Securing Our Future

Transcription

Securing Our Future

Securing Our Future
Ontario First Nations Child Car Restraint Project
Final Report March 2012
Copyright © 2012 Chiefs of Ontario
March 2012
SECURING OUR FUTURE
DISCLAIMER
This document does not necessarily reflect the views of any of the First Nations that participate in the Chiefs
of Ontario, the government of Canada or the province of Ontario. This report is not intended to provide legal
advice, nor should it be construed as providing legal authority or direction. No warranty of any kind is given by
the Chiefs of Ontario. The Chiefs of Ontario disclaims liability in respect of anything done in reliance, in whole
or in part, on the contents of this report.
COPYRIGHT
Rights reserved. This document is copyrighted by the Chiefs of Ontario 2012. It may not be reproduced or
transmitted for education, training or research purposes by any means, electronic or mechanical, including
photocopying or any information storage or retrieval system, without permission from the publisher or
authors, provided that the Chiefs of Ontario is credited.
CONTACT INFORMATION
Chiefs of Ontario
111 Peter Street, Suite 804
Toronto, Ontario
M5V 2H1
416-597-1266
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Acknowledgements
The Chiefs of Ontario wish to extend their gratitude to the staff of the Chiefs of Ontario, the Injury Prevention
Advisory Working Group, the Health Coordination Unit, researchers, consultants, training facilitators,
participants and especially to our Elders, whose wisdom has guided us towards securing a future “through
injury prevention and the promotion of safe and healthy communities for generations to come.” We
acknowledge the contributions of our partners; the Political Territorial Organizations; Independent First
Nations, and participating First Nation Communities. Nicolette Kaszor, Ontario Region, First Nations and Inuit
Health Branch – Health Canada and Indigenous Health Research Development Program – McMaster University
for guidance and project funding. In the assistance of completing research component of the project; Dr.
Sheila Cote-Meek, Associate Vice-President, Academic and Indigenous Programs, Laurentian University,
Project Researcher and Jenny Leigh Solomon, Research Student Assistant from Laurentian University; Dr.
Alison Macpherson, Research Collaborator and Consultant, York University and First Nations and Inuit Child
and Youth Injury Indicators Working Group for assistance in the completion of data analysis. Natalie Zeitoun,
Ontario Ministry of Transportation – Traffic Safety Division; Safe Kids Canada and Mark Medalen, Washington
Traffic Safety Commission and Washington Indian Tribes, for funding, resources, and guidance on child
passenger safety education. Dawn Marsden, formally of First Nations Centre - National Aboriginal Health
Organization for resources and training in research; St. John’s Ambulance for certified child car seat technician
training; Jeff Skye, Aboriginal Police Services for guidance and child passenger safety promotion, Fern
Assinewe, Consultant – Literature Review and Ryan Red Corn, Buffalo Nickel formally of Red Hand Media. The
final report was completed by Deanna Jones-Keeshig, Injury Prevention Coordinator of the Chiefs of Ontario in
conjunction with the Injury Prevention Advisory Working Group. Meegwetch/Nya Weh for your support and
contributions towards injury prevention in Ontario First Nations and contributions in the completion of this
project and final report.
Injury Prevention Advisory Working Group:

Francine Pellerin, David Pierce (P), Susan Bale (P), Nishnawbe Aski Nation

Crystal Cummings, Anishinabek Nation - Union of Ontario Indians

Tammi McKenzie, Robin Koistinen, Lyndia Jones (P), Independent First Nations

Carolyn Doxtator, Christi Poulette, Association of Iroquois and Allied Indians

Previous - Harmony Rice, Diana Nason, Colleen Arch of Grand Council Treaty #3
Technicians/Facilitators:

