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«A Thesis Submitted to the College of Graduate Studies and Research In Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy ...»

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HARMONIOUS JOURNEY: UNDERSTANDINGS OF THE HEALTHY BODY AND

BODY IMAGE FOR FIRST NATIONS GIRLS’ IN THE BATTLEFORDS TRIBAL

COUNCIL REGION THROUGH PHOTOVOICE

A Thesis Submitted to the College of

Graduate Studies and Research

In Partial Fulfillment of the Requirements

For the Degree of Doctor of Philosophy

In the Department of Sociology

University of Saskatchewan

Saskatoon By Jennifer Mary Shea  Copyright Jennifer Mary Shea, November, 2012. All rights reserved

PERMISSION TO USE

In presenting this dissertation titled Harmonious Journey: Understandings of the Healthy Body and Body Image for First Nations Girls’ in the Battlefords Tribal Council Region Through Photovoice, in partial fulfillment of the requirements for a Postgraduate degree from the University of Saskatchewan, I agree that the Libraries of the University may make it freely available for inspection. I further agree that permission for copying of this dissertation in any manner, in whole or in part, for scholarly purposes may be granted by the professors who supervised my dissertation work or, in their absence, by the Head of the Department of Sociology or the Dean of the College in which my dissertation work was done. It is understood that any copying or publication or use of this dissertation or parts thereof for financial gain shall not be allowed without my written permission. It is also understood that due recognition shall be given to me and to the University of Saskatchewan in any scholarly use which may be made of any material in my dissertation.

Requests for permission to copy or to make other uses of materials in this dissertation in

whole or part should be addressed to:

Head of the Department of Sociology University of Saskatchewan 9 Campus Drive S7N 5A5 Canada i

DEDICATION

I would like to dedicate this thesis to two individuals who have had a profound and lasting impact on my life. First, to my Grandfather Fergus Tremblett, who taught me the importance of being understanding, driven, accountable and hopeful. Second, to my father-inlaw Keith Halleran, who was the epitome of hard work and dedication. Your absences have left such an immense void, but your characters continue and will remain an immense source of inspiration and motivation.

ii

ABSTRACT

First Nations peoples in Canada are increasingly referred to as an ‘at risk’ population for the development of poor health outcomes. While these health inequalities are well established in the literature, there is a lack of understanding of how health is both defined by First Nations peoples. This thesis describes a community-based participatory research project with First Nations girls in the Battlefords Tribal Council region. The purpose of this project was to explore the ways in which these girls negotiate different meanings of health and the body, as guided by their words and stories. The project design incorporated various methods including individual interviews, sharing circles, photovoice, and art collages. The participants were given cameras with which to take photographs that represented their understandings of health in their communities; they also completed art collages that further explored the healthy body and body image. Following the completion of the photovoice and art projects, the girls discussed their photographs and their understandings of the healthy body and body image in further detail in both individual interviews and sharing circles. This research has been informed by feminist and sociological theories of the body, which acknowledge social and historical influences on health and the body and the agency of individuals.

The thesis is organized in a manuscript style format and, as such, contains three analysis chapters comprised of manuscripts either published in or submitted to academic journals. The findings of this study reveal that the girls have both insightful and holistic definitions of both the healthy body and body image. The first manuscript discusses findings of the girls’ perceptions of health as a holistic concept. The second manuscript details findings of the girls’ personal resilience showcased in their narratives of the healthy body and body image. The third and final manuscript discusses in detail the undertaking of this community-based participatory project, focusing on the strengths and challenges of this particular research project. The discussions and knowledge created by the girls make a valuable contribution to the literature by increasing our collective understanding of how the healthy body and body image are defined by First Nations girls living on-reserve. In this thesis, I argue, as guided by the words of the girls, that health needs to be understood in a more holistic manner, particularly in the design of health promotion materials, programs, and services designed for First Nations youth. This compliments recent literature that views health in a holistic manner. I also discuss the empowering potential that a community-based participatory project presents when working with First Nations youth.

iii ACKNOWLEDGEMENTS





This project and process were very much about relationship building and as such there are many people to thank for making this journey possible. First and foremost, I express my sincere gratitude to the twenty amazing girls who participated in this study. Thank you all so much for sharing your ideas, experiences, time, and enthusiasm with me. What you have taught me carries far beyond what is contained in this thesis, particularly the importance of strength and having a positive outlook on life. Your spirit and strength were with me as I wrote, and I hope I have done you justice as I described your experiences and understandings.

