and organized into a structured Excel spreadsheet. This spreadsheet was purposefully designed to feature the questions provided in the demographic form as headers. Each demographic detail acquired was methodically entered into the corresponding section within the spreadsheet. This meticulous approach ensured a comprehensive and systematically arranged dataset, facilitating further analysis or presentation purposes. 50 3.4 Sample Demographics The sample included a diverse group of participants (see Figure 1) that identified with one or more of the following terms: 1) community members: Status and Non-Status, gender inclusive, youth, and Elders; 2) current traditional wellness clients; 3) Traditional Wellness Practitioners and Knowledge Keepers, and 4) wellness coordinators/providers. The sample size consisted of 20 participants, which included 16 sharing circle participants and 4 interviewees. Participants ranged in age from 16 to 53 years old. Figure 1 Participant Demographics © S. Werstuik (2024) Regarding gender diversity, participants identified as men, women, and two-spirit individuals (see Figure 2), with women constituting the majority (61%) of the sample, followed by men at 28%, and two-spirit individuals at 11%. 51 Figure 2 Gender Demographics © S. Werstuik (2024) The study engaged a variety of key groups in relation to the above purposive groups. Westbank First Nation community members comprised of 11 participants, including both Status and Non-Status individuals and youth. Additionally, the study involved two traditional wellness clients, six traditional wellness practitioners/knowledge keepers, and ten health and wellness coordinators/providers. Notably, no Elders were engaged in the study during this period, and the details outlining the lack of inclusion will be detailed in section 3.5.1 on sharing circle procedures. Among the participants, 14 identified experiences related to traditional wellness practices (see Figure 3). 52 Figure 3 Participants Experience Accessing Traditional Wellness © S. Werstuik (2024) Traditional wellness practices most frequently experienced among participants who have accessed traditional wellness (see Figure 4), encompassed activities like smudging, land-based teachings (such as hunting, fishing, and traditional medicine gathering), language engagement, funeral preparations, participation in ceremonies, sweats, sunrise swimming, and daily prayer. Figure 4 Common Types of Traditional Wellness Experiences © S. Werstuik (2024) 53 3.5 Data Collection Several collaborative methods were employed to ensure respectful and meaningful engagement with the WFN community in this research project. Prior to data collection, the initial approach involved informal contact through email outreach to the department head of the WFN Health and Wellness department, establishing a foundation for an informal relationship. This initial contact led to an in-person meeting and various emailing communications to discuss the project details, which allowed the department director to reflect on the appropriateness of the proposed research and establish how my research study would fit within their respective health initiatives. Regular contact has been maintained with the Health and Wellness department director, including drafts of timelines, schedules of activities, and collaborative iterations of co-creating recruitment ads, research materials, such as the sharing circle and interview guides used to gather data, and letters of support that reflect both the respective communities’ values and my responsibility to those values and the community throughout the research. With the letter of support from WFN, I was then able to attach this document to enhance my application to ethics and further participate and engage with the WFN community, along with the approval from the Health Director among selected staff members of the WFN Health and Wellness department. The ethics submission was made to UBCO Behavioural Research Ethics Board on May 5, 2023, undergoing multiple rounds of revisions before receiving approval on August 3rd. The research and data collection period spanned from August 3, 2023 to November 18, 2023. The data collection period ensured sufficient time for collecting and reviewing research data, and completion of this thesis within the thesis submission timeline for spring 2024. During data collection, I implemented qualitative methods rooted in Indigenous research approaches, specifically aligning with the Enowkinwixw second objective. This involved 54 employing a felt embeddedness approach, a style emphasizing emotional awareness in research (Catungal, 2017). While specific examples and methods of felt embeddedness approaches can vary based on the context of research, Catungal (2017) highlights the concept’s broader application in understanding the emotional dimensions of research such as employing personal reflection activities, in-depth interviews, and group discussion (Catungal, 2017). By utilizing felt embeddedness methods, participants were encouraged to engage meaningfully, fostering personal reflection and expression. The felt embeddedness approach seamlessly integrates with the second objective of the Enowkinwixw process, which entails visioning through a collaborative group-mind. This aligns with one of the methods of felt embeddedness. To implement this integration, reflection exercises were introduced during sharing circles, allowing participants to express their understanding of the Four Food Chiefs—as previously mentioned is a crucial story that informs the Enowkinwixw process. As Jo-Ann Archibald emphasized in Decolonizing Research: Indigenous Story Work as Methodology (2019), ‘stories spark our emotions, make us think more deeply and help us problem solve and take courageous action’ (p.4). These formats of data collection allow Indigenous communities to engage with research in ways that ‘aspire to re-cover, re-cognize, re-create, re-present and “research back” by using our own ontological and epistemological constructs.’ (p.6). I actively pursued embeddedness with the participants, immersing myself not only in capturing their experiences during sharing circles and knowledge-sharing interviews but also integrating these felt embedded practices into my own research process. This involved various engagements with the land and engaging in personal reflection while gathering medicines from sacred places and practicing inherent knowledge that I have been shown and taught throughout 55 my life. For instance, I would go out to gather what I know to be called ‘Indian Tea’ or what is also referred to as Labrador tea, high up in the mountains, harvest sage brush around sacred ceremonial areas, go to powwows, and engage with Indigenous artisans and support their traditional work of gathering and preparing sweetgrass braids, soaps, and artwork. I then reflected on these experiences and always ensured I was in a good mindset when I would bundle together the braided sweetgrass, soap, and artwork to serve as honorariums and gifts for my participants in both the sharing circles and interviews. On one occasion, I involved my family in these activities, sharing stories about my research and the interview process. Each of these outings allowed for me to engage in the research in an alternative felt embeddedness way that supported my understanding of my position within this research and how I related to the knowledge being shared. Besides this, each of the aforementioned felt embeddedness approaches were conducted among sharing circles and interviews through incorporating this approach into the data collection procedures, I invited participants to engage actively by offering the opportunity to lead the opening and closing smudge and prayer. This involved using sage I collected, placing it in a smudge bowl (an abalone shell), and utilizing an eagle feather to cleanse the space and a prayer with good intentions to protect everyone participating. Technical aspects of felt embeddedness were conducted through utilizing both art and verbal-based methods, involving the use of sharing circle and interview guides, demographic questionnaires, and question oriented personal reflection sheets as previously mentioned. The data collection process remained consistent across all sessions, with the only modification being the sharing circle guide, which was enhanced to be 56 more comprehensive for the Youth Council group. Additionally, audio recording was conducted with the group’s permission. 3.5.1 Sharing Circle Procedures The implementation of sharing circles in this research was deemed an appropriate approach for community engagement. It is crucial to recognize that the adoption of sharing circles can vary among communities, with differences in traditional practices. In the WFN community, I was permitted to facilitate sharing circles and record discussions. However, it's important to acknowledge that sharing circles may hold varying degrees of significance across communities. In certain contexts, they may strictly serve healing purposes, prohibiting any form of recording. Moreover, some communities may not practice sharing circles at all. It is imperative to obtain confirmation on what is culturally appropriate within the specific community you are collaborating with. A total of three sharing circle sessions were scheduled, marking the initiative’s engagement with various groups within the community. The first session, initially planned with the WFN Elders Committee on August 31st, had to be rescheduled due to wildfires, causing delays and scheduling conflicts. Despite efforts to find alternative times for sessions until November 2023, engaging with the Elders committee did not come to fruition due to time constraints. The second session, on September 6th, successfully took place with the Health and Wellness Department, involving ten health providers. The third session occurred on September 13th, involving the WFN Youth Council with six participants aged between 16 and 20. Lastly, a session on September 26th, meant for the WFN community at the community services center, unfortunately had no participants in attendance. These varied sessions reflected the challenges and successes encountered during the community engagement initiative. 57 To ensure an efficient and focused session, each sharing circle was limited to a minimum of 4 participants and a maximum of 10. Each sharing circle session lasted between thirty minutes to over one hour in length. I maintained flexible regarding time, aligning with my personal interpretation of Indigenous and traditional teachings. Understanding that traditions aren’t bound by strict time constraints, I embraced the concept of absorbing and experiencing what is offered as it unfolds in both the sharing circles and interview sessions. Sharing circles were more time focused as many individuals were engaging in respective sharing circle sessions during their respective voluntary time outside of scheduled duties, the Health and Wellness team dedicated hours beyond their usual work responsibilities, while the youth participants engaged in the sharing circle during their monthly Youth Council meeting. Despite having numerous agenda items to cover, the youth committed their voluntary time to participating in the sharing circle. Similarly, the Health and Wellness team had to allocate time away from their regular duties within the workday to fulfill their roles in the sharing circle session. This demonstrates their commitment to participating in the initiative despite the additional demands on their time. The sessions followed a standardized format, which included all the necessary paperwork, including the Informed Consent, Demographic Questionnaire, Personal Reflection Page, and Sharing Circle guide, was distributed to the participants. As the discussion facilitator, my role encompassed taking notes, offering necessary materials such as pens, paper, crayons, and providing refreshments that accommodated various dietary preferences. Prior to the commencement of our discussions, I ensured that everyone was briefed on the contents and significance of the consent form, questionnaire, and sharing circle guide. In addition to the administrative details, and in the spirit of creating an inclusive environment, I began with a land acknowledgment to honor the syilx lands upon which we gathered. Following 58 this, a smudging ceremony was conducted to clarify the space that we were in and to set the tone for positive engagement. After this, to further facilitate equitable and respectful conversation within our sharing circle, I briefed participants about the use of the talking stick within our sharing circle and the conduct and role of the talking stick. This brief ensured that only the person holding the stick had the floor for speaking. The direction of passing the stick was determined seasonally, following traditional practices (i.e., the talking stick moves in the direction of either clockwise during spring and summer or counterclockwise during fall and winter). I then reconfirmed with participants that this session would be audio recorded and with their permission then began the recording using an audio recording app. The commencement of the sharing circle then began with an initial opening question from the sharing circle discussion guide, initiating the conversation for example: “When you think of wellness integration as you’ve experienced it, what do you think is working well?” Or “What do you think was in place that enabled [traditional wellness initiatives] to work well?” and was then passed in a clockwise fashion, to adhere to the seasonal protocol as we were in the summer still, around the circle to answer the question at hand. Throughout the sharing circle discussions, I posed additional questions to the group while simultaneously taking field notes to enrich the data collection and facilitate later transcriptions. After the discussion questions were answered, participants were provided a 20-minute personal reflection session, during which they could provide feedback and engage in creative activities such as art creation. The personal reflection sheet included a quadrant for participants to express how the Four Food Chiefs related to traditional wellness integration, a concept I will delve into more deeply in the personal reflection section and results chapter. Once this personal reflection session was finished, to conclude each sharing circle, I performed another smudging 59 ceremony and expressed heartfelt gratitude to the participants for their valuable contributions. As a token of appreciation, each participant received a $50 gift card from a selection of vendors, including Amazon, Starbucks, Winners, Homesense, and Uber. Additionally, they received a traditional gift of which I gathered and purchased from Indigenous artisans and businesses as I had previously mentioned when describing felt embeddedness. The traditional gift featured items