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

1. Reducing Inequities for Aboriginal Women Leaving Intimate Partner Violence (IPV) Victoria Smye RN, PhD Annette Browne RN, PhD Madeleine Dion-Stout RN, BN, MA Colleen Varcoe RN, PhD UBC School of Nursing Funded by the Canadian Institutes of Health Research (CIHR)

2. The Partnership Principal Investigator: Victoria Smye Co-Principal Investigators: Annette Browne, Madeleine Dion Stout & Colleen Varcoe Co-Investigators: Nadine Caplette (Barbara Keith), Lorraine Davies & Marilyn Ford-Gilboe Collaborators: Joyce Fossella (Daniel Parker), Sandra Green, Carol Patrick (Maria) & Roberta Price Community Aboriginal Advisory Team Post Doc Fellow: Denielle Elliott Research Assistant: Donna Hill Research Unit Manager: Koushambhi Khan

3. Participating Organizations • School of Nursing UBC /UWO • Vancouver Coastal Health Authority • Aboriginal Wellness Program • Victims Services • Pacific Association of First Nations Women • Warriors Against Violence Society

4. Background • IPV is a pressing issue facing Aboriginal people in Canada today – rates of spousal abuse are higher against Aboriginal women than Aboriginal men and non-Aboriginal people • Given the socio-cultural, historical, political and economic context of Aboriginal health and well-being, ‘leaving’ IPV needs to be understood within the contextual features of Aboriginal peoples’ lives

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

6. Research Objectives (1) explore Aboriginal women’s experiences of “leaving” IPV; (2) Explore the real and potential benefits and harms of current health and social services; 3) consider what constitutes safe and effective health and social services and support; (4) analyze the women’s experiences within wider institutional and socio-political contexts; and (5) use the research findings to generate recommendations concerning the role of health policy and services and health care providers in contributing to culturally safe services for Aboriginal women.

7. Methods • A participatory study using a descriptive exploratory design and informed by critical theoretical perspectives • In-depth individual and focus group interviews • Photovoice • Participant Observation • Indigenous Perspectives and Epistemologies Analysis:An interpretive thematic analysis using processes described for qualitatively derived data

8. Critical Theoretical Perspectives • Draw critical attention to issues of partnership and voice in the research process; • Involve a commitment to applying knowledge for social change; • Require research teams to critically consider continuities between the past and the present; and • Critique the colonizing potential of research, and in the process, takes steps to mitigate potentially detrimental consequences.

9. Critical Theoretical Perspectives The notion of ‘Intersectionality’ Rather than examining gender, race, the practice of racialization, class relations and the connectedness to historical context as distinctive hierarchies, “intersectionality examines how they mutually construct one another.” (Collins, 2000, p. 157) • Violence against women is located within these intersections (Varcoe, 1996)

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

11. Cultural Safety and Social Justice • Who benefits from this research?; • Is anyone at risk?; • Whose voice is being espoused?; • Whose knowledge is being privileged and how is it being used?; and • What are the outcomes of this research? • Health is a human right and health outcomes are the object of the social justice research agenda (Reimer Kirkham & Browne, 2006).

12. Ethics RCAP, OCAP, CIHR: • the research design and process, including dissemination of findings is being conducted in partnership; • research is guided by a Community Aboriginal Advisory Team (CAAT) –includes aconsultative process with Key Leaders in Indigenous Health; • building capacity is a reciprocal process; and • research benefits Aboriginal people.

13. Sample • Aboriginal women who have left IPV (or decided to stay) (n=25) and have accessed: • victim services and/or • a referral agency for First Nations women and/or • support groups for women who have experienced or are experiencing violence by an intimate partner • Non-Aboriginal women (n=5) who have left IPV (or decided to stay) • Aboriginal men attending a support group for men who have been violent (n=10) • Providers working in these settings (n=10)

14. Field Observations: Support Groups • ‘Complex trauma’ is an ongoing lived experience for the participants. • The justice system has become a central intervention for most of the male participants. • Decisions to leave and/or stay are attached to the legacy of colonialism and cultural issues such as ties to family, community, and nation

15. Summary • Aboriginal women’s experiences of leaving and staying are differently shaped by intersecting circumstances in women’s lives. • Men are an important part of the solution to the issue of IPV against women. • Aboriginal women’s experiences of leaving and staying provide an essential window to understanding what constitutes accessible, safe and responsive health and social services and supports.

17. References • Canadian Institutes of Health Research (CIHR) (May, 2007). CIHR Guidelines for Health Research Involving Aboriginal People. Ottawa: Author. • Collins, P.H. (2000). It’s all in the family: Intersections of race, gender, and nation. In U. Narayan & S. Harding, Decentering the centre: Philosophy for a multicultural, postcolonial and feminist world (pp. 156-176). Indiana: Indiana University Press. • Fraser, N. & Naples, N.A. (2004). To interpret the world and to change it: an interview with Nancy Fraser, Journal of Women, Culture and Society, 29 (4), 1103-1124. • Reimer Kirkham, S. & Browne, A. J. (2006). Toward a Critical Theoretical Interpretation of Social Justice Discourses in Nursing.Advances in Nursing Science, 29(4), 324-339.Royal Commission on Aboriginal Peoples (RCAP). (1993). Guidelines for ethical research with Aboriginal peoples. Ottawa: Canada • Schnarch B. (2004). Ownership, control, access, and possession (OCAP) or self-determination applied to Research: A critical analysis of contemporary First Nations Research and some options for First Nations Communities. First Nations Centre National Aboriginal Health Organization. 1-40. • Ramsden, I. (1993). Kawa Whakaruruhau. Cultural safety in nursing education in Aotearoa, New Zealand. Nursing Praxis in New Zealand,8(3), 4-10. • Ramsden, I. (2000). Cultural safety/Kawa whakaruruhau ten years on: A personal overview. Nursing Praxis in New Zealand, 15(1), 4-12. • Smye, V., & Browne A. J. (2002). ‘Cultural safety’ and the analysis of health policy affecting Aboriginal people. Nurse Researcher, 9(3), 42-56. • Varcoe, C. (1996). • Young, I. M. (1990). Justice and the Politics of Difference. Princeton, NJ: Princeton University Press.