Ripples in the water: a toolkit for Aboriginal people on hemodialysis.

In 2004-2005, the authors were engaged in a community-based research study with people of Elsipogtog First Nation to determine the causes of and solutions to non-adherence among community members with chronic kidney disease. This study highlighted the need for a toolkit intended for Aboriginal people who are required to undergo hemodialysis at a dialysis unit in a city away from their rural community, so that they are sufficiently educated, supported and resourced to access and experience culturally relevant health care. This paper presents the findings of a two-year community-based research study to develop the prototype or model for such a toolkit. The research involved meeting with nine community members in group meetings at least monthly over the two years to determine what such a toolkit should include and how it should best be presented. It also entailed an extensive review of relevant literature and relevant educational materials, as well as individual interviews with key stakeholders. The project resulted in a culturally relevant toolkit that can be staged according to people's readiness for the information and that fosters collaborative discussions between patients, family members and health care practitioners.