Grant: Project Grant

While historically uncommon, today, cancer is common and has a greater impact on Ontario Indigenous populations. Cancer Care Ontario (CCO), Ontario's provincial cancer agency, runs the screening programs for breast, colorectal and cervical cancer. Screening catches cancers early, at a stage when they are more likely to be treatable. Indigenous persons in Ontario are screened less often in Ontario than the general population. In prior work, we learned that a generally poor Indigenous experience of cancer screening (racism during health care encounters, problems with CCO's mailed invitations to be screened (did not receive or difficulties understanding) and poor support for screening participants) might lead to lower participation. To address these gaps, we will do 3 linked projects with the overall objective of improving Indigenous peoples' experience of cancer screening in Ontario. First, we will examine Indigenous cultural safety (CS) at CCO. CS is defined as quality care for people of diverse ethnicities. CS emphasizes respecting cultural differences, demands empathy and self-reflection, and is attentive to empowering the care recipient. We will develop a CS Assessment tool then use it to interview CCO leaders and employees about their values, beliefs, and experiences of Indigenous CS and their opinion of CCO's commitment to these issues. Second, we will work with First Nations, Inuit and Métis partners separately to develop CS and implementable communication strategies and materials using established health communication principles. Third, we will collaboratively develop a CS shared decision making (SDM) strategy with Indigenous partners. SDM is a process where patients work with clinicians or peers to make health care decisions based on science as well as their values and preferences. Findings from these 3 projects will inform recommendations for change in Ontario's cancer screening programs so as to improve Indigenous persons' experiences with cancer screening.