Marion Maar, PhD

Co-creating Vaccine Confidence though Anishinabe Theatre: COVID-19 Vaccination Uptake in Indigenous Youth and Young Adults

This project is newly started in late 2021. We will work to co-create a culturally grounded, evidence-based, youth/young adult-engaged health education intervention. We will incorporate what is known about promising practices in vaccine confidence within a strengths-based community-based participatory (CBPR) framework. The work will be guided by (1) Indigenous experts in public health, culture, theatre and art, leadership, research ethics and engagement, and (2) co-led by academics in health, medicine, serious game development, and (3) most importantly, those with lived experience of being young Indigenous people (First Nations, Métis). We consider serious games in the broader sense, to include non-digital as well as digital experiences that have an explicit and carefully thought-out educational purpose but are still enjoyable!

Intimate Partner Violence and Healthy Relationships

Rizkalla K, Reade M, McGregor L, Pilon R, Maar M.  Intimate Partner Violence against Indigenous Men in Heterosexual Relationships: Towards a Cultural Safe Response in Primary Health Care Settings. International Journal of Indigenous Health. 16(1): 261-274. 2021. https://doi.org/10.32799/ijih.v16i1.33060

Rizkalla K, Maar M, Pilon R, McGregor L, Reade M. Improving the Response of Primary Care Providers to Rural First Nation Women who Experience Intimate Partner Violence: A Qualitative Study. BMC Women’s Health. 20(1): 209. 2020. https://doi.org/10.1186/s12905-020-01053-y

Bennett B, Maar M, Manitowabi D, Moeke-Pickering T, Trudeau-Peltier D, Trudeau S. The Gaataa’aabing Visual Research Method: A Culturally Safe Anishinaabek Adaptation of Photovoice. International Journal of Qualitative Methods. 18: 1-12. 2019. https://doi.org/10.1177/1609406919851635

The Noojamadaa Exhibit displays pictures curated by Indigenous community members, representing the meaning of healthy Indigenous relationships. As an extension to this exhibit, attendees are invited to participate in a thoughtful community experience by joining Indigenous artists in conversations about reconciliation. Artists have included Debajehmujig Storytellers, Randy Trudeau Sheila Trudeau, Mariette Sutherland and others. https://www.seven-grandfathers.ca/noojamadaa-exhibit.html . Select Exhibit location and dates:

• 2019/2 Chiefs of Ontario Research Symposium (Invited)
• 2018/6 McMaster University (Invited)
• 2018/4 Queen’s Park Government of Ontario (Invited)
• 2017/9 Organization: JEH MacDonald House, Vaughan, Ontario (Invited) in collaboration with “I.AM: Intergenerational Arts Movement” and “Debajehmujig Storytellers”
• 2017/3 McEwen School of Architecture (Invited) https://www.sudbury.com/lifestyle/lets-heal-noojamadaa-exhibit-open-until-the-end-of-the-month-571829
  https://www.manitoulin.com/photovoice-exhibit-tackles-intimate-violence-positive-images-displayed-architecture-school/
  https://kimfahner.wordpress.com/2017/03/27/a-reflection-on-the-noojamadaa-exhibit-and-howphotographs-speak/
• Manitoulin Debajehmujig Creation Centre https://www.manitoulin.com/innovative-photo-exhibit-debajehmujig-gives-voice-families/

Indigenous Health and Wellness

In collaboration with traditional knowledge keepers, we examined the role of traditional Anishinabe healing in mental wellness and recovery from addictions. Unique is our discussion of the reality of merging two healing traditions in terms of culture, and protection of clients, healers, clinicians, and Aboriginal knowledge, based on many years of study on Manitoulin Island.

Maar M, Shawande M. Traditional Anishinabe Healing in a Clinical Setting: The Development of an Aboriginal Interdisciplinary Approach to Community-based Aboriginal Mental Health Care. Journal of Aboriginal Health. 6(1): 18-27. 2010. https://doi.org/10.3138/ijih.v6i1.28993

Maar M, Erskine B, McGregor L, Larose T, Sutherland M, Graham D, Shawande M, Gordon T.                                Innovations on a shoestring: A Study of a Collaborative Community-based Aboriginal Mental Health Service Model in Rural Canada. International Journal of Mental Health Systems. 3(27). 2009. http://www.ijmhs.com/content/3/1/27

Maar M. Clearing the Path for Community Health Empowerment: Integrating Health Care Services at an Aboriginal Health Access Centre in Rural North Central Ontario. Journal of Aboriginal Health. 1: 54-64. 2004. https://jps.library.utoronto.ca/index.php/ijih/article/view/28932/24054

Land based Healing

[Link to Website https://www.seven-grandfathers.ca]

