Community-Based screening and triage versus standard referral of Aboriginal children

Health solutions for Aboriginal children should be guided by their community and grounded in evidence. This manuscript presents a prospective cohort study protocol, designed by a community-university collaborative research team. The study’s goal is to determine whether community-based screening and triage lead to earlier identification of children’s emotional health needs, and to improved emotional health 1 year later, compared to the standard referral process. We are recruiting a community-based sample and a clinical sample of children (ages 8 to 18 years) within one Canadian First Nation. All participants will complete the Aboriginal Children’s Health and Well-being Measure (ACHWM)© and a brief triage assessment with a local mental health worker. All participants will be followed for 1 year. Children with newly identified health concerns will be immediately connected to local services, generating a new opportunity to improve health. The development of the research design and its execution were impacted by several events (e.g., disparate worldviews, loss of access to schools). This manuscript describes lessons learned that are important to guide future community-based research with First Nations people. The optimal research design in an Aboriginal context is one that responds directly to local decision makers’ needs and respectfully integrates Aboriginal ways of knowing with Western scientific principles. Such an approach is critical because it will generate meaningful results that will be rapidly adopted, thus reducing the knowledge-to-action gap.