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Background The COVID-19 pandemic presented unprecedented challenges to local health systems, widening gaps in support and disrupting available care. Within Canada, First Nations communities have been disproportionately affected by the pandemic, which exacerbated an already strained system of appropriate services and supports. As part of a broader community-based participatory research project ( The First Nations Wellness Initiative ), the aim of this research was to explore how the COVID-19 pandemic affected people seeking and providing mental wellness supports within a First Nations community, with an eye to informing ways to enhance community strengths to better address pandemic-related challenges and develop community-identified opportunities for mental wellness promotion. Methods From September 2020 to March 2022, one-to-one interviews with people with lived experiences with mental health and/or substance use challenges ( n  = 2) and individuals supporting loved ones with lived experiences ( n  = 7) as well as two focus group discussions (i.e., with community youth ( n  = 5) and frontline service providers ( n  = 5)) were conducted in Saugeen First Nation, Ontario, Canada by a local research coordinator/Knowledge Holder. Individuals shared experiences with mental wellness and/or substance use challenges and experiences accessing/providing mental wellness supports during the pandemic. Recommendations for improving supports during and beyond the pandemic were also provided. These qualitative data were analyzed thematically, using a hybrid inductive-deductive approach. Results Challenges faced during the pandemic included difficulties finding and navigating available supports; problems connecting via virtual services; and lack of access to cultural and/or spiritual supports. Participants described relational supports (kinship, friends, the broader community) as well as formal supports (culturally-embedded programs, group supports, youth support group) as key community strengths drawn upon during the pandemic to promote mental wellness. In terms of service provision, challenges balancing differing community needs and concerns were highlighted. Participants shared ideas for expanding and adapting mental wellness promotion and supports to develop a stronger system of care for mental wellness and substance use challenges. Conclusions The findings point to opportunities for building on existing community strengths and promoting locally-led, culturally-grounded supports for mental wellness and substance use challenges to enhance capacity of First Nations communities to support their members in the face of public health crises.

Objective Documenting cannabis use is important for patient care, but no formal requirements for consistent reporting exist in primary care. The objective of this study was to understand how cannabis use is documented in primary care electronic medical record (EMR) data. Results This was a cross-sectional study using de-identified EMR data from over 398,000 patients and 333 primary care providers in Alberta, Canada. An automated pattern-matching algorithm was developed to identify text and ICD-9 diagnostic codes indicating cannabis use in the EMR. There was a total of 11,724 records indicating cannabis use from 4652 patients, representing approximately 1.2% of the patient sample. Commonly used terms and ICD-9 codes included cannabis , marijuana/marihuana, THC, 304.3 and 305.2. Nabilone was the most frequently prescribed cannabinoid medication. Slightly more males and those with a chronic condition had cannabis use recorded more often. Overall, very few patients have cannabis use recorded in primary care EMR data and this is not captured in a systematic way. We propose several strategies to improve the documentation of cannabis use to facilitate more effective clinical care, research, and surveillance.

The emergence of Alzheimer's disease and related dementias (ADRD) in Indigenous populations across Canada is of rising concern, as prevalence rates continue to exceed those of non-Indigenous populations. The Intergenerativity Model, guided by Indigenous Ways of Knowing, nurtures a psychosocial approach to promoting healthy brain aging and quality of life. Community-based participatory action methods led by interviews, focus groups, and program observations aid in identifying the barriers to and facilitators of success for intergenerational social engagements in the Anishinaabe community of Wiikwemkoong in northwestern Ontario. A qualitative thematic analysis guides future recommendations for programming opportunities that foster traditional roles of older First Nation adults and support intergenerational relationships. The results of this project elicit culturally appropriate recommendations for community-driven supports that address healthy brain aging. These outcomes are relevant to other Indigenous communities as the framework for determining that culturally appropriate health supports can be adapted to the unique context of many communities.

The emergence of Alzheimer’s disease and related dementias (ADRD) in Indigenous populations across Canada is of rising concern, as prevalence rates continue to exceed those of non-Indigenous populations. The Intergenerativity Model, guided by Indigenous Ways of Knowing, nurtures a psychosocial approach to promoting healthy brain aging and quality of life. Community-based participatory action methods led by interviews, focus groups, and program observations aid in identifying the barriers to and facilitators of success for intergenerational social engagements in the Anishinaabe community of Wiikwemkoong in northwestern Ontario. A qualitative thematic analysis guides future recommendations for programming opportunities that foster traditional roles of older First Nation adults and support intergenerational relationships. The results of this project elicit culturally appropriate recommendations for community-driven supports that address healthy brain aging. These outcomes are relevant to other Indigenous communities as the framework for determining that culturally appropriate health supports can be adapted to the unique context of many communities. L’émergence de la maladie d’Alzheimer et des démences apparentées (MADA) chez les populations autochtones du Canada est de plus en plus préoccupante, étant donné que la prévalence dépasse maintenant celle des populations non autochtones. Le modèle « d’intergénérativité », guidé par les savoirs autochtones, est axé sur une approche psychosociale visant à promouvoir le vieillissement sain du cerveau et à améliorer la qualité de vie. Les méthodes d’action participative communautaires impliquant des entrevues, des groupes de discussion et l’observation de programmes ont permis d’identifier des obstacles et des facilitateurs assurant la réussite des engagements sociaux intergénérationnels dans la collectivité Anishinaabe de Wiikwemkoong, dans le nord-ouest de l’Ontario. Une analyse thématique qualitative a orienté les recommandations futures pour le développement de programmes favorisant les rôles traditionnels des aînés des Premières Nations et soutenant les relations intergénérationnelles. Ce projet a mené à la formulation de recommandations culturellement appropriées pour favoriser le vieillissement sain du cerveau, grâce à des interactions sociales intergénérationnelles plus significatives. Les résultats de cette étude sont pertinents pour les autres communautés autochtones souhaitant adopter ce cadre d’action ou certaines de ses suggestions dans leur communauté. Eshkam getnaamshkaagonaawaa Anishnaabek maanda aawzowendamowin miinwaa aasaadziwin pii dash Megwenhik maampii Canada, aapichi znagendaagwad awashime ni baatiinwaat Anishnaabek eni naapinejig owi. Naabiisjigan gii zhichigaade Anishnaabe kendaaswin nakaazang wii naadmaagemgag wii ni mnamaadziimgag ni gchipiitzing owi wiinendip miinwaa maadziwin. Maamwi wiidookaaswin enskaamgag ndakenjigewin nakaazang nbwaachwewin, mizoodbiwin, dibaamjigewin wiimkigaadek enoondesek miinwaa waanaadmaagemgag wii ni aanke nakaazang Wiikwemikoong, Giiwedwaabanang, Ontario. Mooshkin weweni ndakenjigeng da naadmaagemgat waa ni naaknigeng naadmoondwaa geyaabi waabi yaajig. Owi dash gaa mkigaadek, Anishnaabe-aadziwin geni nakaazang wii miikming aasgaabowitaadwin wii ni mino gkaang. Maanda gaabi mkigaadek dani miikse naabiisjiganing Anishnaabe aadziwin ge naadmaagwaad kina Anishnaabek.