Reducing Reducing Inequities for Inequities for Aboriginal Women Aboriginal Women Leaving Intimate Leaving Intimate Partner Violence Partner Violence (IPV)(IPV)

Victoria Smye RN, PhDVictoria Smye RN, PhDAnnette Browne RN, PhDAnnette Browne RN, PhD

Madeleine Dion-Stout RN, BN, MAMadeleine Dion-Stout RN, BN, MAColleen VarcoeColleen Varcoe RN, PhD RN, PhD

UBC School of NursingUBC School of Nursing

Funded by the Canadian Institutes of Funded by the Canadian Institutes of Health Research (CIHR)Health Research (CIHR)

The PartnershipThe PartnershipPrincipal Investigator: Principal Investigator:

Victoria SmyeVictoria SmyeCo-Principal Co-Principal

Investigators: Investigators: Annette Annette Browne, Madeleine Browne, Madeleine Dion Stout & Colleen Dion Stout & Colleen VarcoeVarcoe

Co-Investigators: Co-Investigators: Nadine Nadine Caplette (Barbara Caplette (Barbara Keith), Lorraine Keith), Lorraine Davies & Marilyn Davies & Marilyn Ford-GilboeFord-Gilboe

Collaborators: Collaborators: Joyce Joyce Fossella (Daniel Fossella (Daniel Parker), Sandra Parker), Sandra Green, Carol Patrick Green, Carol Patrick (Maria) & Roberta (Maria) & Roberta PricePrice

Community Aboriginal Community Aboriginal Advisory TeamAdvisory Team

Post Doc Fellow:Post Doc Fellow: Denielle Elliott Denielle ElliottResearch Assistant:Research Assistant: Donna Hill Donna HillResearch Unit Manager:Research Unit Manager: Koushambhi Khan Koushambhi Khan

Participating OrganizationsParticipating Organizations

• School of Nursing UBC /School of Nursing UBC /UWOUWO• Vancouver Coastal Health Vancouver Coastal Health

AuthorityAuthority– Aboriginal Wellness ProgramAboriginal Wellness Program

• Victims ServicesVictims Services

• Pacific Association of First Pacific Association of First Nations WomenNations Women

• Warriors Against Violence Warriors Against Violence SocietySociety

BackgroundBackground• IPVIPV is a pressing issue facing is a pressing issue facing

Aboriginal people in Canada today – Aboriginal people in Canada today – rates of spousal abuse are higher rates of spousal abuse are higher against Aboriginal women than against Aboriginal women than Aboriginal men and non-Aboriginal Aboriginal men and non-Aboriginal peoplepeople

• Given the socio-cultural, historical, Given the socio-cultural, historical, political and economic context of political and economic context of Aboriginal health and well-being, Aboriginal health and well-being, ‘leaving’ IPV needs to be understood ‘leaving’ IPV needs to be understood within the contextual features of within the contextual features of Aboriginal peoples’ livesAboriginal peoples’ lives

Purpose of the Purpose of the StudyStudy

Explore Aboriginal Explore Aboriginal women’s experiences of women’s experiences of ‘leaving’ intimate ‘leaving’ intimate partner violence to partner violence to inform an understanding inform an understanding of what constitutes of what constitutes appropriate, safe health appropriate, safe health and social services and and social services and support for Aboriginal support for Aboriginal women and familieswomen and families

Research ObjectivesResearch Objectives(1) explore Aboriginal women’s experiences of (1) explore Aboriginal women’s experiences of

“leaving” IPV; “leaving” IPV;

(2) Explore the real and potential benefits and (2) Explore the real and potential benefits and harms of current health and social services;harms of current health and social services;

3) consider what constitutes safe and effective 3) consider what constitutes safe and effective

health and social services and support; health and social services and support;

(4) analyze the women’s experiences within wider (4) analyze the women’s experiences within wider institutional and socio-political contexts; and institutional and socio-political contexts; and

(5) use the research findings to generate (5) use the research findings to generate recommendations concerning recommendations concerning the role of health the role of health policy and services and health care providerspolicy and services and health care providers in in contributing to culturally safe services for contributing to culturally safe services for Aboriginal women.Aboriginal women.

MethodsMethods

• A participatory study using a descriptive A participatory study using a descriptive exploratory design and informed by critical exploratory design and informed by critical theoretical perspectivestheoretical perspectives

In-depth individual and focus group interviewsIn-depth individual and focus group interviews PhotovoicePhotovoice Participant Observation Participant Observation Indigenous Perspectives and EpistemologiesIndigenous Perspectives and Epistemologies

Analysis:Analysis: An interpretive thematic analysis An interpretive thematic analysis using processes described for qualitatively using processes described for qualitatively derived dataderived data

Critical Theoretical PerspectivesCritical Theoretical Perspectives

• Draw critical attention to issues of Draw critical attention to issues of partnership and voice in the research process; partnership and voice in the research process;

• Involve a commitment to applying knowledge Involve a commitment to applying knowledge for social change; for social change;

• Require research teams to critically consider Require research teams to critically consider continuities between the past and the continuities between the past and the present; andpresent; and

• Critique the colonizing potential of research, Critique the colonizing potential of research, and in the process, takes steps to mitigate and in the process, takes steps to mitigate potentially detrimental consequences. potentially detrimental consequences.

