Community Health Indicators Toolkit, 2nd Edition: January 2010

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Community Health Indicators Toolkit, 2nd edition
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First Nation’s Health Development:
Tools for Program Planning
and Evaluation
Community Health Indicators Toolkit
This project was made possible by funding from the following organizations: Canadian Institutes of Health Research (Institute
of Aboriginal Peoples’ Health and Institute of Population and Public Health), Saskatchewan Health Research Foundation
and Northern Medical Services, University of Saskatchewan.
nd
August 2010 (2 Edition)
Community Health Indicators Toolkit
Published by:
Saskatchewan Population Health and Evaluation Research Unit
University of Regina & University of Saskatchewan
www.spheru.ca
December 2006 (revised August 2010)
ISBN: 978-0-9780261-2-7 (hardcopy binder)
ISBN: 978-0-9780261-3-4 (CD ROM)
This publication is also available on the internet at www.spheru.ca
For additional copies of this publication, please contact:
SPHERU
University of Regina – Prince Albert Campus
1500 – 10th Avenue East
Prince Albert, Saskatchewan
Canada S6V 7S3
E-mail: [email protected]
Fax: (306) 953-5305
Suggested citation:
Jeffery, B., Abonyi, S., Hamilton, C., Lidguerre, T., Michayluk, F., Throassie, E., Anthony, B.,
Bird, S., Denechezhe, M., Thomas, L., Whitecap, Z. (2010). Community Health Indicators
Toolkit. University of Regina and University of Saskatchewan: Saskatchewan Population
Health and Evaluation Research Unit.
Acknowledgements
The research team would like to thank the leadership and membership of the participating
communities for welcoming us into their communities and for their practical assistance and
insightful contributions to the project.
This project was made possible by funding through grants from the following organizations:
Canadian Institutes of Health Research (CIHR)

 Canada's major federal funding agency for health research. This project was funded by two
of the institutes:
Institute of Aboriginal People’s Health (IAPH)

 supports research to address the special health needs of Canada's Aboriginal people
Institute of Population and Public Health (IPPH)

 supports research into the complex interactions (biological, social, cultural,
environmental) which determine the health of individuals, communities, and global
populations
Saskatchewan Health Research Foundation (SHRF)

 provincial government-funded agency responsible for funding health research in
Saskatchewan
 encourages and facilitates research in the health sciences, health-related social sciences,
and other health-related fields
 provides funding to individuals and agencies working on research projects that are
consistent with a provincial health research strategy
Northern Medical Services (NMS), University of Saskatchewan

 one of three divisions of the Dept. of Family Medicine, College of Medicine, University of
Saskatchewan
 works with district Health boards and Tribal Councils in the north to liaise with other health
care personnel, local community committees and other agencies who provide services to
the community
First Nation’s Health Development Toolkit Page i

Researchers
Principal Research Team

Bonnie Jeffery, Ph.D., Faculty of Social Work and Saskatchewan Population Health and
Evaluation Research Unit, University of Regina
Principal Investigator
Sylvia Abonyi, Ph.D., Department of Community Health and Epidemiology and
Saskatchewan Population Health and Evaluation Research Unit, University of Saskatchewan
Co-principal Investigator
Colleen Hamilton, Saskatchewan Population Health & Evaluation Research Unit
Project Coordinator
Saskatchewan First Nation Partners

This multidisciplinary and collaborative project was undertaken in partnership with three First
Nations health organizations: Prince Albert Grand Council (PAGC), the Athabasca Health
Authority (AHA) and the Northern Inter-Tribal Health Authority (NITHA). The PAGC, AHA
and NITHA managers were members of the research team.
Prince Albert Grand Council, Health & Social Development

Ernest Sauve – Director
Anne Unsworth – Community Health Manager
Athabasca Health Authority

Georgina MacDonald – Chief Executive Officer
Northern Inter-Tribal Health Authority
Academic Partners
Shannon Avison, First Nations University
Georgia Bell-Woodward, Saskatoon Health Region
Ronald Labonte, Ph.D., University of Ottawa
George Maslany, Ph.D., University of Regina
Michael McCubbin, Ph.D., Laval University
Nazeem Muhajarine, Ph.D., University of Saskatchewan
Brandon Anthony, Ph.D., Central European University, Budapest
First Nation’s Health Development Toolkit Page ii

Research Assistants
Shawn Ahenakew
Kim Ahenakew
Jori Cachene
Marcy Burka-Charles
Julian Miller
Nuelle Novik
Charity Peterson
Kayla Pruden
Andrea Sanderson
Nadia Stadnyk
Leigh Tomilin
Sue Wilson-Cheechoo
First Nation’s Health Development Toolkit Page iii

Introduction
In the process of conducting the 2002 evaluation of transferred health services from First
Nations and Inuit Health Branch (FNIHB) to the Prince Albert Grand Council (PAGC) in
Saskatchewan, PAGC health managers expressed a desire to address questions beyond
the scope and capacity of the evaluation that they felt were relevant to the ongoing
development of health services in their member communities. They were especially
interested in the issue of the health effects of other human services on community health
and wellness. PAGC health managers were also interested in determining what information
communities could collect to track and monitor their progress in the area of community
health outcomes.
The First Nation’s Health Development: Tools for

Program Planning and Evaluation project was built
What is a Framework?
upon the 2002 evaluation to consider these issues. A framework is simple model of
complex things. Much like a house
The primary objectives of this research project were 1)
plan starts with a simple outline of its
to develop an evaluation framework and 2) to develop walls and rooms, the finished house
with furnishings is much more
indicators for use by First Nations health organizations complicated. A framework for
community health indicators is
to track the effects of health and human service similar. It is a simple model of
programs under their jurisdiction. The outcome of this complex social, cultural, economic
and environmental relationships and
research project is the Community Health Indicators behaviours that effect the wellness of
a community.
Toolkit.
This Community Health Indicators
Framework organizes the concepts of
The Community Health Indicators Toolkit is, in community health described by
community members into key areas
essence, the evaluative framework manual. It was (domains) with proposed
measurements (indicators). These
designed to assist with the identification and collection indicators can then be tracked over
time to see if there have been
of data, based on the framework domains and indicator
changes, allowing for evaluation of
categories, that would help measure progress on progress. When used in this way the
indicators framework becomes an
improving community health. Evaluative Framework.
This section will help you navigate through the toolkit

as you review the Community Health and Wellness Evaluative Framework and indicators
that have been developed as part of this research project. Many indicators will be relevant
to your community. However, this framework can also act as a guide to help you develop
other indicators that reflect the uniqueness of your own community.
First Nation’s Health Development Toolkit Page 1

Structure of the Toolkit:
The toolkit consists of:
What is an Indicator?
1. a diagram of the Evaluation Framework An indicator is a measure of
something. It is usually a
number, but not always. Letter
2. a section on each of the domains of community grades in school are an indicator
health and wellness with their associated indicators but not a number.
For example, playing sports was
3. A Methods section, which provides detailed one of the activities identified as
contributing to a healthy lifestyle.
information on the research process. People playing sports could
therefore be an indicator of a
healthy lifestyle.
Further descriptions of the Evaluative Framework and the
domain sections appear below:33
1. The Evaluation Framework Diagram identifies:
 the key factors (domains) which impact the health and wellness of a community
 the specific areas within each domain (indicator categories) identified as playing a
role in community health and wellness
 the important individual health and addiction issues affecting the health and wellness
of the community
Figure 1 – Evaluation Framework Diagram
Indicator Categories
Domain

2. The individual domain sections of the manual include:
What is a Domain?
A domain is a major category
a) a description of the domain and a list of the that has been identified as
being an important area that
indicator categories (see Figure 2) affects health. A domain
identifies key issues that need
b) a numbered list of community proposed to be measured by specific
indicators.
indicators within the domain, grouped by
For example, Healthy Lifestyles
indicator category and issue areas (see was identified as a key area
Figure 2) that affects both individual and
community health and is
therefore a domain of
c) a set of Data Sheets, which organizes the
community health and
indicators within each category into an indicator wellness.
table (see Figures 3 & 4)
d) a list of data source references that identify the source of the specific question,
measure, or existing data that is listed in the indicator table (see Figure 5)
e) a Tool Sheet, which provides an example of a how one might collect data and
calculate a value for a specific indicator (see Figure 6)
How to Use the Toolkit

As you look at the framework diagram, you may be interested in
How are Indicators Used?
finding out more about one area that affects the health and
Collecting information on
wellness of a community. For example, people spoke about how indicators can provide data to
enable decision-making, set
participating in social and physical activities is part of a healthy priorities, or evaluate the
lifestyle. The toolkit identifies ways in which communities proposed progress of a plan or program.
For example, measuring the
that participation levels in social and physical activities could be
level of participation in sports
measured. activities can help determine
whether a desired participation
level is being met, or if a
specific program is having the
The participation indicator category of the Healthy Lifestyle desired effect. Measuring
domain contains a number of community-proposed indicators that activity levels of different
groups, like Elders or youth,
statistical information can be collected on to measure participation, can help identify whether
these groups are being served
as it relates to a healthy lifestyle. You may want to find out if any of by existing programs.
these indicators would be useful measures in your community. The
steps outlined in the following pages show how you would use the
toolkit to do this.

Step 1
 Go to the Healthy Lifestyles section of the toolkit, which is identified by a tab in

the binder.
 As you flip to the Healthy Lifestyle section, you will see that the first page provides a
description of the Healthy Lifestyle domain, and lists numbered indicators under each
indicator category (see Figure 2).
 Looking at the Participation category, you will see the list of indicators (numbered 9 –
15) that relate to Participation.
 You will note that these indicators have been further grouped under “Social Activities”
and “Elders and Youth”. These are areas in which issues have been identified that
relate to specific participation indicators.
Figure 2 – Domain Description & Indicator List
Domain Description
Indicator Category
Issue Area
Proposed Indicators

Step 2
 Go to the Healthy Lifestyles Data Sheets, which follow the indicator lists of the
Healthy Lifestyle section.
 Flip through the Data Sheets to the beginning of the Participation indicator category,
identified in the title line: Health Lifestyles >> Participation (see Figure 3).
 The Participation indicator category is further broken down under issue areas:
Social Activities (indicators 9 &10); Physical Activities (indicators 11-14); and Elders
and Youth (indicator 15).
 A description of the issues identified is provided below the title line, in italics.
Figure 3 – Data Sheet Identification
Title Line
Domain
Healthy Lifestyle
Indicator Category
Participation
Issue Area
Social Activities
Issues Identified

Step 3
 The Participation indicators are contained in an indicator table, which appears just
below the description of the issues identified (see Figure 4).
 The indicator tables contain existing statistical data on northern Saskatchewan

communities and suggested questions or measures that could be used to perform a
community based survey.
 A data map of existing data directs you on how to find it online. Follow each step of
the data map to find the relevant information, or the closest possible site where you
can contact someone to gather that data.
Figure 4 – Data Sheet Indicator Table
Indicator Table
Indicator
Data Sources
Data Map

Step 4
 Listed at the end of each group of indicator tables, are the data source references,
where the information was gathered (see Figure 5). This is a direct reference to the
source of the specific question, measure, or existing data that is listed in the
indicator table. Keep in mind that online sources often change and you may have to
visit the original site and find the specific document yourself.
 Each information source in the indicator tables is assigned a letter such as A), B),
C), etc. The letter in the indicator table and the letter in the data sources are
matched, so you can find the specific data source for each piece of information in
the indicator table.
Figure 5 – Data Source References
Data Source References

Data Map to Reference

Step 5
 Finally, at the end of each domain section a Tool Sheet has been created to provide
an example of how one might collect and interpret data to measure a specific
indicator (see Figure 6).
 The Tool Sheet contained in the Healthy Lifestyle domain uses indicator #13 –
Playing Sports as an example.
Figure 6 – Tool Sheet
An excerpt from the

Healthy Lifestyle Tool
Sheet

Notes About a Few of the Surveys and Existing Data
Any information (questions) that is listed as RHS (Regional Health Survey) has already
been gathered for some communities and can only be accessed by that community.
General survey questions are offered as examples for community developed surveys.
The Statistics Canada information is also readily available and easily found on their
website. The data link will connect to the most up to date information that can be found.
The direct data map to the questionnaires for this information is included here:
Find source at: http://www.statcan.gc.ca >> (English/French) >>

Definitions, Data Sources and Methods >> under the heading
Questionnaires; Alphabetical list >> English or French Questionnaire of
Aboriginal Peoples Survey – 2001

Community Health Indicators Framework
First Nation’s Health Development Toolkit

Economic Viability
A state of community self-sufficiency, where there are businesses and economic
partnerships to promote a local economy; jobs available to sustain personal and family
needs; food, housing and medical services that are affordable; and a sense of optimism
when community members consider future developments.
Indicators:
Employment Cost of Living Health Benefit Coverage

Local Availability Cost of Food Cost of Housing Prescription Drugs
1 – unemployment rate no indicators proposed 13 – % of income spent on housing 20 – drug costs paid out-of-pocket
2 – jobs in the community Cost of Healthy Food 14 – housing waitlists 21 – unfilled prescriptions
3 – people working outside community no indicators proposed 15 – low income housing availability Medical Transportation
Strategic Training Food Subsidies Utility Costs 22 – medical transportation coverage

4 – training for potential jobs 8 – food programs & usage 16 – cost of utility hook-up/reconnects 23 – treatment not followed due to cost
Disincentives to Work 9 – incentive to carry healthy foods Competitive Retailing Companion & Translation Services
Indicator #1 Transportation Costs 17 – level of retail competition 24 – Elders & youth travelling alone
5 – cost of working vs social assistance 10 – cost of fuel Social Assistance Rates
Local Business 11 – distance to services 18 – costs met by social assistance

6 – local businesses 12 – cost of airline travel Single Parent Families
7 – employment in local business 19 – single parent families

… continued on next page
First Nation’s Health Development Toolkit Economic Viability Page 1

Funding for Community Programs
Sufficient Funding
no indicators proposed
Stable Funding
Infrastructure
Staffing
25 – vacant staff positions

26 – staff training levels
27 – length of time in position
28 – community satisfaction with staff
Promotion
29 – program participation rates

30 – program awareness levels

Economic Viability
Economic Viability >> Employment >> Local Availability
Issues Identified: Having few jobs available in the community requires people to leave in order to obtain work, which impacts
family members left behind, community morale and volunteerism. Local jobs contribute to community
sustainability.
Community Proposed
Indicator # Community Level Data Sources (suggestions)
Indicator
Local survey required – suggested measures:
Existing data found at:
A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
Profiles or 2006 Aboriginal Population Profile >> Choose a community
Unemployment B) http://www.hrsdc.gc.ca/eng/home.shtml >> Aboriginal skills and training strategic investment fund >> Economic action
1 rate plan – support for workers and the unemployed >> Employment insurance (EI) >> Economic regions >> EI Economic region
maps >> Saskatchewan >> Northern Saskatchewan >> (click) View unemployment rate &
benefit table
C) Northern Saskatchewan Training Needs Assessment Report 2009 – 2010
See Glossary of Unemployment Terms used by Statistics Canada (next page)
See Indicator 1
# of jobs in the
2 community Local survey required
% of community
3 members working Local survey required
outside the
community

Data Sources:
A) Statistics Canada: 2006 Community Profiles. Find source at: http://www12.statcan.ca/census-recensement/2006/dp-pd/prof/92-

594/index.cfm?Lang=E
B) Human Resources & Skills Development Canada. Find source at: http://srv129.services.gc.ca/rbin/eng/nortsask.aspx?rates=1
C) Northern Saskatchewan Training Needs Assessment Report 2009 – 2010. Find source at:
http://career.kcdc.ca/fore/pdf/2009/2009RegionReportfinalwithcover.pdf

Glossary of Unemployment Terms used by Statistics Canada
Participation Rate
Refers to the labour force in the week (Sunday to Saturday) prior to Census Day (May 15, 2001), expressed as a percentage of the population 15
years of age and over.
Employment Rate
Refers to the number of persons employed in the week (Sunday to Saturday) prior to Census Day (May 15, 2001), expressed as a percentage of
the total population 15 years of age and over.
Note: The “% of adults not working for pay or in self-employment” is expressed as a percentage of the total population.
Unemployment Rate
Refers to the unemployed expressed as a percentage of the labour force in the week (Sunday to Saturday) prior to Census Day (May 15, 2001).
Unemployment rate = Unemployed X 100
Labour Force
When last worked for pay or in self-employment

Refers to the year or period in which persons last worked for pay or in self-employment (even if only for a few days). It includes those who
worked without pay in a family farm, business or professional practice. It does not include unpaid housework, unpaid childcare, unpaid care to
seniors or volunteer work. It is used to identify persons with recent paid work experience.
Unemployed (in reference week)

Persons who, during the week (Sunday to Saturday) prior to census day (May 15, 2001) were without paid work or without self-employment work
and were available for work and either:
 Had actively looked for paid work in the past four weeks, or
 Were on temporary lay-off and expected to return to their job, or
 Had definite arrangements to start a new job in four weeks or less.
The unemployed category consists primarily of those persons who, during the week prior to enumeration (count; to ascertain a number), were
without paid work, were unavailable for work, and had actively looked for paid work in the past four weeks.

