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UBC Theses and Dissertations

Exploring strategies for fostering optimal sexual health with Aboriginal girls living in rural Canadian commmunities : perspectives from a rapid evidence assessment Birtwistle, Catherine


This Rapid Evidence Assessment (REA) investigated strategies for fostering positive sexual health promotion among Aboriginal girls living in rural Canadian communities. Twenty four research papers oriented to informing and examining sexual and reproductive health of Aboriginal girls' were analysed using established criteria. After comprehensive categorizing, coding and appraisal, seven themes were identified, which outline domains for sexual health promotion with Aboriginal youth. Collectively these themes reflect the complex, intersecting forces shaping reproductive health among Aboriginal youth. Doane and Varcoe’s (2005) approach to relational inquiry, and the concept of cultural safety, provided the theoretical lenses through which to explore and synthesize the literature. The REA analysis resulted in the identification of the following themes: 1) Positive youth development (PYD) which includes peer and mentoring interventions; 2) Health-promotion that reflects diverse approaches to Aboriginal culturally-specific curriculum; 3) Relationship patterns and contextual understanding of risk behaviours; 4) Historic, contextual and structural factors; 5) Protective factors and connectedness; 6) Health practitioner responsibility; and 7) Effective youth skill building. The literature reviewed for this REA demonstrates how Aboriginal youth require effective reproductive health services and interventions grounded in an integrated understanding of specialized sexual health practices, local cultural knowledge, and a meaningful exchange of cultural knowledge. Public health nurses are responsible for providing culturally competent care that moves beyond sensitivity that and is informed by local cultural safety knowledge when planning and implementing care. From this analysis, and drawing on my experiences in practice, I argue that sexual health decisions are strengthened most significantly by the knowledge, self-esteem and confidence gained from authentic positive relationships between girls and the nurses who support them. A relational practice approach of genuinely connecting and responding to Aboriginal girls needs is significant for nurses to support in ways that ultimately affect better decision-making. Given the findings of this analysis, further research that is grounded in local Aboriginal contextual knowledge will provide insights that can support sexual health promotion.

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