Critical Theoretical Critical Theoretical PerspectivesPerspectives

The notion of ‘The notion of ‘IntersectionalityIntersectionality’’

Rather than examining gender, race, Rather than examining gender, race, the practice of racialization, class the practice of racialization, class relations and the connectedness to relations and the connectedness to historical context as distinctive historical context as distinctive hierarchies, “intersectionality hierarchies, “intersectionality examines how they mutually construct examines how they mutually construct one another.” (Collins, 2000, p. 157)one another.” (Collins, 2000, p. 157)

Violence against women is located Violence against women is located within these intersections (Varcoe, within these intersections (Varcoe, 1996)1996)

Cultural SafetyCultural Safety

• a critical cultural lens to shift a critical cultural lens to shift attention from the ‘culture’ of attention from the ‘culture’ of the ‘Other’ to the culture of the ‘Other’ to the culture of health care and structural health care and structural inequities and power relations inequities and power relations that shape health care and that shape health care and health and health and our partnershipsour partnerships

Cultural Safety and Social Cultural Safety and Social Justice Justice

• Who benefits from this research?; Who benefits from this research?; • Is anyone at risk?; Is anyone at risk?; • Whose voice is being espoused?;Whose voice is being espoused?;• Whose knowledge is being privileged Whose knowledge is being privileged

and how is it being used?; and and how is it being used?; and • What are the outcomes of this What are the outcomes of this

research? research?

Health is a human right and health Health is a human right and health outcomes are the object of the social justice outcomes are the object of the social justice research agendaresearch agenda(Reimer Kirkham & Browne, 2006).(Reimer Kirkham & Browne, 2006).

EthicsEthicsRCAP, OCAP, CIHR:RCAP, OCAP, CIHR:1.1. the research design and the research design and

process, including process, including dissemination of findings is dissemination of findings is being conducted in being conducted in partnership; partnership;

2.2. research is guided by a research is guided by a Community Aboriginal Community Aboriginal Advisory Team (CAAT) Advisory Team (CAAT) –– includes aincludes a consultative consultative process with Key Leaders in process with Key Leaders in Indigenous HealthIndigenous Health; ;

3.3. building capacity is a building capacity is a reciprocal process; andreciprocal process; and

4.4. research benefits Aboriginal research benefits Aboriginal people. people.

SampleSample• Aboriginal women who have left IPV (or Aboriginal women who have left IPV (or

decided to stay) (n=25) and have accessed:decided to stay) (n=25) and have accessed:– victim services and/or victim services and/or – a referral agency for First Nations women a referral agency for First Nations women

and/or and/or – support groups for women who have support groups for women who have

experienced or are experiencing violence by an experienced or are experiencing violence by an intimate partnerintimate partner

• Non-Aboriginal women (n=5) who have left Non-Aboriginal women (n=5) who have left IPV (or decided to stay) IPV (or decided to stay)

• Aboriginal men attending a support group Aboriginal men attending a support group for men who have been violent (n=10)for men who have been violent (n=10)

• Providers working in these settings (n=10)Providers working in these settings (n=10)

Field Observations: Support Field Observations: Support Groups Groups

• ‘‘Complex trauma’ is an ongoing lived Complex trauma’ is an ongoing lived experience for the participants.experience for the participants.

• The justice system has become a The justice system has become a central intervention for most of the central intervention for most of the male participants. male participants.

• Decisions to leave and/or stay are Decisions to leave and/or stay are attached to the legacy of colonialism attached to the legacy of colonialism and cultural issues such as ties to and cultural issues such as ties to family, community, and nation family, community, and nation

SummarySummary• Aboriginal women’s experiences of leaving Aboriginal women’s experiences of leaving

and staying are differently shaped by and staying are differently shaped by intersecting circumstances in women’s intersecting circumstances in women’s lives.lives.

• Men are an important part of the solution Men are an important part of the solution to the issue of IPV against women.to the issue of IPV against women.

• Aboriginal women’s experiences of leaving Aboriginal women’s experiences of leaving and staying provide an and staying provide an essentialessential window window to understanding what constitutes to understanding what constitutes accessible, safe and responsive health and accessible, safe and responsive health and social services and supports.social services and supports.

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