Adapting an Indigenous child health measure for Inuit children in Iqaluit, Nunavut
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Abstract
Introduction: Culturally appropriate assessment is vital for learning health systems; however, few such tools for Indigenous children exist. In 2011, Indigenous health leaders and scientists collaborated to create the Aaniish Naa Gegii: the Children’s Health and Well-being Measure (ACHWM) for Indigenous children aged 8 to 18 years. It was adapted for Inuit in Ottawa and named Qanuippit. The Government of Nunavut (GN) expressed interest in integrating the Qanuippit territory-wide. This study aimed to adapt the Ottawa Inuit version for Nunavut, to ensure they had a valid wellness measure to guide community-based health services planning for Inuit children in Iqaluit.
Methods: We used a mixed-methods approach to consider the full spectrum of health, from wellness to illness. All data gathered was governed by Inuit Qaujimajatuqangit (IQ) principles. We consulted eight Iqaluit-based experts in Inuit education, culture, and children’s health to ensure cultural relevance and identify any missing content. In February 2024, interviews were conducted by the local mental health team, with 15 Inuit children (7.7 -17.9 years). Each child completed the draft of the Qanuippit that resulted from the Expert review, and local mental health workers examined the children’s understanding of each item. The analysis focused on items with critical input from two or more participants. Once finalized, a pilot implementation study explored how mental health workers integrated the Qanuippit in practice.
Results: Experts reported eight items of concern; one had a clear solution, and the remaining seven were identified for monitoring. Children identified 11 problematic items; two had clear solutions, while consultation continued for the remaining items. Mental health workers reported that the tool was a positive, strengths-based experience. The Qanuippit aided in forming connections with clients, which positively impacted their practice.
Conclusions: The Qanuippit has proven to be a good fit to assess the health and well-being of Inuit children in Iqaluit.
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References
Government of Canada SC. Focus on Geography Series, 2021 Census - Canada [Internet]. 2022 [cited 2025 Aug 28]. Available from: https://www12.statcan.gc.ca/census-recensement/2021/as-sa/fogs-spg/page.cfm?lang=E&topic=8&dguid=2021A000011124. Accessed 28 Aug 2025.
Department of Finance Canada. Chapter 6: A Fair Future for Indigenous Peoples | Budget 2024 [Internet]. 2024 [cited 2025 Sep 17]. Available from: https://budget.canada.ca/2024/report-rapport/chap6-en.html. Accessed 17 Sep 2025.
Government of Canada SC. The Daily — Indigenous population continues to grow and is much younger than the non-Indigenous population, although the pace of growth has slowed [Internet]. 2022 [cited 2025 Sep 23]. Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/220921/dq220921a-eng.htm. Accessed 23 Sep 2025.
Wabano MJ, McGregor LF, Beaudin R, Jacko D, McGregor LE, Kristensen-Didur S, et al. Health profiles of First Nations children living on-reserve in Northern Ontario: a pooled analysis of survey data. CMAJ Open. 2019;7:E316–22.
Statistics Canada. Indigenous population continues to grow and is much younger than the non-Indigenous population, although the pace of growth has slowed [Internet]. 2022. Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/220921/dq220921a-eng.htm.
Trading Economics. Canada - Population ages 0–14. 2025 [cited 2025 Sep 23]. Available from: https://tradingeconomics.com/canada/population-ages-0-14-percent-of-total-wb-data.html. Accessed 23 Sep 2025.
Owais S, Tsai Z, Hill T, Ospina MB, Wright AL, Van Lieshout RJ. Systematic Review and Meta-analysis: First Nations, Inuit, and Métis Youth Mental Health. J Am Acad Child Adolesc Psychiatry. 2022;61:1227–50.
Graham S, Muir NM, Formsma JW, Smylie J. First Nations, Inuit and Métis Peoples Living in Urban Areas of Canada and Their Access to Healthcare: A Systematic Review. Int J Environ Res Public Health. Multidisciplinary Digital Publishing Institute; 2023;20:5956.