Economic Viability
Economic Viability >> Employment >> Strategic Training
Issues Identified: When industry is developed in the region, local people are often not qualified for the available jobs. A need
exists for targeted training in advance of industry start-up so that when industry is set up and jobs are
available, local people are trained and qualified.
Community Proposed
Indicator
# training A) http://www.cameco.com/ >> Careers >> Responsibility >> Sustainable Development >> Sustainable Communities >>
programs directly Northern Sask. Opportunities
4 related to
B) http://www.cameco.com/ >> Careers >> Responsibility >> Sustainable Development >> Sustainable Communities >>
available job Northern Career Quest
opportunities
C) http://www.gov.sk.ca/ >> About government >> News releases >> November 2006 >> Northern Saskatchewan to
Receive 650 Training Opportunities
Data Sources:
A) Cameco. Find source at:

http://www.cameco.com/responsibility/sustainable_development/communities/creating_opportunity_in_northern_saskatchewan/
B) Cameco. Find source at: http://www.cameco.com/responsibility/sustainable_development/communities/fueling_the_future/
C) Government of Saskatchewan. Find source at: http://www.gov.sk.ca/news?newsId=8fb30b50-9679-4f96-a302-206201b62a19

Economic Viability
Economic Viability >> Employment >> Disincentives to Work
Issues Identified: Employment can negatively impact living costs by the loss of access to low income housing, subsidized utility
rates and medical cost coverage. As a result it can be more economically viable to remain on social assistance.
Community Proposed
Indicator
See Indicator 1
Unemployment
rate Local survey required
Cost analysis on
benefits of
5 Local survey required
working vs. social
assistance
Data Sources:
No indicator/survey source at this time

Economic Viability
Economic Viability >> Employment >> Local Business
Issues Identified: Local businesses contribute to a tax base (in provincial communities), provide employment and increased
infrastructure, and improve community morale.
Community Proposed
Indicator
# of local Existing data found at:
6 businesses in the
A) http://www.saskjobfutures.ca/ >> Local labour market >> Community Facts >> Select Community
community

# of community Existing data found at:
members
7 employed in local A) http://www.saskjobfutures.ca/ >> Local labour market >> Community Facts >> Select Community
businesses
Data Sources:
A) Saskatchewan Job Futures – Community Facts. Find source at: http://www.saskjobfutures.ca/index.cfm?event=page.community

Economic Viability
Economic Viability >> Cost of Living >> Cost of Food
Issues Identified: Cost of food in all categories in northern communities is high, especially in relation to income levels.
Community
Indicator
Proposed Community Level Data Sources (suggestions)
#
Indicator
A) Healthy Food Costing Assessment (Community Vitality Monitoring Partnership Process Project).
B) Refer to the DIAND Alternative Northern Food Baskets publication. Calculating the cost of a northern food basket involves detailed
None proposed calculations.

C) Existing data for costs of a weekly northern food basket dated 1991-1995 for the communities of Regina, Prince Albert, La Ronge,
Black Lake and Stony Rapids. Find source and extensive data on Food Mail at:
http://www.ainc-inac.gc.ca >> English >> The North >> Food & Nutrition >> Food Costs >> Northern Food Basket >> Saskatchewan
Data Sources:
B) Lawn, Judith and Hill, Frederick. 1998. Alternative Northern Food Baskets. Ottawa: Minister of Indian Affairs and Northern Development
C) Indian and Northern Affairs Canada. (2004). Northern Food Basket; Saskatchewan. Find source at: http://www.ainc-inac.gc.ca/nth/fon/fc/rgrs-
eng.asp

Economic Viability
Economic Viability >> Cost of Living >> Cost of Healthy Food
Issues Identified: Cost of healthy foods (typically fresh & perishable) is high in relation to other foods available and income
levels, resulting in low consumption.
Community
Indicator
#
Indicator
Local survey required – suggested questions and measures:
B)Health Canada: Alternative Northern Food Baskets

Refer to Health Canada and the Alternative Northern Food Baskets publication (listed in references). Note: this is quite an involved
calculation/ process.
C) Food Quality in Labrador survey:

None proposed - What is keeping you from buying more fresh fruit and vegetables? (List includes the option “they cost too much”)
- Since this time last year, how has the price of fresh fruit and vegetable in your community changed?
D) Nutrition and Food Security in Kugaaruk survey:

- If you cannot get country food, can you tell me why? (List of answers includes “Gas too expensive” and “Repairs too expensive”
- Some families might say “We couldn’t afford to eat healthy meals”. In the last 12 months did this happen often, sometimes, or never for
your household?
- Some families might say, “We could only feed our children less expensive foods because we were running out of money to buy food”.
In the past 12 months did this happen often, sometimes, or never for your household?
Data Sources:

C) Food Quality in Six Isolated Communities in Labrador – Questions 7/8
Find Source at: http://www.ainc-inac.gc.ca/nth/fon/pubs/survfoo2001/survfoo2001-eng.pdf
D) Nutrition and Food Security in Kugaaruk, Nunavut. Baseline Survey for the Food Mail Pilot Project – Questions 403/602/603
Find Source at: http://www.ainc-inac.gc.ca/nth/fon/pubs/kg03/kg03-eng.pdf

Economic Viability
Economic Viability >> Cost of Living >> Food Subsidies
Issues Identified: There is a lack of food subsidy programs – the existing Food Mail program is not widely known or understood
and is not directly accessible by community members. Incentives do not exist to encourage stores to carry
healthy food products.
Community Proposed
Indicator
Local survey required – suggested questions:
A) Food Quality in Labrador study (retailer survey): If the quality of fresh fruit and vegetables improved in your store, do you
# and use of food think you would sell more of these foods?
8 programs
B) Nutrition and Food Security in Kugaaruk survey: Where do you usually buy most of your food? From the Coop, from
Yellowknife by Food Mail, or from the south by air cargo?
Incentives for A) Food Quality in Labrador study (retailer survey):
stores to carry - If the quality of fresh fruit and vegetables improved in your store, do you think you would sell more of these foods?
9 healthy food - If the quality of fresh food improved, would you: Increase prices because customers would be willing to pay more? Lower
items prices, because you would have less spoilage? Continue to charge the same price?
Data Sources:
A) Food Quality in Six Isolated Communities in Labrador – Questions 7/8

Find Source at: http://www.ainc-inac.gc.ca/nth/fon/pubs/survfoo2001/survfoo2001-eng.pdf
B) Nutrition and Food Security in Kugaaruk, Nunavut. Baseline Survey for the Food Mail Pilot Project – Question 500
Find Source: http://www.ainc-inac.gc.ca/nth/fon/pubs/kg03/kg03-eng.pdf

Economic Viability
Economic Viability >> Cost of Living >> Transportation Costs
Issues Identified: Residents in remote communities pay higher costs for fuel and travel longer distances to access some services.
Residents in communities not accessible by road must pay the cost of airfare to travel outside the community.
Community Proposed
Indicator
10 Cost of fuel Local survey required
Distance to
services

Cost of airline A) http://www.bookpronto.com/index.php?p=3806 >> Pronto Airways >> Book a flight
12 travel to PA,
Saskatoon B) http://www.transwestair.com/ >> Transwest Air >> Book Online
Data Sources:
A) Pronto Airways. Find source at: http://www.bookpronto.com/index.php?p=3806
B) Transwest Air. Find Source at: http://www.booktranswest.com/

Economic Viability
Economic Viability >> Cost of Living >> Cost of Housing
Issues Identified: An overall scarcity of housing units contributes to higher rents and a further lack of low-income housing units
contributes to overcrowding as those with low incomes move in with other family members. Frequent moves in
search of better housing increases costs (i.e. re-hookup of utilities).
Community Proposed
Indicator
% of income
spent on housing
Housing waiting
lists
# of low income
housing units
Data Sources:

Economic Viability
Economic Viability >> Cost of Living >> Utility Costs
Issues Identified: Utility costs can vary depending on whether a person is on social assistance or not. The cost of utilities is
impacted by the cost of utility re-hook-ups.
Community Proposed
Indicator
Dollar amount of
16 utility hook-ups Local survey required
and reconnects
Data Sources:

Economic Viability
Economic Viability >> Cost of Living >> Competitive Retailing
Issues Identified: Food and fuel costs were reduced in communities where there was competition between retailers.
Community Proposed
Indicator
# of retailers per
17 commodity (i.e. Local survey required
fresh food, gas)
Data Sources:

Economic Viability
Economic Viability >> Cost of Living >> Social Assistance Rates
Issues Identified: Social assistance rates do not adequately provide for the cost of living in northern Saskatchewan.
Community Proposed
Indicator
% of cost of living
18 met by social Local survey required
assistance rates
Data Sources:

Economic Viability
Economic Viability >> Cost of Living >> Single Parent Families
Issues Identified: Many families are headed by single parents who experience reduced economic power (loss of spousal
economies of scale) and increased costs (child care and other supports.)
Community Proposed
Indicator
# of single parent http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
19 families Profiles or 2006 Aboriginal Population Profile >> Choose a community
Data Sources:


Economic Viability
Economic Viability >> Health Benefit Coverage >> Prescription Drugs
Issues Identified: The cost of prescription drugs is not always covered, depending on factors such as status and whether an
individual is on social assistance. A recent policy requiring Treaty people to sign a confidentiality waiver or
pay for health benefits up front has impacted whether people fill their prescriptions or not.
Community Proposed
Indicator
% of drug costs
paid “out of
pocket” vs. by
health programs
# of prescriptions A) RHS (Adult survey):

21 issued to a patient - During the past 12 months, have you experienced any of the following barriers to receiving healthcare?
but not filled (List includes: Not covered by Non-Insured Health benefits [e.g. service, medication, equipment]; Prior approval for services
under Non-Insure Health Benefits was denied; Could not afford direct cost of care/service; Could not afford direct costs;
Could not afford childcare costs). - Community level data for RHS survey exists: must be accessed by community.
Data Sources:
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adult survey) – Question 54. Find Source at: http://www.rhs-
ers.ca/english/pdf/rhs2002-03_files/questionnaires/rhs2002-03_adult_questionnaire.pdf
(no longer available online)

Economic Viability
Economic Viability >> Health Benefit Coverage >> Medical Transportation
Issues Identified: Coverage of costs for travel away from the community for medical treatment often do not cover the actual costs.
e.g., accommodation is not always provided after hospital discharge; travel coverage is to the closest major
centre from the community, not the city where the doctor or specialist is located. The abuse of medical
transportation coverage results in a rigid application of benefits.
Community Proposed
Indicator
% of actual costs A) RHS (Adult survey):
covered by
22 medical - During the past 12 months, have you experienced any of the following barriers to receiving healthcare?
transportation (List includes: Not covered by Non-Insured Health benefits [e.g. service, medication, equipment]; Prior approval for services
funding under Non-Insure Health Benefits was denied; Could not afford direct cost of care/service; Could not afford direct costs;
# of patients who A) RHS (Adult survey):
do not follow
23 recommended - During the past 12 months, have you experienced any of the following barriers to receiving healthcare?
treatment due to (List includes: Not covered by Non-Insured Health benefits [e.g. service, medication, equipment]; Prior approval for services
cost under Non-Insure Health Benefits was denied; Could not afford direct cost of care/service; Could not afford direct costs;
Data Sources:
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adult survey) – Question 54
Find Source: http://www.rhs-ers.ca/english/pdf/rhs2002-03_files/questionnaires/rhs2002-03_adult_questionnaire.pdf

Economic Viability
Economic Viability >> Health Benefit Coverage >> Companion & Translation Services for
Elders and Youth
Issues Identified: Transportation costs are usually provided only for the person seeking treatment and as a result, very ill Elders
and youth often have to travel alone. Elders do not have someone who can translate for them, especially
needed to understand complex medical terminology.
Community Proposed
Indicator
# of Elders &
youth (under 16)
travelling alone
for medical care
Data Sources:

Economic Viability
Economic Viability >> Funding for Community Programs >> Sufficient Funding
Issues Identified: Programs are chronically under-funded in some or all areas of operation. In order to be effective and produce
desired outcomes, programs require sufficient funding (budget) to carry out identified activities.
Community Proposed
Indicator
None proposed Local survey required
Data Sources:

Economic Viability
Economic Viability >> Funding for Community Programs >> Stable Funding
Issues Identified: Programs require stable, long-term funding to allow for planning and evaluation, and to develop community
commitment and support.
Community Proposed
Indicator
Data Sources:

Economic Viability
Economic Viability >> Funding for Community Programs >> Infrastructure
Issues Identified: Programs require suitable infrastructure to carry out identified activities (buildings, equipment, supplies).
Community Proposed
Indicator
Data Sources:

Economic Viability
Economic Viability >> Funding for Community Programs >> Staffing
Issues Identified: Programs often do not have sufficient funds to attract and hire trained staff; short-term funding can result in a
lack of staff commitment.
Community Proposed
Indicator
% of required
positions vacant

% of staff with A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
26 formal training Profiles or 2006 Aboriginal Population Profile >> Choose a community
Trained staff -
27 length of time in Local survey required
position
Community
28 satisfaction with Local survey required
staff

Data Sources:


Economic Viability
Economic Viability >> Funding for Community Programs >> Promotion
Issues Identified: In order for community members to support and participate in programs, an awareness and connectedness must
be developed.
Community Proposed
Indicator
Program
participation rates
Program
awareness levels
Data Sources:

Tool Sheet – Economic Viability
Economic Viability >> Employment >> Strategic Training
Issues Identified: When industry is developed in the region, local people are often not qualified
for the available jobs. A need exists for targeted training in advance of industry
start-up so that when industry is set up and jobs are available, local people are
trained and qualified.
Proposed Indicator: # 4 – of training programs directly related to job opportunities

Suggested Measure: Compare the number of specific industry job opportunities available to the
number of local training spaces available related to the positions.
Information Source: Local survey
How to use this measure:
Step 1) Identify the specific job opportunity that will be available in the community or region.
Step 2) Identify training programs that directly relate to the type of job opportunity identified.
Step 3) Identify the # (number) of spaces available in those training programs.
Step 4) Use the ‘Indicator Calculation Tool’ formula to calculate the measure.
Indicator Calculation Tool Calculation Example
( ) training program X ( ) spaces ( 1 ) driller training program X ( 5 ) spaces

( ) specific positions ( 10 ) drilling positions available
( ) 5
( ) 10
X 100 = .50 X 100
= % participating = 50%
X = multiplied by ( ) = Insert number here = divided by
What does this information mean?

Of the 10 drilling positions available, only 50% of the necessary training seats are available to provide
local training to community members who would then be qualified for the positions. This information
could be used to support requests to colleges to deliver training programs, and to funding agencies to
provide financial support for these training spaces.

Environment
Based on a respect for and commitment to the environment, this domain refers to the
knowledge and resources necessary to manage the impact of development, both within
and outside the community, and to ensure the environment is protected for future
generations.
Indicators:
Respect for the Environment Impact of Development Jurisdiction Expertise
Valuing Natural Resources Pollution no indicators proposed 10 – funding from SERM
no indicators proposed 2 – air quality 11 – EHO to interpret reports
Commitment 3 – water quality Resource Protection
1 – community clean-ups 4 – levels of pollutants Monitoring Human Health
Environmental Clean Up 7 – monitoring programs in place Environmental
5 – clean up agreements in place Enforcement 12 – # forest fires near community
Community Sustainability 8 – conservation officers per sq. kms. 13 – health effects of fire smoke
6 – decrease in fish/wildlife populations Jurisdiction Structural
Indicators #2, #3 9 – funds available for EHO monitoring 14 – accidents in home
First Nation’s Health Development Toolkit Environment Page 1

Environment
Environment >> Respect for the Environment >> Valuing Natural Resources
Issues Identified: An appreciation for the beauty and resources that the land, water, fish and animals provide to current and
future generations.
Community Proposed
Indicator
Data Sources:

Environment
Environment >> Respect for the Environment >> Commitment
Issues Identified: Communities have a commitment to respect and protect the environment.
Community Proposed
Indicator
Community
clean-ups
Data Sources:

Environment
Environment >> Impact of Development >> Pollution
Issues Identified: Industry (mines), population increase (residents and tourists) and lack of proper waste management systems at
the community level are sources of land, air and water pollution.
Community Proposed
Indicator
A) http://www.cri.ca >> Our communities >> Scroll down: Choose your community (if available - Black Lake, Camsell
Portage, Fond du Lac, Stony Rapids, Uranium City, Wollaston Lake)
2 Air quality
B) State of the Watershed Report 2007. Saskatchewan Watershed Authority. Find source at:
http://www.swa.ca/Publications/Documents/aaStateOfTheWatershedReport.pdf >> Summary Tables (pp. 130 – 135) >> For
Uranium City. Fond du Lac and Camsell Portage see results for ‘Lake Athabasca ‘ watershed: for Stoney Rapids and Black
Lake, see ‘Black Lake’ watershed: for Wollaston Lake, see ‘Reindeer River/Wollaston Lake’ watershed.
A) http://www.cri.ca >> Our communities >> Scroll down: Choose your community (if available - Black Lake, Camsell
Portage, Fond du Lac, Stony Rapids, Uranium City, Wollaston Lake
Water quality
3 (safe to drink the B) State of the Watershed Report 2007. Saskatchewan Watershed Authority. Find source at:
lake water) http://www.swa.ca/Publications/Documents/aaStateOfTheWatershedReport.pdf >> Summary Tables (pp. 130 – 135) >> For
Uranium City. Fond du Lac and Camsell Portage see results for ‘Lake Athabasca ‘ watershed: for Stoney Rapids and Black
Lake, see ‘Black Lake’ watershed: for Wollaston Lake, see ‘Reindeer River/Wollaston Lake’ watershed.
C) Uranium Mining Cumulative Effects Monitoring Program 2002 Annual Report – Table 8 – No current online source
Levels of
D) http://www.environment.gov.sk.ca/ >> environment >> programs & services >> land >>mining >> abandoned mines
4 pollutants
(uranium) E) Final Report on Abandoned Mines – Government of Saskatchewan. 2004. Available from:
http://www.gov.sk.ca/news?newsId=232d5f43-352f-4be4-b0a2-b8fc674d9a1b
x – suppressed to meet the confidentiality requirements of the Statistics Act

