My Quality Improvement portfolio features a very strong and very community-oriented Health Equity Research Program. This body of work features my research into Shared-decision making with a special focus in Indigenous contexts, traditional medicine integration into existing health systems, and the development of culturally-responsive and culturally-safe supports for Indigenous cancer patients.
It is my aim with my Health Equity Research to help the College of Medicine reach its social accountability mandate to: “work with partners in government, academia, health services and community to meet the priority health needs of the province. This means, in particular, identifying areas of unmet need and working toward addressing those gaps”. By developing strong community and system partner connections with representatives from the Saskatchewan Health Authority, FSIN, the Métis Nation Saskatchewan and the Prince Albert Grand Council, together with Indigenous patients, we have been able to engage in truly meaningful and impactful research designed to enhance and improve health outcomes for the province’s Indigenous populations. My Indigenous Navigator Project, which encapsulates much of the community partnership outreach I have done in this field, was recently recognized by SHRF through an Establishment Grant allowing this important work to be financially supported over the next three years. In 2017 I was invited to chair the Canadian Partnership against Cancer’s flagship Equity Advisory Committee.
In addition to this, I have made some significant contributions towards the development of both QI Tools and Theory. For example, I have developed very close research collaborations between the College of Medicine and Darwin University (specifically with Dr. Gill Westhorp of the Northern Institute). Out of those collaborations I have advanced realist methodology and capacity building through training seminars and workshops on both campuses. Furthermore, I have developed and refined a Shared Decision Making Program Theory using realist methodology that formed the basis for an important and growing research collaboration with Dr. France Legare of Laval University. This includes a recently successful CIHR foundation grant of which I was a content expert with Dr. Legare.
 medicine.usask.ca. (2018). College of Medicine Division of Social Accountability Strategic Plan 2016-2020. [online] Available at: https://medicine.usask.ca/department/schools-divisions/social-accountability.php [Accessed 11 Jul. 2018].
Assessing the Support Needs for Saskatchewan Indigenous Cancer Patients and their Families: A Multi-Method Study
In January 2018, the Saskatchewan Health Research Foundation (SHRF), in partnership and in collaboration with the Saskatchewan Centre for Patient Oriented Research (SCPOR) announced Sâkipakâwin was a successful recipient of a prestigious SPROUT grant. SPROUT grants are intended to cultivate research in Saskatchewan to address patient-identified priorities with the goal of growing patient-oriented solutions for the health care system.
The study’s objectives include:
to determine how Indigenous people in Saskatchewan understand cancer,
to identify the current status of Indigenous cancer care support in the province
to detect Indigenous cancer care service gaps.
to assess the cultural responsiveness of cancer services,
to determine how the Saskatchewan Cancer Agency (SCA) and other cancer service providers are working with Indigenous communities, and
to establish cancer service priorities of Indigenous people and communities
Sâkipakâwin’s research team members are diverse and contribute a wealth of experience, experiential and specialized knowledge, skills and expertise. Our team consists of:
Dr. Gary Groot (Principal Investigator)
Dr. Tracey Carr (Co-investigator)
Eugene Arcand (Patient and Family Advisor)
Lorna Arcand (Patient and Family Advisor)
Terri Hansen-Gardiner (Patient and Family Advisor)
Raymond Laliberte (Patient and Family Advisor)
Darren Okemaysim (Patient and Family Advisor)
Gabe Lafond, Saskatchewan Health Authority (SHA) *Co-applicant
Tania Lafontaine, SHA *Co-applicant
Corey Miller, SHA *Co-applicant
Dr. Veronica McKinney, Northern Medical Services *Co-Applicant
Dr. Sylvia Abonyi, Department of Community Health and Epidemiology, University of Saskatchewan *Co-applicant
Dr. Ray Deobald, Department of Surgery, University of Saskatchewan
Andreea Badea, Research Coordinator
Leonzo Barreno, Research Assistant
Adel Panahi, Research Assistant
Jennifer Sedgewick, Research Assistant
Lorena Stringer, Research Assistant
Lydia Holden, Administrative Support
The Indigenous Health Collective
Advancing Indigenous Health Knowledge in Saskatchewan
Currently in Saskatchewan, no formal support structure exists connecting the province’s remote and often isolated northern Indigenous communities with system stakeholders and health researchers. The goal of this patient-oriented research program is to engage Indigenous patients in northern Saskatchewan as partners to pinpoint and address locally-identified health care needs.
A collaborative partnership between the Federation of Sovereign Indigenous Nations, the Metis-Nation Saskatchewan, the Saskatchewan Cancer Agency, the Saskatchewan Health Authority Vice President of Indigenous Health, and this research program will build capacity through the establishment of an Elders Council. This Council will serve as a culturally-appropriate mechanism to guide Indigenous patient-oriented researchers in the province, link them with northern, remote communities and offer supports to ensure research respects and complies with cultural protocols and specifically addresses the health priorities as identified by patients in these areas. This program will cultivate a community of learning that will foster community-based dialogues and exchanges that can result in sparking innovative ideas and new partnerships that will help ensure health policy in Saskatchewan is responsive to patient needs, delivered in culturally appropriate ways and integrates Indigenous healing.
The Indigenous Health Collective is funded by a SHRF-SCPOR Patient-Oriented Research Leadership Award. Learn more about this award here.
A Journey with You
Indigenous Peer Navigation in Saskatchewan Cancer Care
“My hope is to educate cancer patients so that it may ease the fear of the unknown, so when they hear the word "cancer" it is not always a death sentence.”
-Terri Hansen-Gardiner, Indigenous Patient Navigator
The physical symptoms combined with the emotional distress of a cancer diagnosis can make the cancer-care journey difficult for patients and their families. For many Indigenous people in Saskatchewan, the burden of cancer is amplified by a host of systemic, cultural and personal challenges and barriers.
Cancer rates are rising faster in Canadian Indigenous communities compared to the general population. Poor survival and screening rates, and later-stage diagnoses have resulted in cancer becoming the leading cause of death in some Indigenous communities in Saskatchewan. Indigenous cancer patients may find themselves traversing an increasingly complex and fragmented health care system with great difficulty.
Dr. Groot's ongoing research, informed by Indigenous Elders and community-based partners, calls for specialized support that addresses these logistical, institutional, and cultural safety challenges. This study will pilot an Indigenous Patient Navigator in a Saskatchewan context and attempts to gain a deeper understanding of the unique health experiences and barriers facing Indigenous people with cancer. Using a methodological approach based in realist philosophy that takes into account the importance of patient trust and worldview in engaging in a shared decision-making process with health care providers, this study will follow 30 Indigenous cancer patients accompanied by an Indigenous Patient Navigator as they journey through Saskatchewan's cancer care system from first diagnosis to return home. Using qualitative interviews and mobile-app based questionnaires, we hope to gain a clearer picture of how Indigenous Navigators might improve patient understanding thus removing some of the obstacles patients face in accessing and receiving care.
This research project is funded by a 2018 SHRF Establishment Grant.
Principal Investigator: Dr. Gary Groot
Co-Investigators: Donna Goodridge, Sylvia Abonyi, Nathaniel Osgood, Gillian Westhorp