I would like to thank my amazing “powerhouse” committee. I have been truly blessed to have had the honour of working with four brilliant academics. To my supervisor, Dr. Jennifer Poudrier, I cannot begin to thank you for all the knowledge that you shared, your belief and trust in me to be a part of such an amazing project, and most importantly for being a wonderful friend.

I will forever be grateful for all that you have done and for giving me such an amazing opportunity. To my committee members, Dr. Roanne Thomas, Dr. Karen Chad, and Dr. Bonnie Jeffery, you were always a joy to meet with and brought a smile to my face, and I thank you for all for your feedback and advice, and for challenging and supporting me throughout this process.

All of you brought unique perspectives and strengths that weaved together to create an amazing tapestry; I have learned so much from each of you and I could not have asked for four better mentors. I would also like to thank my external examiner Dr. Heather Castleden for offering her time and perspectives which in turn helped to strengthen this thesis.

I would like to thank the community members that made this project a success. To Janice Kennedy, I am in awe of your ability to juggle numerous demands and your determination to improve the health of community members in the Battleford Tribal Council region. To the four amazing and inspiring Community Youth Outreach Workers, Jessica Atcheynum, Lenore Kiskotagan, Kimberly Burnouf, and Kellie Wuttunee, I cannot begin to thank you for the time and efforts you put into this project. You are all such intelligent and strong women and your dedication and impact on the girls and youth in your communities were continuously evident throughout this project. To the community research assistants, Tanya Delmore, Lillian Blackstar, and Sonya Whitecalf, I greatly appreciate your sharing of knowledge and contributions as well as your belief in this project. To the coordinator of the larger project with women, Carolyn Brooks, thank you for everything that you have done for this project, for being a sounding board, and for iv being an amazing friend. My sincere gratitude to Elder Melvina Thomas for joining us and offering prayer during Phase One of this project. You were an invaluable presence to the girls, the team, and I as we began our work together. I would also like to thank additional staff members at Battleford Tribal Council Indian Health Services, Lillian Pooyak, Jose Pruden, and Sandra Favel Rewerts, for your support and feedback in the planning stages of this project and onwards.

My sincere thanks to the Indigenous Peoples’ Health Research Centre for your generous funding that made this project possible.

I would like to thank my colleagues at the University of Saskatchewan for all your support, for making us feel welcome in our new home, and for all the good times and laughter;

your friendships are some of the best souvenirs from my life in Saskatchewan. I would especially wish to thank my colleague Meridith Burles, who has always been one of my biggest cheerleaders. You were always there when I needed to talk through ideas or if I needed something read. You were an invaluable support system throughout this process and beyond.

Most importantly, you were my family when I was so far away from my own. Additionally, I would like to thank all the administrative staff in the Department of Sociology for your help and kindness.

To my colleagues at the Newfoundland and Labrador Centre for Health Information, thank you all your support and understanding especially when I needed some time off to write. It was difficult to be away from Saskatchewan as I wrote this thesis, and being surrounded by supportive and understanding co-workers also pursing graduate degrees has been extremely helpful.

To Randy Johner I am grateful for your advice and feedback on the design of a manuscript based thesis, thank you for providing your thesis as an example of this approach.

Thank you to Gillian Binsted for your insightful comments and editorial help, your assistance has been invaluable as I prepared this thesis. My sincere gratitude to Jennifer Phillips your assistance with formatting this thesis.