Maar M, Ominika T, Manitowabi D. Community-led Recovery from the Opioid Crisis through Culturally-based Programs and Community-based Data Governance. International Indigenous Policy Journal. 13(2):1-28. 2022.  https://doi.org/10.18584/iipj.2022.13.2.13792

Indigenous Chronic Illness Care

McGregor L, Maar M, Young N, Toulouse P. Keeping Kids Safe: Caregiver’s Perspectives on the Determinants of Children’s Physical Activity in Rural Indigenous Communities. Rural and Remote Health. 19(1): 4833. 2019. https://doi.org/10.22605/rrh4833

McGregor L, Toulouse P, Maar M, Young N. Caregivers’ Perspectives on the Determinants of Dietary Decisions in Six First Nation Communities. International Journal of Indigenous Health. 13(1):122-139. 2018. https://doi.org/10.32799/ijih.v13i1.30306

Pilon R, Benoit M, Maar M, Cote-Meek S, Assinewe F, Daybutch G. Decolonizing Diabetes. International Journal of Indigenous Health. 14(2): 252-275. 2019. https://doi.org/10.32799/ijih.v14i2.31895

Manitowabi D, Maar M. “We stopped sharing when we became civilized”: A Model of Colonialism as a Determinant of Indigenous Health in Canada. Journal of Indigenous Social Development. 7(1): 1-19. 2018. https://journalhosting.ucalgary.ca/index.php/jisd/article/view/58480/43984

Maar M, Burchell A, Little J, et al. A Qualitative Study of Provider Perspectives of Structural Barriers to Cervical Cancer Screening Among First Nations Women. Women’s Health Issues. 23(5): 319-325. 2013. https://doi.org/10.1016/j.whi.2013.06.005

Maar MA, Manitowabi D, Gzik D, McGregor L, Corbiere C. Serious Complications for Patients, Care Providers and Policy Makers: Tackling the Structural Violence of First Nations People Living with Diabetes in Canada. International Indigenous Policy Journal. 2(1). 2011. https://doi.org/10.18584/iipj.2011.2.1.6

Maar M, Gzik D, Larose T. Beyond Expectations: Why do Aboriginal and Euro-Canadian patients with type 2 diabetes on a northern, rural island demonstrate better outcomes for glycemic, blood pressure and lipid management than comparison populations?. Canadian Journal of Diabetes. 34(2): 127-135. 2010. https://doi.org/10.1016/S1499-2671(10)42009-2

International Collaborations: DREAM GLOBAL

My research in this area is focused on implementation science and Indigenous cultural considerations in the process evaluations of pragmatic clinical trials, especially in eHealth. With collaborating co-authors, we have created best practices based on five years of data collection that focus on integration of cultural perspectives in implementation science.

DREAM-GLOBAL (Diagnosing hypertension—Engaging Action and Management in Getting Lower Blood Pressure in Indigenous and low- and middle-income countries) studied a culturally based SMS text messaging–based system for blood pressure measurement and hypertension management in Canadian Indigenous and Tanzanian communities. Publications include:

Tobe SW, Yeates K, Campbell NRC, Maar MA, Perkins N, Liu PP, Sleeth J, McAllister C, Hua-Stewart D, Wells G, Bernick J. Diagnosing hypertension in Indigenous Canadians (DREAM-GLOBAL): A randomized controlled trial to compare the effectiveness of short message service messaging for management of hypertension: Main results. The Journal of Clinical Hypertension. 21: 29-36. 2019. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.13434

Limbani F, Goudge J, Joshi R, Maar MA, et al. Process evaluation in the field: global   learnings from seven implementation research hypertension projects in low-and middle-income countries. BMC Public Health. 19(953): 1-11. 2019. https://doi.org/10.1186/s12889-019-7261-8

Maar M, Beaudin V, Yeates K, Boesch L, Liu P, Madjedi K, Perkins N, Hua-Stewart D, Beaudin F, Wabano MJ, Tobe SW. Wise practices for Cultural Safety in Electronic Health Research and Clinical Trials with Indigenous People: Secondary Analysis of a Randomized Clinical Trial. Journal of Medical Internet Research. 21(11): e14203. 2019. http://dx.doi.org/10.2196/14203

Barsky J, Hunter R, McAllister C, Yeates K, Campbell N, Liu P, Perkins N, Hua-Stewart D, Maar M, Tobe SW. Evaluation of Implementation, User Perspectives and Feedback from DREAM-GLOBAL, a mobile Health Intervention in Canadian Indigenous and Tanzanian Communities for Individuals living with Hypertension (Preprint). JMIR mHealth and uHealth. 12. 2018. http://dx.doi.org/10.2196/preprints.12639

