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Rating Health and Social Indicators for Use with Indigenous Communities: A Tool for Balancing Cultural and Scientific Utility

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Abstract

This study reports on the development and evaluation of a rating tool to assess the scientific utility and cultural appropriateness of community-level indicators for application with Indigenous populations. Indicator criteria proposed by the U.S. Institute of Medicine were culturally adapted through reviewing the literature and consultations with academic and Indigenous stakeholders. Pre-testing and collaborator feedback drove the iterative development of the tool with stakeholder groups in Canada, Aotearoa/New Zealand, and Australia. Pilot testing with 17 raters across countries involved rating the same selection of six health and social indicators using a six-point ordinal scale. The final version of the rating tool includes 16 questions within three criterion domains: importance, soundness, and viability. Academic and community stakeholder review established face and content validity. The indicator rating tool demonstrated good internal consistency and excellent inter-rater reliability for two of three pilot testing groups. Use of this instrument can strengthen collaborative research planning and evaluation with Indigenous communities through selection of relevant and culturally appropriate indicators for application to public health research, prevention programmes, and health and social policy.

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Acknowledgments

This project was funded by the Canadian Institutes of Health Research through the International Collaborative Indigenous Health Research Partnership program and the Global Health Research Program (#109286). MD was supported by a Canada Research Chair for Population Health. We express thanks to: Janice Muir and Tania Jones (Department of Human Services Victoria, Australia); Dr. Alf Bamblett (Victorian Aboriginal Community Services Association, Australia); Veronica Weisz, Fiona Barnes, and Petra White (Victorian Aboriginal Education Association Inc., Australia); Peter Waples-Crowe (Victorian Aboriginal Community Controlled Health Organisation, Australia); Paul Paton (Victorian Aboriginal Corporation for Languages, Australia); Joyce Doyle (Rumbalara Football Netball Club, Australia); Leah Johnston, Professor Di Bretherton, Professor Ian Anderson, and Dr. Michael Tynan (University of Melbourne, Australia); Dr. Ross Bailie, Julie Brimblecombe, Joseph Fitz, and Maria Scarlett (Menzies School of Health Research, Northern Territory, Australia); Amelia McGregor (Kahnawake School Diabetes Prevention Project, Québec, Canada); Jocelyn Bruyere (Cree Nation Tribal Health Centre, Manitoba, Canada); Dr. Sharon Bruce (University of Manitoba, Canada); Dr. T Kue Young (University of Toronto, Canada); Dr. David Dannenbaum, Jill Torrie, Solomon Awashish, and Pierre Lejeune (Cree Board of Health and Social Services of James Bay, Québec, Canada); Morehu Te Whare (Ngati Maniapoto, Aotearoa/New Zealand); and Morehu Timoti Tokomauri (Ngati Tuwharetoa, Aotearoa/New Zealand). We also express gratitude to all others involved in teleconferences, pre-testing and pilot testing sessions, including people of the Yolngu community of Galiwin’ku, Northern Territory, Australia; nga tangata o Te Arawa, Ngati Porou me Tainui waka, Aotearoa; the Cree Nation Tribal Health Centre in Manitoba, Canada; and the Cree Board of Health and Social Services of James Bay, Québec, Canada.

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Authors and Affiliations

  1. School of Health Sciences, The University of South Australia, PVC Office, Level 5, Playford Building, City East Campus, North Terrace, Adelaide, SA, 5001, Australia

    Mark Daniel, Margaret Cargo & Catherine Paquet

  2. Département de médecine sociale et préventive, Université de Montréal, Montréal, PQ, Canada

    Mark Daniel, Elisabeth Marks & Catherine Paquet

  3. Department of Psychiatry, Psychosocial Research Division, Douglas Hospital Research Centre, McGill University, Montréal, PQ, Canada

    Margaret Cargo

  4. Te Roopu a Iwi o Te Arawa Charitable Trust, Inc. Private Training Establishment, Rotorua, New Zealand

    David Simmons & Margaret Williams

  5. Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

    David Simmons

  6. Onemda VicHealth Koori Health Unit, Centre for Health and Society, School of Population Health, The University of Melbourne, Melbourne, Australia

    Kevin Rowley

  7. Department of Medicine, St. Vincent’s Hospital, The University of Melbourne, Melbourne, Australia

    Kevin Rowley & Kerin O’Dea

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  1. Mark Daniel
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  2. Margaret Cargo
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Correspondence to Mark Daniel.

Appendix 1

Appendix 1

Final indicator rating tool .

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Daniel, M., Cargo, M., Marks, E. et al. Rating Health and Social Indicators for Use with Indigenous Communities: A Tool for Balancing Cultural and Scientific Utility. Soc Indic Res 94, 241–256 (2009). https://doi.org/10.1007/s11205-008-9420-7

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