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UBC Theses and Dissertations

All my relations : patient oriented research for reconciliation and empowerment of Indigenous women’s experiences with cervical screening Giovannoni, Marina


Cervical cancer is caused by high risk strains of the Human Papillomavirus (HPV), but is preventable through vaccination and screening. In British Columbia (BC), cervical cancer occurs predominantly in under screened women, and First Nations women have a 92% higher rate of invasive cervical cancer than non-First Nations women. The current standard of care in the province screening is via the Pap test; Indigenous women experience complex barriers to accessing Pap testing, which has contributed to the higher rates of cervical cancer. CervixCheck North (CCN) is a project in partnership with Carrier Sekani Family Services (CSFS) that offers under screened First Nations women in 11 Northern BC First Nations communities the option to self-collect a sample to be tested for the presence of cancer-causing HPV. This thesis explores the ability of patient oriented research, in combination with Indigenous methodologies to conduct ethical research in First Nations communities, and offers a qualitative review and suggested improvements to CCN. Data was collected from 6 communities using focus groups and a survey, and analyzed using thematic analysis and network analysis. Eleven themes were selected from the transcript data at four levels of impacts to cervical screening, individual, community, health system, and research level, and vetted by community members in an iterative process. Theme convergence was found to occur at the community level, surrounding knowledge acquisition as a source of empowerment. In order to maximize the positive impacts of HPV self-collected projects, holistic health approaches must be taken that involve health education community events. Recruitment of the most vulnerable women is facilitated by offering various options for women to screen, and by hiring champions for the project who are trusted members of the community. For researchers, using both patient oriented methodologies and Indigenous methodologies functions to bridge the divide between Western and Indigenous ways of knowing within academia. At a policy level, the most impactful changes to the health care system that can function to improve Indigenous peoples’ health must be informed by Indigenous voice, and meaningfully incorporated into existing health structures to truly achieve self-determination and reconciliation.

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