Wichitasowin: Indigenous Patient Navigator for Young Adults Study

Purpose: to implement and evaluate a novel Indigenous Patient Navigator (IPN) pathway for Indigenous young adults with complex and chronic medical conditions, and their families, living in Maskwacis, AB learning to manage their health condition transitioning into adulthood.

Hypothesis: the Indigenous-Led Pathway for Young Adults will provide substantial benefits to youth and families, including but not limited to cultural ceremony and Elder-support, emotional support, accessing medical appointments and preventing loss to follow-up, feeling engaged with the adult health care system, developing self-management and self-advocacy skills, and reducing feelings of anxiety and isolation. The investigators expect the pathway will improve the health of Indigenous adolescents and young adults living with chronic health conditions in Maskwacîs, ultimately improving the wellbeing of the entire community.

Justification: The investigators' previous research has identified key barriers to care included finances (e.g., cost and availability of transportation to healthcare appointments), intergenerational trauma making it difficult to prioritize the health condition, racism and discrimination in health care settings, lack of cultural safety, and loss of benefits at age 18 (e.g., Jordan's Principle does not apply to young adults). Facilitating factors identified include family support and culture, peer support networks, health condition education, and having safe spaces in healthcare settings where Indigenous imagery and medicines were visibly displayed.

During a series of in-person meetings with our Community Advisory Committee (CAC) the Investigators discussed study findings and possible strategies to address them. The Elders and Knowledge Keepers concluded that a community-based, Indigenous-led patient navigator service would be a logical approach to helping transition-age youth navigate the healthcare system between pediatric and adult care. It was felt that both the barriers and facilitators summarized above provided evidence for the need for an IPN, and that an IPN could help mitigate some of the social determinants of health that prevent adolescents and young adults from attending medical appointments, filling prescriptions, and managing their health condition(s). IPN programs in Canada exist in acute care settings, children's hospitals, cancer care, and adult outpatient settings. To the Investigators' knowledge, a community based IPN program focusing on transition age youth does not yet exist in Canada.

Objectives