Abstract
Objective
Several literature reviews have highlighted the under-representation of Métis in research regarding Aboriginal Peoples. However, to date, an in-depth examination of trends in Métis research has not been undertaken. This literature review aims to identify trends and gaps in Métis-related health/well-being research over the past three decades (1980–2009).
Methods
Health, medical and social sciences literature databases including Cochrane, CINAHL, Embase, Pubmed, PyschInfo, and Web of Science were searched for Métis-relevant peer-reviewed articles published between 1980 and 2009 via two search strategies: 1) using the terms “Métis,” “mixed-blood” or “half-breed,” and 2) using a combination of terms: (Aboriginal OR Indigenous OR native OR “First Nation” OR Indian) and (mixed OR European OR Caucasian OR white) and “Canada”. Articles pertaining to the health/well-being of Métis in Canada were retained, coded and analyzed by study type/design, gender-specificity, geography, research topic, the extent to which Métis-specific breakdown of findings was provided, and methodological quality relating to validity and reliability of the study.
Results
Noteworthy strengths in Métis research were observed, including increasing attention to chronic diseases, diet/nutrition/physical activity, and maternal and child health; a trend towards increased presentation of Métis-specific results among pan-Aboriginal studies, and female-specific and qualitative studies; and an equitable focus on urban and rural areas. Gaps were seen in research related to environment/toxicology, genetics, health delivery/programming/policy, injury, mental health (MH)/addictions, social determinants of health, and violence/crime. In addition, a dearth of male-specific research was identified. Also, most articles were cross-sectional in design. Finally, despite an increase in Métis-related articles over the past three decades, a large proportion of articles remained pan-Aboriginal in nature and did not provide a Métis-specific breakdown of findings. With respect to methodological quality, nearly two thirds of all studies were of strong or moderate quality (cross-sectional studies), good quality (cohort/case-control studies) or acceptable quality (qualitative and mixed methods studies).
Conclusion
Several gaps exist in Métis-related health/well-being research with respect to study type/design, gender-specificity, research topics, presentation of Métis-specific findings, and methodological quality. In addition to specific gaps, the overall limited number of research articles/studies needs to be recognized. These deficiencies could be alleviated by increasing targeted funding and support for Métis-related research, and removing barriers to Métis-specific research. Addressing gaps in Métis health research will enable identification of appropriate targets for intervention and, subsequently, design, development and evaluation of interventions to address Métis health disparities and their determinants.
Keywords: Review, Indigenous population, health research, medical research, trends, Métis
Résumé
Objectif
Plusieurs revues de la littérature spécialisée ont souligné la sous-représentation des Métis dans la recherche sur les Autochtones. Jusqu’à maintenant cependant, on n’avait pas encore mené d’examen approfondi des tendances dans la recherche sur les Métis. Notre revue de la littérature vise à cerner les tendances et les lacunes dans la recherche liée à la santé et au bien-être des Métis au cours des trois dernières décennies (1980-2009).
Méthode
Nous avons consulté des bases de données d’articles sur la santé, la médecine et les sciences sociales, à savoir les bases Cochrane, CINAHL, Embase, Pubmed, PyschInfo et Web of Science, pour y répertorier les articles sur les Métis évalués par des pairs et publiés entre 1980 et 2009. Nous avons utilisé deux stratégies de recherche: 1) l’emploi d’équivalents anglais pour les termes « Métis » et « sang-mêlé » et 2) l’emploi de combinaisons d’équivalents anglais de certains termes: (autochtone OU indigène OU « Première Nation » OU Indien) et (mixte OU Européen OU blanc) et « Canada ». Les articles afférents à la santé/au bien-être des Métis au Canada ont été retenus, codés et analysés selon le type/le plan d’étude, la sexospécificité, la géographie, les thèmes de recherche, la présence d’une catégorie « Métis » dans la présentation des résultats, et la qualité méthodologique (validité et fiabilité de l’étude).
Résultats
Nous avons observé certaines forces méritant d’être soulignées dans la recherche sur les Métis, notamment l’attention accrue aux maladies chroniques, au régime/à la nutrition/à l’activité physique et à la santé maternelle et infantile; une tendance croissante à présenter des résultats propres aux Métis dans les études pan-autochtones, les études sur les femmes et les études qualitatives; et une attention équilibrée aux zones urbaines et rurales. Nous avons observé des lacunes dans la recherche liée à l’environnement/la toxicologie, la génétique, la prestation/la programmation/les politiques de santé, les traumatismes, la santé mentale/la toxicomanie, les déterminants sociaux de la santé et la violence/la criminalité. Les études spécifiquement axées sur les hommes étaient rares. Et la plupart des articles portaient sur des études transversales. Enfin, malgré l’augmentation des articles liés aux Métis au cours des trois dernières décennies, une grande proportion des articles étaient encore de nature pan-autochtone et ne présentaient pas de résultats propres aux Métis. En ce qui a trait à la qualité méthodologique, près des deux tiers des études étaient de qualité très bonne à moyenne (études transversales), de bonne qualité (études de cohortes/études cas/témoins) ou de qualité acceptable (études qualitatives et mixtes).
Conclusion
Il y a plusieurs lacunes dans la recherche sur la santé/le bien-être des Métis en ce qui a trait aux types/plans d’étude, à la sexospécificité, aux thèmes de recherche, à la présence d’une catégorie « Métis » dans la présentation des résultats et à la qualité méthodologique. Outre ces lacunes spécifiques, le nombre limité d’articles de recherche/d’études en général est préoccupant. Ces carences pourraient être comblées en augmentant le financement et l’appui ciblés à la recherche liée aux Métis et en abolissant les obstacles à la recherche spécifiquement axée sur les Métis. Le fait d’aborder les lacunes dans la recherche sur la santé des Métis permettrait de fixer des cibles d’intervention appropriées et, par la suite, de concevoir, d’élaborer et d’évaluer ces interventions pour s’attaquer aux disparités d’état sanitaire des Métis et à leurs déterminants.
Mots clés: évaluation; population indigène, recherche en santé, recherche médicale, tendances, Métis
Footnotes
Conflict of Interest: None to declare.
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