Judy Manning Animbiigoo Zaagi’igan First Nation

Lilly Slipperjack, Robina Baxter, Hillary George, Eabametoong First Nation

Allison White, Leslie Maracle, Mohawks of the Bay of Quinte

Wanette Ashkewe, Liz Stevens, Nipissing First Nation

Bill and Colleen Arch Onigaming First Nation
(P) Is previous member
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Table of Contents
Overview: Ontario First Nations…………………………………………………………………………………………………………………………….…...6
Indigenous Knowledge……………………………………………………………………………………………………………………………………………………..7
First Nations Worldview……………………………………………………………………………………………………………………………………………………8
First Nations Cultural Framework………………………………………………………………………………………………………………………………..….10
First Nations Relations…………………………………………………………………………………………………………………………………………………….13
First Nations Historical and Contemporary Issues……………………………………………………………………………………………………………14
Literature Review on First Nations Injuries and Injury Prevention………………………………………………………………………………..15
Background: Injuries and Injury Prevention in Ontario First Nations…………………………………………………………………………….28
Ontario First Nations Injury Prevention Initiative………………………………………………………………………………………………….…..29
Securing Our Future – Ontario First Nations Child Car Restraint Project………………………………………………………………….……30
Education .............................................................................................................................................................................. 33
Training ................................................................................................................................................................................. 39
Evaluation ............................................................................................................................................................................. 49
References ............................................................................................................................................................................ 64
Appendix………………………………………………………………………..………………………………………………………………………………………….…..67
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Overview: Ontario First Nations
The Chiefs of Ontario is the coordinating organization for Ontario First Nations located within the boundaries
of the Province of Ontario. The purpose of the Chiefs of Ontario office is to enable the political leadership to
discuss regional, provincial and national priorities affecting First Nation people in Ontario and to provide a
unified voice on these issues. As such, the Chiefs of Ontario office acts as a Secretariat and coordinating body
for the First Nations and Four (4) political territorial organizations, as well as the Independent First Nations.
There are 133 First Nation communities in Ontario and in 2010 the INAC registered population for 127 IR was
181,524. Many of these communities are affiliated with tribal and territorial entities and all communities work
with the Chiefs of Ontario at a regional level. At the territorial level there are 4 Political Territorial
Organizations and the Independent First Nations.
They include the following:
Nishnawbe Aski Nation
Grand Council Treaty #3
Anishinabek Nation – Union of Ontario Indians
Association of Iroquois and Allied Indians
Independent First Nations
It is important to note that the Grand Council of Treaty #3 established an independent process for health
governance in 2011.
SECURING OUR FUTURE
March 2012
Chart of Ontario First Nation community, territorial and regional organization.
Chiefs of Ontario
Ontario First Nations
133 Communities
4 Political Territorial
Organizations
Independent First
Nations
12 Communities
Anishinabek Nation UOI
Nishnawbe Aski
Nation
Grand Council Treaty
#3
39 Communities
47 Communities
24 Communities
Unaffiliated PTO
3 Communities
Association of
Iroquois & Allied
Indians
8 Communities
First Nations in Ontario are comprised of three groups of original peoples; the Anishinaabek, the
Onkwehonwe and the Muskegowuk.1 It is important to know who the original peoples are, where they have
come from, and how they got to be where they are today, in order to understand their story and the future
they are working towards. Each of these peoples is a Nation of Nations. They are a people of families,
extended families, clans, communities and Nations whose relation and connection extend to the earth,
creation and Creator. Each has their own sacred stories, unique history, distinct language, culture and ways of
living. Within their creation stories and in their own languages, they are known as the original human beings,
the first peoples of this land, created by the Creator and placed upon Turtle Island. (North America)
Indigenous Knowledge is derived from the original teachings, language and life ways of First Nation
peoples. As Battiste & Henderson (2000) explained, “Indigenous knowledge is a complete knowledge-system,
with its own epistemology, philosophy, and scientific and logical validity… which can only be understood by
means of pedagogy traditionally employed by the people themselves.”2 Indigenous knowledge among First
Nation peoples continues to be carried, practiced, transmitted and translated from one generation to the
next. “The full extent of that knowledge is held within sacred societies and is demonstrated in ceremonial
ritual, complete with knowledgeable use of traditional teachings and ceremonial articles such as within the
Midewiwin Lodge, the Long House and their sacred societies.”3
1
Water Declaration of the Anishinaabek, the Onkwehonwe and the Muskegowuk, October 2008 – Chiefs of Ontario
Hopkins, Dumont, Cultural Healing Practice within NADAP/YSAPS Discussion Paper, February 2010 – FNIH, Health
Canada
3
Hopkins, Dumont, Cultural Healing Practice within NADAP/YSAPS Discussion Paper, February 2012 – FNIH Health
Canada
2
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Indigenous Knowledge
Additionally, in families, communities and peoples, indigenous knowledge is “held by wisdom keepers,
ceremonial practitioners, traditional doctors, pharmacists and counsellors” as well as others that represent
almost all aspects of the lives of First Nations peoples. “Indigenous knowledge, however, is not static. Human
beings are continuously discovering or coming to new understandings about things that have existed in
Creation from the beginning. The knowledge carried today has the benefit of the knowledge left by our
ancestors; something always rooted in the Creation stories. It is these stories, that hold the knowledge from
which all else is derived and understood. They tell us that the structure, pattern and processes of creation are
repeated in all aspects of life, from the structure of the universe to the structure of both human and otherthan-human beings.”4 It is this shared knowledge and life bestowed from one generation to the next, “like a
continuous thread of a string of lives,”5 that connects our living experience with meaning and purpose through
time. “Our present day thinking is inclusive of the legacy of our ancestors and of what our ancestors are
waiting for us to do. Our thoughts also include the future generations, recognizing that they are already
looking back toward us with the awareness that our decisions and our actions are impacting them. It is a living
past, a living future, and we are the living connection in between.”6 Indigenous knowledge is the foundation
of First Nation worldview. It is in understanding the key concepts of indigenous knowledge which formulate
the framework of the First Nation worldview, that an understanding about First Nation peoples can be
developed.
First Nations Worldview
“The very first concept at the centre of everything is the spirit.”7 “Spirit is best understood through
Creation stories, the foundation for all indigenous knowledge. Creation stories are the evidence base for all
that exists within Creation, and the relationship between all elements of Creation”8 including the Creator,
whom is recognized as the spirit whom has created all of life. “The Indigenous worldview, being Spiritual,
then, simply means that the Indigenous person is spirit-motivated and that Indigenous culture is spiritcentered. Spirituality is a way of being-in-the-world that is spirit-based and spirit-driven.”9 The recognition of
this concept is the key to understanding the Indigenous way of being; of seeing, relating, knowing and
behaving and living within the world. (Hopkins, Dumont 2010) "Indigenous World View is said to be “holistic”
meaning it encompasses all aspects of life, the physical, mental, emotional and spiritual aspects of life"
(Benton-Banai, 1988)10 Thus, “Another primary concept of the Indigenous worldview that comes from the
creation story is the Circle. When life moves out equally in the four directions, it forms a perfect circle.
4
Ibid.
Benton-Banai, E., Elder, Traditional Teacher and Grand Chief of Three Fires Midewiwin Lodge,
6
Ibid.
7
Canada
8
Ibid.
9
Ibid.
10
Benton-Banai, The Mishomis Book, 1988
5
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First Nations Worldview
Each of those energies that cause the circle to move equally in each direction is a different energy. So,
the energies of the four directions are what hold all of life together in the great circle of life’s unfolding. Thus
it was established for all time that the circle would be the way in which all life unfolds as it moves forever
towards the creation and re-creation of life. This concept is of primary significance in understanding the total
Indigenous worldview. It is the primary pattern of unfolding, growth and change.” 11 “The Circle is
synonymous with wholeness. All things work together in an interdependent fashion, forming an
interconnected web of integrated wholeness. Though each part is a recognizable unit, it only has meaning
when in relationship to the whole. Wholeness is the perception of the undivided entirety of things. To see in a
circular manner is to envision the interconnectedness and the interdependence within life. The wholeness of
life is the Circle of life. It is an all-embracing principle, perfect and complete, including everything. It is
timeless and absolute, yet it encompasses time and gives it meaning. It is the whole of creation, yet it
incorporates and helps us to understand all the “parts” of the created whole.”12
From this concept of the circle and the wholeness to life as being interconnected and interdependent,
flows another important concept about life. In the understanding of the First Nation worldview, not only is
everything interconnected and interdependent but everything is interrelated. The knowledge that “we are all
related” is derived from creation stories. Simply, “We are all relatives because we have the same Mother”13
Hopkins, Dumont further explains that “The Creation story of the Anishinabe underlines the indigenous
people’s identity with the land and their relationship to Creation. People were not only shaped by the land,
but were also created from the land. That this original placement of indigenous people was on the Island that
sits on the back of the Great Turtle (North America), is essential to the origin story — this is the special place
for the Red Colour of human kind. The idea of being created from the land and being placed on the land forms
an essential aspect of “aboriginality” or “indigenousness” (i.e. the Anishinabe identity). The Anishinabe
person is inseparable from the land. Their identity, sense of place and history are intimately related to the
land.”14 Within indigenous knowledge and understanding derived from creation stories, all of life in being
created by the creator share the same source and elements of life and are therefore related. The creation of
humankind from the earth means that original peoples are a part of family that extends to the earth and
universe. “The Earth herself is a living, breathing, conscious Being, complete with heart/feeling, soul/spirit,
and physical/organic life, as it is with all the relatives of creation. “15 And, “The universe itself is said to be a
family — Grandfather Creator, Grandmother Moon, Mother Earth. All of Creation is relatives to the human
being.”16
11
Canada
12
Canada
13
Ibid.
14
Ibid.
15
Ibid.
16
Canada
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First Nations Cultural Framework
Foundationally based within indigenous knowledge and First Nation worldview as derived from the
many distinct original teachings and ways of life of various First Nation peoples, there is a shared way of
seeing, relating, knowing and living that is uniquely indigenous. This cultural framework presents an
illustrated view of indigenous knowledge and First Nations worldview. The Four Directions of Indigenous
Intelligence was developed by Dr. James Dumont. It was developed in response to the limitations of conveying
indigenous knowledge and First Nations worldview from other people’s knowledge systems and worldviews.
This cultural framework was initially developed and utilized in the interpretation of the results of the First
Nations and Inuit Regional Health Survey - First Nations Information Governance Centre and was presented in
a Discussion Paper on Cultural Healing Practices within National Native Alcohol and Drug Abuse Programs and
Youth Solvent Addiction Program Services for First Nations and Inuit Health Branch – Health Canada. It
effectively summarizes the collective concepts of indigenous knowledge within First Nation worldview which
have been presented and how these concepts are operationalized from an individual perspective.
Additional concepts that were presented in indigenous knowledge and First Nation worldview are
illustrated through a spiral model of the four directions. This model illustrates a First Nation view and
experience of the world and outlines the concepts and linkages between the Creator, Creation, Peoples, Gifts
of Life, First Nations, Life Cycle, and the Individual. The circles are linked in a spiral to illustrate the
interconnected, interrelated and interdependent wholistic view of life. Thus, this spiral model of the four
directions represents the living context of First Nations within a cultural framework. The source of this
knowledge is derived from Edward Benton-Banai’s, The Mishomis Book, 1988 and from academic
presentations by Peter O’Chiese, Herb Nabigon and James Dumont. The model begins with the Creator, for it
is the creator whom created all of life and is the source of all life. The first circle entitled Creation identifies
the elements of life within creation and the four directions. It recognizes that all of life was created with and
is sustained by these elements. Within the circle of creation is the universal and earth family. The second
circle represents the four colors of original Peoples within the four directions. Within indigenous creation
stories, the Creator created four original (4) colors of human beings. The third circle represents the Gifts of
the four directions. These are the elemental energy and character of each direction. The four directions is
essentially the cultural framework of First Nations worldview and indigenous knowledge. In vision all of life is
perceived as an interconnected, interdependent and interrelated whole that is spirit centered and originates
from the Creator. Through time, life is experience upon the earth through a living relationship with all of
creation in a continuum of past, present and future. In knowledge the capacity to think and reason develops
understanding about life. In movement, the ways of being and living is motivated by vision, relationship and
knowledge about self within life. The fourth and fifth circle is about the composition of First Nation Peoples
and the Life Cycle. First Nations are comprised of individuals, families, communities and Nations. The four
stages of human life are child, youth, adult and elder. The sixth circle depicts all aspects of the individual. The
four aspects of an individual are spirit, heart, mind and body. This is the First Nation perspective on a whole
individual. Individual health and wellness depends on the nurturing and balance of all aspects of an individual
person and person’s life within the context of the whole of life.
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Four Directions of Indigenous Intelligence
The Indigenous Way of Being is the total response of the
total person with the total environment. It is a way of
doing that involves the whole person – body, mind,
heart and spirit. This way of being and doing generates
the finest creative expression and the highest quality of
experience of the individual person within environment.
The Indigenous
Way of Thinking
uses the totality
of the mind in its
intellectual and
intuitive and
spiritual capacity,
as well as
sensory and
emotional
inspiration. The
indigenous way
of knowing
involves total
faculty learning
and calls on the
total responsiveness of the total
person. It is a
way of knowing
that is inspired
from the heart as
well as generated
from the mind’s
intelligence.
The Indigenous
Way of Seeing is
spirit-centered.
It is a total way
of seeing. The
Indigenous
person has the
capacity for
“total vision”
which
encompasses the
whole of reality,
considers all
levels of
knowing, is
informed by all
of the senses
(physical,
emotional,
intuitive and
spiritual), and
maintains the
interdependence
interconnectedness and holistic
experience and
integrity of the
total
environment.
The Indigenous Way of Relating is an all-encompassing way of
relating in a world that is personal, caring, responsive and sharing.
It is inclusive of all beings: human and other-than-human. This
way of relating is respectful of the individual and responsive to the
integrity of the collective whole.
The Four Directions of Indigenous Intelligence
17
17
Canada
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FIRST NATION WORLDVIEW
FIRST NATIONS
LIFE CYCLE
INDIVIDUAL
18
18
Jones-Keeshig, D – Four Directions Model of First Nation Worldview, 2011
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First Nations Relations were established historically with other peoples through treaties.
The Upper
Canada and post-Confederation treaties in Ontario forged the basis of relations between First Nations and the
Crown. To the First Nations, the treaties were sacred, living documents that affirmed their sovereignty, and
created mutually binding obligations in a peaceful and everlasting way 19. The treaties established 13320 First
Nations communities and recognized the traditional territories of First Nations within Ontario.
21
19
Treaty Commission in Ontario – Final Common Discussion Paper, Kathleen Lickers, July 2009
Chiefs of Ontario, www.chiefs-of-ontario.org
21
Chiefs of Ontario, www.chiefs-of-ontario.org
20
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First Nations Historical and Contemporary Issues
The perception of the Crown in treaty relations was very different and the implementation of
colonialistic governmental policies and laws resulted in significant changes that affected every aspect of the
life of First Nation people. The most pervasive legislation was the Indian Act legislation of 1876. “It is
important to understand both the origins and impact of the Indian Act. The Indian Act reflected the core
assumptions held about Indigenous peoples by the dominant Euro-Canadian society in the mid to late 19th
century. Its basic premises, summarized as providing for “civilization, protection and assimilation,” 22
instituted a colonial regime that was deliberate in breaking down the life ways of First Nation people as
expressed within their cultures, traditions, languages and practices. The intent of government was clearly
stated by Duncan Campbell Scott, Head of the Department of Indian Affairs in the 1920s: “Our objective is to
continue until there is not a single Indian in Canada that has not been absorbed into the body politic and there
is no Indian question.”23 The residential schools were one of the most significant acts of government policy
and law to implement civilization and assimilation of First Nation peoples and the most traumatic. Residential
schools “separated children from their families, communities, and culture in order to ‘kill the Indian in the
child’.” 24 The purpose of residential schooling was to assimilate Aboriginal children into mainstream Canadian
society by disconnecting them from their families and communities and severing all ties with languages,
customs and beliefs. To this end, children in residential schools were taught shame and rejection for
everything about their heritage, including their ancestors, their families and, especially, their spiritual
traditions. The impacts of disconnection and shaming were compounded by the physical and sexual abuse
many children experienced at these schools, often by multiple perpetrators and many for the entire duration
of their childhood. The tools of cultural genocide are cultural shame, cultural disconnection and trauma. It is
now understood that unresolved, multiple disconnections and historical trauma are directly responsible for
many of the problems facing Aboriginal people today.”25 Contemporary issues in relations and disparities
within First Nations can be traced to these changes and their impacts. “The traumas of this colonial legacy
continue today with Indigenous people disproportionately experiencing poverty, poor health, incarceration,
youth suicides, unprecedented levels of violence against Indigenous women, child apprehension and,
substandard levels of access to basic needs including water and homes.”26 These challenges, however, do not
exist only as a result of historical changes and events, but continue to be pervasive in First Nation communities
as a result of existing governmental policies and laws in relations to First Nation peoples and, the current
governmental programs and services which continue to lack substantive long term planning, comprehensive
approaches, adequate and sustainable resources to support capacity development to meet and address the
needs in First Nation communities.
22
McCaslin, Wanda D, Boyer, Yvonne, First Nations Communities at Risk and in Crisis: Justice and Security – NANO
Journal of Aboriginal Health, November 2009
23
Walia, Harsha. The Dominion, September 2009 http://www.dominionpaper.ca/articles/2943
24
Ibid.
25
Chansonneuve, Deborah. Reclaiming Connections: Understanding Residential School Trauma Among Aboriginal
People, Aboriginal Healing Foundation, 2005
26
Walia, Harsha, The Dominion, September 2009 http://www.dominionpaper.ca/articles/2943
March 2012
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First Nations Historical and Contemporary Issues
The injury rates in First Nations speak to the challenge of the conditions in First Nation communities,
the impacts of health determinants, and the traumas of a colonial history and its legacies. However, despite
these changes, the natural strengths and resiliency of First Nations as expressed within the identity and
culture of the peoples has enabled them to meet these challenges and to pursue the assertion of their rights
and governance as First Nations in order to secure and ensure the future of their peoples. “The impact of
history and ongoing legacy of harm needs to be understood to ensure the response is framed by an
understanding of the First Nations context: the culture, the history, colonization, the nationhood of the
people, and that planning, policy, strategy and programs will be based on strengthening First Nation
communities in order to facilitate change.”27 The Ontario First Nations Injury Prevention Initiative and the
Securing Our Future Ontario Child Car Restraint Project was designed, developed and implemented to build
upon First Nation strengths and enhanced the capacity of First Nations to address injury prevention through
the promotion of child passenger safety and thus, securing their future.
Literature Review
-
Defining Injury: Injury is defined as “physical damage to the body…resulting from
acute exposure to various kinds of energy…in amounts that exceed the threshold of physiological tolerance”
(World Health Organization, 1999, cited in McDonald, 2001). There are two major categories of injuries,
intentional and unintentional (McDonald, 2001, First Nations Centre, 2005). Intentional injuries are the result
of deliberate acts of violence, inflicted by oneself (for example, suicide) or by another individual (including
homicide, family violence and assaults) (McDonald, 2001; Health Canada, 2001). Unintentional injuries can
result from actions such as falls, drowning, burns, motor vehicle collisions and poisonings (Brant County Health
Unit, June, 2008). In the past, unintentional injuries were commonly described as “accidents” (Health Canada,
2001; Barss, Smith, Baker & Mohan. 1998). Current thought suggests this term is imprecise and misleading as
it suggests that the incident was “an unpredictable and unpreventable random event” whereas “injuries
generally result from combinations of adverse environmental conditions, equipment, behaviour, and personal
risk factors, any or all of which can be changed” (Barss et al., 1998, p. 9). Further, there is extensive evidence
showing that most injuries are both predictable and preventable (Pless & Hagel, 2005). It is reported that 90%
of all accidents are preventable (Brant County Health Unit, 2008). The consequences of both categories can
be devastating, impacting the individual and/or family for the remainder of his/her life. Consequences can
include death or disability, as well as a diminished quality of life due to depression, alcohol and substance
abuse, smoking, eating and sleeping disorders, HIV and other sexually transmitted diseases, emotional
anguish, pain, activity limitations and grief as the result of the death of a loved one (Health Canada, 2001; First
Nations Centre, 2005). In addition, there are financial costs associated with injuries, with scarce resources
diverted to the care and treatment of injuries. Health Canada (2001) estimates that in 1995 unintentional
injuries cost Canada $8.7 billion ($300 for every citizen) in direct costs for treatment, including hospital care,
physician services, prescription drugs and rehabilitation services. There are also indirect costs to society in the
form of a loss in productivity.
27
McCaslin, Wanda D, Boyer, Yvonne, First Nations Communities at Risk and in Crisis: Justice and Security – NANO
Journal of Aboriginal Health, November 2009
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Literature Review - Risk and Protective Factors
Risk factors are personal or environmental conditions that increase the likelihood that individuals will
develop one or more health and/or behavioural problems (Hawkins, Catalano, & Arthur, 2002). These factors
can relate to society, community, family and the individual (McDonald, 2001). The First Nations Regional
Longitudinal Health Survey (RHS) 2002/03 (First Nations Centre, 2005) suggests it is the interaction of these
factors that influence injuries. McDonald (2001) describes a number of risk factors that are known to
predispose individuals to injury, and that are known to be present in First Nation communities. Many of these
risk factor categories are experienced in significantly higher levels in First Nation communities than in the
general Canadian population. These factors are organized by category and include:
Community Environment:
o Poverty,
o High unemployment,
o Inadequate housing, and
o Cultural devaluation;
Family Environment:
o Alcohol, tobacco and other dependency of parents,
o Parental abuse and neglect,
o Financial strain,
o Large, overcrowded family,
o Unemployed or underemployed parents,
o Single female parent without family/other support, and
o Family violence or conflict;
Vulnerability of the Individual:
o Child of an alcohol, tobacco or drug abuser, and
o Physical or mental health problems,
o Personality traits such as insecurity (First Nations Centre, 2005);
Early Behaviour Problems:
o Emotional problems,
o Inability to cope with stress,
o Low self-esteem, and
o Aggressiveness;
Adolescent Problems:
o School failure and dropout;
o At risk of dropping out,
o Violent acts,
o Drug use and abuse,
o Teenage pregnancy/teen parenthood,
o Unemployed/underemployed, and
o Suicide ideation.
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Literature Review
Other reasons are also offered as explanations for the high injury rates in First Nations. For example, it
is thought that motor vehicle collisions result in higher rates of injury amongst First Nation people as many live
at a distance from commodities or services, including emergency care (McDonald, 2001; Health Canada, 2001).
They also use riskier types of vehicles, such as snowmobiles and all-terrain vehicles, under unsafe conditions
such as on ice, public or poor roads. Alcohol and substance abuse are also thought to contribute to the
greater risk of injury in motor vehicle collisions.
Factors associated with higher risk of suicide and violence includes poor social conditions and
community dysfunction (McDonald, 2001). Higher suicide rates have been correlated to community
characteristics including more occupants per household, more single parent families, fewer Elders, lower
average income, and lower levels of education. Overcrowding and poor housing also increase the risk of
injury, and can contribute to high levels of stress which may lead to family violence. A hunting lifestyle
subjects the population to risk of firearm injuries and suicide by use of the firearms. Other factors which make
women more susceptible to injury may be gender inequality, rigid gender roles, and general acceptance of a
man’s right to be violent with a partner (First Nations Centre, 2005).
The risk of death by drowning is greater as many First Nation communities are located near bodies of
water, and are often required to cross the water to access commercial or service organizations (McDonald,
2001). Cold water temperatures in the north, reduced access to swimming lessons and lifesaving training,
lifestyle choices including the use of substances, and a lack of emphasis on safety habits (such as use of
flotation devices) are also factors that can lead to death by drowning. Injury as a result of fire or flame may be
related to the use of wood frame in the construction of homes, limited use of smoke detectors and smoking
habits.
The RHS 2002/03 (First Nations Centre, 2005) reported the following:







