The Red River Cart Model: a Métis conceptualization of health and well-being in the context of HIV and other STBBI

OBJECTIVES: Métis people experience health inequities and often face discrimination when accessing health services. Métis-specific services are limited, and pan-Indigenous approaches to health services fail to acknowledge heterogenous identities and distinct health needs of the Métis. This study explored a Métis response to HIV and other sexually transmitted and blood borne infections to inform public health services development for Métis people. METHODS: As part of the DRUM & SASH Project, this study used a community-based research approach which privileged Métis knowledges and processes. Three gathering circles were held in Alberta, Canada, with self-identified Métis individuals who had lived experience or intimate knowledge of HIV/hepatitis C or worked in HIV/HCV service provision. The gathering circle process integrated Métis cultural practices in discussions about Métis understandings of health. Gathering circles transcripts were used to inform the description of the model emerging through the dialogue. RESULTS: Twelve diverse Métis people participated in gathering circles. Participants identified 12 determinants of health and well-being grounded in Métis culture and imagery, including Métis medicine bag, fiddle, cart tarp, flag, Capote coat, sash, York boat, moccasins, grub box, weapons, tools, and stove. The Red River Cart Model, a Métis-specific model of health to guide service planning, was created from these discussions. CONCLUSION: The Red River Cart Model provides a holistic view of the determinants of Métis health and has potential as a collaborative client assessment resource for STBBI community health service providers. Additionally, this model may be helpful to other health service providers for developing Métis-specific/informed services and improving cultural safety for the Métis.