Data Sources:
A) Athabasca Working Group Environmental Monitoring Program 2003

Find source at: http://www.cri.ca/communities/index.html (may no longer be available)
B) State of the Watershed Report 2007. Saskatchewan Watershed Authority. Find source at:
http://www.swa.ca/Publications/Documents/aaStateOfTheWatershedReport.pdf
C) Canada North Environmental Services & Zajdlik & Associates. (May, 2003). Uranium mining cumulative effects monitoring program 2002 annual report.
Saskatoon: Saskatchewan Environment; La Ronge, Saskatchewan (Project no.1038)
D) An Assessment of Abandoned Mines in Northern Saskatchewan (Year Two) May 2002. Find source at:
http://www.environment.gov.sk.ca/adx/aspx/adxGetMedia.aspx?DocID=2136,626,247,94,88,Documents&MediaID=1202&Filename=Assessment+of+Aband
oned+Mines+-+Year+2.pdf&l=English
E) Final Report on Abandoned Mines – Government of Saskatchewan. Find Details at: http://www.gov.sk.ca/news?newsId=232d5f43-352f-4be4-b0a2-
b8fc674d9a1b

Environment
Environment >> Impact of Development >> Environmental Clean Up
Issues Identified: Determining who is responsible for the cleanup of abandoned industrial sites (contaminated soil, materials &
equipment) and spills is challenging because of the many jurisdictions involved including local bands and
municipalities, provincial and federal governments and industry.
Community Proposed
Indicator
Clean-up
5 agreements in Local survey required
place
Data Sources:

Environment
Environment >> Impact of Development >> Effects of Community Sustainability
Issues Identified: Changes in landscape, wildlife habitat, air and water quality can affect the sustainability of communities at the
most basic level – a livable environment.
Community
Indicator
#
Indicator
Decrease in A) Saskatchewan Game Report 2007 – 08. Find Source at:
fish and http://www.environment.gov.sk.ca/adx/aspx/adxGetMedia.aspx?DocID=1968,254,94,88,Documents&MediaID=1061&Filename=Saskatchewan+Game+Report.pdf
6 wildlife
populations B) Beverly and Qamanirjuaq Caribou Management Board Newsletter. For most recent update on caribou herds, see:
http://www.arctic-caribou.com/publications_newsletter.html
Water
See Indicator 3
quality
Air quality See indicator 2
x – suppressed to meet the confidentiality requirements of the Statistics Act
Data Sources:
A) Saskatchewan Game Report 2007 – 08. Find Source at:

http://www.environment.gov.sk.ca/adx/aspx/adxGetMedia.aspx?DocID=1968,254,94,88,Documents&MediaID=1061&Filename=Saskatchewan+Game+Repor
t.pdf

B) Beverly and Qamanirjuaq Caribou Management Board Newsletter. For most recent update on caribou herds, see:
http://www.arctic-caribou.com/publications_newsletter.html

Environment
Environment >> Impact of Development >> Jurisdiction
Issues Identified: In addition to developmental impacts within their jurisdiction, communities sustain the developmental impacts
from decisions made in other jurisdictions over which they have no control.
Community Proposed
Indicator
Data Sources:

Environment
Environment >> Resource Protection >> Monitoring
Issues Identified: Monitoring of air and water quality, wildlife habitat, and waste management is required to protect the
environment.
Community
Indicator
#
Indicator
A) Uranium Mining Cumulative Effects Monitoring Program 2002 Annual Report – Table 8 – No current online source
B) Athabasca Working Group Environmental Monitoring Program 2002 - 2005: Pollution levels for local water; wildlife; air; plants -
http://www.cri.ca >> Our communities >> Scroll down: Choose your community (if available - Black Lake, Camsell Portage, Fond du Lac, Stony
Rapids, Uranium City, Wollaston Lake
Monitoring
programs C) Saskatchewan Game Report 2007 – 08. Provincial Wildlife counts. Find Source at:
http://www.environment.gov.sk.ca/adx/aspx/adxGetMedia.aspx?DocID=1968,254,94,88,Documents&MediaID=1061&Filename=Saskatchewan+Game+Report.pdf
7 in place
D) Final Report on Abandoned Mines – Government of Saskatchewan. 2004. Available from: http://www.gov.sk.ca/news?newsId=232d5f43-352f-
4be4-b0a2-b8fc674d9a1b
E) Environment Canada Weather Office. Go to http://www.weatheroffice.gc.ca/canada_e.html >> Select ‘Saskatchewan’ >> Select either ‘Stoney
Rapids’ or ‘Uranium City’
F) State of the Watershed Report 2007. Saskatchewan Watershed Authority. Find source at:
Data Sources:
A) Canada North Environmental Services, Zajdlik & Associates. (May, 2003). Uranium Mining Cumulative Effects Monitoring Program 2002 Annual Report.
Saskatoon: Saskatchewan Environment; La Ronge, Saskatchewan
B) Athabasca Working Group Environmental Monitoring Program 2003. Find source at: http://www.cri.ca/communities/index.html
(may no longer be available online)

C) Saskatchewan Game Report 2007 – 08. Find Source at:
http://www.environment.gov.sk.ca/adx/aspx/adxGetMedia.aspx?DocID=1968,254,94,88,Documents&MediaID=1061&Filename=Saskatchewan+Game+Repor
t.pdf
D) Final Report on Abandoned Mines – Government of Saskatchewan. 2004. Available from: http://www.gov.sk.ca/news?newsId=232d5f43-352f-4be4-
b0a2-b8fc674d9a1b
E) Environment Canada Weather Office. Find source at: http://www.weatheroffice.gc.ca/canada_e.html
F) State of the Watershed Report 2007. Saskatchewan Watershed Authority. Find source at:

Environment
Environment >> Resource Protection >> Enforcement
Issues Identified: An adequate number of conservation officers is needed to enforce environmental regulations in the region,
especially with the increase in hunting and fishing camps.
Community Proposed
Indicator
# of conservation officers A) http://www.environment.gov.sk.ca/ >> Corporate >> Contacts and Office Locations >> Select Prince Albert for northern
8 contacts
(per square kms)
Data Sources:
A) Saskatchewan Environment contacts – contact information for provincial environment representatives Find source at:
http://www.environment.gov.sk.ca/contact-information

Environment
Environment >> Resource Protection >> Jurisdiction
Issues Identified: The lack of an integrated approach by various jurisdictions dealing with the same issue prevents needs from
being met.
Community Proposed
Indicator
Funds available A) http://www.environment.gov.sk.ca/ >> corporate >> contacts and office locations >> Select Prince Albert for northern
for an EHO to contacts
9 monitor area
regardless of
jurisdiction
Data Sources:
A) Saskatchewan Environment contacts – contact information for provincial environment representatives - Find source at:
http://www.environment.gov.sk.ca/contact-information

Environment
Environment >> Resource Protection >> Expertise
Issues Identified: There is a need for long-term land use planning and management of environmental impacts from industry;
communities require access to expertise to help interpret the environmental reports they receive.
Community Proposed
Indicator
10 Funding from SERM Local survey required

Availability of A) http://www.environment.gov.sk.ca/ >> Contact Information >> Select Prince Albert for northern contacts
EHO to help
11 community
members interpret
reports
Data Sources:
A) Saskatchewan Environment contacts – contact information for provincial environment representatives

Find source at: http://www.environment.gov.sk.ca/contact-information

Environment
Environment >> Human Health >> Environmental
Issues Identified: Effects of forest fires on air quality.
Community Proposed
Indicator
# of forest fires A) http://www.environment.gov.sk.ca/ >> Wildfire Management >> Current fire activity >> Fires to date map
12 near the
community
Health effects of
forest fire smoke
on community
health
Data Sources:
A) Information regarding forest fires

Find source at: http://www.environment.gov.sk.ca/Default.aspx?DN=12b6b5f3-0104-4e0f-b3a5-3c914855a138

Environment
Environment >> Human Health >> Structural
Issues Identified: Effects of housing (and other structural) quality on human health, including accidents due to houses in
disrepair and health hazards such as black mold.
Community Proposed
Indicator
# of accidents in
the home
Data Sources:

Tool Sheet – Environment
Environment >> Resource Protection >> Enforcement
Issues Identified: An adequate number of conservation officers is needed to enforce
environmental regulations in the region, especially with the increase in
hunting and fishing camps.
Proposed Indicator: # 8 – number of conservation officers per square kilometers

Suggested Measure: Compare the number of conservation officers assigned within a specified
geographic range to the number required.
Information Source: 1) SERM (Saskatchewan Environment and Resource Management)

http://www.environment.gov.sk.ca >> Corporate >> Contacts and Office Locations >>
Select Prince Albert for northern contacts
2) Local survey
Step 1) Identify the # (number) of conservation officers required or desired within a specific
geographic range (in kms).
Step 2) Identify the # of conservation officers (identified from the information source above)
assigned to the specific geographic range
( ) conservation officers assigned to area ( 2 ) conservation officers assigned to area
( ) conservation officers required in area ( 6 ) conservation officers required in area

( ) 2
( ) 6
X 100 = .333 X 100
= % of needed officers = 33% of needed officers
Only one-third of the required conservation officers are available for the specified geographic
area to properly enforce environment regulations. This information could be used to support a
request for additional conservation officers.

Identity & Culture
An ability to convey community history, cultural and traditional practices and language,
along with the nurturing of a holistic approach to life and intergenerational relationships.
Activities that promote community culture and identity are acknowledged as key to
developing positive self-esteem and positive self-image for community members.
Indicators:
Community Identity 9 – recognition of positive contributions 16 – Elders leaving for end of life care Healing & Restorative Justice
Cultural Activities 10 – distance from other communities 17 – support programs for Elders 24 – healing circles & participation
1 – cultural activities & participation Communication Maintaining Traditional Practices
2 – volunteering at cultural events 11 – community newsletter Traditional Practices 25 – costs of Elder visits
Spiritual Activities Spiritual 26 – costs of traditional education
3 – spiritual activities & participation Elders 18 – visits to community by Medicine Man 27 – local teachers in schools
4 – visits by spiritual leaders Involvement with Youth Cultural 28 – cultural awareness programs
Community Events 12 – formal Elder / youth activities 19 – traditional cultural activities Traditional Ways
5 – community events & participation 13 – informal Elder / youth activities Language 29 – traditional education programs
6 – transparency in use of event funds Involvement in Community 20 – youth speaking traditional language 30 – people hunting and fishing
Community Morale 14 – social gathering places for Elders 21 – teachers speak traditional language 31 – access to hunting and fishing
7 – feeling safe in the community 15 – community decision with Elder input 22 – language used in assembly/council 32 – methods of hunting and fishing
8 – condition of buildings & grounds Remain in Community 23 – youth involved in language classes 33 – Elder/youth in traditional activities
First Nation’s Health Development Toolkit Identity & Culture Page 1

Community Knowledge
Cultural Knowledge (Elders)
Indicators #12, #13, #15

Recognizing Multi-Cultural
History
34 – cultural awareness events
Knowledge of Community History
Indicators #27, #29

Promotion of Community
35 – applying for and receiving grants

36 – approaching mines to invest
Sharing
Parenting
Volunteerism
37 – volunteering at community events

38 – informal volunteering
Resources
39 – game shared after hunts

Identity & Culture
Identity & Culture >> Community Identity >> Cultural Activities
Issues Identified: Activities that represent/celebrate cultural awareness and practices help provide an understanding of cultural
values and support community identity.
Community Proposed
Indicator
Local survey required – suggested measures and existing data found at:
# and type of
1 cultural activities A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
and participation Profiles or 2006 Aboriginal Population Profile >> Choose a community
Level of
2 volunteering at Local survey required
cultural events
Data Sources:


Identity & Culture
Identity & Culture >> Community Identity >> Spiritual Activities
Issues Identified: Spiritual activities that represent the beliefs of community members help to develop identity and common values
and provide support for community members.
Community Proposed
Indicator
# and type of
spiritual activities
and participation
levels
# of visits by
4 spiritual leader to Local survey required
community
Data Sources:

Identity & Culture
Identity & Culture >> Community Identity >> Community Events
Issues Identified: Events within the community that bring people together help to develop social relationships and supports as
well as community knowledge, identity and morale. It is important that there is accountability for funds raised
at events.
Community Proposed
Indicator
# and type of
community events
and participation
levels
Transparency in
6 use of funds Local survey required
raised at events
Data Sources:

Identity & Culture
Identity & Culture >> Community Identity >> Community Morale
Issues Identified: Having a sense of belonging, pride and well-being within a community is an important factor in promoting
positive activities and encouraging participation in community events. A sense of belonging is sometimes
heightened by the remoteness of a community. A feeling of security is also very important for community
morale.
Community Proposed
Indicator
Indicator of
7 ‘feeling safe in the Local survey required
community’
Condition of
8 buildings and Local survey required
grounds
Recognition of
positive
9 contributions (e.g. Local survey required
citizen of the
month)

Community Proposed
Indicator
Distance from
10 other Local survey required
communities
Data Sources:

Identity & Culture
Identity & Culture >> Community Identity >> Communication
Issues Identified: The community’s ability to share information with all members is important to generate awareness of
community issues and foster community activities and involvement.
Community Proposed
Indicator
Community
newsletter
11 (distribution Local survey required
method and #, #
of copies read)
Data Sources:

Identity & Culture
Identity & Culture >> Elders >> Involvement with Youth
Issues Identified: An emphasis is placed on building and maintaining relationships between Elders and youth to allow for the
transmission of traditional culture, spirituality and language, and to maintain inter-generational ties.
Community Proposed
Indicator
# of formal
Elder/youth
Local survey required
12 activities and
participation
levels
# of informal (e.g.
fishing and
13 hunting) Local survey required
Elder/youth
activities
Data Sources:

Identity & Culture
Identity & Culture >> Elders >> Involvement in Community
Issues Identified: The opportunity to have a social network and remain involved in the community allows Elders to pass on
valuable knowledge to the community and improve community well-being.
Community Proposed
Indicator
Social gathering
places for Elders
14 in community Local survey required
(e.g. coffee
house)
# of community
15 decisions with Local survey required
Elders’ input
Data Sources:

Identity & Culture
Identity & Culture >> Elders >> Remain in Community
Issues Identified: Supports in the community that recognize the importance of caring for Elders allow for Elders to remain in the
community and experience a good quality of life, despite health or other concerns. A great sense of loss is
experienced when Elders pass away outside the community.
Community Proposed
Indicator
# of Elders who
must leave
community for
end of life care
# of support
programs in the
community for
17 Elders (e.g. home Local survey required
care, palliative
care, specialized
senior housing)
Data Sources:

Identity & Culture
Identity & Culture >> Traditional Practices >> Spiritual
Issues Identified: Practicing and promoting traditional methods of spirituality supports traditional values and ways of life,
offering a common vision and raising individual identity with the community and the environment.
Community Proposed
Indicator
# of visits to
18 community by Local survey required
Medicine man
Data Sources:

Identity & Culture
Identity & Culture >> Traditional Practices >> Cultural
Issues Identified: Practicing and promoting traditional cultural practices is important to maintaining traditional values, beliefs
and lifestyle. Cultural activities develop community identity and morale among members.
Community Proposed
Indicator
# of traditional A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
cultural activities Profiles or 2006 Aboriginal Population Profile >> Choose a community
& participation
19 (celebrations,
rituals, culture
camps)
Data Sources:


Identity & Culture
Identity & Culture >> Traditional Practices >> Language
Issues Identified: Language plays a central role in preserving First Nations’ identity, philosophy/worldview and traditions; it is
important to support traditional language use within the community (especially the youth).
Community Proposed
Indicator
Local survey required – suggested questions and existing data found at:
A) RHS (Adolescent survey):
% of youth who Question 12-What languages do you speak? (List of Aboriginal languages to check off) - Community level data for RHS
20 speak traditional survey exists: must be accessed by community.
language
B) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community

# of teachers who B) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
21 speak traditional Profiles or 2006 Aboriginal Population Profile >> Choose a community
language

Language used in B) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
22 assembly/council Profiles or 2006 Aboriginal Population Profile >> Choose a community
meetings

Community Proposed
Indicator
# of youth Existing data found at:

involved in B) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
23 traditional Profiles or 2006 Aboriginal Population Profile >> Choose a community
language
education
Data Sources:
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adolescence survey) - Question 12
Find source at: http://www.rhs-ers.ca/english/pdf/rhs2002-03_files/questionnaires/rhs2002-03_youth_questionnaire.pdf
B) Statistics Canada: 2006 Community Profiles. Find source at: http://www12.statcan.ca/census-recensement/2006/dp-pd/prof/92-


Identity & Culture
Identity & Culture >> Traditional Practices >> Healing & Restorative Justice
Issues Identified: Healing/restorative justice is a traditional practice that supports community responsibility and allows for
retention of community members.
Community Proposed
Indicator
# of healing
circles/
participation
levels
Data Sources:

Identity & Culture
Identity & Culture >> Traditional Practices >> Maintaining Traditional Practices
Issues Identified: The costs of maintaining traditional culture can be a financial burden. Difficulties are experienced in hiring
local teachers who can maintain language and culture among youth; promoting an understanding of traditional
practices with others who come into the community is important in developing support for traditional ways.
Community Proposed
Indicator
Costs of Elder
visits
(transportation,
honorariums)
Costs of
traditional
education
programs

% of local A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
27 teachers in Profiles or 2006 Aboriginal Population Profile >> Choose a community
schools

Community Proposed
Indicator
# of cultural
awareness
28 programs Local survey required
delivered to
service providers
Data Sources:


Identity & Culture
Identity & Culture >> Traditional Practices >> Traditional Ways
Issues Identified: Practicing traditional ways of life such as hunting and fishing is a way to preserve cultural practices and
support self-sustainability.
Community Proposed
Indicator
# of traditional A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
education Profiles or 2006 Aboriginal Population Profile >> Choose a community
29 programs (skills, D) RHS Adolescent survey:
language) Question 14-Who helps you in understanding your culture? (List includes: My grandparents and Community Elders …among
other choices) - Community level data for RHS survey exists: must be accessed by community.

