Addressing Frailty with Community-Directed Physical Activity Programs in Manitoban First Nations Communities
About the Project
Four First Nations communities in Manitoba want to improve the health balance of their older adults. This would improve the overall health of their communities. The communities would like to focus on the physical being of their older adults. The four communities are working in a project with researchers from the College of Rehabilitation Sciences (University of Manitoba) to make this happen. They have a partnership named Kiga mamo anokimin onji minoayawin, Anishabe for “We will work together for health and wellness”.
In this project, the team will learn how physical activity programs designed with and by First Nations communities can improve the health of their older adults. The communities play an important part of the research team. After a long history of colonization and mistrust, First Nations communities must decide on the approaches that will be used to improve the health of their own people. Elders, older adults and other community members will be a part of the research process.
The project team will have three main tasks:
- The first task is to learn what the four communities think about the word “frailty”. The word frailty may mean different things to different people and their communities. Knowing what people think of frailty and how to prevent it, will help develop programs that will work.
- The second task is to develop and test community-specific physical activity programs. Each community will tailor their own program to their own strengths, resources and environment. In each community, 10 older adults will be in a program for six to eight weeks. Each program will address all four aspects of the person in the medicine wheel: physical, spiritual, emotional, and mental.
- The last task of the project will be for communities to share what they learned. They do this with video storytelling. They will share to others in their own community as well as other First Nations communities across Manitoba and Canada.
This project will support each community’s ability to provide programs to prevent and reduce frailty. As well, sharing community learning will provide other First Nations communities with ideas on how to develop programs to prevent and reduce frailty. The information from this project will also help researchers and health care providers understand how to best provide care to First Nations communities to prevent frailty.
- Cara Brown — University of Manitoba
- Ruth Barclay — University of Manitoba
- Debbie Beach-Ducharme — University of Manitoba
- Lisa Engel — University of Manitoba
- Moni Fricke — University of Manitoba
- Leanne Leclair — University of Manitoba
- Jacquire Ripat — University of Manitoba
- Sandra Webber — University of Manitoba
- Michelle Bushie — Adam Hardisty Health Centre
- Sherry Duffenais — Adam Hardisty Health Centre
- Cheryl Parkes — Lake Manitoba First Nation
- Debbie Hunter — Black River First Nation
- Charlene Green — Bloodvein First Nation
- Juliette Cooper — University of Manitoba
Keywords: First Nations; Manitoba; frailty; participatory; medicine wheel; holistic; physical activity; co-design; digital storytelling
Aim: Develop or enhance programs addressing the physical being for older adults in First Nations communities by co-designing and delivering contextually relevant programming to prevent and reduce frailty.
- Determine feasibility of co-designed programs addressing physical being for addressing frailty in Manitoba First Nations communities.
- Determine cultural validity of the concept of frailty and the Pictorial Fit-Frail (PFSS) scale in Manitoba First Nation communities.
- Facilitate knowledge sharing of lessons learned from the participating communities to other MB First Nation communities.
Four Anishinabe communities have committed to this project: Hollow Water, Lake Manitoba, Black River, and Bloodvein. Geographically they range from being 150 to 250 km from the largest centre in Manitoba (Winnipeg), and their populations range from approximately 300 to 1200 residents. Each community is currently at different stages of physical programming development. In common among communities is the need to address low older adult engagement in programming. Other challenges relate to practical issues such as transportation, limited suitable infrastructure, winter weather, and limited access to physical activity health professionals. Communities also identified potential facilitators to community participation such as opportunities for social engagement and connection to culture.
This project was facilitated by a partnership between the participating First Nations communities and CoRS, named Kiga mamo anokimin onji minoayawin (Anishabe for “We will work together for health and wellness”). The communities used their worldview of health based on the Sacred Hoop, which focuses on achieving balance between the physical, spiritual, emotional and mental being, to identify that their older adults need support in engaging their physical being to achieve health. Promoting physical activity is consistent with Western evidence that physical activity prevents and reduces multiple components of frailty, including sarcopenia, functional impairment, cognitive decline and depression. When implementing health promotion programs in First Nations communities, they need to be context-specific and acknowledge potential differences in values, culture, resources, and environment.
This research will use a postcolonial community-based participatory research (CBPR) approach that acknowledges historical power relationships, and makes space to value Indigenous worldviews. This approach emphasizes the need for a relational partnership with the community affected by the health issue in the research process to improve health equity.
Throughout the research, we will follow principles of community engagement with First Nations including authentic engagement, shared respect, trust and commitment to mutually empowered long-term relationships; respect for the local/contextual knowledge and values of the community; and shared authority, responsibility and accountability.In order to evaluate the feasibility of the co-designed programs, we will focus on areas identified by Bowen and colleagues including acceptability, demand, implementation, practicality, adaptation, integration, and (limited) efficacy-testing.