Yeates K, Campbell N, Maar MA, Perkins N, Liu P, Sleeth J, Smith C, McAllister C, Hua-Stewart D, Wells G, Tobe SW. The Effectiveness of Text Messaging for Detection and Management of Hypertension in Indigenous People in Canada: Protocol for a Randomized Controlled Trial. JMIR Research Protocols. 6(12): e244. 2017. https://doi.org/10.2196/resprot.7139

Maar MA, Yeates K, Perkins N, Boesch L, Hua-Stewart D, Liu P, Sleeth J, Tobe SW.  A Framework for the Study of Complex mHealth Interventions in Diverse Cultural Settings. JMIR Mhealth Uhealth. 5(4):e47. 2017. https://doi.org/10.2196/mhealth.7044

Maar M, Yeates K, Toth Z, Barron M, Boesch L, Hua- Stewart D, Liu P, Perkins N, Sleeth J, Wabano MJ, Williamson P, Tobe SW. Unpacking the Black Box: A Formative Research Approach to the Development of Theory-Driven, Evidence-Based, and Culturally Safe Text Messages in Mobile Health Interventions. JMIR Mhealth Uhealth. 4(1): e10. 2016. https://doi.org/10.2196/mhealth.4994

Tobe SW, Maar M, Roy MA, Warburton DE. Preventing Cardiovascular and Renal Disease in Canada’s Aboriginal Populations Canadian Canada’s Aboriginal Populations. Canadian Journal of Cardiology. 31(9): 1124–1129. 2015. https://doi.org/10.1016/j.cjca.2015.05.024

Maar M, Yeates K, Barron M, Hua D, Liu P, Moy Lum-Kwong M, Perkins N, Sleeth J, Tobe J, Wabano MJ, Williamson P, Tobe SW. I-RREACH: An engagement and assessment tool for improving implementation readiness of researchers, organizations and communities in complex interventions. Implementation Science. 10(64): 1-13. 2015. https://doi.org/10.1186/s13012-015-0257-6

Medical Education Research

Bessette N, Reade M, McGregor L, Berti J, Naokwegijig B, Maar M. Culturally Safe Practices in the Co-creation of Medical Education Curriculum with Indigenous Animators: Outcomes from an Indigenous Learning Circle. Journal of Medical Education and Curricular Development. 2023. (Forthcoming)

Maar M, McGregor L, Desjardins D, Delaney KZ, Bessette N, Reade M. Teaching Culturally Safe Care in Simulated Cultural Communication Scenarios during the COVID-19 Pandemic: Virtual Visits with Indigenous Animators. Journal of Medical Education and Curricular Development. 9: 1-12. 2022 https://doi.org/10.1177/23821205221091034

Hudson, G.L, Maar, M. The Making of the World’s Only Medical School Mandatory Placement in Indigenous Communities: Northern Ontario School of Medicine (NOSM). In Transforming Medical Education: Historical Case Studies of Teaching, Learning, and Belonging in Medicine, edited by D. Gavrus, S. Lamb. McGill-Queen’s University Press, 2022. 252-277

Maar M, Bessette N, McGregor L, Lovelace A, Reade M. Co-creating Simulated Cultural Communication Scenarios with Indigenous Animators: An Evaluation of Innovative Clinical Cultural Safety Curriculum. Journal of Medical Education and Curricular Development. 7: 1-9. 2020. https://doi.org/10.1177/2382120520980488

Phillips SP, Webber J, Imbeau S, Quaife T, Hagan D, Maar M, Abourbih J. Sexual Harassment of Canadian Medical Students: A National Survey. EClinicalMedicine. 7: 15-20. 2019. https://doi.org/10.1016/j.eclinm.2019.01.008

Strasser R, Hogenbirk JC, Jacklin K, Maar M, Hudson GL, Warry W, Cheu H, Dube T, Carson D. Community engagement: A central feature of NOSM’s socially accountable distributed medical education. Canadian Medical Education Journal. 9(1): e33-e43. 2018. https://journalhosting.ucalgary.ca/index.php/cmej/article/view/42151

Maar M, Boesch L, Tobe SW. Enhancing Indigenous health research capacity in northern Ontario through distributed community engaged medical education at NOSM: A qualitative evaluation of the community engagement through research pilot program. Canadian Medical Education Journal. 9(1): e21-e32. 2018. https://journalhosting.ucalgary.ca/index.php/cmej/article/view/42187

Reade M, Maar M, Cardinal N, Boesch L, Lacarte S, Rollins T, Jeeves N. The Impact of Hidden Curriculum in Wilderness-Based Educational Events on Interprofessional Competencies: A Mixed-Methods Study. Journal of Research in Interprofessional Practice and Education. 6(2): 1-16. 2017. http://dx.doi.org/10.22230/jripe.2017v6n2a235

