Engaging Indigenous Youth Through Popular Theatre to Mobilize Research Findings

Mobilizing research findings in communities is not easy. As well mobilizing findings to healthcare professionals and community members in a way that they can see the value or advantage of utilizing some of the research findings is also difficult. So much comes at both these populations every day as they engage in daily life and daily work.

Combine this with the fact that our research findings are stark and hard to hear. Frightening stories of fear, bullying, intimidation, racism, and discrimination were common themes in Indigenous people’s experiences to access emergency services. What could we do in order to undertake research mobilization and yet not alienate those who 1) assisted us to understand the findings and those 2) who facilitated our entry into the healthcare setting?

These particular research findings were part of the Access Research Initiative series of investigations that originated from a community request to investigate access. Following consultations with Indigenous people in Alberta we formed a community and research team to understand how best to investigate access to healthcare services. Within this research initiative Indigenous and community-based participatory methodologies were integral to our planning and to our investigations. The team led by Dr. Cameron together with an interdisciplinary team was comprised of Indigenous and non-Indigenous researchers, graduate and undergraduate students, and postdoctoral researchers with community guidance and additional guidance from both Indigenous and non-Indigenous healthcare administrators and healthcare professionals. The entire initiative was under the guidance of Eminent Scholar Elder Rose Martial.

Our Popular theatre dissemination project was based on the implementation of an Indigenous led intervention study in one urban and one rural acute setting to further investigate access. Here through the placement and assistance of an Indigenous Health Care worker in these settings, in Canada often these individuals are called Community Health Representatives (CHR), we investigated whether the CHR having both Indigenous knowledge and health knowledge eased Indigenous people’s access experiences in emergency departments in two settings. The intervention then involved the placement of two Indigenous CHRs in an urban and a rural acute care setting.

Following the completion of these two intervention projects we investigated modalities of effective knowledge mobilization through talking to our partners, our research team and our Advisory Team. The original suggestion of a onetime theatre performance evolved into a drama program working toward presenting a popular theatre. We are grateful to Dr. Cora Weber Pillwax from our research team for leading us in this direction.

We then began to work toward implementing a Popular Theatre Approach in one of the community high schools in the community. Another of our investigators Dr. Lisa Bourque Bearskin facilitated our re-entry into the community to request at various levels permission to undertake this project. This required much consulting, conceptualizing, planning, eventually achieving national funding to undertake a Popular theatre approach. Once permissions were in order, we engaged Indigenous youth at high school in a drama education process with the help of a popular theatre artist, to teach, to work toward understanding the findings and then, for the students to generate, interpret, and re-present the data in a popular theatre. There had not been a drama program in the school and there were several students who wished to learn about drama itself so the project itself generated much interest. This was a wonderful outcome of engagement with the theatre artist and the research team; of learning critical drama techniques and tools; of writing a script together to present the findings and then to engage the attendees in a conversation afterward. The program lasted six months but also we provided more drama training after the popular theatre as students wanted to learn for example how to act comedy.

Specifically, three narratives taken from research data were shaped and molded by the students into a popular theatre drama using their own experiences and creativity. The preparation of each vignette was a focal point for Indigenous youth to reflect and discuss their personal experiences of access to healthcare services. After working together during 6 months of almost weekly sessions, the students developed a 1-hour production of five skits that were fleshed out and refined in preparation for a community symposium with community members, managers, and healthcare professionals. This first popular theatre access symposium of knowledge mobilization was held in the community, Indigenous youth portrayed and engaged the audience with research material helping the audience find a voice to contribute to communal discussions. Attendees at the symposium found the presentation engaging and an effective and stark way to portray how inequitable experiences of access to healthcare unfold moment-by-moment. The healthcare professionals, community members, managers/administrators in attendance discussed that while they have witnessed first-hand discriminative care in the healthcare system, the popular theatre re-enacting distressing stories had a profound effect on them. However, in the discussion the audience was very clear that everyone in their communities already knew and had experienced much of this. Healthcare professionals in the audience were clear that they too had seen these types of care happening in various healthcare settings. Between the students and participants there was a direct connection, because the skits were experienced as real. The most startling moment was hearing the open and straightforward dialogue in response to the interpretation of the youth on such a complex issue. In this way the live performance of findings served to concretize rather than abstract the experiences of research participants.

A year later, we were able to secure funding and plan our second research mobilization symposium for one day inviting all levels of healthcare professionals, all areas of health care, invitations to the communities and healthcare community agencies. This event was held at a large urban hospital health care centre, attracted more than 80 individuals where much progress was made in the dissemination of the findings and discussions on how best to implement bias free care.

In closing, based on the collective findings of the Access Research Initiative above and given the severe health disparities that Indigenous people carry worldwide, we appeal to nurses and nurse leaders. It is crucial to engage in decolonization and reconciliation practices to advance health equity. Our first step is engaged learning about diverse Indigenous populations and health, and truthfully reflecting on connections to practice.  We need to stop problematizing Indigenous culture and peoples and demand equitable health service delivery.  Rooted in cultural safety, nurses need to focus on the strengths and personal/community attributes of personal agency, power dynamics in health care systems, and authentic engagement strategies that uplift the whole community. The history and contribution Indigenous peoples’ knowledge, understanding and experiences in accessing health care must be recognized and integrated within nurse education and practice, noting how this advances the nursing discipline.  We must remain grounded and strong in our support of ongoing decolonization and reconciliation efforts by upholding the UNDRIP (2007) and TRC (2015) Calls to Action.

We invite you to learn more about this experience by reading our article HERE. Free 30-day access is available for this article beginning  22 October.

After you’ve had a chance to read this piece, please share your thoughts, ideas, or experiences with our community in the comments below so we can continue this discussion!