like sweetgrass, sage, canned salmon, tea leaves, soap, or a coffee mug. This gesture aimed to allow me to engage in traditional land-based knowledges and support Indigenous businesses and extend our gratitude to the community that I was privileged to work with. 3.5.2 Knowledge Sharing Interview Procedures Participants recruited for the study were invited to take part in semi-structured interviews lasting approximately one hour per session as an alternative to attending the sharing circles. Similar to the approach in sharing circles, I respected the relative nature of time, allowing participants the space to express their knowledge at their own pace. This approach ensured that, as a researcher, I honored and embraced the knowledge shared with me, recognizing the time it takes for this exchange to occur. We coordinated interview schedules based on mutual availability, offering options for in-person meetings at comfortable locations, such as on the land or in meeting rooms at the WFN Community Services Centre. Alternatively, interviews could be conducted via Zoom, which took place at my residence using UBC Zoom services hosted on Canadian servers. Four one-on-one interviews were conducted with participants in a parallel fashion to the sharing circle groups. There were no instances in which individuals who expressed interest in an interview did not follow through with the interview process. In addition to ensuring an Indigenous-based approach to data collection by conducting the one-on-one interviews in semi-60 structured informal settings. These informal interactions took various forms, including activities like gathering medicines, coffee conversations and on the land settings, as determined by the participants. The methodology for data collection in each of these included involving the use of demographic questionnaires, audio recording, as well as the collection of field notes, drawings, and personal reflections such as stories. The only variation in this process was the incorporation of gathering art or personal reflection data, which was selectively introduced based on considerations like time constraints or participants feeling that their verbal contributions were sufficiently comprehensive. It is important to note that while this study involved a relatively limited number of interview perspectives, it is noteworthy that all individuals who approached for a 1-on-1 interview expressed interest and ultimately completed the interview. Before each interview, like the procedures followed in sharing circles, I ensured that consent forms and demographic questionnaires were provided to and obtained from the participants. These documents were shared either physically or via email before the interview began. The interviews followed the same opening and closing procedures established for the sharing circles, as mentioned earlier. The interviews took place between August 16 and October 24, 2023. The initial interview on August 16th involved two participants. We conducted this interview in the mountains, aiming to delve into their experiences as traditional wellness clients and their roles as knowledge keepers within the community. Throughout the session, we gathered plant medicines and enjoyed hiking around the landscape, exploring different areas together (see Figure 2.2). Eventually, we settled under the shade of some trees, where our conversation continued for over three and a half hours. This particular interview holds a special place as one of my favorites. Both participants have provided their permission for this photo to be published in this thesis. 61 Illustration 2 Visiting on the Land with Semi-Structured Interview Participants 102 & 103 Participants were given dedicated time for a personal reflection session, mirroring the twenty-minute allocation used in sharing circles. A four-quadrant coloring page was provided, encouraging creative expression for sharing their thoughts. However, not all interview participants opted to engage in this particular form of personal reflection. Some preferred to convey their reflections by answering questions related to the Four Food Chiefs during the interview. 3.5.3 Personal Reflection Procedures As the sharing circles or interview sessions ended, participants who willingly submitted their personal reflection sheets were then provided with a release form. This form served a dual purpose: it ensured the rightful identification of participants’ ownership over their created personal reflections, and granted permission for the utilization of these reflections in this thesis. The voluntary personal reflections as well as the signed release form were collected after each sharing circle and interview session and were immediately uploaded to the UBC One Drive. 62 3.6 Data Safety Procedures All group sharing circle sessions and knowledge-sharing interview data provided in sharing circles and knowledge sharing interviews were meticulously recorded and subsequently transcribed verbatim. All collected data, notes, and artistic contributions were anonymized and uploaded to the UBC ONE Drive for initial safekeeping of the data and subsequently transferred to the WFN database in collaboration with the Westbank First Nation Records Department. This collaborative effort aimed to ensure perpetual accessibility to the information by the WFN health and wellness department. Additionally, it guaranteed the secure protection of this information in accordance with the WFN Records Policy and Procedures, specifically adhering to the Freedom of Information and Protection of Privacy Policy (2018). This approach aligns with the First Nations principles of ownership, control, access, and possession, commonly recognized as OCAP® (First Nations Information Governance Centre, 2023). These principles affirm that First Nations possess authority over data collection processes and have ownership and control over how this information is utilized (First Nations Information Governance Centre, 2023). 3.7 Data Analysis The NVivo 14 software provided by UBC was utilized for data translation purposes. It is imperative to note that all knowledge gathered and provided in this study is the exclusive property of WFN, necessitating explicit authorization from WFN for any dissemination of the data. 3.7.1 Inductive Thematic Findings When engaging in data analysis, my supervisory committee directed me to employ a qualitative approach based on Braun and Clarke’s (2019) thematic analysis. This thematic approach prioritizes reflexivity, urging the researcher to acknowledge biases and preconceptions 63 influencing data interpretation. It promotes an iterative, inductive process for identifying emergent themes from raw data, facilitating systematic organization and coding to unveil underlying patterns. This flexibility accommodates various data types and research contexts. The method focuses on nuanced interpretation rather than mere summarization, encouraging researchers to construct coherent narratives that capture data essence while acknowledging multiple perspectives and interpretations (Braun & Clarke, 2019, p. 589-597). Applying the inductive aspect of thematic analysis where codes, or labels, are generated directly from the data itself rather than being determined or predefined beforehand. In this approach, researchers immerse themselves in the raw data, such as interview transcripts, field notes, or texts, and identify patterns, themes, or concepts that emerge naturally from the data content. These emerging patterns are then assigned descriptive codes or labels that capture the essence of the data without imposing preconceived categories or theoretical frameworks (Braun & Clarke, 2019). Inductive coding allows for a more exploratory and open-ended analysis, enabling researchers to uncover unexpected insights and perspectives within the data (Braun & Clarke, 2019). For instance, Dr. Laura Struik and I meticulously examined the transcriptions, embracing an experiential orientation. Our focus was on capturing participants’ experiences and perspectives, highlighting their direct and indirect responses to questions. This approach aimed to generate themes aligned with the research objectives, emphasizing the meaning ascribed by participants rather than asserting preconceived notions about the research topic (Byrne, 2022; Braun & Clarke, 2019). Subsequently, Dr. Struik and I continued to engage in collaborative discussions to further synthesize the findings after each sharing circle or interview. For instance, one significant theme that emerged among all of the sharing circles and interviews pertained to the ethics and attributes of good leadership, revealing diverse perspectives among the sharing 64 circles and interviewees regarding its relevance to traditional wellness integration. After completing the sharing circles and Interviews Dr. Struik and I gathered these insights and examined how they could be coded to a preliminary framework that consisted of a) high-level categorical codes (e.g., Strengths, Barriers, Way forward) that aligned with research objectives; and b) low-level categories that varied to accommodate individuality and prioritize each sharing circle and interview transcript nuances. For instance, within the ‘Strengths’ category, ‘good leadership’ emerged as a distinct low-level category to preserve diversity among each group transcript. 3.7.2 Deductive Thematic Analysis In this segment I overview the deductive thematic analysis coding approach which involves the utilization of pre-existing codes or a predetermined coding scheme to analyze the data. These codes are derived from established theories, concepts, or frameworks relevant to the research question (Braun & Clarke, 2019). The researcher applies these codes to the data and identifies patterns, themes, or concepts that align with the pre-existing codes. In essence, deductive coding follows a top-down approach, with prior knowledge guiding the coding process. It is important to note, however, that remaining open to emerging codes and themes is emphasized even in deductive analysis (Braun & Clarke, 2019). To implement this approach, I systematically organized the coded lower-level category data from the previous section within each of the Four Food Chiefs—Skəmxist-Black Bear, Ntitiyix-Spring Salmon, Siyaʔ-Saskatoon Berry, and sp’iƛ̓əm-Bitter Root. The complete deductive analysis extends to interpretation and reporting, prioritizing rich, nuanced interpretation over mere summarization (Braun & Clarke, 2019). This involves crafting a coherent narrative that captures the essence of the data, considering multiple interpretations and 65 perspectives. This interpretive process is exemplified through the visual representation of the Food Chiefs. Additionally, I referred to the Enowkinwixw theoretical framework to also provide guidance and examine the themes comprehensively, aiming for coherence and consistency throughout my research. 3.7.3 Attributes of the Four Food Chiefs This section delves into the attributes embodied by each of the Four Food Chiefs within the Westbank First Nation’s governance and self-governance structure, as outlined in the WFN Strategic Planning Framework (Westbank First Nation, 2023). The Four Food Chiefs—Skəmxist-Black Bear, Ntitiyix-Spring Salmon, Siyaʔ-Saskatoon Berry, and sp’iƛ̓əm-Bitter Root—symbolize integral aspects of equitable inclusion and consensus. For a comprehensive understanding of these symbolic representations, please refer to the theoretical framework section in chapter three, which elucidates the Captikʷɬ (oral history) of ‘How Food Was Given’ of the Four Food Chiefs. The identified attributes associated with each food chief contribute to the holistic goal of fostering well-being and cultural continuity. Skəmxist-Black Bear, embodies governance, leadership, culture, protocol, tradition, and contemplation, underscores the importance of effective leadership in traditional wellness initiatives. Leadership traits identified during data collection, such as active listening, safe spaces, and non-judgment are identified as essential for engaging in traditional practices, aligning with Black Bear’s emphasis on governance and leadership. Ntitiyix-Spring Salmon represents action, planning, and development, reflecting the need for strategic initiatives to enhance access and participation in traditional wellness. Strategies aimed at fostering collaborative environments and improving accessibility align with the action-oriented nature of Spring Salmon. Siyaʔ-Saskatoon Berry, embodying 66 community, well-being, innovation, youth, and family, emphasizes community connection, wellness, and youth support. Initiatives focused on passing on traditional knowledge, creating safe spaces, and engaging the entire community are themes that resonate with Saskatoon Berry. Lastly, sp’iƛ̓əm-Bitter Root, representing land, sustainability, and interconnectedness, underscores the integral role of land-based knowledge and practices in well-being. Recognizing the importance of incorporating land-based healing opportunities and respecting local teachings reflects the interconnectedness highlighted by Bitter Root. Overall, the attributes associated with each food chief offer valuable insights into fostering cultural continuity and well-being within the Westbank First Nation community. In employing the deductive analysis approach, I incorporated a reflexivity tactic to discern the most fitting placement of each theme within the attributed categories. My reflective process predominantly involved contemplating the findings and assigning each lower-level inductive category theme to the food chief that resonated most closely with my interpretation of participants’ responses. This interpretation was primarily centered on the language participants utilized, emphasizing relational aspects to the Food Chiefs, and the relevance of the topics they raised in connection to each food chief attribute. Additionally, I considered participants’ demographics, aligning with the Enowkinwixw process to ensure generational variance across each theme. 67 Chapter 4: Results In this chapter, the results of the research are broken down into two fundamental components. The initial segment involves an in-depth inductive thematic analysis of the key themes found, meticulously presenting nuanced data and themes extracted directly from the unfiltered accounts of participants. This approach aims to capture the experiences, voices, and stories of the participants without introducing any external bias, when providing a understanding of the key themes that have emerged. The second facet of the results encompasses the deductive thematic process, wherein the nuanced findings are interpreted within the structured framework of the Four Food Chiefs. This analytical approach seeks to discern patterns and relationships, bridging the granular details obtained through inductive analysis with the overarching conceptual framework. Ultimately, the aim of this chapter is to offer a comprehensive perspective that integrates both inductive and deductive insights to the findings of the research. To enhance clarity, a visual representation of the final thematic findings will be presented, highlighting their alignment with the Four Food Chiefs framework. This visual representation serves as a succinct tool to communicate the intricate interplay between the emergent themes and the established conceptual framework, providing a clear and insightful summary of the study’s results. 