30.9% of lower-income households reported injuries in comparison to 23.4% of higher-income households.
33.6% of males reported injuries in comparison to 23.8% of females, especially in relation to injury caused
by sports, bicycle accidents or environmental factors.
Injury rates are lowest in children.
Injury rates are higher in youth and young adults (18-34) in comparison to older adults.
Younger men are at significantly greater risk than other age and gender groupings (42.8% of men 18 – 34).
Injury rates were significantly higher amongst people:
o Who had used illegal drugs in the previous year,
o Who were frequent, heavy drinkers in the previous year,
o Who had experienced depression in the previous year or had ever considered suicide, or
o Who had a close friend or family member who had committed suicide in the previous year, and
Higher injury rates were found in more isolated communities in comparison to non-isolated communities.
The RHS 2002/03 identifies risk factors of particular relevance to youth. These include cultural norms that
support violence, unsafe recreational areas, and easy access to firearms, low rates of seatbelt use, insufficient
supervision, risk-taking behaviour and alcohol abuse.
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Although there appears to have been a decrease in injury rates with higher levels of formal education, the
findings were not statistically significant. The results of the RHS 2002/03 (First Nations Centre, 2005) also
suggest that men and women experience similar rates of violence. The report suggests this may be related to
gender differences in the types of violence experienced. It is thought women are more vulnerable to domestic
violence, while men experience the same level of violence in relation to other types of assault as a result of
fights and brawls. It was also reported that injury rates did not appear to be associated with the size of a
community or its transfer status.
Research by Chandler and Lalonde (1998) suggest that greater community control of its own services,
cultural facilities and land base can act as a protective factor in relation to youth suicide. The RHS 2002/03
(First Nations Centre, 2005) suggests it could be argued that greater control may also be associated with other
lower intentional injuries such as assault or family violence.
Literature Review - Injuries in the General Population of Ontario
An Ontario study examining the economic burden of injuries found that, in 1999, 4,044 people in
Ontario died as a result of injury, that 75,176 people were hospitalized as a result of injury, and 492,438
people experienced injuries that did not lead to hospitalization (SMARTRISK, 2006). The study estimated that
20,693 of the total injuries “resulted in partial, permanent disabilities” while another 1,426 injuries “resulted
in total, permanent disability” (SMARTRISK, 2006, vii). Translation of these figures means that in Ontario 65
people are injured each hour and 11 people die of injury each day.
The cost of these intentional and unintentional injuries amounts to $5.7 billion per year (SMARTRISK, 2006).
Of the total cost:
 78% ($4.5 billion) are related to unintentional injuries, of which falls are the most costly category ($1.9
billion), followed by motor vehicle collisions ($1.1 billion) (a 2007 document produced by Ontario’s
Injury Prevention Strategy, 2007, reports that in 2004-2005, motor vehicle collisions account for 44% of
major trauma hospitalizations and unintentional falls account for 34% of these hospitalizations)
 Intentional injuries account for 19% of the total costs (approximately $1.1 billion). Of this amount,
suicide and self-inflicted injury amounts to a cost of $886 million and interpersonal violence accounts
for costs of $230 million
 Injuries related to physical activity amount to a cost of $655 million, with collisions in sports activities
amounting to $166 million
 Alcohol-related injuries cost Ontarians $440 million ($156 million associated with motor vehicle traffic
collisions, $117 million for unintentional falls, $115 million for suicide and self-inflicted injury, and $52
million for interpersonal violence.
The study also found injury rates varied across regions within Ontario and that physical activity related
injuries varied by age. The study recommended that the province invest in a comprehensive injury prevention
strategy encompassing surveillance, research and evaluation across multiple disciplines, effective
dissemination of information, and evidence-based programming and policies. It is important to note that the
study did not isolate First Nation specific information.
March 2012
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Literature Review - Injuries in First Nation People
Injuries have reached epidemic proportions in Canada; and the situation in First Nation populations is
even more serious (McDonald, 2001 and 2004). First Nation people experience the same types of injuries as
other Canadians; however, the rate of injury amongst the Aboriginal population, both males and females, is
higher in comparison to the non-Aboriginal population. Statistics Canada (cited in Chandrakant and Ramji,
2005) reports that in 2005, 25% of Aboriginal people aged 12 – 19 years, 25% of those aged 20 – 24 years, and
15% of those aged 45-64% reported a serious injury in the previous year. Amongst the Aboriginal population,
males experience a greater risk of non-fatal injuries in comparison to females (22.2% in comparison to 16.9%).
Injuries are also reported as the most common reason for hospitalizations amongst First Nation people (First
Nations Centre, 2005).
There is some discrepancy in the literature regarding the leading cause of death. Injury and poisoning
were reported as the leading causes of death in the First Nation population in 1999 (Health Canada, 2003). In
2005, the results of the RHS 2002/03 identified injury as the second leading cause of death in First Nations,
following circulatory disease. Differences in rates may be due to the fact that Health Canada’s report is based
on mortality statistics and the Regional Health Survey statistics are based on self reported rates. Both sources
agree that injury accounts for approximately 25% of all deaths in this population, with death occurring at a
relatively young age (Health Canada, 2001, First Nations Centre, 2005). Premature death as a result of injury
was up to seven times higher than other causes in 1999. For those First Nation people under the age of 45,
injuries are the leading cause of death, with the rates of injury higher in men than in women.
McDonald (2004) reports there are patterns related to injury among the various age groups under 45.
For the group as a whole, the injuries are primarily non-intentional, but among youth (aged 10 – 19) and early
adults (aged 20 – 44) the pattern changes, with intentional injuries being the most common cause of death.
Suicide and self-injury account for 38% of deaths in the youth and early adults and homicide accounts for 7%
of deaths among early adults. Chandrakant and Ramji (2005) report similar findings. They report that for
Aboriginal children and adults up to the age of 44 years injuries resulting from accidents and poisoning are the
most common cause of death. Not surprisingly, they also report that injuries and poisoning are the leading
cause of Potential Years of Life Lost (PYLL) in the Aboriginal population.
The RHS 2002/03 reports that injury is responsible for over half the Potential Years of Life Lost.
Amongst First Nation males, the types of injuries causing the most deaths were suicides, motor vehicle
collisions, suffocations and drowning, and homicides (Health Canada, 2003). First Nation females were more
likely to die from motor vehicle collisions than from suicides or homicides; however, they attempt suicide
more often than males. Chandrakant and Ramji (2005) note that amongst Aboriginal youth and early adults,
injuries and poisonings are commonly intentional. Suicide and self-injury are responsible for 37% of deaths in
youths and 23% of deaths amongst early adults. Overall, the suicide rate is three to four times greater for all
age groups in comparison to the non-Aboriginal population. Amongst those aged 10 – 19, the rate is five to six
times greater than the same age group in the non-Aboriginal population (Second Diagnostic on the Health of
First Nations and Inuit People in Canada, 1999, cited in Chandrakant and Ramji, 2005). Suicide is most
common amongst young Aboriginal men.
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Other reports also examine death rates amongst the First Nation population as a result of injury. For
example, Kirby & LeBreton, citing A Second Diagnostic on the Health of First Nations and Inuit People in
Canada (2002, p. 61) report that:
o
o
The rate of deaths due to injuries and poisonings is 6.5 times higher for First Nations and Inuit
than for the total Canadian population, and
The suicide rate among the Aboriginal population for all age groups is about three times higher
than the rate for the population of Canada as a whole, while the rate of suicide amongst
Aboriginal youth is 5 – 6 times higher than the suicide rate of youth in the general Canadian
population.
Motor vehicle collisions are amongst the leading cause of death in all age groups, with the exception of
those aged 65 and over (Chandrakant and Ramji, 2005). Overall, the most significant losses of life are due to
motor vehicle collisions, suicide and accidental drug poisoning (McDonald, 2001).
Health Canada (2001, p. 14) states that “homicide is the third most common cause of injury death in
First Nations people in the Atlantic, Manitoba and Saskatchewan regions”; while in British Columbia, the
homicide rate was 4.7 times higher than the rate in the general British Columbian population. It is also
believed that the death rate for accidental falls amongst First Nation populations is higher than in the general
population. For example, in British Columbia, the age-standardized mortality rate from falls is almost 3 times
the rate of the general population (Health Canada, 2001). First Nation populations are also considered at a
higher risk for injury due to fire. Reports suggest that in 1997 there were 25 reserve residents who died in
fires, while 45 experienced non-fatal injuries.
Family violence also contributes to high rates of injury. Although there is little hard evidence, it is
suspected that assault and injuries related to family violence are higher in the First Nation population (Health
Canada, 2001). Chandrakant and Ramji (2005. pp. 46-47) report the following:

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
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
Studies have shown that at least 75% of Aboriginal women have been victims of family violence. Up to
40% of children in Northern Native communities have been physically abused by a family member
(National Clearinghouse on Family Violence, 1997).
Among children in the general population, less than 25% have reported physical assaults or violent crimes.
The Ontario Native Women’s Association has reported that 80% of respondents from a survey have
indicated personal experience of family violence, which is eight times the estimated rate for Canadian
women as a whole.
A 1999 Statistics Canada survey found that 25% of Aboriginal women and 13% of Aboriginal men reported
experiencing violence from a current or previous partner over the past five years, compared to 8% of
Canadian women and 7% of Canadian men within the general population. Almost 49% have been beaten,
choked, threatened with a gun or knife or sexually assaulted.
37% of Aboriginal women and 30% of Aboriginal men reported experiencing emotional abuse such as
insults and jealousy.
57% of women [who] experienced abuse indicated that their children witnessed the violence (Aboriginal
Domestic Violence in Canada, 2003).
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Literature Review
The RHS 2002/03 explored First Nation experience with injuries requiring medical care in the year prior
to participation in the survey (First Nations Centre, 2005). 28.8% of First Nation adults reported having
sustained such an injury. This compares to only 13.1% of Canadians 12 years and older (2003) and to 20%
Aboriginal people living off-reserve (2000-2003) who reported an injury serious enough to have limited their
normal activities. The study questioned participants about the nature and cause of the injury (First Nations
Centre, 2005).
The leading types of injuries reported are as follows:
 Major cut, scrape or bruise – 14.3%,
 Major sprain or strain – 12.7%,
 Broken bones – 9.0%,
 Burns or scalds – 4.3%,
 Dental injury - 3.9%,
 Dislocation - 3.4%,
 Concussion – 2.9%,
 Hypothermia, frostbite 1.6%,
 Injury to internal organ – 1.5%, and
 Poisoning – 1.1%.
The major causes of injury reported are as follows:
 Fall/trip – 10.7%,
 Sport – 6.2%,
 Motor vehicles – 5.4%, including cars, snowmobiles, ATVs,
 Violence – 4.8%,
 Burns/scalds – 2.3%,
 Bicycle – 1.8%,
 Environmental – 1.7%,
 Suicide attempts/self-injury – 1.0 %, and
 Other – 8.3%.
The RHS 2002/03 also questioned the involvement of alcohol. Many participants refused to respond to
this question; such under-reporting is likely due to the stigma associated with the use of alcohol. The results
must therefore be interpreted as estimates only. In general, 5.1% of all incidents reported involved alcohol.
However, it was implicated in 27.6% of motor vehicle collisions, 25.7% of falls, 56.9% of instances of violence,
and 80% of suicide attempts. The involvement of alcohol was rare in relation to burns or sports injuries.
Non-fatal injuries are also a concern as they constitute a major component of disability in Canada
(Chandrakant and Ramji, 2005). McDonald (2001, p. 5) states that the number of deaths due to injury is
“dwarfed by the number of survivors of injuries, many of whom suffer lifelong health consequences.” In
Saskatchewan and Manitoba, injuries account for the three top reasons for visits to physicians and for
hospitalizations amongst First Nation peoples (Health Canada, 2001). In Manitoba, the rates of hospitalization
due to injury are three times the provincial rate (34 versus 10 per 1000).
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Many experience disability as a consequence of injury. Chandrakant and Ramji (2005) report, that
Aboriginal disability rates are much higher in all age groups in comparison to the general Canadian population.
The First Nations and Inuit Regional Health Survey National Report (1999, p. 151) estimates that “nearly a
third of all-Aboriginal peoples (31%) aged 15 years and older had a disability”, representing more than double
the Canadian rate. Although the report does not specify the percentage of disabilities associated with injuries,
it does state that “the disparity in rates of injury, accidents, violence, self-destructive/suicidal behaviour, and
chronic illnesses all correspond with the disparity between First Nation/Inuit rates of disability and that of the
Canadian population” (RCAP, 1995 cited in the FNIRHS, 1999).
Off-reserve Aboriginal people reported a higher level of activity-limiting injuries in comparison to nonAboriginals, 14.3% of Aboriginal males in comparison to 8% of non-Aboriginal males and 8% of Aboriginal
females in comparison to 6% of non-Aboriginal females. It is thought this may be a function of the reality that
males are more likely to participate in high risk activities. Aboriginal males are more likely to report limitations
to their activities as a result of injury than are Aboriginal females (14.3% in comparison to 10.3% respectively).
Literature Review - Injuries in Ontario First Nation People
Chandrakant and Ramji (2005, p. 29) report:
The leading causes of death by age group vary but include injury and poisoning, circulatory diseases,
cancer and respiratory diseases. In the Aboriginal population, a large proportion of unintentional
injuries result from motor vehicle accidents.
For children through to adults aged 44, the most common cause of death were injury from accidents
and poisoning. Deaths among children were classified as non-intentional. However, in youth and early
adults, the causes of injury and poisoning were more commonly intentional: suicide and self-injury
accounted for 37% of deaths in youths and 23% of deaths in early adults. In addition, 7% of deaths in
early adults aged 20-44 were homicide.
These authors also report that motor vehicle collisions are “among the leading causes of death in all
age groups except those aged 65 and over (Chandrakant and Ramji, 2005, p. 29). The authors also
discuss non-fatal injuries, but the data presented refers to the Canadian Aboriginal population, rather
than to the Ontario Aboriginal population.
Literature Review - Injuries in First Nation Youth and Children
Children are particularly vulnerable to injury. McDonald (2001, p. 9) reports that:
Injury is a major health concern for First Nations and Inuit people during the first seventeen years of
life. According to the First Nation and Inuit Regional Health Survey 13% of First Nations and Inuit
people will have a broken bone by the time they are seventeen, 4% will have incurred a serious
health injury, 3% will have been seriously burned, 3% will have almost drowned, and 2% will have
experienced frost bite.
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Literature Review
The Canadian Institute of Child Health (cited in Health Canada, 2001, p. 8) reports that:
In the mid-1990s, the injury death rate among First Nation infants was almost 4 times higher than in
the total Canadian population (63 versus 17 per 100,000). It was more than 5 times higher in
preschoolers (83 versus 15), and more than 3 times higher in teenagers between the ages of 15 and
19 (176 versus 48).
Literature Review - Youth
The RHS 2002/03 found that 49.5% of First Nations youth aged 12–17 and 17.5% of children aged 0–11 had
experienced an injury serious enough to need medical care in the year prior to completing the survey (First
Nations Centre, 2005). The rates found by the RHS are almost double in comparison to other youth in Canada
(23.5% of adolescents aged 12–19) and for First Nations youth living off-reserve (26.3%). The variance in the
rates should be used cautiously as the question posed to the other groups differed. Canadian youth and offreserve First Nation youth were asked to report injuries “serious enough to limit normal activities.”
Youth participating in the RHS report the following types of injuries (First Nations Centre, 2005. p. 185):
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




