NIICHRO has recently applied for a grant for CHR training in tobacco control strategies. This article discusses the objectives, activities, and rationale for this project entitled “A Demonstration Project to Establish Community-Based ‘Best Practices’ in Aboriginal Communities.”

The objectives of this proposal are:

1.To build the capacity of Community Health Representatives (CHRs) to take a leadership role in tobacco control initiatives;
2.To develop high-quality, comprehensive, culturally sensitive and effective region-based training tools on tobacco control programming for CHRs and their communities;
3.To build a record of “best practices” in tobacco control programming in First Nations and Inuit communities throughout the country; and
4.To reduce the number of Aboriginal people in Canada who are:
-taking up smoking, particularly youth;
-continuing to smoke; and
-being involuntarily exposed to second- hand tobacco smoke.

NIICHRO’s current training model involves an annual “Train the Trainer” session, which involves teaching the CHRs about the topic to be delivered. The effectiveness of CHRs delivering these programs rests on their professionalism and the fact that they are rooted in the communities they serve and can deliver the message directly to the people.

Through the Regional CHR Training in Tobacco Control Strategies: Demonstration Project to Establish Community-Based “Best Practices” in Canada’s Aboriginal Communities, NIICHRO hopes to create a new regional training model.

The activities of this proposed project will be:

1. The development of a training tool for three regional training sessions, which will include curriculum and materials covering the following topics:

Health and Tobacco – making the connections and identifying the tobacco strategies that work; sharing knowledge of best
practices in Aboriginal communities around the world;

Building a community plan – community development tools for tobacco strategies involving community members and
community leadership;

Facilitating skills – how to run effective support groups and community events;

Working with youth, children and schools – “best practices” in the school environment;

Home visits and supporting families – sharing stories and information on how to honor and support families and their homes;

Evaluating health programs – collecting and sharing data and the importance of building the “best practices” record; and

Self-care and the CHR – tools and support for CHRs in their own struggles with non-traditional tobacco use.

The rationale as to why such a project is needed:

1. Tobacco misuse is a very serious problem in Canada’s First Nations and Inuit communities. Smoking is a major public health problem in Canada in general and one that is very high among First Nations and Inuit peoples. The First Nations and Inuit Tobacco Control Strategy was created in recognition of the overwhelming problem of non-traditional tobacco use in these communities.

2. It has been very difficult for health authorities and policy developers to get accurate information about the impact of health programming on Aboriginal communities. As a result, ongoing program development and the impact of program delivery have also been difficult to determine. This has been apparent in the efforts to establish effective tobacco control strategies for Canada’s Aboriginal nations.

- In the past, the First Nations and Inuit communities had little control over the survey design, community ownership of the process, or free access to the research data collected by health and social surveys. The best way to have the core values of respect, trust, responsibility, freedom, holism, kindness and humility integrated into the program development, implementation and evaluation is to have that work led and controlled by community members themselves. The CHR
system of health delivery was created for that reason.

3. CHRs are in the best place to take a holistic approach in the implementation of a tobacco strategy. CHRs are found in almost every Aboriginal community across Canada and they are frequently asked to determine their community’s health needs and coordinate the administration of programming. The support for health programming for First Nations and Inuit communities is largely based on the level of isolation and/or geographic relationship to the larger centers.

4. Many CHRs are over-burdened, lack resources to get to national conferences/ workshops and need support to do their work effectively. Without this project, the ability of CHRs to
effectively implement long-term tobacco control strategies is questionable. Capacity building with CHRs – providing them with community development tools, personal support and program strategies – is the only way to ensure the success of this project.

5. It is within NIICHRO’s role to support and train CHRs. NIICHRO is mandated to:

-Contribute towards upgrading the quality of health care of Indian and Inuit people to the standard enjoyed by the rest of the
population of Canada;

-Provide a forum for CHRs to communicate and exchange information with each other on health issues and the improvement of the CHR program at the national level;

-Create and promote awareness and understanding of the CHR program in Canada;

-Provide a mechanism and a means for advising First Nations and Inuit communities;

-Advise First Nations and Inuit Health Branch and others on all matters pertaining to CHRs.

6. The communities that CHRs serve are so diverse in experiences, resources and cultures that the only way for NIICHRO to effectively address this problem is to create a new
regional training model. NIICHRO has established its ability to provide up-to-date, culturally appropriate materials as well as many successful National Training Sessions.

In order to fully accommodate the regional disparities and distinctions and to ensure the tobacco control strategy is effectively developed and implemented, it is imperative that NIICHRO reaches CHRs within the context of their own
regions. In Touch Magazine and the NIICHRO website will keep its readership posted as to the progress of this proposed project.