4.1 Strengths Throughout the sharing circles and interviews, numerous themes emerged regarding the strengths of traditional wellness integration, Indigenization, and cultural safety. These themes underscored the support and enhancement of current engagement formats and experiences within 68 traditional wellness practices. The following sections will delve into various themes related to the strengths observed in the research. Firstly, I will explore how access to diverse traditional outlets can positively influence wellness. Next, I will examine the role of access to traditional wellness in fostering community connection. The third theme will investigate how essential traits of good leadership enhance engagement in traditional wellness practices. Following that, I will explore the impact of wellness initiatives and how they become more effective when local teachings are incorporated. Lastly, the discussion will revolve around the integral role of land-based knowledges in shaping individuals’ health and wellbeing, emphasizing the significance of current knowledge and access to land-based wisdom. 4.1.1 Access To Diverse Traditional Outlets Increases Wellness Participants in the study found that existing access to Indigenous health authorities such as First Nations Health Authority, is a valuable resource, primarily because of the financial support efforts focused on Indigenous-specific wellness by these authorities. Notably in this segment of participant voices, Coralee Miller, specifically requested their name to be associated with their quotations and contributions. All quotations and contributions attributed to Coralee Miller have been approved by the participant for mention by name, which has significantly informed the thesis findings in a community-based way that respects the voices and values of members looking for their words to be heard. This is a way of practicing relational accountability, where it is important to know who and where our knowledge is coming from. Participant 119 Coralee Miller explained that Indigenous health authorities offer more accessible avenues to explore traditional Indigenous wellness which they found was beneficial for someone who is unfamiliar of where to turn to or how to begin engaging with traditional wellness. Other participants explained that in their experience the incorporation of traditional wellness outlets in 69 schools and workplaces as advocated by policies, such as having Elders available for support and incorporating daily practices like smudging before a workday, was recognized as creating safe and beneficial spaces to engage in traditional wellness. This is especially noteworthy as participant 120 brought to light the presence of these outlets in settings that typically do not prioritize traditional wellness such as institutions like school or work is a strength that should continue to be built upon. Collectively participants emphasized that engaging with these traditional wellness outlets in diverse settings serves as beneficial pathways to connect with traditional practices. This engagement has a positive impact on various aspects of life, significantly contributing to the overall wellness of individuals by increasing participants’ openness and willingness to embrace traditional wellness and knowledge. Consider the following quote: (Participant 105, Health and Wellness Sharing Circle, Community Member) “I want to say doing smudges in the morning, that’s really been a nice implementation and yeah, having people be all open. Even if they don’t want to do the individual smudge or not, they can still participate. That is essential because a lot of the things that we deal with, you know it can take a toll on us, so having that cleanse at the beginning of the day really helps.” 4.1.2 Access to Traditional Wellness Fosters Community Connection Participants expressed that the opportunity to engage with the community in traditional ways supports the creation of connections within the community. This interaction, as described by participants, enables individuals to learn, grow, and establish a robust support network, aiding in navigating various aspects of life. Embracing traditional wellness practices allowed participants to cultivate an openness that can facilitate connections with like-minded individuals who share similar aspirations. The participants in the study highlighted the significance of engaging with the community in traditional ways, emphasizing the positive impact on 70 connection-building within the community. As expressed by Participant 102, there is a profound fulfillment derived from being part of the process and witnessing others’ experiences. This communal engagement, according to the participant, feeds the soul and contributes to personal healing. Participant 103 echoed the sentiment, emphasizing the importance of relationships formed within the community beyond structured programs, providing an additional layer of support outside of one’s family. The sentiment was further reinforced by Participant 120, who stressed the value of connecting with Elders and knowledge keepers for traditional wellness on a personal level. The participants collectively emphasized the reciprocal nature of these connections, highlighting the importance of ensuring that the engagement with traditional wellness is a learning experience for both the participant and the knowledge keeper, contributing to the overall well-being of the individuals involved. The following participant explains the feeling and meaning of these connections. (Participant 120, Interview, Youth/Knowledge Keeper/Traditional Wellness Client) “Yeah, I feel like On my own time, getting traditional Wellness Is through Elders and like knowledge keepers. So I feel when I connect with people with my family or people and the community I live in…Engaging with traditional wellness. What has worked well, I think it’s just getting that opportunity, building those connections in a reciprocal way and ensuring that there’s no harm done and It’s like you’re learning, through the practice [of traditional wellness] as on both sides [both the participant and knowledge keeper].” 4.1.3 Essential Traits of Good Leadership Enhances Engagement in Traditional Wellness Participants emphasized that the ethics and attributes of good leadership qualities that encompass traits like active listening, fostering safe spaces, providing opportunities for community engagement, empowering youth, and respecting diverse learning styles. Each of these are essential for effective leadership in traditional wellness settings. Participants shared how good leadership shaped their experiences engaging with traditional wellness. Participant 101 71 highlighted the positive impact of leaders who fostered an open and inclusive space, encouraging everyone to contribute and making it acceptable to acknowledge personal achievements. This, according to the participant, created a community-based program that felt welcoming. Participant 102 underscored the importance of non-judgmental leadership within the realm of traditional wellness, emphasizing that individuals should be able to practice wellness in their own way without judgment. Participant 103 delved into the concept of leadership in governance, stressing the need for leaders to be connected to the values they protect, including the land, people, and traditions. The participant emphasized the importance of leaders being humble, admitting mistakes, seeking help when needed, and refraining from using their positions to harm others. Collectively, these accounts underscore the significance of leadership qualities such as inclusivity, non-judgment, humility, and a commitment to community well-being in fostering positive engagement with traditional wellness. (Participant 101, Youth Sharing Circle, Youth/Community Member/Traditional Wellness Client) “I was young, and I just remember it was a really, open space and the leaders were very like about just incorporating everyone and getting a say from everyone and making it feel like it was ok to like praise yourself which was really cool.” 4.1.4 Wellness Initiatives are Impactful When Local Teachings are Provided Participants revealed the pivotal role of embracing and honoring local teachings through safeguarding traditional knowledge. Participants highlighted that by perpetuating storytelling traditions and prioritizing Indigenous support systems over westernized approaches actively encourages cultural grounding and respects generational knowledge. Participant 103, a Community Member, Knowledge Keeper, and Traditional Wellness Practitioner, highlighted the significance of having a network of support that revolves around sharing life experiences through cultural stories. The participant stressed the importance of nurturing a supportive environment 72 where traditional teachings and stories guide the process of navigating challenges. The participant expressed a desire for support systems that prioritize traditional approaches over westernized methods, emphasizing the intention to help individuals navigate difficulties in a way that aligns with their cultural traditions. (Participant 119 - Coralee Miller, Community Member/Knowledge Keeper) “…But we learned about medicine by watching the black bear. You know, when it’s got a sick stomach. Look at what it eats. We learned about intermittent fasting from the rattlesnake. We learned about self-care from the deer. These teachings are there, and we have received them and passed them on for a reason.” 4.1.5 Current Knowledge of and Access to Land Based Knowledges are Integral to Peoples Health and Wellbeing Participants explained the intrinsic values of interacting with the land as a fundamental traditional wellness practice. Participants stressed the importance of integrating the land into wellness practices, highlighting the existing benefits and advocating for the continued inclusion of land-based practices in attaining holistic health approaches. Participant 102 expressed the idea that, similar to various faith or belief systems, connecting with the land serves as a source of hope and mental well-being. Describing the outdoors as their church, the participant emphasized the grounding and comfort found in nature. This connection provides a space for reflection, contemplation, and a means to clear thoughts and minds. Participant 103 expressed a similar viewpoint, sharing a simple yet profound appreciation for the positive impact of being on the land. The participant highlighted the benefits of solitude, the sense of freedom, and the overall improvement in well-being. Moreover, the participant emphasized the unique combination of land and life, expressing how being on the land contributes to health, happiness, and a space for emotional release. Both participants advocated for the continued integration of land-based 73 practices in traditional health and wellness approaches, citing the land as a place that not only enhances physical health but also provides a therapeutic space for emotional well-being and personal growth. Participant 120 expresses the full rounded meaning of being intrinsically connected and why the land is important not only in traditional wellness but also in defining the essence of Indigenous identity. Consider the following quote: (Participant 120, Interview, Youth/Knowledge Keeper/Traditional Wellness Client) “I feel like land is really important because that’s where a lot of our traditional practices have happened. Out on the land you go up the hill to do whatever you need to do. Or you go picking and you go gathering; all those things are done on the land and what things are called is also really important. So like I would say, yeah, language ties huge into that just because place names like what this place means, what it’s done, what it’s historically known for, like those marks on the hill share a specific story. I feel that is really important because we get to understand the tmxulauwx (earth) all living things like timixw (living things), and then those words themselves like tmxulauwx (earth) means spinning like all together and then on the soil, and it also explains how were all interconnected. So that word itself means a lot. And like is hard to define through English, but it’s like, yeah, describing like earth. So I think just like having the connection to land and also like having our obligations to the land is really important because we don’t own the land, right? But we’re caretakers for the land. So we have to, uphold that. So that’s why there’s fire keepers. That’s why, like, there’s all these things we all work together in that way. We all have plan or obligation to do that and that goes through everything like community governance like how everything is like played out…” 4.2 Barriers Following a structure akin to the prior high-level category, this subsequent section is structured to present participants’ perspectives on the prevailing barriers they encountered while attempting to engage with traditional wellness. Several prominent themes are identified, shedding light on the multifaceted challenges hindering the engagement with and access to traditional wellness. Firstly, the prevalence of various accessibility issues acts as a significant barrier, impeding individuals from fully participating in traditional wellness practices. Secondly, the lack of consistency in leadership and programming emerges as a discouraging factor that can 74 deter engagement in traditional wellness initiatives. The third theme highlights the complexities associated with navigating traditions, presenting difficulties in the implementation of traditional wellness outlets. Finally, the section underscores the profound impact of historical trauma and stigma on individuals’ engagement and desire to participate in traditional wellness activities and initiatives. Together, these themes paint a comprehensive picture of the obstacles and considerations that must be addressed to promote meaningful involvement in traditional wellness practices. 