Finally, I would like to thank my family and lifelong friends for support and understanding throughout my university life. To my husband, Trevor Halleran, I cannot begin to thank you for all your love and support, and for taking this journey with me. I greatly appreciate your confidence in me, as having you by my side gave me focus and made me stronger.

v

TABLE OF CONTENTS

PERMISSION TO USE

DEDICATION

Abstract

ACKNOWLEDGEMENTS

LIST OF TABLES

LIST OF FIGURES

LIST OF COMMON ABBREVATIONS

CO-AUTHORSHIP STATEMENT

Chapter 1 - Introduction to the Research

1.1 Introduction

1.2 Terminology Used in Thesis

1.3 Overview of the Larger Project, the Battlefords Tribal Council (BTC) Region, and Participating Girls

1.3.1 The Beginning Stages of My Involvement with the Communities in the BTC Region 5 1.3.2 Participating Girls’

1.4 Purpose, Research Questions, and Contributions

1.5 Thesis Organization

Chapter 1 References

Chapter 2 - Critical Understandings of Health and the Body

2.1 Introduction

2.2 Historical and Current Understandings of Health and Body Image for Aboriginal Peoples

2.2.1 Aboriginal Health in Canada

2.2.2 Social Determinants of Health

2.2.3 Health of Aboriginal Women and Girls

2.2.4 Youth and Girls’ Body Image

2.2.5 Resilience and Aboriginal Health

2.3 Theoretical Understandings of the Body

2.3.1 Sociological Theories of the Body

2.3.1.1 The Social Body

2.3.1.2 The Body and Agency

2.3.2 Feminist Theory

2.3.2.1 Feminism and the Body

2.3.2.2 Feminist Standpoint Theory

2.3.2.3 Black Feminist Thought and Postcolonial Theory

2.4 Summary

Chapter 2 References

Chapter 3 - Methodology and Methods

vi

3.1 Introduction

3.2 My Standpoint

3.3 Decolonizing Methodologies

3.4 Community-Based Participatory Research

3.5 Photovoice

3.5.1 Photovoice and Youth

3.5.2 Photovoice Exploring Aboriginal Health

3.5.2 Application of Photovoice

3.6 Research Design

3.6.1 Partnerships, Relationship Building & Planning

3.6.2 IPHRC Grant

3.6.3 Recruitment of Participants

3.6.4 Phase 1: Photovoice Projects and Individual Interviews

3.6.5 Analysis

3.6.6 Phase 2: Sharing Circles and Community Event Planning

3.6.7 Inspirational Evening - Gala Celebration

3.6.8 Knowledge Translation

3.7 Ethical Considerations

3.8 Summary

Chapter 3 References

Chapter 4 – Manuscript 1

Understanding the Healthy Body from the Perspective of First Nations Girls’ in the Battlefords Tribal Council Region: A Photovoice Project

4.1 Abstract

4.2 Background

4.3 Methods

4.3.1 Project Design

4.3.2 Decolonizing Methodologies and Photovoice

4.3.3 Participants

4.4 Findings

4.4.1 Healthy/Unhealthy Foods

4.4.2 Community

4.4.3 Relationships

4.4.4 Physical Activity

4.4.5 Additional Healthy Behaviours

4.5 Discussion

4.6 Conclusion

Chapter 4 References

Chapter 5 – Manuscript 2

In Their Own Words: First Nations Girls' Resilience as Reflected Through Their Understandings of Health

5.1 Abstract

vii

5.2 Introduction

5.3 Theoretical Understandings of the Body

5.4 Methods

5.4.1 Study Design

5.5 Findings

5.5.1 Body Image

5.5.1.1 Appearance

5.5.1.2 Friendship & Weight

5.5.1.3 Gender

5.3.1.4 Beauty

5.5.2 Loss

5.5.3 Addictive Substances

5.6 Discussion & Conclusions

Chapter 5 References

Chapter 6 – Manuscript 3

Reflections from a Creative Community-Based Participatory Research Project Exploring Health and Body Image with First Nations Girls’

6.1 Abstract

6.2 Introduction

6.3 Background

6.3.1 Decolonizing Methodologies

6.3.2 Community-Based Participatory Research

6.3.3 Photovoice



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