Background and Context:
Concerned by apparent increases in the numbers of people diagnosed with and dying from cancer, some Dene communities of the Northwest Territories (Canada) approached the Government of the Northwest Territories (GNWT) to learn more about underlying causes and address the needs of people affected by the disease.
The aim of this initiative was to allow a culturally appropriate airing of concerns; enhance knowledge exchange; facilitate dialogue on a sensitive topic, mobilize communities to address barriers and gaps in the cancer care continuum; and establish an evidence base and linkages that could be used towards the development of a needs-based, culturally-safe territorial cancer strategy.
The GNWT delivered two sharing circles in 2012, in partnership with the Saint Elizabeth First Nations, Inuit, and Métis Program and a third in 2013, each in a different remote community.
The sharing session approach fostered culturally-appropriate, meaningful discussions on cancer, with value placed on preexisting community knowledge and the lived experience of cancer survivors and affected community members. Experience sharing and knowledge exchange increased understanding among and between community members, community champions, health care professionals, and facilitators.
Outcomes/What was learned:
We were able to identify areas for improvement in cancer prevention and patient transition experiences throughout the cancer journey, specifically: risk factor and screening awareness; availability of culturally-appropriate resources; integration of traditional medicine; palliative care and survivor support needs; etc. Other outcomes included self-reported participant empowerment and ownership of community wellness initiatives, and strengthened collaboration between the GNWT and community leadership.
The sharing session approach is an important input in the development of its forthcoming cancer strategy. Such methodology enhances the quality of evidence and relationships, ultimately strengthening strategy development and implementation. Inclusive, culturally-appropriate approaches such as community sharing circles can be considered a best practice in needs assessment, data collection, and stakeholder engagement.