Knowledge & Research

Project Scope

The ACHH Initiative’s ultimate goal is to gather and combine traditional and Western knowledge to better understand how Indigenous children’s pain is experienced, expressed, interpreted, assessed and treated. What began in one Indigenous community (Eskasoni First Nation) expanded to three maritime communities and will now be expanding to additional communities across the country and internationally in the coming years.

Early research findings suggest that a complex mix of factors have led to a cultural divide for First Nations children in pain and non-Indigenous health care providers. We want to help bridge that gap.

Western-based health care professionals use pain measurements like facial expressions and numeric scales which may not be accurate tools for diagnosis and treatment of Indigenous children’s pain. Issues of discrimination and intergenerational trauma (including residential school experiences), as well as a lack of understanding of cultural traditions by health professionals, have added to the problem.

Why it’s important

Research shows that chronic illness in First Nations communities is almost three times what it is in the general population, and Indigenous children have higher rates of painful conditions, more injuries, and more painful ear, dental and musculoskeletal issues.

These high rates of painful conditions impact Indigenous children’s ability to grow, learn and achieve the same outcomes as other kids. The measurement and treatment of Indigenous children’s hurt needs to be urgently addressed.

Project Goals and Objectives


  • To collect Indigenous community members’ perspectives on how pain is expressed, interpreted, and managed in Indigenous children;
  • To determine the best ‘self-report’ pain mechanisms appropriate for Indigenous children; and
  • To examine provincial health indicators.


  • Phase 1: Using qualitative methods of storytelling and art we will explore the questions raised from the original Eskasoni-based research, and determine if the same perspectives are held in other Indigenous communities.
  • Phase 2: Using both qualitative and quantitative methods we will develop and test the ACHH Kids Hurt App,  created by and for Indigenous children using culturally relevant narrative and visual representations.
  • Phase 3: Using quantitative data we will explore and compare Indigenous and non-Indigenous children’s pain-related health care data, such as health care utilization and diagnoses.
  • Phase 4: Drawing on the collective knowledge gained and filtered through the team’s Two-Eyed Seeing perspectives, we will share our knowledge with health professionals and students, communities, universities and hospitals. This sharing could take the form of university courses, videos, continuing education, publications, and more!

Find out more

Check out our Presentations and Publications page to see when we’re coming to your area to share our results!