Grant: CIHR Fellowship

First Nations, Inuit and Métis (FNIM) women have been identified as having a rapid increase in rates of cancer in relation to non-FNIM women. They also face cultural barriers to health service use. An approach to health decision making, called shared decision making (SDM), has been found to improve the participation of people in their healthcare. SDM lowers barriers to healthcare participation by supporting people in their engagement with their health environment and care providers. As well, peer support helps people in the health system as they make decisions about care. The purpose of this study is to develop and then test a SDM strategy used by peer support workers to increase FNIM women's participation in decisions about breast cancer screening. This project has two theory driven phases that will be designed and conducted with an advisory group that includes members of the FNIM communities. First, a review of the literature will identify ways in which SDM tools and approaches can be adapted for use by a range of populations. This information will be used to tailor the SDM strategy with FNIM peer support workers who are currently working in cancer care. We will adapt the strategy until these peer support workers and the advisory board agree that the strategy is ready to test with FNIM women making cancer screening decisions. Next, a new group of FNIM women will be recruited as peer support workers and trained to use the SDM strategy. Each peer will be matched to a FNIM woman who is making a decision about participating in breast cancer screening. The participation and experience of the FNIM peers and women will be evaluated. The research will be used to inform the development of strategies that support people to participate in decisions about their health, and in this way better ensure access to the care they need.