Cut, scrape or bruise – 34.8%,
Sprain or strain – 21.6%
Broken bone, fracture - 15.8%,
Burn or scald – 12.6%,
Hypothermia, frostbite – 6.6%,
Dental injury – 4.3%,
Dislocation – 4.0%,
Concussion – 3.7%,
Accidental poisoning – 0.8%, and
Injury to internal organ – 0.8%.
The study also found injury rates significantly higher for young men (53.1%) in comparison to young
women (45.5%), although the difference does not hold for all types of injuries. The difference is accounted for
by the higher rates in sports and bicycle injuries amongst young men. There is no significant difference in the
rates between genders in relation to falls, motor vehicle crashes or burns/scalds. Causes of injuries amongst
First Nation youth as reported in the RHS (First Nations Centre, 2005) are as follows:

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

Fall – 20.7%,
Sports – 20.1%,
Motor vehicles – 11.9% (includes cars, trucks, ATVs, snowmobiles and collisions between motor
vehicles and bicycles),
Bicycle – 10.8%,
Burns/scalds – 7.6%,
Other assault – 5.3%, and
Other assault – 6.2% (note the report does not offer an explanation of why there is a second “other
assault” category).
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The findings also indicate:
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Older youth (aged 15 – 17) are at greater risk of motor vehicle crashes in which the youth is the driver,
of assault and of burns/scalds; however, the difference is not statistically significant.
A strong correlation exists between injury and depression and low levels of self-esteem.
Youth who frequently participate in sports and extracurricular activities are more likely to be injured
than those who do not.
Youth who report having problems learning at school are significantly more likely to report an injury
(55.3% in comparison to 44.7% who do not report such problems).
The use of alcohol was involved in 6.4% of injuries overall and 27.1% of injuries due to assault.
Half of youth reported having had a drink of alcohol in the year prior to the survey, of these 56.0% in
comparison to 44.6% of youth who did not report the use of alcohol.
Family situations (including mother’s attendance at a residential school and living arrangements) were
not found to be statically significant for the rate of injury, and
Youth who report suicide by a family member or close friend in the year prior to the survey are
significantly more likely than other youth to report having been injured themselves.
Literature Review - Children
Injury rates in childhood are low in comparison to other age groups; however, injuries are still the
leading cause of death in children. The RHS (First Nations Centre, 2005) reports that 17.5% of First Nations onreserve children are injured seriously enough to require medical attention in the year prior to the survey, in
comparison to 12% of Aboriginal off-reserve children in 2000/01 and 10% of Canadian children as a whole in
2000/01. The RHS also reports that 14.4% of children aged 0 – 5 and 20% of children aged 6 – 11 years
experienced one or more injuries in the year prior to the survey.
The most common types of injuries amongst these children are:

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




Major cut, scrape or bruise – 9. 8%,
Fracture – 4.0%,
Major sprain/strain – 3.0%,
Dental injury – 2.5%,
Concussion – 0.9%, and
Dislocation – 0.7%.
The most common causes of injuries are:







Fall/trip – 7.6%,
Bicycle – 2.8%,
Sports – 2.1%,
Motor vehicle – 1.5%,
Dog bite – 0.8%, and
Other – 3.6%.
March 2012
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Literature Review
Other relevant findings include:
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


No statistically significant differences related to gender.
Older children are significantly more likely to be injured.
Children who participate in physical activity more than once a week (19.3%) are significantly more
likely to report an injury in comparison to children reporting activity once a week or less (11.4%).
Family characteristics such as: whom the child lives with, household size, household income or parental
education, do not show significant differences in relation to the rate of injury.
Injury rates are higher for children whose parents attended a residential school (although this might
relate to other factors such as province of residence as some provinces and territories have higher
injury rates).
Semi-isolated communities appear to have higher rates of childhood injuries than do non-isolated
communities.
Community size and transfer status do not appear related to injury rates amongst children.
The bulk of motor vehicle collisions for children involved bicycle-vehicle collisions, and most of the
remaining incidents involve collisions between vehicles and pedestrians.
Literature Review - Child Passenger Safety
The RHS (First Nations Centre, 2005) reports few children were injured as passengers in motor vehicles.
Despite this, a study conducted in three Manitoba First Nations found low baseline rates (pre-test) for the use
of child restraints in comparison to the general Canadian population (IMPACT, 2007). Baseline results for
adult restraint were also low. The study examined the “correct use of car seats, booster seats, and seat belts
by children and their parents, riding in the rear seat for children 12 years and younger, and not riding in the
back of pickup trucks” (p. 1).
The study employed focus groups, pre- and post-test assessments of child passenger safety practices using
roadside and parking lot surveys to test the outcome of community-based interventions, and the use of a
control group. These interventions included:
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

Training of community Child Restraint Technicians,
Correction of errors during roadside and parking lot surveys,
Individual counselling,
Education and seat clinics,
Purchase and distribution of low cost multi-stage car seats, and
Replacement of defective car seats.
The results showed significant increase in the use of child restraint in the largest community, but not in the
other intervention or control communities (IMPACT, 2007). Use increased substantially for infants and
toddlers, but not for the use of booster seats and seat belts. Factors that may have influenced this are that
the study focused on younger children and the fact that Manitoba law does not require the use of booster
seats.
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The study also found that parents who use seat belts are more likely to correctly use child restraints
and a rear seating position for their children. Incorrect use of child restraints involved low chest clips, loose
harnesses and placement of the seat belt behind the child’s back. Placement of children in the front seat and
premature graduation to seat belts were also found to be common. There was no significant change in seating
position or the riding in the back of pickup trucks following interventions. The study identified the following
barriers to the use of restraints:











Cost was a barrier; seats are expensive, especially for larger families,
Lack of awareness about use car/booster seats,
Access – car seats are not stocked in local stores and there are no loaner programs,
Lack of a vehicle – those who rely on others for rides tend not to use child restraints,
Perceptions that risk is low – travel within the community tends to be at low speeds for short
distances,
Overcapacity – vehicles crowded with more people than seat belts,
Conformity/peer pressure – low utilization of car seats in the community,
Discomfort for pregnant women and young children,
Low enforcement – tickets are not issued within the community,
Use of older vehicles which do not have the tether anchors and the cost associated with rectifying this,
and
Installation complexity.
The study identified three best practices (IMPACT, 2006). These were the brief interventions provided at the
roadside and parking lot check stops, the interaction with individual families at the check stops, and the
distribution of car seats to non-users. Prevention and intervention strategies recommended are summarized
in Table 1.
Table 1 – Recommended Child Passenger Safety Strategies
Category
Strategy
Infrastructure