A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples
Survey Community Profiles or 2006 Aboriginal Population Profile >> Choose a community
B) CBM (Adult and Youth surveys):
Q21-Did you go hunting for geese/ducks in the last year?
Q22-Did you go out to make dry-fish in the last year?
% of people in Q23-Did you go on the fall hunt to Artillery Lake this last fall?
30 community who Q26-How many caribou have you harvested in the last year?
hunt and fish
Q27-How many times have you taken youth caribou hunting in the last year?
C) EAGLE Health Survey:
Question 28-Does____ do any fishing?
Local survey required for hunting and fishing rights, as per community
Q29- What does ____ do with the fish they catch? (List includes: Eat them; Share them; Give them away; Sell them; Throw
them back; Other).

Community Proposed
Indicator
Access to hunting
and fishing
Methods of
hunting, fishing
and food
preparation
# of traditional
activities
involving Elders
and youth
Data Sources:

B) CBM: Community-Based Monitoring Project (page 26: adult survey in PDF; page 37: youth survey in PDF) – Questions 21/22/23/26/27
C) Eagle Project Health Survey:

Chiefs on Ontario, Environment Department. 2001. Eagle Project Health Survey. – Question 28/29
http://chiefs-of-ontario.org/Assets/Documents/Environment/ehs2.pdf
D) RHS: First Nations and Inuit Regional Longitudinal Health Survey – Question 14
http://www.rhs-ers.ca/english/pdf/rhs2002-03_files/questionnaires/rhs2002-03_youth_questionnaire.pdf

Identity & Culture
Identity & Culture >> Community Knowledge >> Cultural Knowledge (Elders)
Issues Identified: Understanding cultural knowledge is a way to develop an identity and shared vision within a community; it also
allows for Elders to pass on knowledge and develop inter-generational ties.
Community Proposed
Indicator
# of formal
Elder/youth
activities and See Indicator 12
participation
levels
# of informal (i.e.
fishing and
hunting) See Indicator 13
Elder/youth
activities
# of community
decisions with See Indicator 15
Elders’ input
Data Sources:
See for indicators 12, 13 & 15

Identity & Culture
Identity & Culture >> Community Knowledge >> Recognition of Multi-Cultural History
Issues Identified: Recognizing and celebrating the multi-cultural aspects of a community can help bring people together despite
differences, and helps to educate community members about different cultures and ways of life.
Community Proposed
Indicator
# of cultural
awareness events
34 and # of cultures Local survey required
explored (e.g.
Mosaic Days)
Data Sources:

Identity & Culture
Identity & Culture >> Community Knowledge >> Knowledge of Community History
Issues Identified: Understanding community history is important to inform community members about their community and
background. The ability to know who you are and where you come from is important to developing a sense of
belonging and identity.
Community Proposed
Indicator
# of traditional
education See Indicator 29
programs
% of local
teachers in See Indicator 27
schools
Data Sources:
See for indicators 27 & 29

Identity & Culture
Identity & Culture >> Community Knowledge >> Promotion of Community
Issues Identified: The ability for the community to promote itself to outside sources that can assist in achieving more cultural
awareness and promotion of traditional practices. The promotion of community events within and outside the
community is important to attract participation and help develop relationships.
Community Proposed
Indicator
Applying and
receiving grants
35 to support Local survey required
knowledge
building programs
Approach mines
36 to invest in Local survey required
community
Data Sources:

Identity & Culture
Identity & Culture >> Sharing >> Parenting
Issues Identified: Shared parenting is a sense of responsibility to all youth in the community, it is an important traditional value
that assists the community in being responsible for each other and looking out for one another’s well-being.
Community Proposed
Indicator
Data Sources:

Identity & Culture
Identity & Culture >> Sharing >> Volunteerism
Issues Identified: Volunteers are important for a community to operate successful programs and lower the cost of maintaining
their community. Volunteering shows a sense of responsibility and care for your community that develops from
having a strong identity.
Community Proposed
Indicator
# of volunteers for Local survey required

37 community events
Level of informal
volunteering
(assisting Elders,
helping others
with building
projects, etc.)
Data Sources:

Identity & Culture
Identity & Culture >> Sharing >> Resources
Issues Identified: Sharing resources such as food and labour is important to provide well-being to the entire community,
especially when individuals are experiencing difficult living situations. Sharing also exemplifies the collective
spirit of the community and the amount of compassion for fellow community members.
Community Proposed
Indicator
A) EAGLE Health Survey:
Game shared after
39 hunts Q29- What does ____ do with the fish they catch? (List includes: Eat them; Share them; Give them away; Sell them; Throw
them back; Other).
Data Sources:
A) Eagle Project Health Survey: Chiefs of Ontario, Environment Department. 2001. EAGLE Project Health Survey.
http://chiefs-of-ontario.org/Assets/Documents/Environment/ehs2.pdf

Tool Sheet – Identity & Culture
Identity & Culture >> Traditional Practices >> Language

Issues Identified: Language plays a central role in preserving First Nations identity,
philosophy/worldview and traditions; it is important to support traditional
language use within the community (especially the youth).
Proposed Indicator: # 20 – % of youth who speak traditional language

Suggested Measure: Compare the number of youth who speak their traditional language with the
number who do not.
Information Source: Existing data and suggested questions that could be used in a local survey
are provided below. Limitations to the existing data are noted below (see *).
A) RHS (Adolescent survey): http://www.rhs-ers.ca/english/pdf/rhs2002-03_files/questionnaires/rhs2002-

03_youth_questionnaire.pdf (no longer available online)
Question 12 - What languages do you speak? (A list of Aboriginal languages to check off is provided)
Note: Community level data for RHS survey exists; must be accessed by community.
The following related data also exists from the RHS (adolescent survey):
Question 9 – What language do you most often use in daily life?
Question 10 – How important is it to you to speak your First Nations/Inuit language?
Question 11 – What languages do you understand?
B) http://www.statscan.gc.ca >> (English / French) >> Community Profiles >> 2001 Aboriginal Peoples Survey Community
Profiles or 2001 Aboriginal Population Profile >> Child / Saskatchewan / Choose a community
% of children who can speak or understand an Aboriginal language

Importance of child speaking and understanding an Aboriginal language:
Very important or somewhat important (%)
Not very important or not important (%)
% of children who understand an Aboriginal language:
Very well or relatively well
With effort / A few words / Not well at all
% of children who can speak an Aboriginal language:
Very well or relatively well
With effort / A few words / Not well at all
% of children who receive help learning an Aboriginal language from:
Grandparents
Parents
Aunts and uncles
School teachers
Other persons

Step 1) Identify the number of youth in the community.
Step 2) Identify the number of youth who speak their traditional language, by using existing data
(as in the table above) or by conducting a local survey. Suggested survey questions can
be found in the Regional Health Survey (RHS) as well as the 2001 Aboriginal Peoples’
Survey Community Profiles.
( ) # of youth who speak their traditional language ( 225 ) youth who speak their traditional language
( ) # of youth in the community ( 300 ) youth in the community

( ) 225
( ) 300
X 100 = .75 X 100
= % who speak traditional language = 75% speak traditional language

Although this information indicates the number of youth who speak the language, more information
would be needed to determine the frequency of use and fluency. Understanding the extent to which
the traditional language is being passed on to youth could be used to determine the effectiveness of
existing cultural and language programs and events, and to support proposals for traditional language
education in the schools.
* Limitations of the Existing Data:

As not all community members took part in the Regional Health Survey or the 2001 Aboriginal Peoples’ Survey, the data
may not accurately reflect the participation levels in a particular community, and should be used with caution.

Food Security
Food security is defined as the ability to identify and access nutritious food that will
contribute to a healthy lifestyle. Food security takes into account the cost of food, access
to nutritious food, use of traditional foods, and the relationship of food to one’s health.
Indicators:
Cost of Food Availability & Quality of Food Food Programs
Cost of Food Competitive Retailing 13 – snack programs at schools/events

no indicators proposed 4 – food delivery times Collective Action
Cost of Healthy Food 5 – delayed or lost shipments 14 – bulk food ordering/purchasing

no indicators proposed 6 – availability of fresh vs. unhealthy food 15 – Good Food Box program
Food Subsidies 7 – food received in poor/unfit condition 16 – food programs
1 – availability and use of food programs 8 – compensation for unfit shipments
2 – incentives to carry healthy food Traditional Foods
Competitive Retailing 9 – levels of hunting and fishing

3 – level of retailer competition 10 – traditional food availability
Nutrition Education
11 – nutrition education programs

12 – cooking classes
First Nation’s Health Development Toolkit Food Security Page 1

Food Security
Food Security >> Cost of Food >> Cost of Food
Issues Identified: Cost of food in all categories in northern communities is high, especially in relation to income levels.
Community Proposed
Indicator
Local survey required – suggested measures found at:
A) Refer to the DIAND Alternative Northern Food Baskets publication (listed in references). Calculating the cost of a
None proposed northern food basket involves complex calculations.
B) Healthy Food Costing Assessment - Healthy Food Costing Assessment (Community Vitality Monitoring Partnership
Process project). Involves detailed calculations.
Data Sources:
A) Lawn, Judith and Hill, Frederick. 1998. Alternative Northern Food Baskets. Ottawa: Minister of Indian Affairs and Northern Development
B) Community Vitality in Northern Saskatchewan. Third Annual Report of the Community Vitality Monitoring Partnership Process 2001.
Find source at: http://www.northern.gov.sk.ca/docs/publications/annualReport00_01.pdf (may no longer be available online)

Food Security
Food Security >> Cost of Food >> Cost of Healthy Food
Issues Identified: Cost of healthy foods (typically fresh & perishable) is high in relation to other foods available and income
levels, resulting in low consumption.
Community Proposed
Indicator
Local Survey required – suggested questions and measures found at:
A) Healthy Food Costing Assessment: Healthy Food Costing Assessment (Community Vitality Monitoring Partnership
Process project). Involves detailed calculations.
B) Health Canada: Alternative Northern Food Baskets - Refer to Health Canada and the Alternative Northern Food Baskets
publication (listed in references). Note: this is quite an involved calculation/ process.
C) Food Quality in Labrador survey:

- What is keeping you from buying more fresh fruit and vegetables? (List includes the option “they cost too much”)
None proposed - Since this time last year, how has the price of fresh fruit and vegetable in your community changed?
D) Nutrition and Food Security in Kugaaruk survey:

- If you cannot get country food, can you tell me why? (List of answers includes “Gas too expensive” and “Repairs too
expensive”
- Some families might say “We couldn’t afford to eat healthy meals”. In the last 12 months did this happen often,
sometimes, or never for your household?
- Some families might say, “We could only feed our children less expensive foods because we were running out of money to
buy food”. In the past 12 months did this happen often, sometimes, or never for your household?
Data Sources:
A) Community Vitality in Northern Saskatchewan. Third Annual Report of the Community Vitality Monitoring Partnership Process 2001. Find source at:
http://www.northern.gov.sk.ca/NorthenMines/Publications/CommunityVitality/CVitalityAnnualReport01.pdf (may no longer be available online)

C) Food Quality in Six Isolated Communities in Labrador – Questions 7/8 (Retailer survey questions 6/7)
Find source at: http://www.ainc-inac.gc.ca/nth/fon/pubs/survfoo2001/survfoo2001-eng.pdf
D) Nutrition and Food Security in Kugaaruk, Nunavut – Questions 403/602/603

Find source at: http://www.ainc-inac.gc.ca/nth/fon/pubs/kg03/kg03-eng.pdf

Food Security
Food Security >> Cost of Food >> Food Subsidies
Issues Identified: There is a lack of food subsidy programs – the existing Food Mail program is not widely known or understood
and is not directly accessible by community members. Incentives do not exist to encourage stores to carry
healthy food products.
Community Proposed
Indicator
A) Food Quality in Labrador study (retailer survey): If the quality of fresh fruit and vegetables improved in your store, do you
# and use of think you would sell more of these foods?
1 food programs
B) Nutrition and Food Security in Kugaaruk survey: Where do you usually buy most of your food? From the Coop, from
Yellowknife by Food Mail, or from the south by air cargo?
Incentives for Local survey required – suggested questions:

stores to carry B) Food Quality in Labrador study (retailer survey):
2 healthy food - If the quality of fresh fruit and vegetables improved in your store, do you think you would sell more of these foods?
- If the quality of fresh food improved, would you: increase prices because customers would be willing to pay more? Lower
items
prices, because you would have less spoilage? Continue to charge the same price?
Data Sources:
A) Nutrition and Food Security in Kugaaruk, Nunavut. – Questions 500

Find source at: http://www.ainc-inac.gc.ca/nth/fon/pubs/kg03/kg03-eng.pdf
B) Food Quality in Six Isolated Communities in Labrador. – Questions 6/7


Food Security
Food Security >> Cost of Food >> Competitive Retailing
Issues Identified: Food costs were reduced in communities where there was competition between retailers.
Community Proposed
Indicator
# of food retailers
in the community
for specific
commodities
Data Sources:

Food Security
Food Security >> Availability & Quality of Food >> Food Transportation
Issues Identified: Transporting food to northern communities affects the cost, quality and availability of food for community
members. Nutritious perishable foods are expensive to ship and vulnerable to damage from poor handling. As
a result, store shelves are stocked with more easily transported, but less nutritional convenience foods.
Transportation inefficiencies and poor handling procedures cause spoilage and delayed or lost shipments,
resulting in increased cost and poorer food quality for northern residents. As well, community members feel
there is a lack of respect by food handlers and distributors toward food destined to the north.
Community Proposed
Indicator
Length of time for

4 food to be Local survey required
delivered
# of delayed or Local survey required

5 lost shipments
Amount of
nutritious fresh
6 food available for Local survey required
purchase vs. less
nutritious foods

A) Food Quality in Labrador study (retailer survey):
- How would you describe the quality of the following kinds of food sold in your community? (List of fresh fruits/vegetables to
choose from)
% of perishable - Since this time last year, has the quality of food in your community improved a lot, improved a little, stayed the same,
food received in become worse?
7 poor condition or - When do you find the quality of food to be best and worst?
not fit for - How often do you get complaints from customers about food quality?
- What do you think is the main cause of the problems you have with the quality of fresh food at this time of the year? (list of
consumption reasons…)
- How much of the following foods have you thrown out because of poor quality or spoilage in a typical week? During the
past three months? (list and amounts provided)
- Can you list the foods where you have the greatest problem with quality?
- Compensation information source: food handler company.
Compensation
provided for food
8 lost or received in Local survey required
condition not fit
for consumption
Data Sources:
A) Food Quality in Six Isolated Communities in Labrador. (Retailer survey questions 1/45/8/9/10/11)

Food Security
Food Security >> Availability & Quality of Food >> Traditional Foods
Issues Identified: Making use of local food resources such as fish and wild game provides healthy food and ensures food is not
subjected to transportation problems.
Community Proposed
Indicator
Levels of hunting
9 and fishing A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
Traditional foods
10 available by Local survey required
season
Data Sources:


Food Security
Food Security >> Availability & Quality of Food >> Nutrition Education
Issues Identified: Access to nutritional information is seen as important to assist community members in making informed and
healthy food choices. Demand for healthy food can mean more healthy food is available for purchase.
Community Proposed
Indicator
# of nutrition
education
programs and
attendance
# of cooking
12 classes & Local survey required
attendance
Data Sources:

Food Security
Food Security >> Availability & Quality of Food >> Food Programs
Issues Identified: Community food programs that provide nutritious food at schools and events are seen as a direct way of
ensuring that community members are eating healthy.
Community Proposed
Indicator
# and quality of
snack programs
in school / at
events
Data Sources:

Food Security
Food Security >> Availability & Quality of Food >> Collective Action
Issues Identified: Communities who act strategically and cooperatively to address food issues can reduce the cost and improve
the quality of the food available.
Community Proposed
Indicator
Bulk ordering and

purchase of food
Good Food Box

15 program and Local survey required
participation
# of community
16 food programs Local survey required
and participation
Data Sources:

Tool Sheet – Food Security
Food Security >> Availability & Quality of Food >> Nutrition Education
Issues Identified: Access to nutritional education is seen as important to assist community
members in making informed and healthy food choices. Demand for healthy
food can mean more healthy food is available for purchase.
Proposed Indicators: # 11 – # of nutrition education programs and attendance levels

# 12 – # of cooking classes
Suggested Measures: 1) Compare the number of nutrition programs available to the number required
to address nutrition education needs in the community.
2) Compare the desired participation rates in nutrition programs with current

participation rates.
Note: The nutrition programs offered in the calculation tools can be exchanged with cooking classes. They
could also be specific to a certain group such as Elders or pre-natal women, or related to specific
community health needs.
How to use measure #1:
Step 1) Identify the # (number) of nutrition programs needed within the community and the spaces
needed within those programs.
Step 2) Identify the # of nutrition programs offered.
Step 3) Use the ‘Indicator Calculation Tool #1’ formula to calculate the measure.
Indicator Calculation Tool #1 Calculation Example
( ) # of nutrition programs offered X ( ) spaces ( 2 ) nutrition programs offered X ( 10 ) spaces
( ) # of nutrition programs needed X ( ) spaces ( 3 ) nutrition programs needed X ( 10 ) spaces

( )
( ) 20
X 100 30
= % needed programs available = .666 X 100
= 67% of needed programs are available

Two-thirds (67%) of the nutrition education needs within the community are being met by current
programming. This information could be used to identify and support strategies to address educational
gaps. Strategies may include program evaluation, program consolidation or proposals for additional
programs and funding.