4.2.1 Various Accessibility Issues are a Barrier to Engaging and Accessing Traditional Wellness Participants shed light on several barriers that impede access to traditional wellness resources, emphasizing the need for systemic support and the addressing of gatekeeping practices to facilitate more accessible engagement with these outlets. Participant 110, a community member, discussed the challenges faced by community members and staff, particularly related to transportation, employment, and housing issues, which hinder their ability to support others in their health journeys. Participant 114, a youth and community member, reflected on the impact of misinformation, lack of opportunities, and age-related constraints within their family, highlighting the missed chances for engaging in traditional activities. Participant 102, a community member, knowledge keeper, and traditional wellness client, delved into the contrasting perspectives of structured planning and the unstructured nature of traditional practices on the land. The participant emphasized the importance of flexibility in planning and development to align with the unpredictable timing of certain land-based activities, challenging the common desire for rigid calendars. Together, these accounts underscore the multifaceted 75 challenges individuals face, advocating for a more adaptable and supportive system to enhance accessibility to traditional wellness resources. (Participant 110, Health and Wellness Sharing Circle, Community Member) “…I think the idea of how to fully support our community members and our staff, like a lot of people don’t have transportation and a lot of people don’t have jobs a lot of people don’t have housing and that can be a huge issue for us trying to help support them through their health journey. And yeah, just trying to support our patients to the best of our ability. We need to have the space as staff to deal with that.” 4.2.2 Lack of Consistency in Leadership and Programming Can Deter Engagement in Traditional Wellness Initiatives Participants in the study shared insights into the challenges faced in establishing and sustaining traditional wellness platforms, pointing to factors such as inconsistent availability such as age-related variations. Participant 112, a community member and wellness coordinator, emphasized the significance of trust, noting the difficulties in maintaining engagement when there is a turnover of individuals involved in wellness programs. The participant highlighted the community’s desire for consistency and acknowledged the presence of personal trauma that both participants and staff need to address for collective healing. Participant 117, a youth and community member, advocated for additional opportunities for younger kids and all age groups, addressing the limitations faced by those who were deemed too old or too young for specific programs. These perspectives collectively underscore the critical need to prioritize building trust, implementing reliable program management, and ensuring equitable resource allocation to enhance ongoing accessibility to traditional wellness platforms amidst the multifaceted challenges identified by the participants. 76 (Participant 112 Health and Wellness Sharing Circle, Community Member/Wellness Coordinator) “Trust is a big thing too, there’s been so many different people who run the programs or in our leadership that have come and gone and people like consistency. Different people keep showing up; so, it’s hard to get people back in. It’s hard to get people reengaged. There is just a lack of trust which for some people has created a lot of trauma, I think. We also too, as staff, have a lot of that as well. There’s a lot of healing to do within the community.” 4.2.3 Navigating Traditions Can Create Difficulties in Implementation of Traditional Wellness Outlets Participants unveiled formidable challenges in implementing traditional wellness outlets, citing diverse teachings, varied beliefs and practices, and historical misconduct as significant hurdles. The impact of historical mistrust stemming from health and research misconduct has manifested in gatekeeping practices, hindering the flow of traditional knowledge and creating a general unawareness of engagement protocols. Participant 120, a youth and knowledge keeper, underscored the intricacy of Indigenizing programming, cautioning against unintentional pan-Indigenous approaches and highlighting the diverse community opinions on participating in specific Indigenous ceremonies. Participants both Indigenous and non-Indigenous expressed unease due to the variance in traditional teachings, fearing inadvertent offense or failure to adhere to proper protocols, further complicating their engagement in these traditions. This disconnect poses substantial barriers to cultural safety efforts, impeding the meaningful integration of traditional wellness practices in communities and organizations. The sentiments expressed by Participant 119, who shared a personal story of oral teachings lost through theft, emphasize the hesitation to collaborate with universities due to a perceived appropriation of knowledge. Participant 112, a wellness coordinator, disclosed challenges in reaching knowledge 77 keepers, unsure of proper protocols and hesitant to offend. Additionally, Participant 109, a wellness coordinator and traditional wellness practitioner, highlighted the difficulty faced by those who are Indigenous and culturally inclined specialists in their own community however coming into another community and providing cultural teachings can feel disheartening in not knowing what local customs to adhere to which contributes to a sense of inadequacy as a trained traditional wellness practitioner. These narratives collectively illuminate the complex landscape of implementing traditional wellness outlets and underscore the imperative need for trust-building, clear protocols, and equitable collaboration when informing how to navigate these challenges. (Participant 119 - Coralee Miller, Community Member/Knowledge Keeper) “A lot of it is forgotten because again, a lot of [my grandmothers] stuff was oral and if you weren’t paying attention to your grandparents growing up, they die and then they take everything that they know with them. My uncle was telling me that she had a huge book full of medicines, including drawings. But I guess some students from UBCO at the time worked with her and then they stole that book and then she died from her broken heart. Yeah. So that’s why there’s also that hesitancy to work with universities and colleges. Yeah, because they have this habit where anything you tell them then it becomes theirs.” (Participant 120, Interview, Youth/Knowledge Keeper/Traditional Wellness Client) “…I guess by Indigenizing [programming], can also be seen as like not [properly Indigenizing programming] cause it can also be very pan Indigenous of the practices that are taught. So I think that’s also Interesting. I feel like it’s also good for people who are reconnecting and for those who maybe don’t know. Like if you [practice] pan-Indigenous [wellness practices] and then you bring out teachings in that way. But also a lot people have different feelings on that. So yeah, I feel like if people are involved in a specific Indigenous ceremony, is that a good thing? Is that a bad thing? It really depends on the person running the ceremony and the community you are in so its difficult to know how and when to participate.” 78 4.2.4 Historical Trauma and Stigma’s Impact Engagement and Desire to Participate in Traditional Wellness Activities and Initiatives The generational stigma stemming from historical traumas and the resulting lack of trust with health care systems or lack of practice in traditional wellness requires addressing historical misconducts and building understanding to promote cultural acceptance and engagement. Participants shared reflections on their experiences, specifically focusing on their hesitations or reservations in engaging with traditional wellness practices or healthcare in general. Participant 103, a Community Member, Knowledge Keeper, and Traditional Wellness Practitioner, revealed the challenges faced in accepting the traditional way of life, expressing frustration with the judgment received for minor mistakes during cultural practices. The participant emphasized the need for understanding and a shift away from lateral violence and stigma, particularly when individuals are earnestly trying to embrace their cultural practices. Participant 114, a community member, reflected on childhood experiences and acknowledged the impatience tied to cultural activities, shaped by a lack of proper teachings and strict expectations inherited from the residential school era. As a mother, she recognized perpetuating impatience due to a similar lack of guidance. Participant 119 - Coralee Miller, a community member and knowledge keeper, shared a traumatic experience related to healthcare, describing how her grandmother’s sister died during a tonsillectomy due to inadequate medical care. This historical trauma influenced her grandmother’s fear, creating a reluctance toward medical procedures. These narratives underscore the need to address historical misconduct, build understanding, and promote cultural acceptance to overcome generational stigmas and foster meaningful engagement with both traditional wellness practices and healthcare systems. 79 (Participant 103, Interview, Community Member/Knowledge Keeper/Traditional Wellness Practitioner/Traditional Wellness Client) “Some of the things that really prevented me from accepting the sqilixw [traditional way of life] for a little while or even like I almost walked away; was when I was giving it my sincere all. Giving my passion and drive, my time, energy and sacrifice. To have people pointing down or looking down at me because I didn’t do one thing or two things right. Or you know, and this whole thing about if you don’t do it right, don’t do it. You know what? I can’t be loved like that. There of course, you know, there’s a time and a place to have strict and structured things happen but sometimes not. There’s no need to be laterally violent or have stigma to one another especially not when we’re trying to practice our ways.” (Participant 119 - Coralee Miller, Community Member/Knowledge Keeper) “When I had to get my tonsils taken out my grandma was scared for me. She didn’t want me to get my tonsils taken out because that’s how her sister died. Back then, you went to the Indian Dr. which also doubled as a Vet so it wasn’t very safe. They said all right, she’ll be done by the afternoon but when they went to go pick her up, she died. They let her just drown in her blood. When they took her tonsils out so that traumatized my grandma, so she was just like, don’t do it.” 4.3 The Way Forward Featured in this final inductive high-level category, participants share their initiatives, insights, and aspirations for propelling forward the integration of traditional wellness. They express the desire for its further establishment, envisioning a path for future generations. Their voices highlight effective strategies that engage the entire community, surmount barriers, and enhance current strengths encouraging an Indigenized and culturally safe healthcare landscape that can further support integration strategies. This is shown through a series of key themes centered around the advancement of traditional wellness. Firstly, there is an emphasis on fostering collaborative environments with the community to facilitate growth in traditional practices. This underscores the importance of collective efforts and community involvement in preserving and promoting traditional wellness. Additionally, the theme of enhancing access for 80 the ease of traditional wellness participation in various areas is emphasized, acknowledging the significance of creating accessible pathways for individuals to engage with these practices. The section also delves into effective strategies for passing on traditional knowledge, recognizing the critical role of intergenerational transmission in revitalizing traditional wellness practices. By addressing these themes, the section aims to offer insights into the positive strategies and approaches that can contribute to the flourishing of traditional wellness within communities. 4.3.1 Fostering Collaborative Environments with Community to Allow for Growth in Traditional Practices Participants shared that creating a collaborative environment involves encouraging flexibility with time, kindness, and trust among individuals. By offering opportunities for engagement in traditional practices within this collaborative framework, allows for meaningful interactions aligned with a balanced perspective and relationship with the community. Participants showcase that collaborative traditional wellness encompasses peer mentorship, supporting knowledge keepers, and maintaining leadership roles, all within safe, empowering, and inclusive spaces that support participation and growth for everyone of all ages. Participant 107, a wellness coordinator and traditional wellness practitioner, highlights the importance of reconnecting with cultural traditions, such as gathering medicines and engaging in communal activities, to revitalize syilx traditional community-based practices that has existed since time immemorial. Participant 110, also a wellness coordinator and community member, underscores the challenge of busy schedules but advocates for inclusive participation in traditional activities among all staff, fostering mutual learning and understanding of diverse expressions from community about local traditions to build trust and reduce turnover. Participant 101, a youth and 81 community member and traditional wellness client emphasized the significance of mentorship, collaboration, and leadership programs for younger individuals, providing guidance and pathways for connecting with their culture. Additionally, the participant suggests a flexible approach to exploring various age-appropriate traditional wellness practices, affirming that there is no singular right way to engage with tradition, but rather a personal journey of giving one’s best effort and being present for the experience. Overall, these participants collectively convey the importance of creating safe, empowering, and inclusive spaces that integrate traditional practices, peer mentorship, and collaborative engagement to support the well-being and growth of individuals across different age groups within the community. (Participant 110, Health and Wellness Sharing Circle, Wellness Coordinator/Community Member) “…were so crazy busy, there’s not the time that we just really can’t participate in a lot of stuff we tried. So I think making sure that all staff can be a part of these [traditional] activities when they’re offered and get us all involved together. It would be nice to learn A little bit from everybody and understand what everyone else’s traditions and cultures come from. I think that would help with turnover too, since then we can do some team building, that can build back up that trust and hopefully keep people doing this good work because they feel they get time to learn and connect.” (Participant 101, Youth Sharing Circle, Youth/Community Member/Traditional Wellness Client) “…like when I was a kid, I had a hard time putting myself out there in the sense that, like, I didn’t really want to go to, like, join things unless I had like a buddy or I had like an older person or like an older mentor that could, like, show me the pathway. So I think like programs that encourage collaboration and making friends and mentoring and leadership. And you know, all those themes is gonna be good. That would be like a huge thing for younger people to kind of connect more [with culture].” 