Inuit Tapiriit Kanatami. Social determinants of Inuit health in Canada [Internet]. 2014 p. 1–46. Available from: https://www.itk.ca/wp-content/uploads/2016/07/ITK_Social_Determinants_Report.pdf.
Hus Y, Segal O. Unravelling suicide and related behaviours in Indigenous youth and young adults in the Canadian context. Neuropsychiatr Dis Treat. 2024;Volume 20:2073–94.
Loppie C. Understanding Indigenous health inequalities through a social determinants model. Natl Collab Cent Indig Health. 2022;6–54.
Kanatami IT. National Inuit suicide prevention strategy [Internet]. Ottawa: Inuit Tapiriit Kanatami; 2016. Available from: https://www.itk.ca/wp-content/uploads/2016/07/ITK-National-Inuit-Suicide-Prevention-Strategy-2016.pdf.
Aboriginal Children’s Survey, 2006: family, community and child care. Ottawa: Statistics Canada, Social and Aboriginal Statistics Division; 2008.
Government of Canada SC. Aboriginal Peoples Survey (APS) [Internet]. 2007 Oct. Available from: https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&Id=3600. Accessed 15 May 2025.
Well-being of the non-reserve Aboriginal population: Initial findings of the 2001 Aboriginal Peoples Survey [Internet]. Available from: https://www150.statcan.gc.ca/n1/pub/89-589-x/index-eng.htm. Accessed 15 May 2025.
Aboriginal Peoples Survey, 2006: Public Use Microdata File (Children and Youth) [Internet]. [cited 2025 May 7]. Available from: https://www150.statcan.gc.ca/n1/en/catalogue/89M0027X. Accessed 7 May 2025.
Sheppard AJ, Hetherington R. A decade of research in Inuit children, youth, and maternal health in Canada: areas of concentrations and scarcities. Int J Circumpolar Health. 2012;71:18383.
Government of Canada; Indigenous Services Canada. Evaluation of the Healthy Child Development Program [Internet]. 2024 [cited 2025 Sep 23]. Available from: https://www.isc.gc.ca/eng/1720810446684/1720810497806. Accessed 23 Sep 2025.
MacMillan HL, Jamieson E, Walsh C, Boyle M, Crawford A, MacMillan A. The health of Canada’s Aboriginal children: results from the First Nations and Inuit Regional Health Survey. Int J Circumpolar Health. Taylor & Francis; 2010;69:158–67.
Smylie J, Fell D, Ohlsson A. A Review of Aboriginal Infant Mortality Rates in Canada: Striking and Persistent Aboriginal/Non-Aboriginal Inequities. Can J Public Health Rev Can Santé Publique. 2010;101:143–8.
Adelson N. The Embodiment of Inequity: Health Disparities in Aboriginal Canada. Can J Public Health Rev Can Santé Publique. 2005;96:S45–61.
Kidder KM, Stein J, Fraser JM. The health of Canada’s children: a CICH profile. 3rd ed. Ottawa, Ont.: Canadian Institute of Child Health; 2000.
Canadian supplement to the state of the world’s children 2009: Aboriginal children’s health ; leaving no child behind [Internet]. Toronto (ON): Canadian UNICEF Committee; 2009. Available from: https://unicef.ca/sites/default/files/imce_uploads/DISCOVER/OUR%20WORK/ADVOCACY/DOMESTIC/POLICY%20ADVOCACY/DOCS/Leaving%20no%20child%20behind%2009.pdf.
Moreau E. Conversation, collaboration and change: How a dream for Aboriginal children is bringing organizations together. Paediatr Child Health. 2005;10:536–8.
Ball J. Promoting Equity and Dignity for Aboriginal Children in Canada. Inst Res Public Policy IRPP Choices. 2008;14:1–32.
McIntyre L, Connor SK, Warren J. Child Hunger in Canada: Results of the 1994 National Longitudinal Survey of Children and Youth. CMAJ Can Med Assoc J. 2000;163:961–5.
Katzmarzyk PT. Obesity and Physical Activity Among Aboriginal Canadians. Obesity. 2008;16:184–90.
Che J, Chen J. Food Insecurity in Canadian Households. Health Rep. 2001;12:11–22.
