A qualitative study to create a framework of Métis understandings of brain health promotion and dementia prevention in Alberta, Canada

Abstract:

Background: Indigenous populations experience a higher prevalence of dementia compared to non-Indigenous populations. Brain Health PRO is a web-based educational program designed to increase knowledge around dementia risk factors and help create lifestyle changes. The purpose of this study is to understand whether Brain Health PRO is relevant to Métis communities in Alberta, Canada.

Methods: Métis participants were recruited across Alberta and interviews were completed using the Métis visiting methodology (Keeoukaywin). Data were co-analysed using Indigenous approaches to reflexive thematic analysis.

Results: Sixty-three interviews with 20 participants were completed between April and November 2024. The analysis generated two main themes which suggest the overall design and delivery of Brain Health PRO are not culturally relevant for Métis people in Alberta. The first theme, “Promoting Métis knowledge systems” was demonstrated through discussions of the seven components of Brain Health PRO (physical health, cognitive engagement, nutrition, sleep, social and psychological health, vascular health, and vision and hearing), and how these components excluded traditional Métis knowledge. The second theme, “Holistic approaches to risk reduction” described the how Métis knowledge could influence the way each component is presented and understood together in a Métis worldview. The subthemes were: importance of interaction and balance of multiple components; benefits of in-person program delivery; brain health promotion across the lifespan; accessing resources; and the legacy of colonization.

Discussion: Though the seven components of Brain Health PRO may be useful for Métis people, the content and delivery of these components lacked Métis knowledge and worldviews. In-person engagement with Métis communities is a crucial next step to co-develop resources that are culturally appropriate.

Plain Language Summary:

The question we studied: Indigenous populations experience a higher prevalence of dementia compared to non-Indigenous populations. It is important that educational programs about brain health such as Brain Health PRO are relevant to Indigenous communities. The research question we asked was: Is Brain Health PRO an appropriate education program about brain health for Métis communities in Alberta?

How we studied it: Métis participants who have experience with dementia were recruited across Alberta and participated in interviews related to brain health and Brain Health PRO. We asked several questions like “How does your culture understand dementia?”, and “How does your culture support physical activity?”. The researchers looked for common themes across the interviews.

What we found: Two main topics came up often across the interviews. One topic was the lack traditional Métis knowledge in Brain Health PRO. For example, the Canada Food Guide is suggested in Brain Health PRO, but is not applicable to traditional Métis foods. The other topic described holistic approaches to brain health. In other words, how the different parts of brain health can be understood together as a whole. For example, hunting and berry picking (traditional Métis ways of getting food) involve both physical activity and being with family and community.

Why it matters: Though parts of health and brain health covered in Brain Health PRO may be useful for Métis people, the content and delivery of these components lacked Métis knowledge and worldviews. This tells us that Brain Health PRO is not culturally relevant for Métis people in Alberta. We can take these findings to make resources that are culturally relevant for Métis people in Alberta by including more traditional knowledge and cultural activities.