Posters


Law
Enforcement


Support infrastructure to run and sustain a check stop/car seat clinic model of
intervention
Investigate the potential for the brief intervention, combining check stops with
correction or errors on the spot and distribution of car seats to non-users who do not
own appropriate seat for child
Community coalition or committee representing relevant sectors and disciplines
Sufficient trained child restraint technicians with ongoing support from external
experts
Sufficient supply of low-cost car and booster seats.
Four stage poster and growth chart to indicate when children should move to
booster seat
Initiate enforcement in communities with warnings rather than fines
Warning tickets could give individuals a choice of paying a fine or attending an
educational session on child passenger safety
March 2012
Category
Strategy
Education
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Economic
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SECURING OUR FUTURE
More education by certified technicians
o Need to use car seats
o Need to use booster seats
o Different stages and when to transition
o Assistance with installation
Education on the benefits of seat belt use targeted to children and youth aged 8 – 16
Recommended methods
o Posters in high traffic areas
o Community newsletter
o Educational sessions
o Testimonials, especially in video format
o One-to-one hands-on training for installation of car seats (car seat clinics)
o School presentations (with presenters in uniform)
Key messages:
o Everyone should always buckle up – children and adults
o All children should ride in the back seat
o Children are safest if they follow the four stages (infant, toddler, booster, seat
belt)
o Proper use of restraints
Car seat giveaways
Subsidy programs
Loan programs for casual users (grandparents, visitors) and for those who cannot
afford seats
The provincial Ontario Injury Prevention Strategy is designed to “engage and mobilize a broad range of
partners to reduce the frequency, severity and impact of preventable injury” (Ontario’s Injury Prevention
Strategy, 2007, p. 4).
The strategy is based on the principles of shared responsibility and government leadership, use of
evidence-based approaches including assessment, surveillance, research and evaluation, integrated practices
linking the efforts of individuals, communities, organizations and governments, and recognition of diversity.
Approaches will include promoting safe, healthy and active living, building awareness, and engaging partners,
influencing risk factors, reducing risk for high risk groups, and building capacity and sustainability.
Approaches will be applied in communities, homes, schools, sport and recreation venues, workplaces,
primary health care, long-term care and other settings. Strategy levers will include education, engagement,
engineering, enforcement, evaluation and research, and policy.
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Background: Injuries and Injury Prevention in Ontario First Nations
Injuries are an issue with all populations at all levels. Eight of the 15 leading causes of death for
people ages 15 to 29 years internationally are injury-related. (World Health Organization 2008) Unintentional
Injuries are the leading cause of death among Canadians between the ages of 1-34 in 2005. (Public Health
Agency of Canada 2005) According to a 2001 Health Canada Report, injuries are the leading cause of death
among First Nations in Canada from 1 to 44 years of age.
International
National
Regional
Nation
Community
Family
Self
28
“While the greatest burden of injury is borne by those whose health, wellbeing, and life potential are
directly diminished or destroyed by injury, economic burden studies enable us to calculate the broader
societal burden injury imposes, with respect to cost pressures on our health care system and foregone human
potential in terms of years of life lost and diminished labour market productivity and earnings. The costs that
emerge from this analysis are the costs of inaction – the price we all pay for failing to address injuries that are
largely predictable and preventable.”29 “Unintentional injuries accounted for $5.5 billion or 81% of Ontario’s
$6.8 billion total injury costs in 2004. Intentional injuries were responsible for 16% of total injury costs, while
injuries of other or undetermined intent accounted for 2% of total costs.”30
“In August 2007, the Ministry of Health Promotion launched Ontario's Injury Prevention Strategy:
“Working Together for a Safer, Healthier Ontario, a coordinated plan to reduce the frequency, severity, and
impact of preventable injury in Ontario.” The strategy sets out a government-wide coordinated approach to
addressing injury prevention, the first of its kind in Ontario. Developed in consultation with government
ministries and agencies, public health professionals, and leading injury prevention experts, the strategy
proposes four main approaches: community partnerships and mobilization, public education and engagement,
safe environments, and healthy public policy. The Strategy is a call to action. It acknowledges that reducing
the burden of injury requires that the wide range of personal, social, and economic factors that influence
injury rates be addressed.
28
Chiefs of Ontario, Securing Our Future – Ontario First Nations Injury Prevention Training Facilitator Guide 2011
SMARTRISK. (2009). The Economic Burden of Injury in Canada. SMARTRISK: Toronto, ON
30
29
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Background: Injuries and Injury Prevention in Ontario First Nations
While no single level of government, ministry, or organization can address all the factors that
contribute to injury, Ontario’s strategy provides a critical road map to guide efforts undertaken by the
government and by communities across Ontario.”31 The lack of engagement of Ontario First Nations in
development and inclusion in this strategy presented a significant gap in injury prevention.
Ontario First Nations Injury Prevention Initiative
As a result of injury issues raised nationally, Ontario First Nations in partnership with Health Canada –
First Nations and Inuit Health Branch, Ontario Region conducted an initial environmental scan on injuries and
injury prevention. In 2005/06, First Nations identified Motor Vehicle Collisions, Violence including Suicide
and Falls, as the most frequent injuries occurring within communities. In 2006/07 Injury Prevention priorities
were established in Education, Training, Research and Surveillance. Recommendations included the
development of an Ontario First Nations Injury Prevention Strategy, Action Plan and Business Case for
program resources to reduce the burden of injuries in Ontario First Nation communities. Resolution 08/69
supporting the Injury Prevention Initiative was passed by Chiefs in Assembly at a Special Chiefs Assembly in
November 2008. The resolution supports, coordination and planning, a mandated Injury Prevention Advisory
Working Group and action on Injury Prevention Issues, Priorities and Recommendations.
Injury prevention in Ontario First Nations is challenging without a specific program in injury prevention
and public health in communities to support change and a comprehensive approach towards population
health. However, education, training, research and strategic planning are positive initial steps towards injury
prevention in Ontario First Nations. Injury prevention among Ontario First Nations is necessary to reduce the
incidence rate and burden of injuries. The Ontario First Nations Injury Prevention Initiative and Project has
been established to address issues, priorities and recommendations. To achieve the goal of reducing the
incidence of injuries by reducing the risks and strengthening protective factors that are culturally relevant,
community specific and evidence based, the objectives of the Chiefs of Ontario initiative and associated
projects were to promote awareness of injuries and injury prevention in Ontario First Nations, develop the
evidence and best practices to support initiatives in communities, to develop Ontario First Nation specific
training resources and build capacity through injury prevention training for injury prevention. A final step in
this initiative is to complete a strategy framework and action plan as a planning and action tool for Ontario
First Nations and to support First Nation leadership advocacy efforts for injury prevention programs and
services in communities.
Partnerships
Partnership engagement and collaboration on the design, development and implementation of project
initiatives to promote injury prevention in Ontario First Nations has occurred utilizing existing regional and
national First Nation technical and political processes. This includes the Chiefs in Assembly, the Ontario Chiefs
Committee on Health, Health Coordination Unit and the Injury Prevention Advisory Working Group.
31
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Ontario First Nations Injury Prevention Initiative
Partnerships
The Injury Prevention Advisory Working Group played a key role in fulfilling the goal, objectives and
activities of the project. The First Nation partners from the Ontario First Nation Territorial Organizations of
Nishnawbe Aski Nation, Anishinabek Nation - Union of Ontario Indians, Association of Iroquois and Allied
Indians, Grand Council Treaty # 3, and the Independent First Nations appointed representatives at both
political and technical forums which support partnership and collaborative working relationships to support
Ontario First Nations. It is important to note that although the Grand Council of Treaty #3 is still associated
with the Chiefs of Ontario, they initiated health governance in 2011.
Securing Our Future – Ontario First Nations Child Car Restraint Project
Project Description: Introduction
The “Securing Our Future” Ontario First Nations Child Car Restraint Project was coordinated by the
Chiefs of Ontario and was the first project to be implemented by the Ontario First Nations Injury Prevention
Initiative. The project emerged as a result of an opportunity to partner with First Nations and Inuit Health to
promote child passenger safety in Ontario First Nations. The decision to implement the project was
recommended by the Injury Prevention Advisory Working Group to address the issue of motor vehicle
collisions through identified priorities in education, training and research/evaluation. The project was
acknowledged as the first step towards promoting awareness about injuries and building capacity for injury
prevention in Ontario First Nation communities by beginning with keeping children safe. Among First Nation
people, within traditional indigenous teachings, children are perceived as sacred, a blessing of new life, the
promise of hope and the future. “Securing Our Future” is the title of a video produced by the Washington
Traffic Safety Commission and Washington Native American Tribes to promote child passenger safety in
communities. In March 2009, The Washington State Department of Transportation under the Centennial
Accord Plan now works with the Washington Indian Tribes. The Securing Our Future: Native American Child
Passenger Safety Part 1 and 2 can be viewed at The Washington State Safety Restraint Coalition at
http://800bucklup.org/videos/index.asp It became the title of this project in recognition of the purpose of the
project and honours the shared knowledge and experience of indigenous peoples by extending this message
to Ontario First Nation communities. This was done with their permission.
Overview
There were three (3) components to the project. These components included education, training and
evaluation. In order to implement the project, partnerships were established within each component to
address resource and capacity development for project completion. Challenges were experienced at all stages
of the project and became learning opportunities for all participants of the project. The key to meeting
project goals and objectives were partnerships in order to support both capacity and resources required to
complete project deliverables. Project coordination and delivery was often impacted by the process of
implementing projects within projects and in initiating several firsts.
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Securing Our Future – Ontario First Nations Child Car Restraint Project - Overview
The project experienced many extensions to finalize completion of activities with appropriate and
acceptable outcomes. A significant project first included the Chiefs of Ontario being the first lead research
entity that is not an academic institution. Academic requirements for research were addressed through
partnerships. This facilitated governance and implementation of the principles of Ownership, Control, Access
and Possession (OCAP) in research with First Nations. Further definition of this concept and its’ application,
can be found at First Nations Information Governance Centre (http://rhs-ers.ca/). Additionally the project
facilitated research capacity and mentorships, community facilitators evaluated training in research,
evaluation and ethics, a first time regional First Nation child passenger safety initiative, the development and
distribution of specific First Nation educational resources, and evaluated community demonstration child car
restraint project in Ontario. Additionally, the preliminary results of the project were presented provincially and
internationally. Learning and capacity challenges impacted the timeframe of the project but built experience,
knowledge and awareness of child passenger safety in Ontario First Nations. Car crashes are the number one
cause of death for Canadian children32. A properly installed child safety seat can reduce the risk of serious
injury or death by as much as 75%.33 Common errors include not tightening the seatbelt and harness enough,
and not properly using a tether strap when required.34 Although the evaluation data is too small and limited
in its application to generalize findings to all First Nations it provides clear indications that participants in the
project benefited as result of the project and demonstrated increased knowledge and usage of child car
restraints. Results also indicate that ongoing child passenger safety initiatives are needed in communities to
continue to educate caregivers and support the access, proper use and installation of child car restraints to
enhance child passenger safety. Poverty is a huge factor impacting child passenger safety among First Nations
which affects both knowledge about child passenger safety and ability to purchase child car seats to support
child passenger safety.
It took three (3) years to complete this project. The greatest challenge was overcoming limited
resources and its impacts on the project. The project received initial funding in 2008/09, through First Nations
and Inuit Health Branch funded child passenger safety initiatives to promote increased and correct usage of
child car restraints. In partnership with the PTO/IFN and Ontario First Nations, agreements with five (5)
community demonstration sites were established. Community Sites were selected by the Political Territorial
Organizations and Independent First Nations to target child passenger safety interventions with 10-15 families
whom have children between 0-8 years of age. Nine (9) Community Demonstration Site Facilitators were
trained as certified Car Seat Technicians in the fall of 2008 and received further training in 2009 in research,
evaluation and ethics to support their role as Community Facilitators in the evaluation of community
initiatives. Child Passenger Safety resources were developed in 2009/2010 and distributed as a tool kit to
Ontario First Nations and Community Demonstration Sites. Communities implemented interventions and
evaluations in 2009/2010. Data collection, input and analysis was also initiated in 2009/2010. Further analysis
and reporting was completed in 2010/2011 and the project was finalized in 2011/2012.
32
Ministry of Transportation – Safe and Secure – Choosing the Right Car Seat for Your Child Pamphlet
Infant and Toddler Safety Association
34
Ministry of Transportation – Safe and Secure – Choosing the Right Car Seat for Your Child Pamphlet
33
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Securing Our Future – Ontario First Nations Child Car Restraint Project - Overview
Training enhanced the capacity of community sites to implement Child Passenger Safety initiatives,
provide clinics to support installation and inspection of child car restraints and evaluate initiatives for the
project. However, Individuals and communities will continue to benefit from the knowledge, skills and
experience acquired as a result of training and participation in the project.
Project Objective: To establish the need for support and/or expansion of child car restraint safety initiatives in
Ontario First Nations which will promote correct and increased usage of child car restraints to reduce injuries
to children in automobile collisions and demonstrate best practices.
Project Framework and Criteria: One (1) First Nation community per Political Territorial Organization (PTO)
and Independent First Nations (IFN) will be selected and identified by the PTO/IFN to participate in the project
as community sites, a total of five (5) for Ontario.
Project Framework and Criteria:
The project targeted communities whom currently offer no child car restraint safety initiatives.
The project community demonstration sites will target approximately 10 – 15 families with children
between 0-8 years of age.
Community demonstration sites were encouraged to establish partnerships, linkages and networks to
complete child car restraint safety initiatives, internally and externally.
Identified project activities for Community Demonstration Sites included community determined and
driven initiatives which may include campaigns, events, workshops, and/or resources in addition to child
car restraint clinics.
Community Demonstration Sites signed a Letter of Agreement with the Chiefs of Ontario and were
expected to complete a work plan, budget and final report of their initiative.
Community Demonstration Sites identified two (2) Site Facilitators including contact information
individuals whom will be the Facilitators/Technicians responsible for implementing community initiatives
of the project.
The evaluation of the project was coordinated by the Chiefs of Ontario in partnership with researchers and
community demonstration site facilitators. The Injury Prevention Coordinator, Injury Prevention Advisory
Working Group and Researcher worked in conjunction with community demonstration sites to coordinate
and facilitate the consent, collection and analysis of data from community demonstration sites
implementation of pre and post test intervention evaluation.
Five (5) Community Demonstration Sites identified in conjunction with Political Territorial Organizations
and the Independent First Nations to participate in the project and implement community based child
passenger safety interventions were Animbiigoo Zaagi’igan Anishinaabek First Nation, Eabametoong
First Nation, Mohawks of the Bay of Quinte, Nipissing First Nation, Ojibways of Onigaming.
The following sections in education, training and resources, evaluation provide a report of the project’s
activities and outcomes.
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Education
Poster Design by Ryan Red Corn, Buffalo Nickel formally of Red Hand Media for Chiefs of Ontario
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Child Passenger Safety Educational Promotion and Project Launch – News Release
In 2008/2009, the Chiefs of Ontario - Ontario Regional Chief launched the “Securing Our Future Child
Car Restraint Project” in conjunction with partners to promote Child Passenger Safety in Ontario First Nations
at the Chiefs of Ontario Health Forum in February 2009.
Back: Colleen Arch, Bill Arch, Community Technicians; Jeff Skye, APS
Front: Chesney George, First Nation Parent; Ontario Regional Chief Angus Toulouse; D Jones-Keeshig, IP Coordinator
Facilitating a public launch enhanced the promotion of child passenger safety in First Nation
communities. A panel presentation about the project and demonstration on the correct use and installation
of a car seat was completed by project technicians and sponsored by the Chiefs of Ontario. A First Nation
parent received a brand new car seat appropriate for her child and received instruction on the proper use and
correct installation to safely protect her child during transportation.
As a result of the Securing Our Future – Ontario First Nations Child Car Restraint Project, across the five (5)
communities, child passenger safety was promoted in participating community demonstration sites in the
following educational approaches:



A total nineteen (19) workshops, events and/or forums were held within participating
communities.
Eleven (11) car seat installation and inspection clinics were held on child passenger safety with a
total of 318 participants.
A total of seventy-six (76) car seats were purchased and provided to children of eligible families.
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Securing Our Future – Ontario First Nations Child Passenger Safety Kit