Dumont-Smith C. The Health Status of Canada’s First Nations, Métis and Inuit Peoples. Health Council of Canada; 2005.
Naidoo P. A Critical Look at Health. South Afr Fam Pract. 2004;46:5–7.
Health Council Canada. A Citizen’s Guide to Health Indicators: A reference guide for Canadians [Internet]. Ottawa: Health Council of Canada; 2011. Available from: https://publications.gc.ca/site/eng/392393/publication.html.
Blackstock C, Bruyere D, Moreau E. Many hands, one dream: principles for a new perspective on the health of First Nations, Inuit and Métis children and youth. Ottawa, Ont.: Canadian Paediatric Society; 2006.
Saylor K, Blackstock C. Many hands, one dream: Healthy Aboriginal children and young people. Paediatr Child Health. 2005;10:523–4.
Chandler MJ, Lalonde C. Cultural Continuity as a Hedge against Suicide in Canada’s First Nations. Transcult Psychiatry. 1998;35:191–219.
Young NL, Wabano MJ, Burke TA. A Process for Creating the Aboriginal Children’s Health and Well-Being Measure (ACHWM). Can J Public Health. 2013;104:136–41.
Young NL, Wabano MJ, Blight S. Relevance of the Aboriginal Children’s Health and Well-being Measure (ACHWM) Beyond Wikwemikong. Rural Remote Health. 2017;17:394–404.
Baker-Anderson K, Young NL, Wabano MJ. Inuit Version of the Aboriginal Children’s Health and Well-Being Measure: Qanuippit? Int Socieity Qual Life Res 22nd Annu Conf. Vancouver, Canada: Quality of Life Research; 24.
Young NL, Wabano MJ, Ritchie SD. Assessing children’s interpretations of the Aboriginal Children’s Health and Well-Being Measure (ACHWM). Health Qual Life Outcomes. 2015;13:1–7.
Young NL, Wabano MJ, Usuba K. Validity of the Aboriginal Children’s Health and Well-Being Measure: Aaniish Naa Gegii? Health Qual Life Outcomes. 2015;13:148–56.
Young NL, Wabano MJ, Usuba K. Reliability of the Aboriginal Children’s Health and Well-Being Measure (ACHWM). Springer Plus. 2016;5:2082–7.
Young NL, Jacko D, Wabano MJ. A Screening Mechanism to Recognize and Support Aboriginal Children At-Risk: Based on a Child-centric Survey. Can J Public Health. 2016;107:e399-e403.
Barbic SP, Young NL, Usuba K, Stankiewicz E. Rasch Measurement Theory’s contribution to the psychometric properties of a co-created measure of health and wellness for Indigenous children and youth. J Clin Epidemiol. 2022;151:18–28.
Tagalik S. Inuit Qaujimajatuqangit: The role of Indigenous knowledge in supporting wellness in Inuit communities in Nunavut. Natl Collab Cent Aborig Health NCCAH [Internet]. 2012. Available from: https://www.ccnsa-nccah.ca/docs/health/FS-InuitQaujimajatuqangitWellnessNunavut-Tagalik-EN.pdf.
Healey G, Tagak A. Piliriqatigiinniq “working in a collaborative way for the common good”: A perspective on the space where health research methodology and Inuit epistemology come together. Int J Crit Indig Stud. Queensland University of Technology; 2014;7:1–14.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81.
Pilarinos A, Field S, Vasarhelyi K, Hall D, Fox ED, Price ER, et al. A qualitative exploration of Indigenous patients’ experiences of racism and perspectives on improving cultural safety within health care. CMAJ Open. 2023;11:E404–10.
Saunders V, McCalman J, Tsey S, Askew D, Campbell S, Jongen C, et al. Counting what counts: a systematic scoping review of instruments used in primary healthcare services to measure the wellbeing of Indigenous children and youth. BMC Prim Care. 2023;24:51.
Cherba M, Healey Akearok GK, MacDonald WA. Addressing provider turnover to improve health outcomes in Nunavut. Can Med Assoc J. 2019;191:E361–4.