Smith HA, Reade M, Maar M, Jeeves N. Developing a grounded theory for interprofessional collaboration acquisition using facilitator and actor perspectives in simulated wilderness medical emergencies. Rural and Remote Health (Internet). 17(1): 3880. 2017. https://doi.org/10.22605/RRH3880

Allen D, Abourbih J, Maar M, Boesch L, Goertzen J, Cervin C. Does a one-day workshop improve clinical faculty’s comfort and behaviour in practicing and teaching evidence-based medicine? A Canadian mixed methods study. BMJ Open. 7(7): e015174. 2017. http://dx.doi.org/10.1136/bmjopen-2016-015174

Hudson G, Maar M. Faculty analysis of distributed medical education in Northern Canadian Aboriginal communities. Journal of Rural and Remote Health. 14(4): 20. 2014. https://doi.org/10.22605/RRH2664

Participatory Action Research Methods

Maar M, Conners E, Fancott C, Mussel W, Papadopoulos D. Developing Relationships on a Shared Path to Reconciliation: The Core of Health Transformation and Safe Care for Indigenous People. Healthcare Quarterly. 25(2): 16-24. 2022.  http://doi:10.12927/hcq.2022.26894

Manitowabi D, Maar M. (Invited) The Ethical Space of Respect in Indigenous Health Community-Based Participatory Research. In, Indigenous Research in Canada, edited by J.P. Restoule, E.J. Thompson, and D. McGregor. Canadian Scholars’ Press, Accepted 2022.

Manitowabi D, Maar M. (Invited) Applying Indigenous Health Community-Based Participatory Research. In Indigenous Research: Theories, Practices, and Relationships, edited by D. McGregor, J.P. Restoule, R. Johnston. Canadian Scholars’ Press, pp. 238-260, 2018.

Cidro J, Maar M, Peressini S, Schroth RJ, Broughton J, Jamieson L, Lawrence HP. Strategies for Meaningful Engagement between Community-Based Researchers and First Nations Participants. Frontiers in Public Health. 5: 138. 2017.          https://dx.doi.org/10.3389/fpubh.2017.00138

Lawrence HP, Cidro J, Isaac-Mann S, Peressini S, Maar M, Schroth R, Gordon J, Norman C, Hoffman-Goetz L, Broughton J, Jamieson L. Racism and Oral Health Outcomes among Pregnant Canadian Aboriginal Women. Journal of Health Care for the Poor and Underserved. 27: 178-206. 2016. https://doi.org/10.1353/hpu.2016.0030

Manitowabi D, Maar M. (Invited) Coping With Colonization: Aboriginal Diabetes on Manitoulin Island. In Indigenous Bodies: Reviewing, Relocating, Reclaiming, edited by J. Fear-Segal, R. Tillett. SUNY, 2013.

Manitowabi D, Maar M. The Impact of Socioeconomic Interventions on Anishinaabek Health and Wellbeing. In Anishinaabewin Niiiwin, Four Rising Winds, edited by A. Corbiere, D. McGregor, C. Migwans. Ojibwe Cultural Foundation, pp. 97-112, 2013.

Maar M, Lightfoot N, Sutherland M, Strasser R, Wilson KJ, Lidstone-Jones CM, Graham DG, Beaudin R, Daybutch GA, Dokis BR, Lesage MT, Raymond M, Williamson P. Thinking Outside the Box: Aboriginal Peoples’ Suggestions for Conducting Health Studies with Aboriginal Communities. Public Health. 125(11): 747-753. 2011. https://doi.org/10.1016/j.puhe.2011.08.006

Maar M, Seymour B, Sanderson L, Boesch L. Reaching Agreement for an Aboriginal e-Health Research Agenda: The Aboriginal Telehealth Knowledge Circle Consensus Method. Rural and Remote Health. 10(1):1299. 2010. https://www.rrh.org.au/journal/article/1299

Lightfoot N, Strasser R, Maar M, Jacklin, K. Challenges and rewards of health research in northern, rural, and remote communities. Annals of Epidemiology. 18(6): 507-514. 2008. http://dx.doi.org/10.1016/j.annepidem.2007.11.016

Maar M, Sutherland M, McGregor L. (Invited) A Regional Model for Ethical Engagement: The First Nations Research Ethics Committee on Manitoulin Island. In Aboriginal Policy Research. Moving Forward, Making a Difference (IV), edited by J.P. White, S. Wingert, D. Beavon, P. Maxim. Thompson Education Publishing, 2007.