How to use measure #2:
Step 1) Identify the desired rate of participation in a particular nutrition program. This could also be
broken down to a specific group (Elders, pre-natal women, etc.).
Step 2) Determine the current rate of participation in the program for the specific group, by using
statistics collected by the program, or by conducting a local survey.
Step 3) Use the ‘Indicator Calculation Tool #2’ formula to calculate the measure.
Indicator Calculation Tool #2 Calculation Example
( ) current # of community members participating in ( 75 ) community members participating in program

program
( 180 ) desired community members participating in
( ) desired # of community members participating in program
program
75
( ) 180
( ) = .416 X 100
X 100 = 42% participating
= % participating

Of the identified 180 community members who would benefit from the program, only 75 or 42% are
participating. This information can be used to identify the need for further research to find out why the
participation rate is low and to develop and support strategies to increase attendance.

Services & Infrastructure
Defined as the availability and access to services and related infrastructure; respectfully
delivered health and human services; adequate and affordable housing, recreation facilities
and programming; and specialized services designed to meet the needs of Elders and
youth.
Indicators:
Community Infrastructure Service Delivery Compassionate 28 – meals on wheels program

Sewer & Water Local 19 – wait time for appointment transport. 29 – social gathering place for Elders
1 – houses with/without water & sewer 9 – services available in community 20 – compassionate policy exceptions 30 – programs & activities for Elders
2 – water borne illnesses 10 – health professionals in community 21 – cultural awareness programs 31 – local palliative care for Elders
3 – houses relying on bottled water 11 – visits by health professionals Confidential Infrastructure
Locally Staffed 12 – local service usage 22 – service confidentiality guidelines 32 – size/capacity of facility
4 – treatment facilities without staff 13 – community training in ERT 23 – staff trained on confidentiality 33 – suitability of facility
5 – facility staff from community 14 – distance from services Youth 34 – facility usage
6 – community staff training levels Consistent 24 – specific services for youth 35 – proper equipment for facility
Indicator #2 15 – frequency of health service delivery 25 – new funds for youth programs
Roads 16 – scheduled services delayed 26 – youth addiction treatment facilities Housing
7 – accidents on roads 17 – time to complete treatment plans Elders Availability
8 – repairs due to road conditions 18 – treatment completed/compromised 27 – medical translator/companion 36 – residents per house
First Nation’s Health Development Toolkit Services & Infrastructure Page 1

37 – generations per house 53 – programs with proper equipment 72 – utilization of existing resources Jurisdiction Fragmentation
38 – Tuberculosis rates Programming 86 – # agencies involved in funding

39 – housing waiting lists 54 – activities available Technology 87 – resources allocated to administration
Quality 55 – summer activities available Current Participation
40 – houses in need of repair 56 – programs cancelled 73 – water/sewer technology used 88 – service staff from community
41 – quality of housing insulation 57 – participation & retention levels High Speed Internet 89 – staff turnover rates
42 – presence of black mold 58 – age range of participants 74 – internet use in the community 90 – mechanisms for participation
43 – frequency of sewer back-ups Staffing 75 – internet technology at health facility 91 – health education and awareness
44 – accidents in the home 59 – funding for trained staff 76 – distance education enrolment Collaboration
45 – EHO inspector visits 60 – programs run by staff vs. volunteers 77 – internet reliability 92 – community inter-agency meetings
Elders 61 – range of programs offered Data Management 93 – regional inter-agency meetings
46 – housing units designed for Elders 62 – participation and retention levels no indicators proposed 94 – service delivery collaborations
47 – house maintenance for Elders 63 – support for recreation staff Communication
Affordable Youth Service Sustainability 95 – community newsletter

48 – low cost housing units 64 – youth centre in community Sufficient Funding 96 – community meetings
49 – % of income required for housing 65 – youth involved in programs 78 – levels of program/service funding Realistic
Jurisdiction Fragmentation 66 – school drop out rates 79 – program needs met by funding Indicator #12
50 – agencies responsible for housing 67 – school absentee rates 80 – vacant positions 97 – proximity of duplicate services
51 – time to complete house repairs 68 – youth alcohol and drug use Stable Funding 98 – medical transport driver/patient ratio
Ownership Promotion 81 – long term vs. short term funding 99 – funder cutbacks re: abuse perception
no indicators proposed Indicators #54, 57, 58 82 – duration of programs Staffing
69 – direct contacts to provide information 83 – programs cancelled Indicator #21

Recreation Affordable 84 – staff turnover rates
Facilities 70 – cost of recreation to users Indicator #80
52 – type/condition of recreation facilities 71 – volunteers assisting with programs 85 – funding commitments honoured

Services & Infrastructure >> Community Infrastructure >> Sewer & Water
Issues Identified: Communities require adequate sewer and water treatment systems that use proper technology, meet current
standards and are operated and maintained by trained staff.
Community Proposed
Indicator
A) RHS (Adult survey):
# of houses - What is the main water supply for your household? (List includes: local/community water supply; trucked, well;
with/without collect yourself from water plant; collect yourself from river, lake, pond; from a neighbour’s house)
- Do you use any other sources of drinking water? (List includes: bottled water, water from another house, boiled tap water,
1 adequate sewer
river lake or stream).
and water - Do you consider the main water supply in your home safe for drinking? - Community level data for RHS survey exists:
services must be accessed by community.
# of illnesses B) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
caused from Profiles or 2006 Aboriginal Population Profile >> Choose a community
2 water borne
diseases
# of houses
relying on
purchased
drinking water

Data Sources:
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adult survey) – Questions 29/30/31
Find source at: http://www.rhs-ers.ca/english/pdf/rhs2002-03_files/questionnaires/rhs2002-03_adult_questionnaire.pdf


Services & Infrastructure >> Community Infrastructure >> Locally Staffed
Issues Identified: Operation and maintenance of critical infrastructure (sewer & water) should be carried out by trained
community members to avoid gaps in service that occur due to staff turnover and scheduling of outside staff.
Community Proposed
Indicator
# of instances
where treatment
4 facilities are Local survey required
without staff
members
# of community
members who are
5 employed in Local survey required
water/sewer
facilities
% of community
6 staff who are Local survey required
properly trained

Community Proposed
Indicator
# of illnesses
caused from
See Indicator 2
water borne
diseases
Data Sources:

Services & Infrastructure >> Community Infrastructure >> Roads
Issues Identified: The quality of roads, both within communities and between communities where roads exist, is often poor,
increasing the cost of vehicle maintenance and reducing mobility.
Community Proposed
Indicator
# of accidents
on roads
# of vehicle
8 repairs due to Local survey required
road conditions
Data Sources:

Services & Infrastructure >> Service Delivery >> Local
Issues Identified: Wherever possible, services should be available locally to enable people to remain in their communities. Where
services have to be “brought in” to a community they should be designed to accommodate that purpose (i.e.
mobility of health professionals). Community members should be trained in critical incident response in
communities without resident trained personnel.
Community Proposed
Indicator
# of services
9 available in the Local survey required
community
# of health
professionals who
live in the
community
# of health
11 professional visits Local survey required
to the community

Community Proposed
Indicator
# of trips outside
of community for
service that is
available locally
# of community
members trained
in ERT / First
Responders; #
training
opportunities
Distance from
services
Data Sources:

Services & Infrastructure >> Service Delivery >> Consistent
Issues Identified: Services need to be regularly scheduled so that people know when they are available, and should be offered as
scheduled, without changes, delays or cancellations.
Community Proposed
Indicator
Frequency of
15 (health) service http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
delivery
# of scheduled
services changed,
delayed or
cancelled
Time period to
17 complete Local survey required
treatment plans
# of treatment
18 plans completed Local survey required
vs. compromised
Data Sources:


Services & Infrastructure >> Service Delivery >> Compassionate
Issues Identified: Services delivered both within and outside the community should be delivered with compassion, respect and
cultural awareness. Services should be designed (and modified as required) to minimize undue inconvenience
and hardship for clients.
Community Proposed
Indicator
Waiting time for

transportation
19 from doctor Local survey required
appointment back
to community
# of policy
exceptions
requested /
granted for
compassionate
reasons
# of cultural
awareness
programs &
attendance rates
Data Sources:

Services & Infrastructure >> Service Delivery >> Confidential
Issues Identified: Services should be delivered in a confidential and professional manner.
Community Proposed
Indicator
# of services with
22 confidentiality Local survey required
guidelines
# of staff trained
on guidelines
Data Sources:

Services & Infrastructure >> Service Delivery >> Youth
Issues Identified: Specific services for youth are essential to keep youth engaged and healthy; those identified included a youth
centre and targeted recreation, addictions, culture, mentoring and education programs.
Community Proposed
Indicator
#, type and use of

specific youth
24 services, Local survey required
programs &
facilities
Amount of new
funds for youth
programs (not
reallocated funds)
Youth addiction
treatment centre
and/or mobile
program
Data Sources: No indicator/survey source at this time

Services & Infrastructure >> Service Delivery >> Elders
Issues Identified: Services for Elders are seen as very important to ensuring they are involved in the community, are involved
with youth, and have the necessary supports to allow them to remain in the community as they grow old.
Community Proposed
Indicator
Medical
translation &
27 companion Local survey required
services available
and funded
Meals on wheels
28 program in Local survey required
community
Social gathering
place for Elders
(e.g. coffee
house)

Community Proposed
Indicator
# and type of
activities and
30 programs for Local survey required
Elders &
participation
Palliative care
31 available in Local survey required
community
Data Sources:

Services & Infrastructure >> Service Delivery >> Infrastructure
Issues Identified: Services require suitable infrastructure to carry out identified activities (buildings, equipment, supplies).
Community Proposed
Indicator
Size / capacity of
facility
Suitability of
33 facility (daycare Local survey required
has windows)
Usage rates of
facility (can
indicate
suitability)
Facility has
35 proper equipment Local survey required
for designed use

Services & Infrastructure >> Housing >> Availability
Issues Identified: A lack of housing units results in overcrowding, contributing to increased incidence of communicable diseases
(esp. tuberculosis, and mental health issues (stress, alcohol & drug abuse). Loss of a housing space is a
deterrent to those who wish to move temporarily from the community to pursue education.
Community Proposed
Indicator
A) RHS (Adult survey):
- How many children usually live in this household?
# of residents per - Including yourself, how many adults live in this household?
36 house - How many rooms are in your home? - Community level data for RHS survey exists: must be accessed by
community.
# of generations
per house
Tuberculosis
rates
39 Housing waiting Local survey required

lists

Community Proposed
Indicator
Data Sources:
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adult survey) – Questions 19/20/25


Services & Infrastructure >> Housing >> Quality
Issues Identified: Many housing units are in disrepair, some without proper services such as sewer and water. Houses in poor
condition contribute to accidental injuries and health hazards.
Community Proposed
Indicator
# of housing
40 repairs needed A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
Housing
insulation quality
Presence of black
mold
Frequency of
sewer backups
# of accidents in
the home

Community Proposed
Indicator
# of visits from
EHO inspectors
Data Sources:


Services & Infrastructure >> Housing >> Elders
Issues Identified: Housing that meets the special needs of Elders (mobility, restricted vision) is required along with programs that
support Elders to remain in their homes and community.
Community Proposed
Indicator
# of housing units
specifically
46 designed or Local survey required
modified for
Elders
Level of
assistance with
47 house Local survey required
maintenance for
Elders
Data Sources:

Services & Infrastructure >> Housing >> Affordable
Issues Identified: An overall scarcity of housing units contributes to higher rents and a further lack of low-income housing units
contributes to overcrowding, as those with low incomes move in with other family members. Frequent moves in
search of better housing increases costs (i.e. re-hookup of utilities).
Community Proposed
Indicator
# of low cost
housing units
% of income
49 required for Local survey required
housing
Data Sources:

Services & Infrastructure >> Housing >> Jurisdiction Fragmentation
Issues Identified: Responsibility for provision and maintenance of housing units is multi-jurisdictional and results in gaps in
availability and quality of housing.
Community Proposed
Indicator
# of agencies
50 responsible for Local survey required
housing
Time period to
51 complete housing Local survey required
repairs
Data Sources:

Services & Infrastructure >> Housing >> Ownership
Issues Identified: Unavailability of serviced lots for individual purchase and difficulties in obtaining financing are challenges to
home ownership.
Community Proposed
Indicator
None proposed A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
Data Sources:


Services & Infrastructure >> Recreation >> Facilities
Issues Identified: Appropriate, well-maintained facilities are required to house recreation and leisure activities. Proper
equipment is also needed for the activities to take place.
Community Proposed
Indicator
# and type and

condition of
52 recreational Local survey required
facilities in the
community
% of programs
53 with proper Local survey required
equipment
Data Sources:

Services & Infrastructure >> Recreation >> Programming
Issues Identified: A range of recreation and leisure programs should allow for all community members to be involved in
activities, facilitating year-round use (not just linked to school year) in all environments. Programs must be
dependable - short term programs discourage participation.
Community Proposed
Indicator
# and type of
activities available
# of activities
55 available during Local survey required
summer months
# of programs
cancelled

Participation & A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
57 retention levels Profiles or 2006 Aboriginal Population Profile >> Choose a community

Community Proposed
Indicator
Age range of
participants in
58 specific (i.e. using Local survey required
ice rink) and
overall activities
Data Sources:


Services & Infrastructure >> Recreation >> Staffing
Issues Identified: Funds must be available to hire staff who are trained in Recreation Services and can properly design, deliver
and promote a broad range of programs and understand how to motivate and retain participation.
Community Proposed
Indicator
Funding available
59 to hire trained Local survey required
staff
# of programs run
60 by trained staff Local survey required
vs. volunteers
Range of
programs offered
Program
62 participation & Local survey required
retention levels

Community Proposed
Indicator
Level of support
63 for recreation Local survey required
staff
Data Sources:

Services & Infrastructure >> Recreation >> Youth
Issues Identified: Providing recreational opportunities for youth is seen as one of the most important ways to keep youth engaged
in the community and to provide an alternative to drug and alcohol use. A youth centre is seen as a critical
facility.
Community Proposed
Indicator
Youth centre in
community
% of youth
65 involved in Local survey required
programs
School drop out

rates
School absentee
rates

Community Proposed
Indicator
Levels of alcohol
68 & drug use among Local survey required
youth
Data Sources:


Services & Infrastructure >> Recreation >> Promotion
Issues Identified: Programs must be promoted to build community support and participation. Individual contact is seen as
important, as well as a group participation approach to keep up motivation (i.e. walking group).
Community Proposed
Indicator
# and type of
See Indicator 54
Program
participation & See Indicator 57
retention levels
Age range of
See Indicator #58
participants
# of direct
contacts to
69 provide Local survey required
information on
activities

Services & Infrastructure >> Recreation >> Affordable
Issues Identified: Services and programs must be affordable for community members as user fees can be a deterrent to usage.
Finding ways to utilize the resources within the community can reduce funding requirements.
Community Proposed
Indicator
Cost of recreation
activities to users
# of volunteers
assisting with
recreation
programs
# of existing
community
resources utilized
for recreation (e.g.
outside rink; field
for ball diamond;
walking trails;
lake)

Services & Infrastructure >> Technology >> Current
Issues Identified: Communities must have access to appropriately current technology (structures, systems, processes, equipment
and training) to properly operate and maintain services and infrastructure.
Community Proposed
Indicator
Water & sewer

treatment
technologies
in use
Data Sources:

Services & Infrastructure >> Technology >> High Speed Internet
Issues Identified: Access to reliable high speed internet is crucial to enable the use of new technology in the health facility, to
access distance educational opportunities, to access information and resources, and to facilitate a broad range
of communication needs.
Community Proposed
Indicator
A) Aboriginal Peoples Adult Survey (Communications section, questions 4, 5):
- In the past twelve months, did you use the Internet?
- Where have you used the Internet in the past twelve months?
Internet use in the Aboriginal Peoples Adult Survey (Education section, question 26)
74 community - Did you take any of your postsecondary courses by correspondence or through some other form of distance education?
By “distance” we mean education received via mail or electronic media such as television, CD-ROM or the Internet?
Internet
technology in use
75 at health care Local survey required
facility