82 4.3.2 Enhancing Access for Ease of Traditional Wellness Participation in Various Areas The participants in the discussion on traditional wellness services advocate for facilitating easier access and integration of these services into the broader healthcare system, emphasizing the crucial need for improvements in cultural competence among medical professionals, revised funding policies, and more inclusive accessibility-focused measures. Participant 119, identified as Coralee Miller, a community member and knowledge keeper, stresses the importance of holding doctors and health institutions accountable for promoting the utilization of traditional wellness resources for patients. They highlight the necessity of cultural competency, urging for increased efforts to familiarize healthcare providers with traditional customs, history, and the ongoing relevance of traditional practices. In alignment with these sentiments, Participant 110, a wellness coordinator and community member, draws attention to funding challenges and the restrictive rules associated with it. They propose a long-term goal of inclusive funding that considers the entire family, acknowledging the limitations imposed on spouses and children who may be excluded from certain programs due to eligibility criteria like being Non-Status. Lastly, Participant 120, a youth, knowledge keeper, and traditional wellness client, envisions institutional changes with embedded cultural knowledge, suggesting the availability of cultural experts for support, especially during critical times such as in locally and culturally relevant mediations in the workplace or school. The participant calls for a transformation in policies to incorporate long-term changes that reflect a commitment to cultural inclusivity within healthcare institutions. Overall, these participants underscore the necessity of comprehensive and culturally sensitive shifts in the healthcare system, encompassing cultural competence, funding inclusivity, and policy reforms to better integrate traditional wellness services for the benefit of the community. 83 (Participant 119 - Coralee Miller, Community Member/Knowledge Keeper) “Doctors and the health institution should be held accountable. That if there are these resources [traditional wellness] for your patient to get them to use it. I think the thing that needs work is cultural competency. There needs to be more encouragement to get people to know your host nation better or just become even more familiar with the First Nation customs and history and what we’re dealing with right now because [our traditions] haven’t gone away. They’ve never went away.” 4.3.3 Effective Strategies for Passing on Traditional Knowledge and Revitalizing Traditional Wellness Practices Participants elaborated on facilitating the transmission of knowledge that reinforces the importance of respectful engagement with traditions. Participants stressed the connection with the land in conveying these practices. It was found that practicing non-judgment and providing generational engagement is crucial when imparting education of traditional wellness. Participant 119, Coralee Miller, highlights the importance of approaching new experiences, such as participating in a sweat or engaging in land-based healing, without judgment. They emphasize the need for gentle guidance and support, expressing a desire to explore sacred spaces and reacquaint herself with the land while acknowledging the learning process. Participant 120 emphasizes the significance of returning to traditional governance methods rooted in wellness and Indigenous ways of thinking, seeking consensus and the well-being of all community members. Participant 102 underscores the holistic benefits of the land for mental, physical, social, and spiritual well-being, advocating for a preventive approach rather than addressing issues after they arise. The participant suggests that engaging with the land can be a transformative educational and treatment method, particularly beneficial for individuals with different learning styles or perceived learning disabilities. Overall, the participants advocate for 84 support opportunities for children, youth adults and Elders valuing grassroots understanding and ensuring respect for all. The endeavor to revitalize traditions also involves the co-creation of Indigenized spaces to facilitate daily engagement with these practices at a micro-level, providing opportunities for land-based healing, enhancing access to language and stories, and promoting education that honors diverse levels of traditional knowledge. (Participant 107, Wellness Coordinator, Traditional Wellness Practitioner) “I think it would come down to teaching mostly. Traditional knowledge is passed down as like most of Indigenous culture is very verbal. So, I think it being carried down or kind of incorporated on a daily basis. Like, you know how rooms here have their name on [the doors] in the traditional language, incorporating it more on that level. It would be kind of like decolonizing our outdoor spaces and our indoor spaces. You know like having access to traditional plants and medicines around. That way, I think kind, of continues it on for our younger generation and most of the time, we’re taught to respect and learn from our Elders, so the Elders will have an older story or a teaching or traditional harvesting method for these medicines or something that they pass down and that’s how it kind of still lives? So I think incorporating that a lot more benefits that the culture will live on for our future generations…” (Participant 120, Interview, Youth/Knowledge Keeper/Traditional Wellness Client “It’s really important to go back to traditionally how we govern ourselves. How we used to govern people was through traditional Wellness and traditional ways of thinking and traditional practices, right, and how we make sure there’s consensus and everyone was ok. So yeah, getting back to those original practices would be beneficial.” 4.4 Gender Findings In the forthcoming section, an exploration of themes related to gender dynamics within traditional wellness practices unfolds, shedding light on the nuanced challenges and opportunities within this cultural context. While not the primary focus of the research question and objectives, this topic was an important conversation that emerged in the discussions and findings and warrants further exploration. One pivotal theme found revolves around the ongoing need for balance in gender roles, underscoring the persistent gaps that exist in achieving equity. 85 The discussion extends to the creation of safe spaces for gender roles, emphasizing the importance of fostering environments that acknowledge and respect gender identities. Furthermore, the section delves into the intrinsic connection between gender and traditional wellness practices, highlighting the role that gender plays in shaping these cultural frameworks. The narrative also brings attention to the significance of Two-Spirit peoples, recognizing their unique roles in certain aspects of healing within traditional communities. Additionally, traditional stories about the creation of men and women with medicinal elements are explored, offering insights into the cultural narratives that underpin gender roles. The section also addresses the concerning loss of knowledge surrounding gender roles, attributing it to the influence of imposing Western perspectives. Lastly, the discussion touches on how traditional gender roles can sometimes be discouraging, providing a nuanced examination of the challenges individuals may face within these frameworks. Together, these themes offer a comprehensive exploration of the intricate intersections between gender and traditional wellness practices, inviting reflection and dialogue on fostering inclusivity and understanding within these cultural contexts. 4.4.1 Addressing the Need for Gender Role Balance in Spaces Participants expressed concerns about the lack of recognition for gender inclusivity and identity within traditional practices, emphasizing the challenges faced by those who identify as Two-Spirit. Some participants criticized the binary nature of these practices, noting that the community should be more open to living in a nuanced “grey world” where individuals should be allowed to engage in practices that best suit them. There’s a cautionary note about the potential harm of internalizing rigid gender norms. On the other hand, Participant 115 advocated for a balanced approach, recognizing the importance of both universal practices that promote 86 gender inclusivity and individual safe spaces for self-expression. Recognizing that there are instances where individual spaces are necessary to foster comfort in expressing unique gender norms, it is crucial to ensure inclusivity by providing spaces for all genders. This inclusivity extends beyond the conventional binary of men and women, encompassing specially crafted spaces for Two-Spirit individuals. Traditionally, our people engaged in ceremonies that honored Two-Spirit individuals, and by creating spaces that align with these traditions, we uphold the cultural heritage of our community. Overall, participants emphasized the need for understanding between different gender roles within the community and suggested a balance between separation and unity to ensure that all individuals can find themselves in meaningful ways. \ Underscoring the necessity of recognizing and adapting traditional practices to accommodate the diversity of gender roles within Indigenous communities. (Participant 115, Youth Sharing Circle, Youth/Community Member) “I can definitely see that more some practices becoming more universal between all genders, and which is which is great to have that that diversity, but also being able to have each people, all peoples, be able to have their own safe space where they can express themselves and understand people that they are similar to them and around them.” 4.4.2 The Importance of Gender in Traditional Wellness Participant 119-Coralee Miller shed light on the significant role of Two-Spirit individuals within Indigenous cultures. Traditionally, those considered ƛ̓aʕkwilx or medicine people who are Two-Spirit often seen as blessings to the community. Coralee explained that the significance of Two-Spirit people within the community stems from having the powers and perspectives of both male and female energies. Beyond their role in healing, Two-Spirit individuals held political importance, particularly in negotiations, due to their ability to embody both masculine and feminine viewpoints. Miller emphasized the cultural honor bestowed upon Two-Spirit people, 87 contrasting it with the contemporary tendency to stigmatize gender identities. Additionally, the discussion extended to traditional stories about the creation of the stl’sqilwx where the Creator used medicines such as mud, sage, juniper, and cedar, highlighting the interconnectedness between individuals, the land, and gender roles. Women, closely tied to the land, particularly water, play a vital role in ceremonies. Men were made with rocks and hard objects to enforce their strength, thus reinforcing the belief in the balanced contributions of both genders and the significance of Two-Spirit individuals in maintaining this equilibrium. The insights provided by Coralee Miller regarding the role of Two-Spirit individuals, traditional stories about gender creation, and the intertwining of gender roles with nature and ceremonies contribute significantly to our comprehension of the profound importance assigned to specific gender roles in traditional wellness and cultural safety. By recognizing and preserving these roles becomes vital not only for cultural authenticity but also for promoting overall wellness and cultural safety within Indigenous communities. (Participant 119 - Coralee Miller, Community Member/Knowledge Keeper) “So as women, we're tied very closely to the land, especially the water and. And that ties in with our menstrual cycles, us and the tides are all connected with the moon and the cycles that. It goes through. So water ceremonies are often done by the women because we are believed to have that closer connection to water. There are some medicines that are only picked by women. Whereas there's some medicines that are only picked by men, but, but then again, if you're two-spirit, you're believed to have both of those parts of you.” 4.4.3 The loss of Traditional Roles due to Imposing Western Perspectives The participants explained the profound impact of colonization and the imposition of Western perspectives on traditional gender roles within Indigenous communities. In particular, participants highlighted the detrimental consequences of residential schooling and the way traditions lost traction within families and communities due to fear and stigmatization. 