title: Approaching Etuaptmumk--introducing a consensus-based mixed method for health services research.
abstract: With the recognized need for health systems' improvements in the circumpolar and indigenous context, there has been a call to expand the research agenda across all sectors influencing wellness and to recognize academic and indigenous knowledge through the research process. Despite being recognized as a distinct body of knowledge in international forums and across indigenous groups, examples of methods and theories based on indigenous knowledge are not well documented in academic texts or peer-reviewed literature on health systems. This paper describes the use of a consensus-based, mixed method with indigenous knowledge by an experienced group of researchers and indigenous knowledge holders who collaborated on a study that explored indigenous values underlying health systems stewardship. The method is built on the principles of Etuaptmumk or two-eyed seeing, which aim to respond to and resolve the inherent conflicts between indigenous ways of knowing and the scientific inquiry that informs the evidence base in health care. Mixed methods' frameworks appear to provide a framing suitable for research questions that require data from indigenous knowledge sources and western knowledge. The nominal consensus method, as a western paradigm, was found to be responsive to embedding of indigenous knowledge and allowed space to express multiple perspectives and reach consensus on the question at hand. Further utilization and critical evaluation of this mixed methodology with indigenous knowledge are required.
authors.affiliation: Institute for Circumpolar Health Research, Yellowknife, NT, Canada.|Institute of Medical Science, University of Toronto, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Susan.chatwood@ichr.ca.
authors.forename: Susan
authors.initials: S
authors.lastname: Chatwood
authors.affiliation: Stanton Territorial Health Authority, Elders Council, Yellowknife, NT, Canada.
authors.forename: Francois
authors.initials: F
authors.lastname: Paulette
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
authors.forename: Ross
authors.initials: R
authors.lastname: Baker
authors.affiliation: Centre for Sami Health Research, University of Tromsø, Tromsø, Norway.
authors.forename: Astrid
authors.initials: A
authors.lastname: Eriksen
authors.affiliation: Centre for Sami Health Research, University of Tromsø, Tromsø, Norway.
authors.forename: Ketil Lenert
authors.initials: KL
authors.lastname: Hansen
authors.affiliation: Health Care Centre Utsjoki, Municipality of Utsjoki, Finland.
authors.forename: Heidi
authors.initials: H
authors.lastname: Eriksen
authors.affiliation: Southcentral Foundation, Anchorage, AL, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Hiratsuka
authors.affiliation: MFN-Centre for Aboriginal Health Research, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Josée
authors.initials: J
authors.lastname: Lavoie
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Wendy
authors.initials: W
authors.lastname: Lou
authors.affiliation: Department of Geography, University of Winnipeg, Winnipeg, MB, Canada.
authors.forename: Ian
authors.initials: I
authors.lastname: Mauro
authors.affiliation: Balsillie School of International Affairs, Wilfrid Laurier University: Centre for International Governance Innovation, Waterloo, ON, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Orbinski
authors.affiliation: National Aboriginal Council of Midwives, Winnipeg, MB, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Pabrum
authors.affiliation: Institute for Circumpolar Health Research, Yellowknife, NT, Canada.
authors.forename: Hanna
authors.initials: H
authors.lastname: Retallack
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
authors.forename: Adalsteinn
authors.initials: A
authors.lastname: Brown
mesh_terms: D003081:Cold Climate; D032921:Consensus; D006302:Health Services Research / Q000379:methods*; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D044382:Population Groups / Q000208:ethnology*; D015397:Program Evaluation; D011786:Quality Control
keywords: health systems stewardship; indigenous values; mixed methods