Evaluating the Impact of a Holistic, Community-Driven, Physical Activity-Based Wellness Program for Indigenous Women using Nominal Group Technique

Abstract

Objective             Indigenous women experience structural barriers to wellness rooted in colonialism and related socio-political processes, making participation in physical activity and access to balanced nutrition challenging. In response, a holistic wellness program was developed in Lloydminster, Alberta, and multiple program iterations have since been completed in urban and rural (including reserve) settings in Alberta, Canada: Onion Lake Cree Nation, Lloydminster and Calgary. The program includes physical activity, nutrition education, bridging to local healthcare support and sharing circles to facilitate reflection. This article collates three years of qualitative data between programs to answer the question: “What does the program do?”   Methods             Between 2017 and 2019, twenty-four participants, four facilitators and three community champions completed post-program interviews. A mixed-methods, qualitative, two-part analysis was completed involving thematic analysis of transcripts followed by a structured consensus-building approach called nominal group technique (NGT).   Results             Collaborative analyses revealed that the program enables: 1) self-actualization through collective effort – development of knowledge, skills, beliefs, and behaviours needed to manage one’s own health, 2) improved personal wellness, and 3) access to social and cultural supports. Cultural relevancy and safety were identified as key elements of the context that supported these changes.   Conclusion             The wellness program for Indigenous women demonstrates positive impacts on the health and well-being of participants. Benefits naturally extend to participant families as well as to communities involved through capacity building. The environment of the program, not simply the education and resources offered within it, also contributes to this positive impact.