A child passenger resource toolkit with posters/pamphlets and DVDs was developed and
distributed to 133 communities, four (4) Political Territorial Organizations, the Independent First
Nations and twenty-eight (28) First Nation police services. The toolkit included the Securing Our
Future poster developed and designed by the Injury Prevention Advisory Working Group and Ryan
Red Corn, Buffalo Nickel formally of Red Hand Media. The poster emphasizes the four steps of
child passenger safety and utilizes the model of the cultural framework of the four directions. The
children are members of Ontario First Nations. The concept of utilizing a shield based on the four
directions within a contemporary design and traditional message is to promote the protection of
children within a culturally recognized framework which enhances the principle of building on the
strengths of the people.
Poster Design: Ryan Red Corn – Buffalo Nickel formally of Red Hand Media
Additionally the toolkit included a companion Securing Our Future pamphlet on child passenger safety,
posters, pamphlets and DVD from Safe Kids Canada. A DVD from Washington Traffic Safety Division entitled
“Securing Our Future” was also included. A letter from the Ontario Regional Chief promoting child passenger
safety and encouraging community initiatives, introduced the toolkit to Ontario First Nations.
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Preliminary Results Promoting Child Passenger Safety: Influencing Government, Policy,
Programs and Services
Provincial and International
Although the target population is Ontario First Nations, opportunities to present on the initiative's
projects and preliminary research findings to promote injury prevention in Ontario First Nations has also
occurred provincially and internationally through separate projects. These opportunities have contributed
to building awareness among government representatives, policy makers, researchers and organizations
to support injury prevention initiatives in Ontario First Nations through linkages, networking and
partnerships.
The St. John’s Ambulance Child Passenger Safety Conference included partners from provincial
government and non-governmental organizations whom are working to promote child passenger safety.
The conference was attended by about 150 – 200 people. A workshop on the Ontario First Nations Injury
Prevention Initiative and Child Car Restraint Project was completed with approximately 50 participants.
International:
Safety 2010 is a major world conference bringing stakeholders in the prevention of unintentional
injuries and violence from around the world to debate, discuss and exchange information and experiences.
The key theme of the conference was Safe and Equitable Communities. The theme was chosen to reflect
the disproportionate burden from almost all types of injuries that falls on poorer communities.
Practitioners, researchers and policy makers from health, criminal justice, education, public administration
and industry were invited to join an international and diverse audience at Safety 2010. It examined
unintentional injuries and violence linked to age, gender and ethnicity; focus on settings including the
home, work, sports and leisure; and explore related environmental and sustainability factors. The
conference examined methods of injury prevention and control including research, surveillance, and
evaluation.
The objective for presenting the Chiefs of Ontario Injury Prevention Initiative projects internationally
was to share the expertise and capacity the organization has built to address injuries among First Nation
peoples. Presentation within an international forum was an opportunity to establish the validity of the
Ontario First Nation Injury Prevention Initiative, the research project findings and the credibility of the
organization to produce and present results which support Injury Prevention Initiatives for Ontario First
Nations. This action will support the next steps towards the establishment of an Ontario First Nation
Injury Prevention Strategy and Action Plan and facilitate the development of a Business Case for Injury
Prevention Initiatives in First Nations, based on evidence based solutions vetted within an international
forum of governmental representatives, policy analysts, researchers and practitioners. With the
opportunity to increase support through enhanced knowledge of Ontario First Nations injuries and injury
prevention initiatives, networking and partnerships were established internationally to support injury
prevention in Ontario First Nation communities.
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International Society for Child and Adolescent Injury Prevention (ISCAIP)
The International Society for Child and Adolescent Injury Prevention extended an invitation to speak on
the Ontario First Nations Injury Prevention Initiative and Securing Our Future – Child Car Restraint Project.
In 1993, injury specialists, researchers, policy makers, educators, medical personnel and advocates
established The International Society for Child and Adolescent Injury Prevention (ISCAIP) to improve the
global dialogue and action for preventing and controlling child and adolescent injuries. The ISCAIP's
objectives are to provide a multidisciplinary forum for global dialogue, assist in providing advocacy at
national and international levels, foster national and international injury prevention initiatives, stimulate
the translation of research findings into programs and policies, and facilitate collaborative and
interdisciplinary international research. The Society promotes the exchange of ideas, science, and
experience among members to facilitate international collaborations, activities, and seminars on research,
programming, and policy. ISCAIP addresses both intentional and unintentional injuries. In recognition that
the most frequent injury occurrences among Ontario First Nations is with children and youth, membership
with this international organization will benefit future initiatives in injury prevention among Ontario First
Nations. The session presentation was attended by approximately 40 participants. An excellent networking
and collaboration opportunity was established with researchers and the World Health Organization as a
result of this presentation.
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Training
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Securing Our Future Child Car Restraint Project Technician and Facilitator Training
Overview
Nine (9) First Nation participants from community demonstration sites identified by our partner
organizations of Nishinawbe Aski Nation, Union of Ontario Indians, Association of Iroquois and Allied Indians,
Grand Council Treaty #3 and the Independent First Nations received training at regional level. The regional
certified training session for Child Car Seat Technicians was provided by St. John’s Ambulance in Mississauga,
Ontario and the Research Facilitator training was co-facilitated by the Chiefs of Ontario and First Nations
Centre of the National Aboriginal Health Organization utilizing a pilot curriculum for community training in
Research, Evaluation and Ethics in Sault Ste. Marie, Ontario. The research training was evaluated by First
Nations Centre of the National Aboriginal Health Organization. Funding for the training session was provided
by Health Canada – First Nations and Inuit Health and the First Nations Centre of Aboriginal Health
Organization.
Chiefs of Ontario
Association of
Iroquois and
Allied Indians
Grand
Council
Treaty #3
2 Participants
2 Participants
Anishinabek
Nation Union
of Ontario
Indians
Nishnawbe
Aski Nation
Independent
First Nations
1 Participant
2 Participants
2 Participants
Grand Council Treaty #3
Treaty #3 was signed on October 3, 1873 and covers a territory of fifty-five thousand (55,000) square
miles. The treaty agreement between the Anishinaabe and the British, among other things, would allow their
“business” within the entire territory and that both the lands and resources would be shared between them as
“brothers.”35 Grand Council Treaty #3 is the historic government of the Anishinaabe Nation in Treaty #3. There
has been significant movement over the years back towards Anishinaabe Nationhood by the member
communities. The treaty area includes 26 First Nations in Northwestern Ontario and 2 First Nations in
Manitoba.36 Two (2) communities, whom are signatories to Treaty #3 are associated with the Independent
First Nations at a territorial level. Thus, at a PTO level, Grand Council Treaty #3 has twenty-four (24) affiliated
communities within Ontario. There are three (3) Tribal Councils and several tribal entities within GCT#3.
35
36
www.gct3.net
www.gct3.net
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Nishnawbe Aski Nation
Nishnawbe Aski Nation (NAN) represents forty-seven (47) First Nation communities within the territory
of James Bay Treaty No. 9 and the Ontario portions of Treaty No. 5. There are seven (7) Tribal Councils and six
(6) NAN communities are unaffiliated with a specific tribal council. This name is based on a principle that is
sacred to their people, the notion of the people and the land, and their unique relationship. Nishnawbe Aski
Nation (known as Grand Council Treaty No. 9 until 1983) was established in 1973 as a territorial organization
representing the political, social and economic interests of the people of Northern Ontario. In 1977, Grand
Council Treaty No. 9 made a public declaration of the rights and principles of Nishnawbe Aski. NAN has a total
land mass covering two-thirds of Ontario spanning an area of 210,000 square miles37.
Anishinabek Nation – Union of Ontario Indians
The Anishinabek Nation incorporated the Union of Ontario Indians (UOI) as its secretariat in 1949. The
UOI is a political advocate for 39 member First Nations across Ontario. The Union of Ontario Indians is the
oldest political organization in Ontario and can trace its roots back to the Confederacy of Three Fires, which
existed long before European contact. The UOI represents 39 First Nations throughout the province of Ontario
from Golden Lake in the east, Sarnia in the south, Thunder Bay and Lake Nipigon in the north. The Anishinabek
Nation has four strategic regional areas Southwest, Southeast, Lake Huron and Northern Superior and each
region is represented by a Regional Grand Chief. The UOI - Union of Ontario Indians delivers a variety of
programs and services, such as Health, Social Services, Education, Intergovernmental Affairs and Treaty
Research. The UOI is governed by a board of directors and has a Grand Council Chief and a Deputy Grand
Council Chief that carry the day-to-day leadership responsibilities. The UOI provides the necessary forum for
collective First Nation actions on housing and other issues through their Chiefs in Assembly, and direction to
the Grand Council Chief by way of resolution.38
Association of Iroquois and Allied Indians
The Association of Iroquois and Allied Indians (AIAI) is a non-profit organization which advocates for the
political interests of eight member Nations in Ontario. It was established in 1969, which was an era in
Canadian politics where integration and assimilation of First Nations was a matter of public policy. The AIAI is
unique among provincial territorial organizations in Canada, because it is an association of several different
member Nations; the Oneida, the Mohawk, the Delaware, the Potawatomi and the Ojibway. Each of these
Nations has different languages, cultural practises and territories, which span much of the province. However,
at AIAI, they form an alliance on political lines to protect their collective Aboriginal and Treaty rights. AIAI
member Nations represent the following communities: the Batchewana First Nation of Ojibways, near Sault
Ste. Marie; the Delaware Nation, near Chatham; the Caldwell First Nation, near Leamington; the Mississauga's
of New Credit First Nation, near Hagersville; Wahta Mohawks near Parry Sound; the Oneida Nation of the
Thames, near London; the Hiawatha First Nation near Peterborough and Mohawks of the Bay of Quinte, near
Belleville.39
37
www.nan.on.ca
www.anishinabek.ca
39
www.aiai.on.ca
38
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Independent First Nations
The Independent First Nations are a collective of twelve (12) First Nations in Ontario whom work within
a political protocol. This includes: Animbiigoo Zaagi’igan Anishinaabek (Ojibway of Lake Nipigon), Bkejwanong
Territory – Ojbways of Walpole Island, Chippewas of Nawash, Chippewas of Saugeen, Iskatewizaagegan First
Nation (Shoal Lake #39), Kitchenuhmaykoosib Inninuwug (Big Trout Lake), Mohawk Council of Akwesasne,
Shawanaga First Nation, Six Nations of the Grand River, Temagami First Nation, Wabaseemoong First Nation
and Whitesand First Nation.
Child Car Seat Technician Training (Certified)
A presentation on injuries and injury prevention in Ontario First Nations which included an overview of
the Ontario First Nations Injury Prevention Initiative was developed and delivered by the Injury Prevention
Coordinator. Training was provided to community facilitators / technicians to enhance capacity to promote
child passenger safety and evaluate interventions. Nine (9) community facilitators /technicians completed
certified car seat technician training from St John's Ambulance in November 2008 in Mississauga, ON.
Facilitator Training in Research, Evaluation and Ethics
The nine (9) technicians also received training in ethics, research and evaluation. The community based
research training initiative was developed by the National Aboriginal Health Organization – First Nations
Centre in consultation with the Chiefs of Ontario. It was co-facilitated by both organizations. The goal of
training was to increase the capacity of facilitators to implement community intervention evaluations.
Training Objectives:
1.
2.
3.
4.
5.
To describe a basic process for facilitating research in the community.
To provide an opportunity to engage in a research exercise.
To introduce basic research terms
To give examples of research in First Nations communities.
To encourage the development of community-designed research for community-based
needs.
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Community Research for Change:
Report on the Pilot Development of a Course Template for First Nations Community
Research Facilitators
August 2009
Prepared By FNC - NAHO
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First Nations Centre, National Aboriginal Health Organization
Community Research for Change: Report on the Pilot Development of a Course Template for
First Nations Community Research Facilitators
Introduction
The Chiefs of Ontario (COO) initiated the Ontario First Nations Child Car Restraint Project and
established five (5) community demonstration sites in Ontario in 2008-2009. The research and evaluation
component of this project will be conducted through the development of a curriculum for enhancing the
capacity of communities in research, evaluation, and ethics.
On February 4th and 5th, 2009, the First Nations Centre (FNC) at the National Aboriginal Health
Organization (NAHO) held a two day pilot workshop for First Nations Community Research Facilitators in
partnership with the Chiefs of Ontario. Participants included the nine Community Demonstration Site
Facilitators who have completed certified training as Car Seat Technicians. The workshop was designed to
facilitate the capacity of participants to conduct evaluation of the Child Car Restraint Program within
established ethical standards of research. The two day workshop was held as a follow up to the technicians’
training. The objective of the workshop was for participants to learn and practice basic skills for partnering,
designing, implementing, evaluating, reporting, and using research in the community.
This pilot project will be used to provide feedback for the creation of a research facilitator focused tool
for building research capacity in First Nations communities and towards the development of community
generated evidence for change.
Methods
Child Car Restraint Technicians, plus the Injury Prevention Coordinator at the Chiefs of Ontario, were
invited to attend this workshop on research facilitation. Over the two days, participants were given an
overview of intervention research, including examples and ethics information, and community protocols were
discussed.
The participants were divided into three groups and completed a team research exercise. The groups
were assigned to either give out a flyer on car seats while asking about car seat use, observe car seat use in a
parking lot, or count cars with and without car seats in a parking lot. Following the data gathering stage, the
teams discussed the exercise and worked on putting the results into a useable format. On the second day, the
participants learned about evaluation and reporting.
Results
In total, there were twelve participants at the workshop. All twelve participants completed the preworkshop questionnaire and ten (10) participants completed the post-workshop questionnaire. The results of
the questionnaire are displayed in table 1.
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Table 1: Pre- and Post-workshop questionnaire results.
PRE-workshop
POST-workshop
I understand the connection
between research and positive
community change.
0% Not at all
33% A Little
42% Yes
8% More than average
17% A lot
0% Not at all
0% A little
50% Yes
30% A lot
I understand the research process.
17% Not at all
33% A little
33% Yes
8% A lot
0% Not at all
20% A little
40% Yes
10% A lot
I’d feel comfortable facilitating
research in my community.
17% Not at all
42% A little
25% Yes
0% A lot
*One person indicated both “Not at
all” and “A little”
20% Not at all
30% A little
20% Yes
0% A lot
I’d like to learn more about doing
research in my community.
0% Not at all
17% A little
67% Yes
8% A lot
0% Not at all
40% A little
30% Yes
10% A lot
I think this research workshop will
be/was informative.
0% Not at all
17% A little
67% Yes
8% A lot
*One person indicated that this was
not applicable
0% Not at all
0% A little
70% Yes
30% A lot
Overall, 70% of participants felt that the workshop was informative. Before the workshop, 33% of
participants had only little understanding of the connection between research and positive community
change. After the workshop, all participants indicated that they understand this link with 20% indicating they
had more than average understanding and 30% indicating “a lot” of understanding. Only 8% of participants
indicated greater than average understanding of the research process before the workshop; however,
following the workshop 30% of participants gave this response. In response to the statement “I’d feel
comfortable facilitating research in my community”, before the workshop 33% of respondents indicated that
they agreed or felt “more than average” and following the workshop this increased to 50%. However, the
same number of participants indicated that they would feel “not at all” comfortable. All participants reported
that this workshop was informative and 30% agreed that the workshop was very informative.
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Discussion and Conclusion
Overall, the workshop helped participants to gain a better understanding of research processes, and
the connection between research and positive community change. All participants found the workshop to be
informative however; facilitators may require more information and practice to become comfortable
conducting research in their communities.
This workshop can be modified for different regions and communities according to the research needs
of participating communities. This will ensure that research methods are appropriate for community members
and for the information being sought. The materials provided to workshop participants will be useful as
reference documents when participants return to their communities and contemplate conducting research
and evaluating the Child Car Restraint Project.
In the future, more information about the relevance and effectiveness of the workshop can be
obtained using open ended questions on the post workshop questionnaire. Participants could be encouraged
to record their thoughts on the workshop using open-ended questions so that this information can be used to
direct the workshop content.
Overall this pilot workshop proved to be successful at helping Community Research Facilitators learn
about basic research skills, including design, implementation, evaluation, and reporting. The research practice
exercise provided participants with firsthand experience in one of many types of research methodologies.
Child Car Restraint Project Technicians and Facilitators with COO IP Coordinator
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Evaluation
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Evaluation
Project Goal and Objectives

The goal of the project was to reduce the occurrence of injuries and fatalities among First Nations
children in automobile collisions through the promotion of child passenger safety and providing
education on the proper installation and use of child car restraints in five (5) communities.
The primary purposes of the Child Car Restraint Project are as follows:

Respond to identified injury issues and prevention priorities.