88 Participants also acknowledged the role of colonization, noting how the shift to a Chief and Council system resulted in the marginalization of women, describing how women transitioned from being leaders to limiting roles, emphasizing the pervasive influence of patriarchy perpetuated by Western ideologies. Participants noted the lack of acknowledgment and serious consideration given to women historically and in contemporary settings. Furthermore, the participants discussed the patriarchal influence on current Elders and knowledge keepers who are responsible for passing on traditional practices, noting that these individuals may unknowingly be perpetuating colonial ideologies. In relation to this, a participant emphasized the expectations of a perfect relationship being limited to a man and a woman, thus excluding gender identities. The participants also touched upon the challenges of integrating traditional wellness into governance due to the dominance of Western and colonial legal structures, such as the Indian Act, hindering the inclusion of traditional aspects. The impact of colonial influences on the discourse surrounding sexuality and body parts was also highlighted, underlining the shift from the traditional acceptance of these topics to stigmatization. Collectively, these perspectives highlight the challenges and losses experienced by Indigenous communities in preserving their traditional gender roles and wellness practices in the face of Western imposition and colonization. (Participant 102, Interview, Community Member/Knowledge Keeper/Traditional Wellness Client) “I think it's also in the way in which the genders have been categorized as well. It's dangerous to be a gay male, but it's also very dangerous to be a gay female and we've had a couple instances of that in our own community. It's colonization. Colonization has really ruined our values. When we had to switch over to a chief and council system we became patriarchal. Our women were no longer leaders. So, then now l see with society and colonialism and you know they’re basically influenced, especially from religion and that type of stuff. You can't talk about sexuality, body parts and gender that's all considered taboo. Where it's like, no, it's not bad, it's just the way it is.” 89 4.4.4 Traditional Gender Roles Can Be Discouraging The participants expressed mixed feelings and challenges associated with traditional gender roles in the context of traditional wellness practices. One participant reflected on their upbringing, highlighting those explicit instructions regarding gender-specific roles were not given to them while growing up. Instead, they learned through experience and were informed about restrictions based on their gender and life stage. This approach instilled fear in them, making them hesitant to engage in certain activities due to the fear of breaking cultural rules. Another participant shared their perspective on gender roles in traditional ceremonies, noting the distinct activities assigned to men and women. They grappled with feelings of difficulty and discouragement, especially when comparing their responsibilities with those of their partner. The participant acknowledged that while certain tasks might seem easier for their partner, they recognized the existence of different roles and acknowledged the variation in difficulty levels. On the other hand, one participant suggested that, in a personal sense, gender roles might not play a significant role, especially in smaller, more intimate settings where individuals may feel comfortable breaking away from traditional expectations. This perspective emphasizes the individual and personal aspects of gender roles within the broader cultural context. In summary, the participants expressed a complex range of emotions and experiences related to traditional gender roles. From the instillation of fear based on gender-specific restrictions to grappling with discouragement in performing assigned roles, these reflections provide insight into the nuanced and sometimes challenging dynamics surrounding gender roles in traditional wellness practices. (Participant 101, Youth Sharing Circle, Youth/Community Member/Traditional Wellness Client) 90 “I think in like my upbringing, I was never like, I don't know if anyone was like shown like or told explicitly like oh women do this and men do this and you can't do this and those kinds of things. It was more like as I experienced things I would get told as I go like oh if you're a woman and you're at this point in your life, then you can't, you know, participate in certain activities. I think that instilled a little bit of like fear into me from like approaching those activities because I was scared to break the rules.” 4.5 Visual Representations of Thematic Analysis Through the deductive thematic analysis, in my perspective it appeared that several of the themes were applicable in connections with multiple or all the Four Food Chiefs. In accordance with feedback provided by one of my committee members, to best represent the findings in a way as to not repeat each theme, it was important to acknowledge that ‘within Indigenous worldviews, interconnectedness is foundational, and the act of categorizing or discriminating data may appear inconsistent with this perspective. However, given the abundance of data themes, many findings could be pertinent to most, if not all, of the attributes associated with the Food Chiefs. For enhanced clarity regarding the visual representation of the thematic analysis (see Figure 5) presented in the upcoming pages, specific themes were positioned within each Food Chief. Addressing the traits crucial to effective leadership, such as engagement in traditional wellness, and the potential deterrent effect of inconsistency in leadership and programming, the themes selected for Skəmxist-Black Bear capture a multigenerational expression for these qualities of good leadership as expressed in the findings. On the other hand, sp’iƛ̓əm-Bitter Root’s wellness initiatives were associated with the impact of local teachings, revitalizing traditional practices, and the integral role of current knowledge and access to land-based knowledge in people’s health and well-being. The relevance to land interconnectedness and 91 sustainability of practices led to the allocation of these themes to Bitter Root. Siyaʔ-Saskatoon Berry’s themes emphasized fostering collaborative environments within the community to facilitate growth in traditional practices, effective strategies for passing on traditional knowledge, and initiatives for revitalizing traditional practices. These themes were attributed based on conversations revolving around community initiatives, youth-oriented approaches, and ways that foster positive health and wellness. Ntitiyix-Spring Salmon’s themes centered on the challenges of navigating traditions in implementing traditional wellness outlets and enhancing access for easier participation in various areas. These themes were chosen for their relevance to the implementation aspect of traditional wellness, providing insights into what to consider when taking action, planning, developing programming, and integrating policies. Central themes that resonated across all Four Food Chiefs included the impact of stigma and historical trauma on engagement and the desire to participate in traditional wellness activities and initiatives. Additionally, the importance of diverse traditional outlets for wellness and the identification of various accessibility issues as barriers to engagement and access to traditional wellness were highlighted. These overarching themes encompassed a broad range of initiatives related to community, leadership, action, planning, land, and sustainability. The reflective insights shared around the outer portion of the diagram for each Food Chief were provided by two participants from the interviews and sharing circle reflection exercise. These reflections were thoughtfully attributed to best capture the essence of the discussed Food Chief, ensuring a comprehensive representation within each segment. 92 Figure 5 Four Food Chiefs Thematic Analysis © S. Werstuik (2024) 93 Chapter 5: Discussion The forthcoming chapter begins with a summary of the research outcomes and captures the fundamental discoveries, and insights garnered through the investigative process. Following this, the chapter delves into a detailed discussion of the principle findings, aiming to illuminate the nuanced aspects and implications that emerge from the data. This critical examination not only explains the findings’ significance but also provides a deeper understanding of each finding’s contextual relevance to the literature. Moving beyond the immediate implications, the narrative then transitions into a thoughtful discussion on how these findings reverberate in practice, policy, and future research considerations. This section aims to bridge the gap between theoretical insights and practical applications, offering a roadmap for stakeholders in diverse fields to integrate these findings into actionable strategies, informed policies, and avenues for further inquiry. The intention is to encourage an understanding of the study’s real-world impact and encourage meaningful applications in various domains. Concluding this chapter, a reflective analysis is dedicated to unfolding the inherent strengths and limitations of the study. This evaluation acknowledges the robust aspects that fortify the research and thesis and transparently addresses any constraints or potential biases that may influence the interpretation of results. This chapter overall looks to present a balanced and nuanced perspective on the study, laying the groundwork for informed discussions and future advancements in the field. 5.1 Summary of Findings The study, centered on the utilizing the Enowkinwixw methodology as an analogy which worked to gain insights from participant sharing circles and interviews, revealing nuanced 94 themes that were further integrated into The Four Food Chiefs thematic analysis framework. Skəmxist-Black Bear highlighted the pivotal role of effective leadership in traditional wellness, contrasting with the deterrent of inconsistent leadership. sp’iƛ̓əm-Bitter Root emphasized the impact of local teachings on wellness initiatives and the importance of revitalizing traditional practices. Siyaʔ-Saskatoon Berry underscored collaborative community environments and effective knowledge transmission. Ntitiyix-Spring Salmon identified challenges in navigating traditions, emphasizing the need for thoughtful planning. Common threads across all Food Chiefs included the importance of diverse traditional outlets, addressing accessibility barriers, and recognizing the impact of stigma and historical trauma on engagement. These collective themes provide guidance for tailored strategies for each Chief, contributing to a holistic understanding of fostering traditional wellness access in various settings. 5.2 Principle Findings The utilization of the Enowkinwixw theoretical framework, supported by the Four Food Chiefs Captikʷɬ (oral history) of ‘How Food Was Given,’ serves as a crucial foundation for exploring topics like traditional wellness integration, Indigenization, and cultural safety. A pertinent example reinforcing the significance of such an approach is found in the article Traditional Anishinaabe Healing in a Clinical Setting: The Development of an Aboriginal Interdisciplinary Approach to Community-based Aboriginal Mental Health Care by Marion et al. (2010) (refer to Chapter 2). This article, with a decade of experience, showcases the development of traditional healing services grounded in a culturally relevant and local Anishinaabe model of holistic health (Marion et al., 2010). Engaging in this culturally relevant and local Indigenous community’s approach proves particularly advantageous for the Westbank First Nation community. The community already 95 integrates the Enowkinwixw framework and the principles of the Four Food Chiefs into its self-governance structure (Westbank First Nation, 2023). This existing integration exemplifies the practicality and cultural resonance of the approach. In contrast, adopting alternative research methodologies such as Community-Based Research (Caine & Mill, 2016) or Participatory Action Research (Jackson and Masching, 2014), which often include westernized elements, that risks perpetuating colonial ideologies when engaging with Indigenous communities, as cautioned by Kovach (2021) and Archibald (2019). Research on Indigenous communities raises concerns about the potential for re-opening wounds when helicopter researcher’s drop-in and drop-out without adequate capacity-building plans in place (Caine and Mill, 2016). This can leave communities with research materials pertaining to their practices and knowledge systems, but in intricate and inaccessible formats, not user-friendly to these communities. Not only this but in many cases have also left communities with appropriated knowledge as described by Blackstock’s Breadth of Life Theory (2009) (see Chapter 2), and as echoed by participants personal accounts shared in this study (see Chapter 4). This perpetuates damaging colonial ideologies in research that involve researching on Indigenous communities about Indigenous communities; rather than with Indigenous communities and for Indigenous communities (Archibald, 2019; Kovach, 2021). The pivotal message underscored here is that meaningful change and action are most effectively facilitated when the work is driven by the community itself, guided by a familiar and culturally rooted framework like Enowkinwixw. This approach and consideration when engaging with Indigenous populations ensures respect for the community’s knowledge and practices, fostering collaboration, sustainability, and the avoidance of harmful colonial legacies in research. 96 This research study identifies a notable change in the approach to research involving Indigenous communities. Traditionally, Westernized science took the lead in understanding and addressing issues relevant to Indigenous communities, often imposing its methods and perspectives (Ijaz and Boon, 2018). The research study in its entirety from methodology, methods and application of the results represents a significant shift. This research and study actively incorporate Indigenous ways of knowing and being throughout the academic research process. It showcases that Indigenous individuals are at the forefront, leading the research and utilizing their own local methods of knowledge gathering. This reversal is considered crucial because it allows for a more authentic exploration of topics that were previously approached from a Western standpoint. By prioritizing Indigenous perspectives and methodologies, the research aims to achieve a more meaningful and culturally resonant understanding of the issues under consideration. The ultimate goal is to generate more effective and sustainable solutions that align with each autonomous Indigenous community values and practices. As emphasized in Eve Tuck’s Suspending Damage: A letter to Communities (2009), there is a need to move away from damage-based research and towards positive-based practices that focus on the voices of Indigenous peoples (Tuck, 2009). As taking this approach when engaging with research recognizes the impacts of colonialism and the need to center Indigenous knowledge and experiences in research by collaborating with Indigenous communities to gain localized perspectives on health (Tuck, 2009). The findings also align with current research emphasizing the significance and impact of integrating traditional wellness practices. This affirmation supports the idea that incorporating traditional wellness can establish supportive and safe environments, ultimately contributing to improved health outcomes, as outlined by Katz et al. (2018). Participants underscored the 97 importance of increased access to traditional wellness as a preventive measure (see Chapter 4). They expressed that the currently available resources contribute positively to their well-being and expressed a hope that these outlets will not only continue but also expand to serve a broader audience. The research study and thesis provide significant contributions of how to engage in an equitable and socially just approach to involve Indigenous communities on the subject matter of Traditional Wellness Integration, Indigenization and Cultural Safety. It highlights the autonomy that each Indigenous community holds in their distinct ways of knowing and being. By prioritizing Indigenous perspectives and methodologies, this study achieved a more meaningful and culturally resonant understanding to advance initiatives outlined in relevant literature and Indigenous impacted commissions and declarations, such as the Truth and Reconciliation Commission: Call to Action #22 and the United Nations Declaration on the Rights of Indigenous Peoples Article #24 and address the health gaps identified in the In Plain Sight Data Report (2021) (refer to Chapters 1 and 2) around cultural understanding, a concerted effort is required at the micro level. This approach is essential for sustaining momentum in addressing systemic issues while avoiding the over-representation or imposition of pan-Indigenous practices that may diminish the significance of individual communities’ beliefs and value systems, which they seek to revitalize. 