Indigenous talking circles : A qualitative, culturally safe data collection method

Introduction
Cultural safety is experienced when people feel safe receiving healthcare. This participatory project, carried out with and by the Atikamekw Nation (Indigenous nation, Québec, Canada), aimed to co-develop a new intervention model to ensure cultural safety of health care for the Atikamekw. A decolonizing research approach, integrating Indigenous epistemologies and methodologies such as talking circles, was adopted. Talking circle is an Indigenous consensual decision-making method rooted in equality of voice that has recently been used as a qualitative data-gathering strategy in the context of Indigenous research.

Goals and methods
Talking circles were used to gather the views and the needs of community members in terms of culturally safe care. Three talking circles (one in each of the three Atikamekw communities) were conducted from June to July 2022 in a culturally safe location identified by the partners. Each circle included at least one Elder, who opened the circle with a ceremony, and 6 to 8 participants. Talking circles lasted an average of 2 hours, and were conducted in French and Atikamekw. Data from talking circles was transcribed verbatim and analyzed using thematic analysis.

Results
The results describe themes related to health care needs: 1. To have access to health care in their language; 2. To feel welcomed in health care organizations; 3. To receive care in an anti-racist environment; 4. To be self-determining in their health care choices; 5. To have a service offer in line with Atikamekw conceptions of well-being and values. These findings were used to co-develop an intervention model.

Conclusions
This research project illustrates how a decolonizing approach centered on Indigenous experiences, knowledge and ways can be used in intervention research. Talking circles proved to be a culturally safe way to gather sensitive data from Indigenous participants, helping to develop a shared vision of the intervention.