Nordic Conference 2017
April 1-2nd, 2017
Montreal
What is Qanuirlipitaa 2017?
Major population health survey for Nunavik that involves the
collection, analysis and dissemination of information (data) on the
health status of the Nunavimmiut
Since 2004…
2014
2013-2015
2012
Future Nunavik Health
Survey Consultation
2010
Plan Nunavik
2009
Quebec’s Government
Plan Nord
NRBHSS Board of Directors
resolution to conduct a new
health survey
Qanuilirpitaa?2017
HOWAREWENOW?
Objectives
o Provide an overall population health profile to support healthy community
development;
o Provide a baseline assessment of health and social conditions in Nunavik
communities that may be affected by forthcoming economic and resource
development in the region (Plan Nord);
o Support the development and empowerment of our communities;
o Follow up on the health and determinants of participants since 2004 (cohort);
o Assess the health status of Nunavik youth;
o Assess the intergenerational evolution of health and its determinants in the age
group 18-30 of 2017 as compared to the same age group of 2004;
o Improve our understanding of health and social issues;
o Provide essential information to support the next Strategic Regional Plan of the
health and social services sector;
o Nurture the research competencies and skills of Inuit;
o Help in specifying further areas for future research.
Qanuilirpitaa?2017
HOWAREWENOW?
Components
o Adult component: assess adult health status in 2017 and follow-up on the adult
participants in 2004 (N=700); recruit 300 additional participants 31 years and over
to insure representativeness of the adult cohort.
Lead researchers: P. Ayotte, M. Lemire, B. Lévesque; Inuit co-lead: M. Pilurtuut
o Youth component: establish a new cohort (N=1000) of young Inuit aged 16 to 30
years old.
Lead researchers: G. Muckle, R. Bélanger; Inuit co-lead: L. Yeates
o Community component:
Phase 1: develop indicators of community assets and conditions to assess
community well-being in collaboration with communities
Lead researchers: M. Riva, C. Fletcher; Inuit co-lead: N. Etok
Phase 2: community empowerment and mobilisation
Lead researchers: P. Simard, F. Bouchard; Inuit co-leads: Community mayors
Qanuilirpitaa?2017 GuidingPrinciples
HOWAREWENOW?
Empowerment and self-determination of Inuit
Respect of all parties involved
Utility/Relevance/Usefulness for the region
Trust between all partners
Transparency
Engagement
Scientific rigor
Realistic approach
Qanuilirpitaa?2017
HOWAREWENOW?
OCAP ™ principles
Ownership (data owned by Nunavik)
Control (of all research phases)
Access (Nunavimmiut must have access to their data wherever they are
held)
Possession (physical control of data and samples)
Qanuilirpitaa?2017
HOWAREWENOW?
Within Nunavik
o
o
o
o
o
o
o
NRBHSS
Kativik Regional Government
Kativik School Board
Makivik Corporation
QarjuitYouth Council
Avataq Institute
Kativik Municipal Housing
Bureau
o Inuulitsivik and Tulattavik
Health Centres
o Municipalities
Partnerships
Between Nunavik and southern
organisations
A successful collaboration established
through Qanuippitaa? 2004 between:
o NRBHSS
o Institut national de santé
publique du Québec (INSPQ)
o CHU de Québec Research
Centre-Université Laval
o Researchers from other
universities (McGill U, Trent U,
etc.)
Qanuilirpitaa?2017
HOWAREWENOW?
Governance
Overall guidance; ensures political
and administrative legitimacy
(main Inuit organizations involved)
Planning
Budget management
General coordination
Management
Committee
Survey content,
design and
methodology
Scientific
Committee
Operational
and Strategic
Committee
Communications
Committee
Communication strategies
Logistic planning and
Survey conduct
August 8 to Sept. 26
(50 days)
CONSULTATION PROCESS
Several Inuit and regional experts were consulted.
Themes were added (deleted) or refined through different consultations.
Who was and will be consulted/who is involved:
o Inuit co-leaders (each component)
o Inuit representation in Qanuilirpitaa committees
o Social and health organizations
o Regional Intersectoral organizations.
Questions asked about each theme through consultations:
o Is it a preoccupation for the community? (provide a continuation to Parnasimautik)
o Is it relevant to you?
o Do you need a better understanding of this topic?
o Was it studied elsewhere?
o Is the proposed approach feasible?
o Is the approach acceptable?
