Survey Series on First Nations People, Métis and Inuit - Health Care Access and Experiences (SSFNPMI-HCAE)

Respondent confirmation (RC) - Question identifier:RC_R01

The following questions are for [NAME_OR_EMAIL].

Indigenous identity (ABM) - Question identifier:ABM_Q01

Are you First Nations, Métis or Inuk (Inuit)?

• 1: No, not First Nations, Métis or Inuk (Inuit)
• 2: Yes, First Nations
• 3: Yes, Métis
• 4: Yes, Inuk (Inuit)

Health care access (HCA) - Question identifier:HCA_R01

The following questions are about health care services in Canada. It incorporates routine care, diagnosis, treatment, and management of physical and mental health as well as health promotion and disease prevention.

Health care access (HCA) - Question identifier:HCA_Q01

In the past 12 months, which of the following health care services did you receive?

• 01: Consultation or treatment from a nurse practitioner
• 02: Consultation or treatment from a family doctor (i.e., general practitioner)
• 03: Consultation with a specialist medical doctor (e.g., surgeon, dental surgeon, allergist, orthopedist, cardiologist, optometrist)
• 04: Treatment for or monitoring of a chronic condition (e.g., high blood pressure, heart disease, kidney disease, diabetes
  Exclude cancer.)
• 05: Dental care (e.g., dental cleaning, denture fitting, cavity fillings)
• 06: Cancer treatment (e.g., radiation, chemotherapy)
• 07: Screening or diagnostic testing (e.g., blood work, cancer screening, x-rays, pap test, mammogram)
• 08: Reproductive care or gynaecological services (e.g., prenatal or postnatal, maternity, fertility treatment of gynaecological concerns or problems, abortion or pregnancy termination services)
• 09: Surgery
• 10: Mental health or addiction services such as counselling or therapy
• 11: Traditional or spiritual healer, knowledge keeper, medicine person, or Elder
• 12: Other health care service (e.g., physiotherapy, massage therapy)
• 13: None of the above

Health care access (HCA) - Question identifier:HCA_Q03

In the past 12 months, did you have to travel outside your community, village, town, or city where you had to be away from home for at least one night to access any health care services?

• 1: Yes
• 2: No

Health care access (HCA) - Question identifier:HCA_Q04

Thinking of the most recent time in the past 12 months where you had to travel outside your community, village, town, or city where you had to be away from home for at least one night to access any health care services, how far away was it?

• 1: Less than 500 km
• 2: 500 km to less than 1,000 km
• 3: 1,000 km to less than 1,500 km
• 4: 1,500 km or more
• 9: DK

Health care access (HCA) - Question identifier:HCA_Q08

How important is it for you to have health care services that support [First Nations/Métis/Inuit/First Nations or Métis/First Nations or Inuit/Métis or Inuit/First Nations, Métis or Inuit] traditional medicines, healing and wellness practices in the Canadian health care system?

• 1: Very important
• 2: Somewhat important
• 3: Not very important
• 4: Not important at all

Health care access (HCA) - Question identifier:HCA_Q09

Why is it important for you to have health care services that support [First Nations/Métis/Inuit/First Nations or Métis/First Nations or Inuit/Métis or Inuit/First Nations, Métis or Inuit] traditional medicines, healing and wellness practices?

• 1: They provide a better overall quality of care than health care services that do not support these practices
• 2: You feel respected for your culture, beliefs and identity when using these services (e.g., you feel less judged)
• 3: You feel safer discussing sensitive or traumatic experiences
• 4: You would be more likely to seek health care if these services were available
• 5: Other reason
• 6: Prefer not to say

Discrimination in health care (DHC) - Question identifier:DHC_R01

The following section deals with questions that could be sensitive to some people. It is important that we ask these questions of everyone to give us an understanding of what people have experienced in their lives.
Remember that all information provided is strictly confidential.

Discrimination in health care (DHC) - Question identifier:DHC_Q01

In the past 12 months, did you experience any unfair treatment, racism or discrimination from any health care professional based on any of the following?

• 01: Your First Nations, Métis, or Inuit identity
• 02: Your ethnicity or culture
• 03: Your race or skin colour
• 04: Your religion or spiritual beliefs
• 05: Your language
• 06: Your accent
• 07: Your physical appearance (Include discrimination on the basis of weight, height, hair style or colour, clothing, jewelry, tattoos and other physical characteristics.
  Exclude discrimination on the basis of skin colour.)
• 08: Your gender (Include men (cisgender and transgender), women (cisgender and transgender) and people who are not exclusively men or women, for example, non-binary, agender, gender fluid, queer, IndigiQueer or Two-Spirit.)
• 09: Your sex at birth (Sex at birth refers to the sex recorded on a person's first birth certificate.)
• 10: Your sexual orientation (Include all sexual orientations such as people who are lesbian, gay, bisexual, heterosexual, or another sexual orientation than heterosexual such as Two-Spirit or IndigiQueer.)
• 11: Your age
• 12: A physical or mental disability
• 13: Some other reason
• 14: Did not experience any unfair treatment, racism or discrimination from any health care professional in the past 12 months

Discrimination in health care (DHC) - Question identifier:DHC_Q02

Thinking of all the times in the past 12 months when you experienced any unfair treatment, racism or discrimination in a health care setting, did you experience any of the following?

