Adapting an Indigenous child health measure for Inuit children in Iqaluit, Nunavut

Introduction: Culturally appropriate assessment is vital for learning health systems; however, few such tools for Indigenous children exist. In 2011, Indigenous health leaders and scientists collaborated to create the Aaniish Naa Gegii: the Children’s Health and Well-being Measure (ACHWM) for Indigenous children aged 8 to 18 years. It was adapted for Inuit in Ottawa and named Qanuippit. The Government of Nunavut (GN) expressed interest in integrating the Qanuippit territory-wide. This study aimed to adapt the Ottawa Inuit version for Nunavut, to ensure they had a valid wellness measure to guide community-based health services planning for Inuit children in Iqaluit. Methods: We used a mixed-methods approach to consider the full spectrum of health, from wellness to illness. All data gathered was governed by Inuit Qaujimajatuqangit (IQ) principles. We consulted eight Iqaluit-based experts in Inuit education, culture, and children’s health to ensure cultural relevance and identify any missing content. In February 2024, interviews were conducted by the local mental health team, with 15 Inuit children (7.7 -17.9 years). Each child completed the draft of the Qanuippit that resulted from the Expert review, and local mental health workers examined the children’s understanding of each item. The analysis focused on items with critical input from two or more participants. Once finalized, a pilot implementation study explored how mental health workers integrated the Qanuippit in practice. Results: Experts reported eight items of concern; one had a clear solution, and the remaining seven were identified for monitoring. Children identified 11 problematic items; two had clear solutions, while consultation continued for the remaining items. Mental health workers reported that the tool was a positive, strengths-based experience. The Qanuippit aided in forming connections with clients, which positively impacted their practice. Conclusions: The Qanuippit has proven to be a good fit to assess the health and well-being of Inuit children in Iqaluit.