Community Proposed
Indicator
# of community
members enrolled
76 in distance Local survey required
education
courses
# of minutes of
interrupted/
unavailable
internet service
Data Sources:
A) Statistics Canada: 2001 Aboriginal Peoples Survey (Adult) – Question 4/5 (Communications Section) & Question 26 (Education Section)


Services & Infrastructure >> Technology >> Data Management
Issues Identified: Data collection systems and trained staff are required to collect and manage the information necessary to
conduct needs assessments, obtain funding and other resources, provide accountability and conduct program
evaluation.
Community Proposed
Indicator
Data Sources:

Services & Infrastructure >> Service Sustainability >> Sufficient Funding
Issues Identified: In order to be effective and produce desired outcomes, services require sufficient funding (budget) to carry out
identified activities.
Community Proposed
Indicator
Levels of
78 program/ service Local survey required
funding
% of program/
79 service needs met Local survey required
by funding
# of vacant
positions
Data Sources:

Services & Infrastructure >> Service Sustainability >> Stable Funding
Issues Identified: Services require stable, long-term funding to allow for planning and evaluation, and to develop community
commitment and support. It is important that funding commitments made to communities are honoured.
Community Proposed
Indicator
Duration dates of
81 funding Local survey required
agreements
Duration of
programs
# of programs
cancelled
Staff turnover
rates
# of vacant
See Indicator 80
positions

Community Proposed
Indicator
# of funding
85 commitments met Local survey required
vs. not kept
Data Sources:

Services & Infrastructure >> Service Sustainability >> Jurisdiction Fragmentation
Issues Identified: Responsibility for services and programs is multi-jurisdictional and results in “patchwork” program and
service delivery that is administratively intensive. A myriad of budget and statistical reporting requirements
uses a great deal of the resources which could be spent on direct service or program delivery.
Community Proposed
Indicator
# of agencies
involved in
86 funding specific/ Local survey required
overall services
and programs
% of resources
87 allocated to Local survey required
administration
Data Sources:

Services & Infrastructure >> Service Sustainability >> Participation
Issues Identified: Involving community (Aboriginal) members in service planning and delivery can ensure appropriate programs
and services, minimize gaps in service created by staff turnover, provide employment, and build community
support and capacity.
Community Proposed
Indicator
# of community
members
88 employed/ Local survey required
involved in
service delivery
Staff turnover
rates
# and type of
mechanisms for
community
90 participation Local survey required
(planning
meetings,
committees)

Community Proposed
Indicator
# of health
education
91 opportunities for Local survey required
community
members
Data Sources:

Services & Infrastructure >> Service Sustainability >> Collaboration
Issues Identified: Communication and coordination of services within communities and between agencies, can improve the range
of services and delivery options available.
Community Proposed
Indicator
# of community
92 inter-agency Local survey required
meetings
# of regional inter-
agency meetings
# of collaborative
94 service delivery Local survey required
initiatives
Data Sources:

Services & Infrastructure >> Service Sustainability >> Communication
Issues Identified: Communication must exist between service providers and the community to ensure members are aware of, use,
and support the service.
Community Proposed
Indicator
Community
newsletter &
distribution/
readership
# of community
96 meetings held and Local survey required
attendance rates
Data Sources:

Services & Infrastructure >> Service Sustainability >> Realistic
Issues Identified: To realistically meet the needs of the community, factors such as service area population, demand, use, cost,
proximity of like services, etc. must be considered in service planning and delivery. Awareness is needed of
what constitutes abuse of services vs. acceptable use.
Community Proposed
Indicator
# of trips outside
of community for
See Indicator 12
service that is
available locally
Proximity of
duplicate services
Medical
98 transportation Local survey required
driver/patient ratio
# of funder
cutbacks due to
perception of
abuse

Data Sources:

Services & Infrastructure >> Service Sustainability >> Staffing
Issues Identified: High rates of staff turnover negatively impact programs in many ways including causing service gaps and
reducing service dependability and usage. An understanding of cultural and geographic realities for non-
Aboriginal and non-northern staff is seen as a way to reduce staff turnover and connect workers to the
community.
Community Proposed
Indicator
# of cultural
awareness
See Indicator 21
programs &
attendance rates
Data Sources:

Tool Sheet – Services & Infrastructure
Services & Infrastructure >> Service Delivery >> Medical Translation &
Companion Services
Issues Identified: Medical translation and companion services are important for the quality of
care, safety and comfort of community members traveling outside the
community for medical services. With the assistance of a translator, Elders
can communicate their needs and understand the care they receive. Safety
issues for both Elders and youth can be addressed by traveling with a
companion, which can also reduce the stress of such trips.
Proposed Indicator: # 27 – Medical translation and companion services available and funded
Suggested Measure: Compare the number of medical trips where translation and/or companion
services are provided to the number of medical trips where these services
were requested, or were deemed to be needed, but were not provided.
Step 1) Identify the # (number) of medical trips where translator or companion was requested or
deemed to be needed, within a given timeframe. This could also be broken down by group
(i.e. Elders, youth).
Step 2) Identify the # of trips where a translator or companion was provided and funded, within the
timeframe (and for the specific group).
( ) trips - translator/companion provided 15 trips - translator/companion provided

( ) trips - translator/companion requested or needed 25 trips - translator/companion requested or needed
but not provided but not provided
( ) 15
( ) 25
X 100 .06 X 100
= % translation/companion needs met = 60% translation/companion needs met

Only ten percent (60%) of the needed or requested translation or companion services are being
provided. This information could be used to demonstrate the need for more funded services, or to
identify the level of service provided to particular groups, such as Elders.

Healthy Lifestyles
Healthy lifestyles relate to positive personal life choices that include proper diet and
physical activity and that build respectful healthy relationships with family and community.
It involves making life choices that contribute to and foster the development of positive self-
esteem within the individual.
Indicators:
Self Care 4 – appointments kept vs missed 9 – participation in community events Motivation
Healthy Eating 5 – comfort disclosing health issues 10 – organizing/volunteering at events Programming
no indicators proposed Healthy Home Physical Activities 16 – activities available
Healthy Socializing 6 – keeping regular bedtime hours 11 – walking 17 – programs cancelled
no indicators proposed 7 – limiting TV/video game use 12 – weight and fitness training 18 – program participation and retention
Healthy Self-Image Hygiene 13 – playing sports 19 – age range of participants
1 – girls saying no to sex 8 – practicing good personal hygiene 14 – skating Promotion
Medical Treatment Elders & Youth 20 – direct contacts to provide information
2 – taking medications as prescribed Participation 15 – Elder/youth activities Environmental Concerns
3 – attendance at support groups Social Activities 21 – walking groups
First Nation’s Health Development Toolkit Healthy Lifestyles Page 1

Affordability
22 – cost of recreation to users
23 – recreation volunteers
Early Engagement
24 – youth participation rates
25 – youth programs
26 – recreation leader to inspire youth
Nutrition / Fitness Awareness
27 – nutrition & fitness programs

Healthy Lifestyle
Healthy Lifestyle >> Self-Care >> Healthy Eating
Issues Identified: Choosing to eat a balanced diet including fresh fruit and vegetables and traditional foods such as caribou,
moose, elk, fish and berries.
Community Proposed
Indicator
A) Health Canada Nutrition Survey:
Question 21-Are you currently eating or trying to eat healthier?
Q22-How long have you been eating or trying to eat healthier, would you say 6 months or less, or for more than 6 months?
None proposed
B) RQH Adult/Adolescent/Child survey:
Question 59/29/50-Do you eat a nutritious balanced diet?
Q 61/31/52-In the past 12 months, how often have you eaten the following traditional foods? (List includes a choice of 10
traditional foods) - Community level data for RHS survey exists: must be accessed by community.
Data Sources:
A) Health Canada Nutrition Survey – Questions 21/22
B) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adult survey) – Questions 59/61
B) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adolescence survey) – Questions 29/31
B) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Child survey) – Questions 50/ 52
Find source at: http://www.rhs-ers.ca/english/pdf/rhs2002-03_files/questionnaires/rhs2002-03_child_questionnaire.pdf

Healthy Lifestyle
Healthy Lifestyle >> Self-Care >> Healthy Socializing
Issues Identified: Avoiding the use of alcohol and drugs when socializing.
Community Proposed
Indicator
Data Sources:
No existing indicator/survey source at this time.

Healthy Lifestyle
Healthy Lifestyle >> Self-Care >> Healthy Self-Image
Issues Identified: Having a healthy self-image means respecting yourself, respecting your body, avoiding the use of steroids (body
building) or excessive dieting to obtain unrealistic body images, and making independent decisions without
giving in to peer pressure.
Community Proposed
Indicator
Girls saying no
to sex
Data Sources:
No indicator/survey source at this time.

Healthy Lifestyle
Healthy Lifestyle >> Self-Care >> Medical Treatment
Issues Identified: Following treatment plans to ensure that health issues are addressed and complications are avoided; being
comfortable with disclosing health issues to health professionals and support groups.
Community Proposed
Indicator
Taking medications as
prescribed
Attendance at support
groups
# of medical appointments
kept/missed

Comfort levels with
5 disclosing health issues A) http://www.statcan.gc.ca >> (English / French) >> Community Profiles >> 2006 Aboriginal Peoples Survey Community
Data Sources:


Healthy Lifestyle
Healthy Lifestyle >> Self-Care >> Healthy Home
Issues Identified: Providing a good environment for children to grow up in.
Community Proposed
Indicator
Keeping regular
bedtime hours
A) RHS Child/Adolescent survey:
Question 57/69 - On average, about how many hours per week does ____ watch TV? Play video games? - Community
Limiting TV/video level data for RHS survey exists: must be accessed by community.
7 game use
Data Sources:
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adolescence survey) - Question 69
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Child survey) – Questions 57


Healthy Lifestyle
Healthy Lifestyle >> Self-Care >> Hygiene
Issues Identified: Practicing good personal hygiene.
Community Proposed
Indicator
Practicing good
personal hygiene
Data Sources:

Healthy Lifestyle
Healthy Lifestyle >> Participation >> Social Activities
Issues Identified: Being active and involved in the community through cultural, spiritual, social, recreational and sporting events.
Community Proposed
Indicator
Attendance /
9 participation in Local survey required
community events
Organizing or Local survey required

10 volunteering at
community events
Data Sources:

Healthy Lifestyle
Healthy Lifestyle >> Participation >> Physical Activities
Issues Identified: Participating in recreational activities that involve physical exercise and fitness.
Community Proposed
Indicator
Local survey required– suggested questions and existing data found at:
A) RHS Adolescent/Adult/Child survey:
11 Walking Question 33/-/54-How often do you participate in any kind of physical activity (either at school or at home, or in your free
time? - Community level data for RHS survey exists: must be accessed by community.
Weight and Q35/63/55-What types of physical activities have you participated in during the last 12 months? (List of activities) - -
12 fitness training Community level data for RHS survey exists: must be accessed by community.
Q 68/-/56-Outside of school hours, how often do you: …Take part in sports teams or lessons - Community level data for
13 Playing sports RHS survey exists: must be accessed by community.
14 Skating Local survey required

Data Sources:
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adult survey) – Questions 63
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Adolescence survey) – Questions 33/35/68
A) RHS: First Nations and Inuit Regional Longitudinal Health Survey (Child survey) – Questions 54/55/56


Healthy Lifestyle
Healthy Lifestyle >> Participation >> Elders & Youth
Issues Identified: Special programs that encourage Elders and youth to engage in community activities and to spend time
together are seen as important.
Community Proposed
Indicator
# of activities
where Elders and
youth participate
together
Data Sources:

Healthy Lifestyle
Healthy Lifestyle >> Motivation >> Programming
Issues Identified: A range of recreation and leisure programs should allow for all community members to be involved in
activities, facilitating year-round use in all environments. Programs must be dependable – short term programs
discourage participation.
Community Proposed
Indicator
# and type of
# of programs
cancelled
Participation &
retention levels
Age range of
participants in
specific and
overall activities
Data Sources:

Healthy Lifestyle
Healthy Lifestyle >> Motivation >> Promotion
Issues Identified: Programs must be promoted to build community support and participation. Individual contact is seen as
important – community involvement to improve participation in activities can build community support.
Community Proposed
Indicator
# of direct
contacts to
20 provide Local survey required
information on
activities
Data Sources:

Healthy Lifestyle
Healthy Lifestyle >> Motivation >> Environmental Conditions
Issues Identified: Environmental conditions such as weather, black flies and bears can reduce the motivation of community
members to participate in outdoor activities; participating in groups is seen as safer.
Community Proposed
Indicator
# of walking
21 groups and Local survey required
# of outings
Data Sources:

Healthy Lifestyle
Healthy Lifestyle >> Motivation >> Affordability
Issues Identified: Programs must be affordable for community members as user fees can be a deterrent to usage.
Community Proposed
Indicator
Cost of recreation
activities to users
# of volunteers
assisting with
recreation
programs
Data Sources:

Healthy Lifestyle
Healthy Lifestyle >> Motivation >> Early Engagement
Issues Identified: A focus on engaging youth in recreation and sports is important to set a lifelong pattern of physical exercise
and to alleviate boredom.
Community Proposed
Indicator
Youth
participation rates
# of programs
specific to youth
Recreation
“leader” in
community to
inspire youth
Data Sources:

Healthy Lifestyle
Healthy Lifestyle >> Motivation >> Nutrition / Fitness Awareness
Issues Identified: Awareness derived from nutrition and health education programs can motivate people to participate in physical
activities and to eat healthy.
Community Proposed
Indicator
Availability of
nutrition/fitness
programs and
attendance levels
Data Sources:

Healthy Lifestyles
Healthy Lifestyles >> Participation >> Physical Activities
Issues Identified: Participating in recreational activities that involve physical exercise and
fitness.
Proposed Indicator: # 13 – Playing Sports

Suggested Measure: Compare the desired participation rates in recreational activities with current
participation rates.
Information Source: Existing data and suggested questions that could be used in a local survey
are provided below. These are focused on children (6-14). Limitations to the
existing data are noted below (see *).
A) RHS Adolescent/Adult/Child survey: http://www.rhs-ers.ca/english/pdf/rhs2002

03_files/questionnaires/rhs2002-03_youth_questionnaire.pdf (no longer available online)
Question 68 - Outside of school hours, how often do you: …Take part in sports teams or lessons?
Note: Community level data for RHS survey exists; must be accessed by community.
B) http://www.statscan.gc.ca/ >> (English / French) >> Community Profiles >> 2001 Aboriginal Peoples Survey Community
Profiles >> Choose: Child / Saskatchewan / Choose a Community
How often child plays sports per week:

Never or less than once (%)
One or more times (%)
C) For specific recreation information that includes past and upcoming events in the Athabasca region go to:
http://www.nscrd.com/index.html
Step 1) Identify the desired rate of participation in sports activities for the age group (example: 6-
14; 15-18).
Step 2) Determine the current rate of participation for the age group, by using existing data (as in
the table above) or by conducting a local survey. Suggested survey questions can be
found in the Regional Health Survey (RHS) as well as the 2001 Aboriginal Peoples’ Survey
Community Profiles.

( ) current # of youth participating in sport activities (375) current # of youth participating in sport activities
( ) desired # of youth participating in sport activities (500) desired # of youth participating in sport activities
( ) 375
( ) 500
X 100 = .75 X 100
= % participating = 75% participating

Of the 500 identified as the desired participation number for the age group identified, 75% are currently participating in
sports. This information could be used to set targets and determine what additional resources and strategies are needed to
recruit the remaining 25% of youth into sports activities. Statistics on participation levels can be also used to support
funding proposals.
* Limitations of the Existing Data:

Existing data do not show the participation levels of all age groups, nor do they indicate the type of sports program or
activities being participated in. As not all community members took part in the Regional Health Survey or the 2001
Aboriginal Peoples’ Survey, the data may not accurately reflect the participation levels in a particular community, and should
be used with caution.

First Nation’s Health Development:
Tools for Program Planning and Evaluation
Research Project
M ETHODS
First Nation’s Health Development Project Page 21

Methods
Table of Contents
A. Introduction .................................................................................................... 1
B. Research Design
1) Participatory Design ............................................................................ 3
2) Negotiating Community Consent ........................................................ 3
3) Data Collection & Analysis .................................................................. 4
 Development of Logic Models ..................................................... 4
 Key Informant Interviews with Health Directors .......................... 6
 Focus Groups with Community Members ................................... 7
C. Development of Community Health Framework & Indicators ....................... 8
D. Pilot Testing the Framework & Indicators ................................................... 10
References .......................................................................................................... 11
APPENDICES ......................................................................................................... 12
Appendix A – Map of Northern Saskatchewan with Research Communities
Appendix B – Memorandum of Agreement to Participate
Appendix C – What Is a Logic Model?
Appendix D – List of Program Logic Models
Appendix E – Logic Model Source Documents
Appendix F – Generic Logic Models
Appendix G – Phase I Interview Questions – Key Informants
Appendix H – Draft Evaluative Indicators Framework
Appendix I – Phase II Interview Questions – Focus Groups
Appendix J – Final Community Health Indicators Framework
Appendix K – An Example from the Toolkit
LIST OF TABLES & FIGURES

Figure 1 – Project Logic Model ................................................................ 2
Table 1 – Focus Group Participants ......................................................... 7
Table 2 – Community Health Indicators Framework Components ........... 9
First Nation’s Health Development Project Page i

Methods
A. Introduction
Background
In the process of conducting the 2002 evaluation of transferred health services from First
Nations and Inuit Health Branch (FNIHB) to the Prince Albert Grand Council (PAGC) in
Saskatchewan, PAGC health managers expressed a desire to address questions beyond the
scope and capacity of the evaluation but that they feel are relevant to the ongoing
development of health services in their member communities. They were especially interested
in the issue of the health effects of other human services (i.e. social development and
recreation programs) on community wellness and capacity. PAGC health managers were
especially interested in determining what information communities could collect to track and
monitor their progress in the areas of community health and capacity outcomes.
This project, the First Nation’s Health Development: Tools for Program Planning and
Evaluation, builds on the 2002 evaluation to consider these issues. Here we describe the
processes and activities undertaken between October 2002 and October 2005 to conduct the
research.
Project Objectives
The objectives of this research project were to develop an evaluation framework and
indicators for use by First Nations health organizations to track the effects of health and
human service programs under their jurisdiction. Underlying the identification of appropriate
indicators was the need to conduct research on local level concepts of community health and
capacity to inform the development of an appropriate evaluative framework within which to
situation programs, activities and indicators (see Figure 1).

