Evaluating the strengths and challenges of PAX dream makers approach to mental health promotion: perspectives of youth and community members in indigenous communities in Manitoba, Canada

ABSTRACT

PAX Good Behaviour Game (PAX-GBG) is an evidence-based approach to co-create a nurturing environment where all children can thrive. This school-based approach was identified as a promising intervention for suicide prevention by First Nations communities in Manitoba, Canada. To enhance this mental health promotion approach, PAX Dream Makers was developed. It is a youth-led addition to PAX-GBG for middle and high school students. This study’s aim was to examine, from the communities’ perspectives, the influence of PAX Dream Makers on youth as well as its strengths, challenges and suggestions for future improvements. A case study method was conducted using interviews and focus groups with 30 youth and 17 adult mentors and elders. Participants reported that PAX Dream Makers provided support and encouragement to the youth, increased their resilience and provided an opportunity to be positive role models. It strengthened PAX-GBG implementation in schools. Challenges included: adult mentors availability, frequent teacher turn-over and community mental distress. Suggestions expressed were: being mindful of cultural and community contexts, increasing community leadership’s understanding of PAX-GBG and better recruitment of mentors and youth. PAX Dream Makers approach was well-received by communities and holds great promise for promoting the well-being of First Nations youth.

KEYWORDS:

• Mental health promotion
• suicide
• children
• youth
• implementation research

Acknowledgments

The authors would like to give recognition to the Swampy Cree Tribal Council community members for their contribution in the conception and design of this study, with special thanks to Elders Cornelius Constant and William Lathlin. The authors attended formal and informal meetings with community members throughout the study. Their guidance has been essential in developing the study protocol. We acknowledge the support and involvement of the Cree Nation Tribal Health Centre staff who co-led the PAX project. We recognize the sincerity and generosity of our government partners in Healthy Child Manitoba Office who funded the PAX-GBG in Manitoba and were dedicated to working with communities and with us to ensure the implementation and evaluation of this intervention. We are equally indebted to our government partners in the Department of Education for their continued support. We thank the Manitoba First Nations Education Resource Centre and the First Nations and Inuit Health Branch for their time, effort, direction, and funding. Finally, the authors thank the PAXIS Institute for the ingenuity, generosity, and interest in adapting and developing PAX for the benefit of Indigenous people. This study was funded by the Canadian Institutes of Health Research, Pathways to Health Equity for Aboriginal People – Implementation Research Team Grant.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ In the Canadian context, the term First Nations refers to Indigenous individuals who are registered members of a band. First Nations has replaced the term Indian as used in the Constitution Act of 1982, which specifies that the Aboriginal Peoples of Canada consist of three groups: Indians (now called First Nations), Inuit, and Métis. In the province of Manitoba, there are five major linguistic groups among First Nations: the Anishinaabe, Cree, Anishininew, Dakota, and Dene.

Additional information

Funding

This work was supported by the Canadian Institutes for Health Research, Pathways to Health Equity for Aboriginal People – Implementation Research Team Grant [P12 – 144646]