UBC Theses and Dissertations
Early intervention with Indigenous families and children in British Columbia : a critical inquiry Gerlach, Alison Jayne
Improving the health of Indigenous children and fostering health equity requires a radical shift beyond prevailing health care approaches. Early child development (ECD) and intervention programs are increasingly recognized for their potential in promoting children’s health and well-being, and appear to be ideally positioned to play a vital role in fostering child health equity. Currently, there is a lack of research on early intervention (EI) programs in the context of Indigenous families and children in Canada. The purpose of this qualitative study was to generate knowledge on how an urban-based EI home-visiting program for Indigenous families and children in BC, known as the Aboriginal Infant Development Program (AIDP), influences families and children’s health and well-being, and is responsive to health and social inequities affecting families and children experiencing social disadvantages. This inquiry was informed by critical theoretical perspectives and undertaken in collaboration with the AIDP. Ethnographic methods of data collection were used to obtain the perspectives of: Indigenous caregivers (n=10) and Elders involved in AIDPs (n=4), AIDP workers (n=18), and administrative leaders of organizations that hosted AIDPs (n=3). Findings demonstrate: (a) a relational perspective of ECD that emphasizes how family well-being and children’s health equity are inextricably connected, and shaped by intersecting structural inequities; (b) how AIDP workers influence family well-being and foster child health equity by: (i) contextually tailoring their programs for female-led single-parent families in urban contexts, and (ii) reframing the EI process so that it is responsive to women’s agency and self-identified priorities, which are frequently centered on accessing determinants of health and navigating the health care and child welfare systems; (c) how locating AIDPs in multi-service organizational hubs enhances a relational orientation to EI, and (d) how AIDP workers traverse a contested ECD landscape and an increasingly complex relationship with the child welfare system. This knowledge will be used to inform and enhance AIDP practices, policies, and education. These findings are applicable to a broad range of ECD and health care disciplines, including occupational therapists, and EI programs that serve Indigenous and non-Indigenous children who live with social disadvantages that stem from structural inequities.
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