Methods
Figure 1
Research Project Logic Model
Location
The research took place in communities selected by the community partners within the Prince
Albert Grand Council district in the northern geographic area of Saskatchewan (see Appendix
A). The PAGC communities included in this project were: Wahpeton Dakota Nation,
Cumberland House Cree Nation, Red Earth Cree Nation, Fond du Lac Denesuline Nation,
Black Lake Denesuline Nation and Hatchet Lake Denesuline Nation. During the time of this
project, the newly formed Athabasca Health Authority (AHA), assumed responsibility for health
service delivery in the Athabasca region (i.e., Black, Lake, Fond du Lac) and at the request of
the Chief Executive Officer, we also included the three provincial communities serviced by
AHA. These communities, with a significant population of First Nations and Aboriginal people,
are Stony Rapids, Camsell Portage and Uranium City.

Methods
B. RESEARCH DESIGN
1) Participatory Design
A participatory research design was used with a team that included university researchers and
managers of three First Nations health organizations: the Prince Albert Grand Council
(PAGC), the Athabasca Health Authority and the Northern Inter-Tribal Health Authority.
Individual communities were consulted prior to interviews to confirm their interest and
participation in the project, and meetings were held throughout the duration of the project to
provide regular updates to the First Nation research partners and community Health Directors.
Significant effort was made to keep the research process iterative, both by the strategies
employed in data collection and analysis and by the participation process of the research
communities. Community Health Directors and First Nations research partners provided
advice and feedback at key points in the project, including reviewing focus group questions
prior to their introduction in community meetings, and critiquing several iterations of the draft
framework, indicators
2) Negotiating Community Consent

It was important to first introduce the project to potential participant communities before
beginning data collection at any level. Because the Health Directors in each of the six First
Nation communities had been identified as the key informants and community level contacts,
a project presentation was made to a meeting of the Prince Albert Grand Council (PAGC)
Health and Social Development Working Group (HSDWG), a forum in which all PAGC Health
Directors participate. This group remained the main communication conduit for the
participating communities. Meetings were also held with senior managers of PAGC, AHA and
NITHA early on in the project.
In addition to the individual consent process for interviews and focus groups, we also
negotiated community consent with the leadership of each of the participating First Nation
communities. A Memorandum of Agreement to Participate (Appendix B) was developed for
Health Directors to take to their leadership for review and approval. This document outlined
both the assistance to be provided by the Health Directors to the project and the products the
researchers and the project would return to the community.

Methods
Measures to ensure confidentiality were outlined in the ethics application approved by the
university and communicated to the communities and research partners during the
development of the Memorandum of Agreement to Participate, as well as during individual
interviews and focus groups. Measures included a Confidentiality Declaration form signed by
research team members and staff who would have access to the interview data.
Confidentiality issues related to the small number of key informants were managed by
ensuring that comments of individual participants would not be identifiable in reported findings.
Interview data is kept in a locked cabinet at the SPHERU Prince Albert office. Interviews and
focus group discussions were taped using digital recording equipment. We ensured that
copies of digital files, both actual interview audio files and transcription files were deleted from
any computers they may have been placed on for working purposes. A set of digital files is
stored password-protected in the locked cabinet along with the interview transcriptions.
3) Data Collection & Analysis
The project included three levels of data collection:
 Collection and analysis of secondary data to create program logic models, and
informal interviews with program managers to confirm logic model accuracy;
 Key informant interviews with Health Directors in each First Nation community;
 Focus groups with community members in six First Nation and three provincial
communities to validate and expand the draft framework and indicators.
Development of Logic Models
The first step in the data collection involved obtaining information on health and human
service programs delivered at the community level in order to build program logic models1.
This was done both to help the researchers understand the community based programs
and to provide an evaluation and planning tool to the program managers. A detailed
description of a logic model is contained in Appendix C.
Although there were nine communities involved in the project, six First Nation and three
provincial communities, logic models were created only for the programs delivered in the
1
A logic model is a summarized graphical representation of the goals, objectives, resources, activities and
anticipated outcomes of a program. It is normally displayed on one page and is used to assist with both the
understanding and evaluation of programs.

Methods
First Nation communities. At the time that the logic models were created, nursing and
professional health services (and other social program) were provided to the participating
First Nation communities through the Prince Albert Grand Council and Bands provided
para-professional health services.2 Therefore, a level of autonomy exists around program
design and spending for program managers at the local level. At this point in the process
program information was collected at the Prince Albert Grand Council level (second level3)
and later verified at the community level.
Program data was first collected through an examination of secondary data, or currently
existing documentation, related to the Health, Social Development, Education, Justice and
Economic Development programs. Second level service managers, who oversee the
delivery of programs to the community, were contacted to inform them of the project and
request program documentation. Materials such as organization charts, annual reports,
program manuals, publications and pamphlets, work plans and daily activity logs were
examined and from them the goals, resources, activities, and short- and long-term
objectives of the programs were determined.
Unstructured interviews were held with second-level program managers to clarify and
confirm our understanding of the programs. Drafts of the logic models were then returned
to these managers who were asked to provide feedback to ensure they accurately
reflected the programs. Revisions were made and a final set of logic models was created
of all the programs that were delivered in each of the communities. A set of generic logic
models, without community variation, was provided to the First Nation research partners;
Prince Albert Grand Council (PAGC) the Athabasca Health Authority (AHA) and Northern
Inter-Tribal Health Authority (NITHA).
In interviews with community Health Directors, the generic logic models were reviewed and
revised to create a set of community-specific logic models, which included variations in
program functioning specific to individual communities. Each community was provided
with their set of logic models, along with a summary sheet highlighting program delivery
information specific to their community.
2
During the time that the study was conducted, the newly formed Athabasca Health Authority began to
provide nursing and professional health services to the two First Nation communities (Fond du Lac, Black
Lake) and provided all health services to the provincial communities of Stony Rapids, Camsell Portage and
Uranium City. The two Bands continue to provide para-professional health services in these First Nation
communities.
3
First level services are those delivered at the community level by community-based staff; second level
services refer to the overall management of programs provided by the Prince Albert Grand Council to member
communities.

Methods
A list of the programs that logic models were developed for is attached as Appendix D;
Appendix E lists the source documents upon which the logic models were created. A set
of generic logic models is included as Appendix F.
Key Informant Interviews with Health Directors
Phase I of the research strategy also involved collecting data from Health Directors in the
six First Nation communities. Interview questions were developed by the research team
(see Appendix G) and researchers travelled to the communities to conduct the interviews.
Part A of the interview questionnaire was designed to discover the major health issues
within communities; how the concepts community wellness and community health are
understood; how the concept of community capacity is understood and how it is seen to
relate to community health; and to determine which domains of community health and
capacity currently defined in the literature are relevant to First Nation communities, and if
any new domains exist. Part B of the interview questions related to the logic models,
which were reviewed and revised by Health Directors to reflect program delivery at the
community level. Questions also addressed how the programs were seen to contribute to
community health and capacity. Parts A and B were separated into two interview sessions.
Interview data were transcribed verbatim and the transcripts were mailed back to the
participants for review and release. Transcripts were then revised if required, and
analyzed using a grounded theory approach (Charmaz, 2000). Using a grounded theory
approach means that interpretations are grounded in the experiences of those being
interviewed, with the researcher consciously limiting preconceived notions about what the
data might or should say. Grounded theory is especially useful in uncovering unanticipated
themes and relationships. Grounded theory begins with assigning codes to text segments
and initiates the interpretation or creation of themes. Coding can be done line-by-line or in
blocks of text (Charmaz, 2000). Coding for this project was done in blocks of text in order
to retain the context in which comments were made. A qualitative data analysis software
package, Atlas.ti (versions 4.2 and 5.0) was used to support data management and
analysis. Atlas.ti is a widely used program based on grounded theory (Barry, 1998) and is
especially useful for managing the coding, analysis, and dissemination processes.
A preliminary analysis was completed for each community interview, beginning with the
themes introduced by interview participants followed by themes drawn from the interview
schedule. These summaries were then combined into one analytical document. From the

Methods
combined interview data, we created a draft framework, consisting of two diagrams that
captured participant perspectives on the concepts of community health/wellness and
capacity.
It was important that the framework be validated by the community-based Health Directors
prior to presenting them at community focus groups, so a meeting was held to review the
initial draft framework. From the feedback received at this meeting, revisions were made
to the framework and a second meeting was held with Health Directors to approve this
version.
Appendix H contains the final draft evaluative indicators framework created for
presentation to the focus groups:
Diagram 1 – Concepts of Community Health and Community Wellness
Diagram 2 – Key Domains of Community Health and Community Wellness
Focus Groups with Community Members
Focus groups were held in each of the First Nation research communities as well as in the
three provincial communities of Stony Rapids, Uranium City and Camsell Portage. In each
instance community representatives (Health Directors in the First Nations communities)
were contacted to assist with identifying participants and organizing the focus group
meeting.
A total of 59 community members took part in ten (10) focus groups, with the number of
participants in each ranging from a minimum of two to a maximum of ten (see Table 1).
Table 1
Focus Group Participants
Participants
Community Focus Groups
N=59
Stony Rapids (AHA) 10
Stony Rapids (community) 7
Uranium City 3
Camsell Portage 4
Fond du Lac 9
Black Lake 8
Hatchet Lake 7
Cumberland House 5
Red Earth 3
Wahpeton 3
Totals: 59

Methods
Focus group participants were presented with the draft evaluative framework and were
asked to respond with their views of community health and wellness (focus group
questions are in Appendix I). Participants were also asked to express these views as
additions or deletions to draft framework. As part of the discussion on each domain and
issue, community-relevant indicators were often suggested by participants.
Focus group participants were also asked to comment on the presentation of the
framework, and for their suggestions for appropriate graphics to use.
Interview data were transcribed verbatim and the transcripts were mailed back to the
participants for review and release. Each participant was asked to edit only their
comments, and not those of others in the group. Transcripts were then revised if required,
and analyzed, again using a grounded theory approach.
Coding of the focus group data was done in blocks of text in order to retain the context in
which comments were made. Each community’s focus group transcript was analyzed for
additions or deletions to the community health and capacity domains, and for new issues
and indicators. A table listing the revisions was created for each community. From the
tables, community-specific framework diagrams were created and returned to each
community. A second level of analysis created a general framework which incorporated
the domains, issues, and indicators common to all communities.
C. Development of Community Health Framework &
Indicators
Development of the comprehensive community health and wellness indicators framework

began with reviewing each domain description and making any necessary revisions to ensure
each one reflected the community definition of the domain. A set of indicator categories was
then identified within each of the domains, and issues and indicators related to each area, as
described by participants, were summarized. The next step was to search for existing data
sources that would potentially be available at the community level. The components of the
community health indicators framework are domain, indicator categories, identified issues,
community-proposed indicators and existing data sources, as illustrated in Table 2, using
Healthy Lifestyles (Self-Care) as an example.

Methods
Table 2
Community Health Indicators Framework – Components
Indicator Community-proposed
Domain Identified Issues Existing Data Sources
Categories Indicators
Healthy eating RHS Adult/Adolescent/Child
Survey – Questions 59/29/50
Health Canada 2003 Nutrition
Survey – Questions 21 & 22
Healthy socializing
Healthy self-image girls saying no to sex
Medical treatment taking medication as no indicator source
prescribed (confidentiality issues)
attendance at support groups local survey of health and
social agencies offering
Self-care
support groups
# of medical appointments no indicator source
kept/missed (confidentiality issues)
comfort with disclosing health no indicator source
issues
Healthy Healthy home keeping regular bedtime no indicator source
Lifestyles hours
limiting TV/video game use RHS Child/Adolescent Survey
– Questions 57& 69
Hygiene
Social activities
Physical activities
Participation
Elders & youth
Programming
Promotion
Environmental
conditions
Motivation Affordability
Early engagement
Nutrition/fitness
awareness
To create the toolkit for use at the community level, the information above was revised into a
more user-friendly format and organized in a binder for easy reference. The web addresses of
possible data sources were identified and referenced in the toolkit. Due to the fact that web
addresses can change without notice, we have sometimes referenced the web source at the
source level (i.e. Statistics Canada specific survey) rather than at the document level. A
student from the Indian Communication Arts Program at First Nations University created a
stylized community health and wellness indicators framework diagram, incorporating the
appropriate colours and shapes identified by our partners and community participants (see
Appendix J). An example of the user friendly format in the toolkit is provided in Appendix K,
where Indicator # 27 from the Services and Infrastructure domain, Service Delivery indicator
category is presented.

Methods
D. Pilot Testing the Framework & Indicators
The toolkit was piloted to test the framework design, format, and layout, and to assess the
availability of indicator data at the community level. A pilot community was selected at the
September 20, 2004 project meeting with community Health Directors. The choice of
community was primarily based on the availability of indicator data from Statistics Canada for
the community; due to in part to its size and its participation in recent surveys. A university
research team member travelled to the community and worked with a community member to
review the framework and the toolkit, and search for data on selected indicators. Additionally,
in April 2005 the draft Community Health Indicators Framework was presented to the health
director in the pilot community, community representatives, and representatives from the
Athabasca Health Authority, for their review and comments. The experience of conducting the
pilot and the feedback received from the pilot community was incorporated into the final
revision of the tool kit. A second phase of the project, which would see the implementation of
the toolkit in participating communities, is planned.

Methods
References
Barry, C.A. (1998). Choosing qualitative data analysis software: Atlas/ti and Nudist compared.
Sociological Research Online, 3. (Available at:
http://www.socresonline.org.uk/socresonline/3/3/4.html)
Charmaz, Kathy. (2000). “Grounded Theory: Objectivist and Constructivist Methods”, in Norman K.
Denzin and Yvonne S. Lincoln (Eds.). Handbook of Qualitative Research. Thousand Oaks,
California: Sage Productions. 509-53

Methods
A PPENDICES

Methods
Appendix A
Communities Participating in the

First Nation’s Health Development Project
Camsell Portage
Fond du Lac
Stony Rapids
Black Lake
Uranium City
Hatchet Lake
Cumberland House
Red Earth
Wahpeton
Northern Saskatchewan
First Nation’s Health Development Project Appendix A

Methods
Appendix B
MEMORANDUM OF AGREEMENT TO PARTICIPATE
Project Title: First Nation’s Health Development:

Tools for Program Planning and Evaluation
The purpose of this memorandum is to provide the terms under which each community agrees to
participate in the above project. The memorandum outlines the assistance provided by the
community contact person and the products the researchers will return to the community.
For the purposes of this project, the community contact will be the Health Director in each First
Nation community and the local leadership (or designate) in the provincial communities in the
Athabasca region.
Primary Research Team: Dr. Bonnie Jeffery, University of Regina

Dr. Sylvia Abonyi, University of Regina
Colleen Hamilton, Project Coordinator
Shawn Ahenakew, Project Assistant
Ernie Sauve, Prince Albert Grand Council
Anne Unsworth, Prince Albert Grand Council
Georgina MacDonald, Athabasca Health Authority
Lionel Bird, Northern Inter Tribal Health Authority
The community contact agrees to:
 Assist the researchers with setting up meetings to interview key informants in the
community
 Assist the researchers with setting up focus groups with Health Committee members
and with community members
 Assist the researchers in identifying a community member who will be hired and
trained to conduct interviews and assist with focus groups in the community
 Provide advice to the researchers on the appropriate methods of involving their
community in this project
 Participate in periodic research team meetings to review the deliverables developed
throughout the project
 Review information specific to their community to ensure that it accurately reflects
their program information
First Nation’s Health Development Project Appendix B-1

Methods
The researchers agree to:
 Provide a document reviewing the literature in the area of Aboriginal health and
capacity building
 Hire and provide training for any community members who may be selected to assist
with interviews and focus groups
 Provide community specific models of each program delivered in the community that
relate to health
 Provide a copy of the deliverables for review and comments
 Provide a manual suggesting the types of information that could be collected to
assist with program planning and evaluation
 Provide ongoing updates on the project work through access to a web-site Where
accessing a web-site is difficult, a CD-ROM of all the information will be provided at
regular intervals
 At all times, the researchers will maintain confidentiality of information gathered from
individual interviews and community focus groups
This document describes the terms of reference for community agreement to participate in this
project. Individual informed written consent will be obtained from those who agree to participate in
the interviews and focus groups.
This memorandum will be reviewed periodically throughout the project to ensure that the project is
being conducted in an appropriate manner in each community. Additional points may be added
throughout the duration of the project.
____________________________ ___________________
Chief Date
____________________________ ___________________
Health Portfolio Councillor Date
____________________________ ___________________
Health Director Date
____________________________ ___________________
Bonnie Jeffery Date
On behalf of the research team
First Nation’s Health Development Project Appendix B-2