THEMES SELECTED (1)
PHYSICAL HEALTH
Subjective rating of general health (incl. quality of life)
Accidents and trauma
Cardiometabolic health
H. Pylori infection, zoonoses & waterborne diseases
Sexually-transmitted infections
Respiratory health
Oral health
Nutritional status and anemia, food security,
contaminants
Adult
Cohort
Youth
Cohort
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
THEMES SELECTED (2)
MENTAL HEALTH AND RELATED DETERMINANTS
Mental health and well-being (depression, suicide,
stress)
Resilience (self-esteem & social support)
Victimization, Bullying & Justice
Family relationships
Men’s health
Consumption of substances, Dependencies & Gambling
Sexual health (risky sexual behaviour, contraception,
healthy relationship & early pregnancy)
Social media & Online communication
Adult
cohort
Youth
cohort
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
THEMES SELECTED (3)
COMMUNITY (AND INDIVIDUAL) LEVEL
DETERMINANTS OF HEALTH
Socio-demographic factors & Housing
Cultural identity, Equity & Intercultural links
Community involvement, Roles & responsibilities
within the community
Community safety
Availability & accessibility of services within the
community (including educational institutions)
Social integration and exclusion
Natural environment (incl. drinking water) &
Land-based activities
Adult
Cohort
Youth
Cohort
Community
Component
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
CLINICAL TESTS/
MEASUREMENTS
Theme
Test/measurement
Cohort
Rationale for inclusion in
Q2017
Anthropometric
measurements
Height, weight, waist size and BMI
Body composition (bioelectrical
impedance analysis)
Youth and Adults
Risk factor for diabetes,
cardiovascular diseases,
metabolic syndrome
Cardiovascular
health
Blood pressure (BP)
Heart rate
Youth and Adults
Cardiovascular health,
metabolic syndrome
Diabetes
OGTT*
Youth and Adults
Diabetes screening
Oral health
Oral exam
Youth and Adults
Gum inflammation, periodontal
diseases, tooth loss, tooth
decay
Lung health
Spirometry (pre- and postbronchodilator)
Youth and Adults
Asthma/COPD
LABORATORY ANALYSES
Biological sample
Laboratory analysis
Cohort
Rationale for
inclusion in Q2017
Blood
Complete blood count
Clinical chemistry
Vitamins, micronutrients, etc.
Contaminants
Specific IgEs, antibody titers
Youth and Adults
Anemia, allergies,
diabetes screening, liver
diseases, nutritional
deficiencies, exposure to
contaminants, zoonoses.
H. pylori
Urine
Clinical chemistry
Contaminants
Youth and Adults
STI testing
Youth – men
Kidney diseases,
nutritional deficiencies,
exposure to
contaminants
Chlamydia and
gonorrhea infection
Vaginal swab collection
STI testing
Youth – women
Chlamydia and gonorrhea
infection
Stool sample collection
H. pylori (antigen)
Youth and Adults
H. pylori (active
infection)
Occult blood presence
Colorectal cancer
screening (50 y +)
COMMUNITY HEALTH
Mapping asset of a community: Enhance positive ressources
to be preserved in the community rather than mapping
problems
Identify actions that communities can take to improve health
and social well-being and minimize negative impacts
Community empowerment project: We also aim to support
the communities in their development, in line with Inuit
aspirations so a community engagement project will be
carried out as a pilot alongside the survey , in 2-3
communities.
TRAINING PROGRAM
This program funded by KSB will:
o
o
o
Help Inuit students and youth to emerge as
research experts and role models in Nunavik;
Contribute to the training of highly qualified
Inuit personnel that are needed in the North in
addition to supporting the conduct of the
Qanuilirpitaa survey;
serve to attract/excite students about the
importance and relevance of environmental
and health studies and sciences in general
Conclusion
Qanuilirpitaa is a Health and well-being survey BY and FOR
the Nunavvimiut
The members of Qanuilirpitaa team are working with the
mayors so each community can participate fully to this
project
Communication is key to interest people and communities to
the survey – relevant information to the population will be
communicate
Participation of Nunavimmiut to the survey must be
enhanced by community leaders in order to foster positive
aspects and improve aspects that need to be improved
PARTNERS
Thank you/Nakurmiik