5.3 Implications for Wellness, Policy, and Future Research Considerations The research findings hold significant potential applications, including the formulation of traditional wellness integration policies with Westbank First Nation or guiding principles for the integration of traditional wellness. These findings and the research project itself can illuminate the attributes and ethical considerations desired by the community when traditional wellness 98 strategies are working to be implemented. Additionally, this research study and thesis can contribute to the establishment of guiding principles for Indigenization from a community perspective, emphasizing the maintenance of cultural safety and the implementation of community-identified cultural safety efforts. Moreover, this research study and thesis can provide a framework of how to engage and establish meaningful research relationships with Indigenous communities. These potential policy documents, guiding principles, potential research framework and qualitative actions can benefit from an autonomic approach to enacting traditional wellness, grounded in local perspectives and traditional ways of knowing and engagement. This approach is exemplified and further discussed in Chapter 2, specifically within the section on ‘Defining Cultural Safety’. For instance, the Enowkinwixw Framework, guided by elements from the local creation story of the Four Food Chiefs, offers an authentic and culturally sensitive research study. This contrasts with implementing pan-Indigenous approaches, which encompass diverse Indigenous peoples but may not universally apply due to variations in practices, acceptance, or acknowledgment among different nations (Marion et al., 2010). Practices such as the Medicine Wheel or Smudging may not be universally accepted, given the diversity among Indigenous nations. 5.3.1 Implications for Wellness The essence of health and wellness is intricately intertwined with the Four Food Chiefs and their attributes, serving as a foundational guide for Indigenized and culturally safe perspectives in health and wellness initiatives. The specific focus on Skəmxist-Black Bear illuminate’s insights around leadership, while sp’iƛ̓əm-Bitter Root highlights aspects related to land, sustainability, and interconnectedness. Siyaʔ-Saskatoon Berry contributes insights related 99 to community, family, youth, and innovation, and Ntitiyix-Spring Salmon brings implications for action, planning, and development. Attributes such as sustainability, action, planning, and development necessitate comprehensive training, vetting processes, and programs prioritizing consistency. Regarding attributes encompassing good leadership, participants underscored the importance of qualities like active listening, creating safe spaces, respecting diverse learning styles, and practicing non-judgment. These qualities should be exhibited by health and wellness providers, traditional wellness practitioners, and program facilitators who facilitate access and enrollment in traditional wellness services. With further regard to leadership roles, including healthcare providers and community leaders in firsthand experiences with traditional wellness outlets fosters a deeper cultural competency. Allowing these leaders to witness and personally engage in traditional practices enhances their understanding of the profound significance of traditional wellness in overall health and well-being. To nurture community, family, and youth well-being, the recommendation is to develop community-based programs enhancing access to traditional wellness outlets. This involves fostering connections, encouraging collaboration, and revitalizing traditional practices. In action, planning, and development, it is crucial to ensure continuous implementation of existing access to traditional wellness outlets in institutional settings or workplaces, expanding these initiatives, and understanding how to connect individuals not only within but also outside these contexts. Incorporating attributes like land, sustainability, interconnection, and community and youth involves land-based traditional programming with activities such as hunting, gathering, and preparing traditional medicines. Engaging the 100 community in these practices fosters communal learning and establishes a network of support extending beyond familial and program settings. These measures align with cultural traditions, offering preventative programming rooted in community wisdom rather than Western-centric approaches. Key considerations include recognizing the time commitment required, tailoring programs to specific time commitments, implementing age-specific programming, fostering peer mentorship opportunities, and ensuring consistency to maintain ongoing community involvement and support. Embracing the attributes of the Four Food Chiefs to inform wellness programming for health and wellness services is crucial for promoting holistic health and wellness that allows Indigenous peoples to maintain their own health outcomes and practices as relating to the United Nations Declaration on the Rights of Indigenous Peoples: Article 24. This establishes a foundation that respects cultural traditions, and aligning with preventative measures embedded in traditional wisdom. 5.3.2 Implications for Policy The collaborative integration of Ntitiyix-Spring Salmon action, planning, and development with Skəmxist-Black Bear leadership and governance reveals common threads that necessitate a comprehensive approach to implication for policy (refer to Figure 5). One critical aspect involves cultivating cultural competency training led by local Indigenous communities that can guide and provide more refined localized policies among healthcare providers. By doing such bridges cultural understanding gaps understanding how historical misconduct and colonial implications have contributed to a stigma around traditional wellness practices and those who look to engage with traditional wellness practices. To address 101 this, a commitment to policy implementation for cultural competency training is paramount. This training should be mandatory for both incoming and senior healthcare providers, emphasizing regular engagement and revisions to stay attuned to evolving cultural dynamics in collaboration with the local Indigenous community. This initiative can help contribute to the adherence to the Truth and Reconciliation Commission: Call to Action #22. Leadership and governance strategies further underscore the importance of incorporating traditional wellness into policies. Establishing a local traditional wellness advisory committee can ensure the vetting of incoming practitioners and outlets, preventing the imposition of pan-Indigenous practices in general health and wellness services. In terms of action planning and development, revising restrictive funding policies is essential for inclusivity. Acknowledging the diverse Indigenous identities, funding policies should be revised to include both Status and Non-status individuals. This shift ensures that Non-status individuals who identify as Indigenous have equal access to health outlets, aligning eligibility criteria with that of their Status family members. Additionally, proactive measures involve maintaining and expanding access to existing traditional wellness outlets within institutional and workplace settings. Recognizing the broader community context, efforts should extend beyond these settings to connect individuals with traditional wellness outlets in external environments, promoting overall health and well-being for Indigenous peoples. 5.3.3 Future Research Considerations In the subsequent section, I delve into prospective research considerations that this study aimed to explore in more depth. However, due to inherent limitations, comprehensive 102 exploration was hindered. Considering these future implications can enhance the comprehensiveness of research studies, resulting in findings that more seamlessly bolster traditional wellness approaches. It is crucial to acknowledge that the existing literature on locally driven Indigenous practices and traditional wellness may lack comprehensiveness, potentially overlooking critical aspects. Moreover, to strengthen and solidify meaningful relationships with Indigenous peoples concerning topics like traditional wellness integration, Indigenization, and cultural safety, a thorough examination of certain elements is necessary. These considerations include gender perspectives, the engagement of Elders, mindful language use, and a deeper exploration of urban Indigenous voices in accessing cultural outlets or traditional wellness. 5.3.4 Gender Specific Gender based findings were found in relation to traditional wellness access however, due to the framework and thematic analysis it was difficult to display these findings. There can be future considerations in further exploration into gender-based relationality rather than analysis (Sanchez-Pimienta et al., 2021). Gender-based relationality is an inclusive understanding of traditional wellness can be better addressed, as relationality is guided and defined not only through analyzing gender binaries, but also through gender-diversity. According to Sanchez-Pimienta et al. (2021), gender-based relationality offers a more nuanced understanding of traditional wellness by emphasizing the importance of relationships and interconnectivity. In contrast, analysis tends to prioritize categorization and classification. Gender-based relationality recognizes that gender is not just an individual identity but also a social and cultural construct that is shaped by relationships and interactions within a community. This approach thus provides a more holistic understanding of wellness that is grounded in the lived experiences of Indigenous peoples. 103 By practicing gender-affirming language and creating inclusive spaces that honor gender-affirming experiences, it is possible to foster environments that are respectful and welcoming to all individuals (Flicker et al., 2014). By ensuring that these gender-affirming practices are applied equally to all individuals, including those who may be marginalized due to factors such as their status under the Indian Act, we can work towards creating truly inclusive environments that prioritize the well-being of all people. 5.3.5 Elders A notable limitation of this study was the inability to engage with the Elders of the community due to time constraints. Elders play a pivotal role in the preservation and transmission of generational and traditional knowledge, which is essential for a comprehensive understanding of traditional wellness initiatives. The time limitations imposed on the study restricted the ability to involve Elders in the research process, representing a gap in capturing their unique perspectives, insights, lived experiences and cultural wisdom. 5.3.6 Language It would be beneficial to explore local language and stories in greater detail about the origins of words and the syntax of the words that represent health or aspects of health. Doing such would further enhance generational knowledge sharing as mentioned by participants in the sharing circle around decolonizing spaces and Indigenizing through the use of language. Through the process of colonization, Indigenous communities were compelled to relinquish their native languages. As a result, a significant portion of Indigenous individuals in Canada now primarily speak English. Despite this shared language, the overarching impact has not encouraged an enhanced cultural understanding. Instead, the deliberate effort towards linguistic 104 assimilation has resulted in the decline of flourishing Indigenous languages and has jeopardized a comprehensive grasp of Indigenous beliefs and traditions. As Kovach demonstrates: “A common colonial language is not the panacea of a mutual understanding between Indigenous and non-Indigenous peoples. Instead, understanding is a layered endeavour. Given the limitations of language alone and the complexities instilled within the word understand, at what point can we say that we do indeed understand something? Is it possible to have understanding across cultures? Yet, for compassionate world to prevail, seek to understand we must.” (Kovach, 2021, p.44). It would also be notable to engage participants in determining how they would like to be referred to within the research. Is the term participant appropriate when engaging with Indigenous communities in research? How can the language in research be further Indigenized to reflect the people within it? 5.3.7 Urban Indigenous Voices A more comprehensive exploration of urban Indigenous populations is necessary to fully grasp the implications associated with reconciliation efforts (Tuck, 2009; Caine and Mill, 2016; Johnson, 2021). This examination extends to evaluating the awareness and accessibility of traditional wellness practices or cultural outlets and their role in supporting the health and wellness of urban Indigenous populations (Tuck, 2009; Johnson, 2021). Further examination focused on urban Indigenous populations could illuminate the distinctive challenges and opportunities faced by urban Indigenous communities in accessing and benefiting from traditional practices, emphasizing the need for targeted interventions that account for the specific nuances of urban living (Tuck, 2009; Marsh, 2018). Such insights are pivotal for shaping not 105 only wellness practices but also for informing policies that address the unique needs of urban Indigenous populations in the broader context of reconciliation efforts (Johnson, 2021; Marsh, 2018). Additionally, this inquiry contributes to the foundation for future research endeavors aimed at promoting the well-being of urban Indigenous communities through culturally sensitive and inclusive health and wellness services. 