Methods
Appendix C
What is a Logic Model?
(online/CD version has PDF inserted here)
First Nation’s Health Development Project Appendix C

Methods
Appendix D
PAGC Program Logic Models
Social Economic
Health Education Justice
Development Development
Sports, Culture &
Nursing Brighter Futures Justice Program Community Internet Access
Recreation
Addictions Daycare
Environmental Health Head Start
Holistic Health
Health Promotion
Diabetes
Home & Community Care
Dental Therapy
Sexual Wellness
Canadian Prenatal Nutrition
Program (CPNP)
Research Communities:
Prince Albert Grand Council: Athabasca Health Authority: Provincial:
Wahpeton Dakota First Nation Hatchet Lake Denesuline Nation Stony Rapids
Cumberland House Cree Nation Black Lake Denesuline Nation Uranium City
Red Earth Cree Nation Fond du Lac Denesuline Nation Camsell Portage
First Nation’s Health Development Project Appendix D

Methods
Appendix E
Logic Model Source Documents
Program Documents
• PAGC Brighter Futures documents: coordinator job description; Community Based

Funding Package Executive Summary; Annual Workplan – April 1, 1999 to March 31,
Brighter Futures 2000
• PAGC Annual Report – 2001-2002
• Health Canada, 2000 – First Nations and Inuit Home and Community Care Planning
Resource Kit – Service Delivery Plan 3A. www.hc-sc.gc.ca/msb
Home and Community Care • Prince Albert Grand Council Health and Social Development – Nursing Program
Workplan – April 1, 2002 to March 31, 2003
• Paskawawaskikh First Nation Home & Community Care Service Delivery Plan, April
2001
Justice Program
• PAGC Justice Program and Services document
• PAGC – Aboriginal Headstart Proposal and Budget 2000-2001, 2001-2002
• Health Canada Website – First Nations Head Start On Reserve

Headstart www.hc-sc.gc.ca/fnihb-dgspni/fnihb/cp/fnhsor/introduction.htm
• Health Canada Website – Population and Public Health Branch, Alberta/NWT

Program/Project Info – Aboriginal Head Start
www.hc-sc.gc.ca/hppb/regions/ab-nwt/program/e_ahs.html
• PAGC Daycare Package – July 2001, Section 4 – Quality Care
• Prince Albert Grand Council Health and Social Development – Daycare Workplan –
Daycare April 1, 2001 to March 31, 2002
• PAGC Monthly Activity Reports from community daycares (Fond du Lac, Red Earth,
Wahpeton,
• Prince Albert Grand Council Health and Social Development – Sexual Wellness
Workplan – April 1, 2002 to March 31, 2003
Sexual Wellness
• Prince Albert Grand Council CSHA (Canadian Strategy for HIV/AIDS) Proposal – April
2001 to March 2002
• Prince Albert Grand Council Health and Social Development-Canada Prenatal

Nutrition Program Proposal Submission Worksheet
• Prince Albert Grand Council Health and Social Development Programs and Services
Canadian Prenatal Nutrition
Program (CPNP)
• CPNP First Nations and Inuit Component – National Framework for Program
Expansion 1999/2000 – April, 2000
• Health Canada website – Population and Public Health Branch, Alberta/NWT Region
Project Info – Canada Prenatal Nutrition Program
www.hc-sc.gc.ca/hppb/regions/ab-nwt/program/e_cpnp.html
• Prince Albert Grand Council Health and Social Development Services Brochure
Diabetes
• Handout: Appendix A Goal for Continuation of the project in order of priority
• Handout: Saskatchewan Region Aboriginal Diabetes Initiative-On Reserve

Programming and Financial Report for 2000/2001 (6 pages-work plan)
First Nation’s Health Development Project Appendix E-1

Methods
Program Documents
• Community Health work plans (Health Transfer Communities)
• Health Canada Website – Aboriginal Diabetes Initiative: First Nations and Inuit in Inuit
Communities Program.
www.hc-sc.gc.ca/fnihb-dgspni/fni…cations/onreserve_program_framework.htm
• Diabetes Education Program Timeline April 2001-March 2002
• Prince Albert Grand Council Job Description: Community Diabetes Nurse Educator
• PAGC document: Duties/Responsibilities: Diabetes Program Assistant
• meeting with Education program manager – information on non-academic (i.e. social)

programs offered through the schools in the communities is only available in the
Education communities
• provided with a list of contacts – education coordinators and principals
Community Internet Access • telephone interview with Information Technology Manager
• Prince Albert Grand Council Programs and Services Brochure
• Prince Albert Grand Council – Health Social Development Dental therapy Program
Work Plan. April 1, 2002 – March 31, 2003.
Dental Therapy
• Prince Albert Grand Council-Health and Social Development Community Work Plans
• Prince Albert Grand Council Job Description: Senior Dental therapist/Dental Therapist
• PAGC Annual Report –2001-2002

Sports, Culture & Recreation • Technical Manual: Saskatchewan First Nation Winter and Summer Games.
• Prince Albert Grand Council Sports, Culture and Recreation Association Policies and
Procedures Manual
updated 5-Feb-03
First Nation’s Health Development Project Appendix E-2

Methods
Appendix F
Generic Logic Models
First Nation’s Health Development Project Appendix F

Methods
Appendix G
Phase I
INTERVIEW QUESTIONS
Health Directors
April 2003
PART A
1. Please tell me about your particular role in planning and delivering health services in your
community.
2. What would you say are the key issues that may be affecting the health of your community?
3. People often talk about the wellness of their communities. In what ways do you think
community wellness is the same as your view of community health? Is it different from your
view of community health?
4. What do you think of when you hear people talk about having capacity in your community?
(Refer to table: These are some of the ways that people define the different elements of
community capacity. I would like to go through each of these with you and ask which ones
fit for your community. What is missing from this information?)
5. We have talked a little about your views of community health and wellness and we have also
heard your views on community capacity. We are interested in knowing how you think
capacity in your community is related to the health of your community.
This is challenging for all of us to think about so, as a starting point, I would like to share how
some others see the linkages between community health, wellness, and capacity. Then I’ll
ask you to talk about which aspects of these would fit for your community and to identify
what is missing that is important in your community.
6. Do you have any other comments that you would like to make?
First Nation’s Health Development Project Appendix G-1

Methods
QUESTION #4
Examples of Community Capacity Elements:
Bjaras &
Haglund Goodman et al. Bopp et al. Laverack
Authors 1991 1998 2000 1999
Domains 1. Needs 1. Social networks 1. Shared vision 1. Participation
assessment & inter-
organizational 2. Sense of 2. Leadership
2. Leadership relationships community
3. Organizational
3. Organization 2. Community 3. Communication structures
resources
4. Resource 3. Sense of 4. Participation 4. Problem
mobilization community assessment
5. Leadership
5. Management 4. Understanding 5. Resource
community history 6. Resources, mobilization
knowledge and
5. Citizen skills 6. ‘Asking why’
participation
7. Ongoing 7. Links with
6. Community learning others
leadership
8. Role of outside
7. Skills agents
8. Community 9. Program
values management
9. Critical
reflexicity
10. Community
power

Methods
QUESTION #5
Figure 1: Basic Framework for Health Indicators
Source: Hancock, T., Labonte, R., & Edwards, R. (2000). Indicators that count! Measuring population health at the
community level. Canadian Journal of Public Health, 90(Supp 1), S22-26.
Figure 2: Community Life Indicators Wheel
Source: Leech, D., Lickers, F.H., & Haas, G. (2002). Innovating a new way for measuring the health of Aboriginal
communities. Ottawa, ON: University of Ottawa.

Methods
Phase I
INTERVIEW QUESTIONS
Health Directors
April 2003
PART B
We would like to review, with you, the program logic models that we developed based on written
program information. We will ask you to reflect on the following questions for each of the programs:
1. From your perspective, do each of the program models correctly describe the programs that
are currently being delivered in your community?
2. From your perspective how do each of these programs contribute to:
a. The health of your community?

b. The capacity of your community?

Methods
Appendix H
Draft Evaluative Indicators Framework

Presented at Focus Groups
Diagram 1 – Concepts of Community Health and Community Wellness
Diagram 2 – Key Domains of Community Health and Community Wellness
First Nation’s Health Development Project Appendix H

Methods
Appendix I
Phase II
INTERVIEW QUESTIONS
Focus Groups
1. Community Health and Community Wellness
a. What does ‘community health’ mean to you?
b. What does ‘community wellness’ mean to you?
c. When you look at the draft framework what is your understanding of:
i. Economic viability?
ii. Services and infrastructure?
iii. Food security?
iv. Healthy lifestyle?
v. Identity and culture?
vi. Health issues?
vii. Addictions?
d. Are there any areas that are missing that should be included as part of how we
would measure community health? Community wellness?
2. Community Capacity
e. What does ‘community capacity’ mean to you?
f. When you look at the draft framework what is your understanding of:
i. Understanding community history?
ii. Community values?
iii. Sense of community?
iv. Education and training?
v. Youth involvement?
vi. Leadership?
vii. Needs Assessment?
viii. Organization?
ix. Resource mobilization?
g. Are there any areas that are missing that should be included as part of how we
would measure community capacity?
First Nation’s Health Development Project Appendix I

Methods
Appendix J
Community Health Framework – Final
First Nation’s Health Development Project Appendix J-1

Methods
First Nation’s Health Development Project Appendix J-2
Methods
Appendix K
An Example from the Toolkit
Community Health Indicators Framework

Domain: Services & Infrastructure
Indicator Category: Service Delivery
Identified Issue: Elders
Indicator: #27 – Medical Translation & Companion Services
First Nation’s Health Development Project Appendix K-1

Methods
Defined as the availability and access to services and related infrastructure; respectfully
delivered health and human services; adequate and affordable housing, recreation facilities
and programming; and specialized services designed to meet the needs of Elders and
youth.
Indicators:
Community Infrastructure Service Delivery Compassionate 28 – meals on wheels program

Sewer & Water Local 19 – wait time for appointment transport. 29 – social gathering place for Elders
1 – houses with/without water & sewer 9 – services available in community 20 – compassionate policy exceptions 30 – programs & activities for Elders
2 – water borne illnesses 10 – health professionals in community 21 – cultural awareness programs 31 – local palliative care for Elders
3 – houses relying on bottled water 11 – visits by health professionals Confidential Infrastructure
Locally Staffed 12 – local service usage 22 – service confidentiality guidelines 32 – size/capacity of facility
4 – treatment facilities without staff 13 – community training in ERT 23 – staff trained on confidentiality 33 – suitability of facility
5 – facility staff from community 14 – distance from services Youth 34 – facility usage
6 – community staff training levels Consistent 24 – specific services for youth 35 – proper equipment for facility
Indicator #2 15 – frequency of health service delivery 25 – new funds for youth programs
Roads 16 – scheduled services delayed 26 – youth addiction treatment facilities Housing
7 – accidents on roads 17 – time to complete treatment plans Elders Availability
8 – repairs due to road conditions 18 – treatment completed/compromised 27 – medical translator/companion 36 – residents per house

Methods
37 – generations per house 53 – programs with proper equipment 72 – utilization of existing resources Jurisdiction Fragmentation
38 – Tuberculosis rates Programming 86 – # agencies involved in funding

39 – housing waiting lists 54 – activities available Technology 87 – resources allocated to administration
Quality 55 – summer activities available Current Participation
40 – houses in need of repair 56 – programs cancelled 73 – water/sewer technology used 88 – service staff from community
41 – quality of housing insulation 57 – participation & retention levels High Speed Internet 89 – staff turnover rates
42 – presence of black mold 58 – age range of participants 74 – internet use in the community 90 – mechanisms for participation
43 – frequency of sewer back-ups Staffing 75 – internet technology at health facility 91 – health education and awareness
44 – accidents in the home 59 – funding for trained staff 76 – distance education enrolment Collaboration
45 – EHO inspector visits 60 – programs run by staff vs volunteers 77 – internet reliability 92 – community inter-agency meetings
Elders 61 – range of programs offered Data Management 93 – regional inter-agency meetings
46 – housing units designed for Elders 62 – participation and retention levels no indicators proposed 94 – service delivery collaborations
47 – house maintenance for Elders 63 – support for recreation staff Communication
Affordable Youth Service Sustainability 95 – community newsletter

48 – low cost housing units 64 – youth centre in community Sufficient Funding 96 – community meetings
49 – % of income required for housing 65 – youth involved in programs 78 – levels of program/service funding Realistic
Jurisdiction Fragmentation 66 – school drop out rates 79 – program needs met by funding indicator #12
50 – agencies responsible for housing 67 – school absentee rates 80 – vacant positions 97 – proximity of duplicate services
51 – time to complete house repairs 68 – youth alcohol and drug use Stable Funding 98 – medical transport driver/patient ratio
Ownership Promotion 81 – long term vs short term funding 99 – funder cutbacks re: abuse perception
no indicators proposed Indicators #54, 57, 58 82 – duration of programs Staffing
69 – direct contacts to provide information 83 – programs cancelled indicator #21

Recreation Affordable 84 – staff turnover rates
Facilities 70 – cost of recreation to users indicator #80
52 – type/condition of recreation facilities 71 – volunteers assisting with programs 85 – funding commitments honoured

Methods
Services & Infrastructure >> Service Delivery >> Elders
Issues Identified: Services for Elders are seen as very important to ensuring they are involved in the community, are involved
with youth, and have the necessary supports to allow them to remain in the community as they grow old.
Community Proposed
Indicator
Medical
translation &
27 companion Local survey required
services available
and funded
Meals on wheels
28 program in Local survey required
community
Social gathering
place for Elders
(e.g. coffee
house)

Methods
Services & Infrastructure >> Service Delivery >> Medical Translation &
Companion Services
Issues Identified: Medical translation and companion services are important for the quality of
care, safety and comfort of community members traveling outside the
community for medical services. With the assistance of a translator, Elders can
communicate their needs and understand the care they receive. Safety issues
for both Elders and youth can be addressed by traveling with a companion,
which can also reduce the stress of such trips.
Proposed Indicator: # 27 – Medical translation and companion services available and funded
Suggested Measure: Compare the number of medical trips where translation and/or companion
services are provided to the number of medical trips where these services were
requested, or were deemed to be needed, but were not provided.
Step 1) Identify the # (number) of medical trips where translator or companion was requested or
deemed to be needed, within a given timeframe. This could also be broken down by group
(i.e. Elders, youth).
Step 2) Identify the # of trips where a translator or companion was provided and funded, within the
timeframe (and for the specific group).
( ) trips - translator/companion provided 15 trips - translator/companion provided

( ) trips - translator/companion requested or needed 25 trips - translator/companion requested or needed
but not provided but not provided
( ) 15
( ) 25
X 100 .06 X 100
= % translation/companion needs met = 60% translation/companion needs met

Only ten percent (60%) of the needed or requested translation or companion services are being
provided. This information could be used to demonstrate the need for more funded services, or to
identify the level of service provided to particular groups, such as Elders.
First Nation’s Health Development Toolkit Appendix K-5

Methods
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Community Health Indicators Toolkit, 2nd edition

Technical Report · January 2010

Bonnie Jeffery Sylvia Abonyi

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Community Health Indicators Toolkit

Canadian Institutes of Health Research (CIHR)

Institute of Aboriginal People’s Health (IAPH)

Institute of Population and Public Health (IPPH)

Saskatchewan Health Research Foundation (SHRF)

Northern Medical Services (NMS), University of Saskatchewan

First Nation’s Health Development Toolkit Page i

Principal Research Team

Saskatchewan First Nation Partners

Prince Albert Grand Council, Health & Social Development

Athabasca Health Authority

Northern Inter-Tribal Health Authority

First Nation’s Health Development Toolkit Page ii

First Nation’s Health Development Toolkit Page iii

The First Nation’s Health Development: Tools for

This section will help you navigate through the toolkit

First Nation’s Health Development Toolkit Page 1

1. The Evaluation Framework Diagram identifies:

Figure 1 – Evaluation Framework Diagram

First Nation’s Health Development Toolkit Page 2

table (see Figures 3 & 4)

How to Use the Toolkit

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 Go to the Healthy Lifestyles section of the toolkit, which is identified by a tab in

Figure 2 – Domain Description & Indicator List

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Figure 3 – Data Sheet Identification

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 The indicator tables contain existing statistical data on northern Saskatchewan

Figure 4 – Data Sheet Indicator Table

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Figure 5 – Data Source References

Data Source References

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Figure 6 – Tool Sheet

An excerpt from the

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Find source at: http://www.statcan.gc.ca >> (English/French) >>

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First Nation’s Health Development Toolkit

Employment Cost of Living Health Benefit Coverage

Strategic Training Food Subsidies Utility Costs 22 – medical transportation coverage

Local Business 11 – distance to services 18 – costs met by social assistance

7 – employment in local business 19 – single parent families

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25 – vacant staff positions

29 – program participation rates

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C) Northern Saskatchewan Training Needs Assessment Report 2009 – 2010

See Glossary of Unemployment Terms used by Statistics Canada (next page)

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