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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2008 Sep 1;99(5):411–417. doi: 10.1007/BF03405252

Exploring Aboriginal Views of Health Using Fuzzy Cognitive Maps and Transitive Closure

A Case Study of the Determinants of Diabetes

Brian G Giles 112, G Haas 112, M Šajna 212, C S Findlay 112,312,✉
PMCID: PMC6975579  PMID: 19009928

Abstract

Objectives

To demonstrate how fuzzy cognitive maps may be used to extract, present and compare Aboriginal perspectives, using the determinants of diabetes as a case study.

Methods

Participants from the Mohawk Community of Akwesasne and the Miawpukek First Nation in Conne River created fuzzy cognitive maps (FCMs) (N=3) detailing their views of “the causes of diabetes in their community”, through a facilitated, group mapping session. For each FCM, the net causal effect of every determinant (direct or indirect) on diabetes was calculated from its transitive closure. The net causal effects were then compared across the set of FCMs to identify strong, weak and controversial determinants.

Results

Comparison of FCMs revealed significant heterogeneity in the perspectives of diabetes. The Akwesasne participants focused heavily on social, traditional and spiritual factors, while Conne River participants placed more importance on direct personal and lifestyle factors. There was, however, a core of strong, validated determinants related primarily to healthy diet and physical activity.

Conclusions

This work demonstrates how FCM may be used to extract and represent different perspectives of complex issues allowing for comparisons among stakeholders or knowledge groups. Comparison of multiple FCM employing the transitive closure may then be used to identify areas of agreement and controversy.

Key words: Knowledge, Native American, NIDDM, social medicine

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