KEY CONCEPTS OF ENGAGING THE SOCIAL REALITY | RECOMMENDATIONS |
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Social and economic resource disparities* Socioeconomic disadvantages
| Considering Indigenous patients’ social and economic realities:
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Family and limited resources
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Knowledge barriers
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Accumulation of adverse life experiences† Family adversity and support
| Considering patients’ adverse life experiences:
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Personal and collective loss
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Effect of residential schools
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Culture frames knowledge‡ Knowledge contextualization and exchange
| Helping build Indigenous patients’ knowledge about diabetes care:
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Culture as therapeutic§ Culture is protective
| Recognizing culture as therapeutic:
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Traditional medicine and ceremony
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E4E—Educating for Equity.
↵* Relationships between resource limitations, socioeconomic status, and the social environment directly affect health and diabetes through material deprivation, as well as indirectly through psychosocial pathways such as stress, depression, anxiety, and loss of control. The ongoing process of colonization is conceptualized to be the apparatus responsible for these barriers affecting Indigenous people’s health and their experiences with diabetes.
↵† Persistent and recurring throughout the life course of Indigenous individuals and communities, adverse experiences accumulate and pervasively influence wellness and health by undermining health behaviour patterns and diminishing resilience and capacity to cope with disease.
↵‡ Placing diabetes care knowledge within the cultural, social, and political landscape of Indigenous people can facilitate patient engagement and learning. In addition, culture is fundamental to effective communication for achieving knowledge exchange and patient education.
↵§ Recognizing culture as a protective factor in promoting health ensures that efforts toward improved diabetes care include using a cultural lens to view Indigenous peoples’ experiences of health and illness, as well as understanding patients’ own preferences and connections, and barriers to cultural resources.