Seek further knowledge about the scope of injuries and injury prevention among Ontario First
Nations and utilize the findings to inform the development of evidence based solutions in injury
prevention and best practices.

Promote child passenger safety in Ontario First Nations, Develop Culturally Relevant Resource
Material and implement increased and correct usage of child car restraints to reduce injuries to
children in automobile collisions in five (5) Community Demonstration Sites.

Evaluate Community Interventions in Child Passenger Safety and Recommend Best Practices.
Instruments and Methods
This research study was designed to evaluate Child Car Restraint Initiatives which were being implemented in
five (5) First Nation demonstration sites in Ontario by the Chiefs of Ontario. The Chiefs of Ontario decided to
utilize a modified version of Transport Canada’s survey for Parent’s Use of Car Seats for Children to assess
whether the initiatives were in fact successful in increasing knowledge of child passenger safety and child car
restraints and increasing correct usage and installation of child car restraints. The survey was modified by the
Injury Prevention Coordinator, the Injury Prevention Advisory Working Group and Project Researcher.
The survey was used to complete pre/post test for the evaluation of child car restraint initiatives in
each of five community demonstration sites. Two individuals from each of the five communities were
assigned the role of Community Demonstration Site Facilitator. These facilitators were responsible for
assembling participants, administering pre test, coordinating the Child Car Restraint information
session and car seat clinics, and then administering a post test. The workshops involved an overview of
the Child Car Restraint Project, videos and slideshow presentations on best practices for child car
safety, and group discussions. The car seat clinics included distribution of car seats to parents, and
hands-on learning on proper car seat installation techniques. Consent forms were completed and pre
and post tests were administered.
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Target Population
Table 2. Community Population On and Off Reserves
Reserve name
Population (number of residents)
On reserve
Off reserve
Total
5
353
358
Eabametoong First Nation
1540
800
2340
Mohawks of the Bay of Quinte
2105
5655
7760
Nipissing First Nation
849
1345
2194
Ojibways of Onigaming
605
-
605
Animbiigoo Zaagi’igan First Nation
The target population included parents and/or guardians with children 0-8 years of age/expectant mothers.
Table 3. Number of participants at each First Nation Demonstration site
Reserve name
Number of participants
12
8
8
16
10
Participating Community Demonstration Sites
Animbiigoo Zaagi’igan First Nation has a total population of 358 people, 353 off reserve and 5 people on
reserve. Animbiigoo Zaagi’igan is an Ojibwe First Nation in Northern Ontario with most members stemming
from Fort Hope down to Onbabika and Audan Areas. Animibiigoo Zaagi'igan Anishnaabek (Lake Nipigon
Ojibway) is signatory to the Robinson Superior Treaty of 1850. However, their First Nation was not granted
land under the treaty. Establishing connections among dispersed membership, the creation of a reserve at
Partridge Lake and a final land agreement was signed in 2005 and the new reserve land base was established
in May 2008. Most First Nations are experiencing a baby boom, with their youth population rising
dramatically. But the trend for the Animbiigoo Zaagi'igan Anishinaabek, is reversed. Nearly 100 of their 310
members are elders and most of them are women.
March 2012
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Participating First Nation Demonstration Sites
The target group for this community included single and multiple families as well as grandparents and any
extended family that used car seats. Children targeted were 8 years old and under. There were 17 participants
in total that attended interventions that included information and presentations at a health forum and a
workshop and car seat clinic. Eleven (11) of the 17 participants completed consent forms, pre tests, and post
tests.
Eabametoong First Nation has a total population of 2340 residents, 800 off reserve and 1540 people on
reserve. Eabametoong is an Ojibwe First Nation located on Eabamet Lake. It is a ‘fly-in’ (isolated) community
with roads that have no street signs or traffic lights. ‘Fly-in’ communities are usually only accessible by air;
however, winter roads allow vehicle access for a certain period during the year. The community maintains a
Health and Social Services unit, Education center, Nursing Station, Tikinagan Family Services center, Police
Station, Administration and Branch Office, and a cable/radio station. There were 9 participants in total that
attended the workshop, completed consent forms, and participated in pre and post testing. The target group
in this community was families with infants and young children, and working families with children. The group
was identified by a sign-up sheet made accessible by the band office. Poster information and pamphlets were
also administered for advertisement.
Mohawks of the Bay of Quinte has a total population of 7760 people with 5655 off reserve and 2105 residents
on reserve. Mohawks of the Bay of Quinte are a Mohawk and English speaking First Nation located in the
Tyendinaga Mohawk Territory. They have many services and programs available to the members of the
community including a Health Center, Health Babies Healthy Children, Maternal Child Health, Early Childhood
Development, Mohawk Family Services, Social Services, and much more. The target group was identified by
presenting the opportunity for a car seat clinic to the various service providers above receiving a good
response. Most of the families that accessed the program had 2-3 children, two of them were pregnant, and
only one was living off reserve. Most of the participants were knowledgeable with car seat safety and
standards. In total there were nine participants who attended the workshop but only 6 completed consent
forms and participated in pre and post testing.
Nipissing First Nation has a total population of 2194 people, 849 on reserve, and 1345 off reserve. The
community is located 320 kilometres north of Toronto in north central Ontario. The reserve is divided into
nine different communities varying in size and is distributed across the Nipissing land base. The target group
was families with children 0-8 years old.
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Participating First Nation Demonstration Sites
Onigaming First Nation
Ojibways of Onigaming is a community with a population of approximately 605 people and is located 3 miles
north of the township of Nestor Falls and 25 miles south of Sioux Narrows. The Ojibways of Onigaming resides
on reserve #35E off highway 17. Eleven participants signed up to participate in the Child Car Restraint Clinic
facilitated within the community. Eleven car seats were purchased and distributed to these participants. The
participants that signed up were parents with toddlers all under two years of age or parents who were
expecting the birth of a child soon.
Analysis of the Data
The purpose of this statistical analysis is to report on the impacts of community child passenger safety
interventions. The data analysis employed in this study primarily included descriptive statistics (i.e.,
frequencies, means, medians, ranges, etc.) to test statistical significance, the appropriate test (T-tests, ANOVA,
or Mann-Whitney) was utilized setting the level of significance at 0.05. Percentages were generally based on
the number of responses to each survey item, thus omitting missing data (blank answers). In some instances
total percentages do not equal 100 because of rounding during this process. Sections 1-6 were analyzed on a
grading scale using the following scoring: 0=incorrect, 1=partially correct, 2=correct. Marks were tallied for
each person for tests administered before the intervention (pre) and after the intervention (post). Most of the
comparisons are between the ‘pre-score’ and the ‘post-score’.
Findings
In order to evaluate the impacts of this project and to identify potential best practices in child passenger
safety, we performed a series of statistical analyses. In doing these analyses, we wanted to answer four broad
questions. These questions are listed below.
1. Were there differences in pre and post evaluation scores among participants based on (communities,
genders, and education and income levels) as a result of community interventions?
2. Were there improvements in knowledge related to child passenger safety and child car restraint usage
among those that participated in this project?
3. What are caregivers doing in relation to child passenger safety and child car restraint usage?
4. Who benefitted most (and least) from interventions?
Additional research questions were explored and the questions and results are presented in a separate section
of the report. The following tables, graphs, and statistics are presented in response to these questions.
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March 2012
Table 3 Summarizes the pre and post test scores of participants who completed both tests based on
community, gender, education and income.
Group
Community
Gender
Number of
participants
Scores
Mean (Standard
Deviation)
Pre-Test
Post-Test
Animbiigoo Zaagi’igan
First Nation
12
7.67
(2.060)
8.75
(2.221)
Eabametoong First
Nation
8
8.75
(6.453)
10.63
(3.701)
Mohawks of the Bay of
Quinte
6
12.88
(5.793)
16.25
(4.590)
16
14.50
(3.286)
16.31
(4.191)
10
12.20
(4.417)
13.40
(5.275)
Women
36
11.64
(4.66)
13.38
(5.69)
Men
10
11.90
(3.98)
14.50
(3.81)
Missing
6
Some high school or
lower
18
9.71 (5.16)
10.53(4.38)
High school graduate
3
11.0 (3.0)
14 (3.61)
Some college/university
13
12.15
(4.72)
16.62
(6.21)
College graduate
10
15.0 (3.33)
15.38
(2.83)
University graduate
4
10.25(3.21)
9.25 (4.27)
Missing
4
Under 40,000
26
10.78
(4.63)
13.50
(5.85)
40,000 to 80,000
12
13.54
(3.78)
13.58 (4.1)
Over 80,000
3
14.33
(1.53)
12.0 (0)
Missing
11
11.23
(4.92)
13.17
(5.10)
Education level
Income level
Total
52
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Changes in knowledge about child passenger safety
18
16
14
Average score
12
10
Pre
score
8
Post
score
6
4
2
0
Mohawks of the Bay of Ojibways of Onigaming
Quinte
Eabametoong First
Nation
Animbiigoo Zaagi'igan
First Nation
Community
Research question: Is there an improvement in post-scores versus pre-scored for knowledge of
child passenger safety and child car restraint usage?
This graph compares the knowledge scores before and after the intervention within the
participating communities. All of the communities demonstrated increased knowledge, and
the Mohawks of the Bay of Quinte improved the most. The paired samples t-test reveals that
there is statistically significant improvement in post-scores compared to pre-scores (t51 =
2.575, p = 0.007). The Wilcoxon Signed Ranks test also supports this finding, there is
statistically significant improvement in the child car safety knowledge level as a result of
education initiative (z = 1.980, p = 0.024).
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March 2012
Use stayed the same
Changes in reported car seat use
Use increased
Use decreased
9
8
Number of participants
7
6
5
4
3
2
1
0
Mohawks of the Bay of
Quinte
Eabametoong First Nation Animbiigoo Zaagi'igan First
Nation
Research question: Is there an improvement in using car seat for children?
This chart portrays reported child car seat usage after the intervention. In all communities use stayed the
same or increased after the session. In case-by-case comparison 31.2% of respondents increased child car
seat usage, 47.9% showed no change, and 20.8% decreased. It would be worth trying to find out why use
decreased after the session.
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Sources of information about vehicle safety for children
70
% of respondents selecting
60
50
40
30
20
10
0
Car seat
Family,
instruction friends,
manual neighbours
Car seat
clinic
Instruction
on car seat
box
Hospital
Prenatal
classes
Internet
Other
Transport Provincial
Family
Canada government doctor or
pediatrician
Source of information
Research question: Where are respondents getting information about child passenger safety and child
car restraint usage based on data from pre-surveys?
This chart shows where participants would go for information about child passenger safety and child
car restraint usage. Most participants reported that they would get it from the instruction manual
(60.8%) or from family friends or neighbours (54.9%). Participants reported at a rate of 54.9%, they
would get information from a car seat clinic. Only 2% of respondents said they would get information
from their family doctor or paediatrician.
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March 2012
Changes in test scores by level of education
10
9
8
Score on the test
7
6
5
same or
lower
4
increased
3
2
1
0
less than high school high school graduate
some
college/university
college graduate
university graduate
Level of education
Child Passenger Safety interventions and changes based on participant’s education levels
Participants with some college/university had the highest number of participants with an
increased score. College and university graduates were more likely to stay the same or lower,
perhaps because they had more knowledge before the intervention.
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Research Questions and Results
Additional research questions explored. The list of research questions and conclusions are listed below. These
are collated and based on aggregate data from 5 First Nation Demonstration Sites:
Research question: Was there an improvement in using the tether strap on forward facing car seats after
community interventions?
There was a significant improvement in the usage of tether straps on forward facing seats in post-scores
compared to pre-scores (z = 2.381, p = 0.009).
Research question: What is the most likely reason for not using tether strap on forward facing car seats?
Respondents indicated that the primary reason for not using tether strap on forward facing car seats is the
unavailability of the anchor for the tether strap in their vehicles (35.8%).
Research question: Are children under the age of 12 years of age being transported in the front seat of the
vehicle?
Based on data from pre-surveys, most respondents (59.2%) never transport children under 12 years old in the
front seat of the vehicle, however, 40.8% reported they did. Reports include a frequency rate of sometimes at
(20.4%), rarely at (12.6%), often at (4.1%) and always at (4.1%).
Research question: What were the reasons for transporting children under 12 yrs in the front seat of the
vehicle based on data from pre-surveys?
The two most frequent answers of respondents were: “that the child is big enough to sit safely in the front
seat” (24%) and “not having enough back seats for children” (12%).
Research question: When are children under the age of 8 years being transported using only a seat belt based
on data from pre-surveys?
Most respondents (75.5%) never transport children under 8 years old using only seat belt, but 24.5% still do.
Research question: What was the most frequent reason for transporting children under the age of 8 years of
age using a seat belt only, based on data of pre-surveys?
Respondents indicated that the most frequent reason (16.3%) for transporting children under 8 years old
using only seat belt was for “short trips in the neighbourhood.”
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Limitations of the Study
It is important to note that due to the small sample size the results of this report cannot be generalized to all
First Nations in Ontario. There are some indications based on the results that participants may not have
understood some questions in the survey and thus the accuracy of the data may have been affected.
Community facilitators mentioned a number of participants whose first language was a First Nation language
had difficulty with understanding the questions as they were in English. In addition to literacy challenges,
educational levels were also cited as a possible issue in some cases. For example, questions asked participants
to complete sections of the survey as applicable (according to child age and appropriate child car restraint
usage). Some participants answered the question correctly during the survey and then incorrectly during the
same survey or they left the question blank (thinking maybe they have already answered it earlier). It is also
important to note that in some instances community environments and experience with vehicles and vehicle
passenger safety in general is very different then mainstream society and may have affected the responses of
participants. Therefore, in cases marks were lost due to an incorrect, incomplete or unanswered question.
Limitations also exist based on the target group for project participants, community identified priority
participants and caregivers with children 0-8 years. The result of the evaluation represents the sample and
does not adequately reflect all people in the community.
Challenges Faced by Community Facilitators
The community facilitators were asked about the challenges they experienced in administering the car seat
clinics and with the data collection. This information was collected during the reporting process:








