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The NCCAH has conducted several key research reports related to the preschool vision screening initiative including:

Preschool Vision Screening and Mentoring Programs: A Complementary Approach to Eye Care for Aboriginal Peoples in British Columbia

This report provides a summary of best practices in preschool vision screening programs and training models with an analysis of how mentoring can contribute to successful, sustainable preschool vision screening for Aboriginal peoples in BC

Preschool Vision Screening for Aboriginal Children in BC : A Needs Assessment

This report examines the vision needs of Aboriginal (First Nations, Inuit, and Metis) children on and off-reserve across British Columbia under the age of six. 
 

Preschool Vision Screening and Aboriginal Eye Health
This report is composed of two sections: first, an environmental scan of provincial, national and international programs and resources related to preschool vision screening and Aboriginal eye health; and second, a review of relevant academic and grey literature on screening programs and Aboriginal vision needs.

Additionally, we have created Aboriginal vision screening training materials including:

Preschool Vision Screening Training Manual

This manual was developed to provide Aboriginal vision screeners with the skills needed to screen preschool children in order to identify eye conditions such as strabismus (turned eye), amblyopia (lazy eye) and refractive erros (decreased vision).

Aboriginal Children’s Health Research 

Aboriginal children and youth are among the most vulnerable and disadvantaged in the province and nationally.  They experience significantly higher rates of morbidity, mortality, sudden infant death syndrome (SIDS), FASD, poor nutrition, and lower birth rates than their non-Aboriginal counterparts.  

Although federal, provincial and territorial governments, along with Aboriginal people themselves, deliver a range of programs for Aboriginal children and youth, significant gaps remain.

In September 2005, Health Canada released the Aboriginal Children’s Health Research Agenda Project to synthesize existing research and identify gaps for future research.

Phase I of the project involved a comprehensive, 10-year retrospective scan of Aboriginal children’s health research literature from Canada, the United States, Australia and New Zealand. In Phase II of the project, key informants from national Aboriginal organizations, Aboriginal health organizations, research institutions, and various government departments were surveyed.

The report highlighted some key findings in Aboriginal child health research in Canada.

• In the period from 1996 to 2005, ninety research articles were published in Canada compared to 196 in the United States and 108 in Australia. Of those produced in Canada, the majority were created by health sector researchers. Only a small minority were produced by the Aboriginal sector itself (national Aboriginal health organizations).
  
  
• The majority of articles focused on Aboriginal infants (0-2 years of age), followed by school-age children (6-12 years old). Aboriginal preschoolers (3-5 years old) accounted for the least number of research papers in all countries.  Only one research paper provided data on Métis children.
  
  
• In Canada, the primary research topics in Aboriginal child health included environmental exposure, growth and development, risk and protective factors such as immunization, and nutrition. There were no articles that dealt with diseases of the eye in Aboriginal children.

Findings from key informant surveys indicate a number of research gaps in Aboriginal child health research including:

• lack of research on Métis, non-status and urban Aboriginal children;
  
  
• lack of meaningful input from Aboriginal communities;
  
  
• lack of meaningful and sensitive research processes;
  
  
• gaps in our understanding of health status, particularly research on preventing, tracking and monitoring FASD;
  
  
• research gaps in the area of health determinants that take into account the historical context of the Aboriginal population, as well as community-wide, inter-generational, and family issues; and
  
  
• research gaps in health care data including cost-effectiveness, service delivery in rural, northern regions, and other barriers to service (Health Canada, 2005).

The perceived barriers to carrying out research to fill these gaps were extensive.  These included lack of capacity; lack of cultural awareness amongst researchers; funding barriers; inadequate health information systems; research exhaustion and mistrust in Aboriginal communities who feel “researched to death”; lack of awareness at a community level; methodological and logistical issues and disparate research priorities (Health Canada, 2005).

In the 1991 Aboriginal Peoples Survey, researchers found that approximately 24% (28,560) of respondents reported having a vision disability and, of those identified, the vast majority lived on reserve.

Despite these statistics, there continues to be a lack of Aboriginal eye health and vision care research in Canada, particularly when compared to the United States and Australia.

A search of PubMed (Medline) and various research and systematic review database sites found approximately twelve peer-reviewed articles on Aboriginal eye health issues, the majority of which dealt with refractive errors (Woodruff et al., 1976; Boniuk, 1973), strabismus (Wyatt et al., 1973), and vision loss related to diabetes in adult and elderly populations.

Of the older research, the 1973 review “A Decade of Northern Ophthalmology” by Dr. Elizabeth Cass from the Arctic Ophthalmology Symposium is of particular interest. Beginning with her first northern excursion in 1959, Dr. Cass documented common visual impairments (refractive errors, strabismus, and cataracts) among First Nations, Métis and Inuit from Aklavik to Pelly Bay.

The research identified social causes of vision loss, such as diet, trauma and occupation, as well as genetic causes such as intermarriage. Research findings also took into account the difficulties of providing vision care in small, isolated Aboriginal communities.  These included language barriers, vast distances between communities, lack of services, poor infrastructure, and fear or distrust of non-Aboriginals.