5.4 Strengths and Limitations In the upcoming sections, the aspects that have shaped the course of this study will be examined in a reciprocal way, shedding light on both its strengths and limitations. Initiating with a discussion on the ‘Personal Interpretation of the Findings,’ the exploration will focus on how the subjective lens through which the findings were interpreted adds depth to the analysis while acknowledging the potential for bias. ‘Time Constraints and Limiting Perspectives’ will follow, delving into the challenges posed by temporal constraints and their impact on the comprehensiveness of the study. Subsequently, attention will be directed towards the ‘Significance of the Methodology,’ elucidating how the chosen research approach influenced the depth and reliability of the insights gained. Finally, focus will shift to ‘Establishing Partnerships,’ uncovering the collaborative efforts that enhanced the study’s richness while acknowledging the complexities of forging such partnerships. Together, these sections aim to provide a comprehensive understanding of balancing the research study’s strengths and limitations. 5.4.1 Interpretation of the Results As the researcher, I acknowledge the inherent limitations of personal interpretation in discerning the desires of the WFN community based on the thematic findings. This research is inherently collaborative, and it is crucial to recognize that I, as the researcher, do not possess the 106 authority to unilaterally impose my own justifications regarding the specific outcomes that should result from this work. Deciding what the community truly needs is a collective effort, and ongoing collaboration is essential to delve deeper and determine specific actions that can effectively address the identified needs. The limitation lies in the imposition of my personal perception on the findings; however, the strength emerges from ongoing collaborative efforts with the community. This collaborative approach ensures that the findings accurately reflect the community’s calls. 5.4.2 Demographic Sample and Time Limitations in perspectives arose from the scope being confined to a single Syilx (Okanagan) community with a sample size n=20. Originally, the intention was to engage with the Okanagan Nation Alliance, aiming for a comprehensive exploration across the Okanagan Nation. This approach sought to involve various traditional wellness practitioners and knowledge keepers, as well as gain a more profound understanding of the health-related aspects by collaborating with the Aboriginal Advocates for Interior Health. However, ethical considerations and time constraints such as meeting the University program requirements, necessitated a narrowing of focus and further refinement of the methodology and data collection informed by the WFN health and wellness department that also dubbed as a strength. 5.4.3 Methodology The familiarity with the theoretical methods employed in this study played a pivotal role in creating a conducive environment for participant engagement. By utilizing these well-established theoretical frameworks, such as the Enowkinwixw Framework and the principles of the Four Food Chiefs, participants felt a sense of comfort and familiarity. This, in turn, facilitated their active participation in the study. The semi-structured knowledge sharing interviews and 107 equitable group discussions provided a flexible platform for participants to express their opinions, encouraging a dynamic exchange of ideas. Another significant strength of this study lies in its positive-based outlook as referred to by (Tuck, 2009), underpinned by the two key research objectives focusing on positive outcomes. By adopting a positive based perspective and moving away from damaged driven outlooks the research aimed to identify and highlight the positive aspects, strengths, and successes within the context of traditional wellness. This approach not only contributed to a more affirmative and empowering narrative but also allowed for a comprehensive exploration of the factors that contribute to successful traditional wellness initiatives. Additionally, the semi-structured knowledge sharing interviews served as a valuable method for gathering in-depth insights from participants. This approach allowed for flexibility in the exploration of individual experiences, ensuring that the richness of participants’ perspectives was captured. The equitable group discussions further enhanced the study’s robustness by promoting a collaborative environment where diverse voices could be heard and shared. Overall, the combination of theoretical familiarity, a positive approach, and the utilization of effective qualitative methods contributed to the success of this study in capturing the nuanced and positive aspects of traditional wellness within the researched community. 5.4.4 Establishing Partnerships As a member of the Westbank First Nation, my affiliation with the community played a crucial role in establishing a sense of comfort and trust among the participants. Being a community member engaged in this work signaled to participants that the research was conducted by someone intimately connected to the community and working for its benefit. This sense of shared identity fostered a more open and genuine engagement with the research process. 108 This connection also proved advantageous in terms of participant recruitment and expediting the research collection process. Having a deep understanding and familiarity with the Westbank First Nation community and its organizational structure enabled me to efficiently identify key contacts and streamline the engagement process. This familiarity not only facilitated quicker access to potential participants but also eliminated the need to build relationships from scratch, ultimately saving a significant amount of time compared to the possible limiting factors of being an outsider trying to establish connections within the community. 5.5 Knowledge-Sharing Plan The research knowledge-sharing plan would include collaboration with participants in understanding the best mode of disseminating the research material. In this regard, and in keeping with the overall lenses and approaches used in this study, I will be adhering to an integrated knowledge translation approach (Nguyen et al., 2020). An integrated knowledge translation approach ensures that knowledge users are embedded in the research process, from conceptualization through to dissemination (Nguyen et al., 2020). This is and will be done through engaging participants via email, engaging the WFN health and wellness department, in the final dissemination of the results. WFN health and wellness co-created interview and sharing circle questions and supported recruitment and has given direction on how they will store and receive the findings through providing their records policy. For dissemination, given that this study is driven by Indigenous methodologies, specifically through the Enowkinwixw theoretical framework where group consensus is crucial an integrated knowledge translation approach inherently fits with this research study’s methodology and will drive knowledge sharing. For example, the participants and knowledge users (WFN) may recommend that this research is 109 shared through a community gathering, a recommended Indigenous Health conference, or in a sharing circle/ceremony format with the participants involved. In this way, traditional and non-traditional forms of knowledge sharing will be utilized as deemed appropriate, and various formats may be utilized for different groups (e.g., story-telling with Elders; pamphlet, or website for Traditional Wellness coordinators). This practice resonates with Indigenous methodologies, reflecting the importance of sustained collaboration and engagement with the community, as advocated by Archibald (2019) and Kovach (2021). The commitment to continued interaction underscores the cultural sensitivity and ethical considerations embedded in Indigenous research methodologies. The dissemination of results could utilize various channels, including presentations, publications, media releases, and community events, as deemed appropriate by the participants involved. This will be done through contacting study participants for a follow-up presentation of this thesis and the results and collaborating what can be done with the findings. I will present options for publication, conferences to attend and configure from participants what they feel is most applicable. Additionally, this research has the potential to generate valuable resources such as a Traditional Wellness program outline, guiding principles document, and safeguarding materials for health and wellness services. These resources can be utilized by outside communities and health ministries to implement or improve their own traditional wellness systems. The knowledge-sharing process will remain open-ended and flexible, allowing for further discussion and adaptation to best serve the interests of the community. 5.6 Conclusion In conclusion, this Master’s thesis has contributed valuable insights into traditional wellness within Indigenous communities, focusing on the Indigenous methodology, Enowkinwixw framework. The study employed sharing circles and interviews, revealing 110 nuanced themes. The findings emphasized the pivotal role of effective leadership, the impact of local teachings, the importance of collaborative community environments, and the challenges in navigating traditions. Common threads, such as diverse traditional outlets, addressing accessibility barriers, and recognizing the impact of stigma and historical trauma, were identified across all Food Chiefs. These collective findings underscore the need for tailored strategies for each Chief, contributing to a holistic understanding of fostering traditional wellness access in various settings. The research represents a significant shift in the approach to studying Indigenous communities, actively incorporating Indigenous ways of knowing and being throughout the academic research process. The study aimed to achieve a more authentic exploration of traditional wellness issues by prioritizing Indigenous perspectives and methodologies. The ultimate goal is to generate effective and sustainable solutions aligned with each autonomous Indigenous community’s values and practices. The research also highlights the importance of engaging in an equitable and socially just approach to involve Indigenous communities in topics related to Traditional Wellness Integration, Indigenization, and Cultural Safety. The Enowkinwix theoretical framework, supported by the Four Food Chiefs, serves as a crucial foundation for this research, ensuring a culturally resonant approach. The study emphasizes the autonomy of each Indigenous community in their distinct ways of knowing and being, aligning with relevant literature and Indigenous impacted commissions and declarations, such as the Truth and Reconciliation Commission’s Call to Action #22 and the United Nations Declaration on the Rights of Indigenous Peoples Article #24. 111 Integral to this research is the implementation of qualitative action within the context of qualitative research, emphasizing active and participatory methods. This approach, guided by the Enowkinwix framework, strengthens research impact, establishes a foundation for ongoing community engagement, and promotes sustainable initiatives. The summary of findings within the Four Food Chiefs framework provides a nuanced understanding of thematic elements, offering insights into the interconnectedness and implications for fostering traditional wellness. The guidance and influence of the Enowkinwixw theoretical framework ensured a culturally sensitive and inclusive approach, avoiding the imposition of pan-Indigenous practices. The research findings hold significant potential applications in formulating policies or guiding principles for the integration of traditional wellness. The autonomic approach, grounded in local perspectives and traditional ways of knowing, contrasts with pan-Indigenous approaches, emphasizing the need for tailored strategies. The implications for wellness, policy, and future research highlight the need for ongoing collaboration, respecting Indigenous communities’ knowledge and practices. Future considerations include a deeper engagement with Elders, exploring local language and stories, and a more comprehensive exploration of urban Indigenous voices. The study acknowledges its strengths, such as personal interpretation, the significance of the chosen methodology, and the establishment of partnerships, while recognizing limitations like time constraints and a narrowed focus on a single community. In sum, this Masters thesis contributes to the ongoing dialogue on Indigenous wellness by prioritizing Indigenous perspectives, fostering collaboration, and promoting sustainable initiatives that have been created by for and with and Indigenous community tailored to their 112 specific ways of knowing. The research underscores the importance of respecting the autonomy of Indigenous communities and employing culturally sensitive and inclusive approaches to address health gaps and promote holistic well-being. 5.7 Final Statement As a syilx (Okanagan) woman, a daughter, a sister, a granddaughter, a friend, a community member, and Indigenous scholar, I recognize the significance of my multiple positionalities and their interconnectedness. My positionality in relation to my research is embedded in my community and cultural values, which are shaped by my experiences, beliefs, and identity. As an Indigenous scholar my intended research looks to identify best practices when integrating traditional wellness practitioners into health and wellness services is timely, appropriate and ongoing. Calls for systemic change in health and wellness systems and beyond are needed now more than ever. As an Indigenous scholar, I recognize the importance of integrating Indigenous knowledge praxis in academic research and aim to facilitate decolonial changes among health and wellness systems. This in turn, will aid in healing processes that are reciprocal, respectful and establish trust among Indigenous communities in relation to health and wellness services. Furthermore, my positionality allows me to advocate for the incorporation of traditional wellness practitioners and Indigenous-led health and wellness services in the mainstream healthcare system from a validated Indigenous perspective. As a member of the community, I recognize the significance of reciprocal relationships and community engaged Indigenized practices. My positionality as a daughter, sister, and granddaughter also highlights the importance of intergenerational knowledge transfer and the preservation of traditional practices and values. 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Thesis/Dissertation
eng
Interdisciplinary Studies
Vancouver : University of British Columbia Library
Attribution-NonCommercial-NoDerivatives 4.0 International
Graduate
Struik, Laura
Huyser, Kimberly Rose
Traditional wellness integration, cultural safety and indigenization strategies for health and wellness services
Text