Obtaining a building to hold the presentation, and motivating participants to attend the session
and car seat clinic.
Participants had difficulty understanding the questions in the survey and said that the post test
was easier as they had a better understanding of the materials presented.
Difficulty obtaining resources to coordinate workshop (i.e., pamphlets, culturally appropriate
videos etc).
Child care was an issue for some parents as they had to bring the children with them to the clinic
which was distracting and took away from the learned process and ability to effectively complete
testing and other paperwork.
Coordinating times that were convenient for everyone.
Weather was an issue as it was not always optimal for car seat installation demonstration.
Challenges identified by the participants in terms of adhering to best practices are the cost of seats
for parents of multiple children, not having their own vehicle and using relatives/friends vehicle
for transportation, not being able to afford new vehicles with anchor or afford the installation of
the anchor in their current vehicle.
Site facilitators reported not having enough money left over to purchase seats needed for
participants.
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Summary and Recommendations
As a result of education initiative we saw an increase in child passenger safety and child car restraint
knowledge as well as an increase in frequency of using child car seats and tether straps. No demographic
factors influence the knowledge of child car restraints among the participants. A recommendation for the
correct usage of forward facing child car seats and anchor use is the establishment of partnerships between
First Nation communities and automobile manufacturers and/or automobile service companies to facilitate
the provision and installation of anchors in older vehicles.
Some of the main child passenger safety issues identified through the surveys include the following:

People not feeling the need to use car seats at all, or thinking that it is only necessary for highway
travel and not for short trips within the community
Parents feeling that the tether strap isn’t necessary for forward facing car seats
Most popular reason for not using the tether strap was that the “vehicle did not have an anchor
for the strap”
Parents not using car seats or the proper car seats due to costs and lack of affordability
Parents lack of knowledge in terms of appropriate age for allowing a child to sit with a seat belt
alone
Parents lack of knowledge in terms of appropriate age to allow a child to sit in the front seat of the
vehicle according to ‘Best Practices’





Further:

40.8% respondents transport children under 12 in the front seat (24% believe that their child is big
enough to sit safely in the front seat)

24.5% respondents transport children under 8 using only seat belt (16.3% do so on short trips in the
neighbourhood)

Improve car seat instruction manual as this is a primary source of information about vehicle safety for
children (60.8% of respondents use this source)
First Nations are a distinct people with identity, culture and life ways that are unique to their Nations. It is
important to understand the context of how historical impacts and contemporary issues contribute to a
predominance of risk factors which influence injury occurrence in communities. It is also important to
recognize protective factors, which build upon a strength based approach for restoring connections and
promote healing and wellness and foster healthy and safe communities.
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SECURING OUR FUTURE
Key to Success
Through this project 4 main initiatives have been identified as top priorities:
1.
2.
3.
4.
Education and Awareness
Training and Mentorship
Community Partnerships, Linkages and Networking Internally and Externally
Government Assistance
Key Recommendations as per the above top priorities include:

Each community should have a committee dedicated to Injury Prevention and responsible for the
implementation of Community Integration Programs.

Get community interested in Injury Prevention Initiatives and child passenger safety. With
incentives perhaps as these have been shown to work well!

Health professionals within the communities should increase knowledge regularly and keep
updated with new laws and best practices for child car safety.

Further distribution of low cost car seats and booster seats to families in the community with
government assistance.

Obtain funding for training and refreshment courses for child car seat technicians within the
communities.

Obtain funding to have yearly car seat clinics.

Obtain funding for installation of an anchor for vehicles that do not have one.
Conclusion
Statistical analysis shows that there is in fact an improvement in knowledge and usage as a result of
the Child Car Restraint initiatives. Parents and guardians are now more aware of child passenger safety, best
practices, and of the use and proper installation of the car seats. The largest factor affecting child passenger
safety is poverty and the barriers in education and challenges of access to resources to support injury
prevention through child passenger safety. This project demonstrated the difference community initiatives
such as this could make in First Nation communities when this factor is addressed and communities are
supported with education and resources. It is important to recognize that First Nations are not homogenous
communities. Each community is unique in its history, language, tradition, culture, and beliefs. This holds
implications in terms of planning, designing, and implementing programs as the strategies used in a
mainstream society may not be appropriate for First Nations communities. Thus, communication and
collaboration with community members is a key to successful intervention and implementation of injury
prevention initiatives.
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References
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Benton-Banai, Edward. (1988). The Mishomis Book.
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Chiefs of Ontario. (October 2008). Water Declaration of the Anishinaabek, the Onkwehonwe and the
Muskegowuk.
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Chiefs of Ontario.
Chiefs of Ontario. (November, 2008). Briefing Note to Special Chiefs Assembly: Ontario First Nations Injury
Prevention Initiative. Toronto: Chiefs of Ontario.
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Chiefs of Ontario. (October 1, 2008). Injury Prevention Advisory Group: Terms of Reference October 1, 2008.
Toronto: Chiefs of Ontario.
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in communities” in Addictive Behaviors, 27, pp. 951-976.
Health Canada. (2001). Unintentional and Intentional Injury Profile for Aboriginal People in Canada: 19091999. Ottawa: Minister of Public Works and Government Services Canada.
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Hopkins, C., Dumont, J., February 2012. Cultural Healing Practice within National Native Alcohol and Drug
Abuse Program and Youth Solvent Addiction Program Services Discussion Paper. First Nations and Inuit
Health - Health Canada
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SECURING OUR FUTURE
March 2012
APPENDIX A: Ontario First Nations Injury Prevention Initiative: Child Car Restraint Project
Pre and post Test for USE OF CAR SEATS FOR CHILDREN40
11
Section 1
UNRESTRAINED CHILDREN
1. Do you ever use a car seat for your child?
YES ❑
If yes, when?
On longer trips in the community
In other family vehicles with car seats installed
Highway travel only
Other
NO ❑
❑
❑
❑
❑___________________
2. At what AGE, HEIGHT, WEIGHT, do you plan to let your child sit in the front seat of a vehicle?
Age
______________________ (years/months)
Height
______________________ (inches/cm)
Weight
______________________
(lbs/kg)
I don’t know ❑
Never
❑
Section 2
CHILDREN USING REAR FACING SEATS
1. When your child outgrows this seat, what will your child use next?
Forward facing seat
❑
Booster
❑
Seat Belt
❑
2. At what AGE, HEIGHT, WEIGHT, do you plan to turn your child forward?
Age
_____________________________ (years/months)
Height
_____________________________ (inches/cm)
Weight
_____________________________ (lbs/kg)
I don’t know ❑
Age
______________________________ (years/months)
Height
______________________________ (inches/cm)
Weight
______________________________ (lbs/kg)
I don’t know ❑
Never
❑
40
Modified and Used with permission from Transport Canada
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Section 3
March 2012
CHILDREN USING FORWARD FACING SEATS
Booster seat ❑
Seat belt
❑
I don’t know ❑
2. At what AGE, HEIGHT, WEIGHT, do you plan to move your child to a booster/seat belt?
Age
________________________ (years/months)
Height
________________________ (inches/cm)
Weight
________________________ (lbs/kg)
I don’t know ❑
3. When using a forward facing seat, you use a tether strap:
Always ❑ Often ❑ Sometimes ❑ Rarely ❑ Never ❑ Don’t remember what a tether strap is ❑
If the tether strap is not always being used, please indicate the reasons (Check all that apply):
Don’t know how to use the tether strap
❑
The vehicle does not have an anchor for the tether strap
❑
Don’t feel the tether strap is necessary
❑
The car seat if often moved from one vehicle to another
❑
Tether strap is too difficult to use
❑
Use an integrated car seat
❑
Section 4
CHILDREN USING INTEGRATED SEATS
Booster seat
❑
Seat belt
❑
I don’t know
❑
2. At what AGE, HEIGHT, WEIGHT, do you plan to move your child to a booster/seat belt?
Age
_____________________________ (years/months)
Height
_____________________________ (inches/cm)
Weight
_____________________________
(lbs/kg)
I don’t know ❑
3. At what AGE, HEIGHT, WEIGHT, do you plan to let your child sit in the front seat of the vehicle?
Age
_____________________________ (years/months)
Height
_____________________________ (inches/cm)
Weight
_____________________________ (lbs/kg)
I don’t know ❑
Never
❑
SECURING OUR FUTURE
March 2012
Section 5
CHILDREN USING BOOSTER SEATS
1. At what AGE, HEIGHT, WEIGHT, do you plan to move your child into a seat belt only?
Age
_____________________________ (years/months)
Height
_____________________________ (inches/cm)
Weight
_____________________________ (lbs/kg)
I don’t know ❑
Age
___________________________ (years/months)
Height
___________________________ (inches/cm)
Weight
___________________________ (lbs/kg)
I don’t know ❑
Never
❑
Section 6
CHILDREN USING SEAT BELTS ONLY
Age
___________________________ (years/months)
Height
___________________________ (inches/cm)
Weight
___________________________ (lbs/kg)
I don’t know ❑
Never
❑
Section 7
ALL DRIVERS PLEASE ANSWER THE FOLLOWING
Are there times when you transport a child under 12 yrs. in the front seat of the vehicle?
Single ❑
Never ❑
Rarely ❑
Sometimes ❑
Often ❑
Always ❑
If yes, please indicate when you use the front seat for children. (You may choose more than one answer)
My vehicle has only one row of seats
❑
My child won’t sit anywhere else
❑
I let my child sit in the front seat as a reward
❑
I like having my child sitting next to me
❑
I don’t have enough back seats for children to sit in
❑
My child is big enough to sit safely in the front
❑
I like being able to see my child
❑
Are there times when a child under 8 uses only a seat belt when you are driving?
YES ❑ NO ❑
69 | P a g e
SECURING OUR FUTURE
If yes, please indicate when. (You may choose more than one answer)
When I am transporting children other than mine
On short trips in the city
On short trips in the neighbourhood
On the highway
When I am transporting children older than 4-5 years old
Other
March 2012
❑
❑
❑
❑
❑
❑________________
How many times per week do you transport children?
Less than once a week
❑
Once a week
❑
2-3 times per week
❑
4-6 times per week
❑
Every day
❑
Several times a day
❑
Where did you get information about vehicle safety for children? (Please check all that apply)
Family, friends, or neighbours
❑
Car seat instruction manual
❑
Hospital
❑
Car seat clinic
❑
Prenatal Classes
❑
Family doctor or Pediatrician
❑
Transport Canada (800 line, pamphlet, website)
❑
Provincial government
❑
Internet
❑
Instructions on the car seat box
❑
Other
❑______________________
Since you have become a parent, would you say that your driving has changed?
Definitely more cautious
❑
Somewhat more cautious
❑
Perhaps a little more cautious
❑
No, my driving habits have not changed
❑
No, I have always been cautious
❑
SECURING OUR FUTURE
March 2012
Section 8
ALL DRIVERS PLEASE ANSWER THE FOLLOWING
Driver’s belt status
Belted❑
Unbelted ❑
Driver’s age?
20-29 ❑
30-39 ❑
40-49 ❑
50-59 ❑
Over 60 ❑
Driver’s gender?
Male ❑
Female ❑
Unsure ❑
Driver’s marital status?
Married/common law ❑
Separated/Divorced ❑
Widowed ❑
Race/Ethnicity
First Nations ❑
Asian ❑
Arabic ❑
Indo-Canadian ❑
Caucasian ❑
African Canadian ❑
Hispanic ❑
Other ❑
Language spoken at home?
English ❑
French ❑
Other ❑
Yearly household income?
Under $40,000 ❑
$40,000 - $80,000 ❑
Over $80,000 ❑
Do you live in a?
Large city (population over
100,000) ❑
Large town or small city
(population between 10,000 and
100,000) ❑
Small town (population under
10,000) ❑
Highest level of education?
Elementary school ❑
Some high school ❑
High school graduate ❑
Some College/University ❑
College graduate ❑
University ❑
71 | P a g e
SECURING OUR FUTURE
APPENDIX B:
March 2012
(Chiefs of Ontario Letterhead)
CONSENT FORM
Research Title:
Chiefs of Ontario, Ontario First Nations Injury Prevention Initiative: Child Car Restraint Project
Investigators:
Sheila Cote-Meek, Director of Academic Native Affairs at Laurentian University
Deanna Jones-Keeshig, Injury Prevention Coordinator at the Chiefs of Ontario
We are working with the Chiefs of Ontario to gather information on the use of Child Car Restraint Usage in Ontario First
Nations communities. This information will assist the Chiefs of Ontario with the development of an Ontario First Nations
Strategy and Action Plan for Injury Prevention. This will ultimately assist with prevention of injuries related to Child car
restraint usage.
This research will take approximately 20 minutes of your time and will involve filling out a questionnaire prior to and
immediately after your participation in training related Child Car Restraint Initiatives delivered by the Community Site
Facilitator in your First Nation.
Your participation in this study is strictly voluntary. You have the right to withdraw at any time without penalty.
If you have any questions or concerns about the study or about being a participant, you may call Sheila at 705-675-1151
extension 3429 or Deanna at 416-559-4838 for information.
Your identity will not be revealed at any time. No names will be forwarded to the researchers or to Chiefs of Ontario on
your participation. In order to maintain confidentiality and anonymity you will be assigned a number so that the
researchers can link your pre and post tests together during analysis of the information.
_____________________________________________________________________________
I agree to participate in this evaluation, and I have received a copy of this consent form.
____________________________
Participant's Signature
___________________________
Witness
______________________
Date
______________________
Date:
March 2012
SECURING OUR FUTURE
73 | P a g e
Copyright © 2012 Chiefs of Ontario

Securing Our Future

Transcription

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