• 01: You were treated with less courtesy and respect than others
• 02: You felt you were being stereotyped (e.g., repeatedly asked if you have problems with alcohol, drugs, or pain medication)
• 03: Your intelligence was questioned
• 04: You were perceived as someone to be afraid of
• 05: Your health concerns were minimized or dismissed
• 06: You had to wait longer to receive care than others
• 07: Your cultural protocols were not respected (e.g., not allowed to smudge or use traditional medicines, not allowed to eat country food, removing medicine bag without permission)
• 08: Other unfair treatment, racism or discrimination you experienced
• 09: None of the above

Discrimination in health care (DHC) - Question identifier:DHC_Q03

Thinking of all the times in the past 12 months when you experienced any unfair treatment, racism or discrimination in a health care setting, in what situations did you experience this?

• 01: In a doctor's office
• 02: In a nurse's office or nursing station
• 03: In a mental health practitioner's office (e.g., psychologist, social worker, psychotherapist, psychiatrist)
• 04: In a community health centre
• 05: In a walk-in clinic
• 06: On a telephone health line or virtual appointment (e.g., HealthLinks, Telehealth Ontario, Health-Line, TeleCare, Info-Santé)
• 07: In a hospital emergency room
• 08: In another hospital service (e.g., MRI, day surgery, CT scan)
• 09: Other health care related situation
• 10: None of the above

Health care needs (HCN) - Question identifier:HCN_Q01

During the past 12 months, was there ever a time when you felt that you needed health care, but you did not receive it?

• 1: Yes
• 2: No

Health care needs (HCN) - Question identifier:HCN_Q02

Which of the following were reasons why you did not receive the health care services that you felt you needed?

• 01: Not given the correct treatment or prescription
• 02: Difficulty getting a referral to a specialist
• 03: Awareness of discrimination or racism in the health care system (e.g., negative experiences of self or family members, services were not culturally safe, lack of trust, stereotyping, social services were called)
• 04: Language barrier (e.g., no service in your official language of choice, or in your Indigenous language)
• 05: Supplemental health insurance coverage was denied (e.g., services were not covered by Non-insured Health Benefits (NIHB))
• 06: No health care services in your area or health care services are too far away
• 07: Did not have access to transportation or cost for travel too high (e.g., did not own vehicle, lack of access to, or cost of public transportation, taxi, plane)
• 08: Lack of available childcare or cost for childcare was too high
• 09: Used own traditional healing methods, ceremonies, and medicines
• 10: Lack of available, culturally appropriate health services
• 11: Health care services not accessible (e.g., physical disabilities, mental health conditions)
• 12: Other reason you did not receive the health care service that you felt you needed
• 13: None of the above

Mental health care needs (MHN) - Question identifier:MHN_R01

The following question is about your mental health.

Mental health care needs (MHN) - Question identifier:MHN_Q01

In general, how is your mental health?

• 1: Excellent
• 2: Very good
• 3: Good
• 4: Fair
• 5: Poor

Mental health care needs (MHN) - Question identifier:MHN_R02

The following questions are about mental health care.

Mental health care needs (MHN) - Question identifier:MHN_Q02

During the past 12 months, was there ever a time when you felt that you needed mental health care, whether or not you received it?

• 1: Yes
• 2: No

Mental health care needs (MHN) - Question identifier:MHN_Q03

To what extent do you feel your mental health care needs were met?

• 1: You sought mental health care, and your needs were fully met
• 2: You sought mental health care, and your needs were partially met
• 3: You sought mental health care, and your needs were unmet
• 4: You did not seek mental health care

Timely access to a health care provider (TAH) - Question identifier:TAH_R01

The next question is about non-urgent primary health care needs that you may have had in the past 12 months.

Timely access to a health care provider (TAH) - Question identifier:TAH_Q01

In the past 12 months, did you consult a health care provider for a non-urgent primary health care need?

• 1: Yes
• 2: No

Timely access to a health care provider (TAH) - Question identifier:TAH_R02

The following questions are about the most recent time you consulted a health care provider for a non-urgent primary health care need in the past 12 months.

Timely access to a health care provider (TAH) - Question identifier:TAH_Q02

How long did you have to wait between the time you requested care and when you spoke with a health care provider?

• 01: On the same day
• 02: The next day
• 03: 2 to 3 days
• 04: 4 to 6 days
• 05: 1 week to less than 2 weeks
• 06: 2 weeks to less than 1 month
• 07: 1 month to less than 3 months
• 08: 3 months to less than 6 months
• 09: 6 months or more

Timely access to a health care provider (TAH) - Question identifier:TAH_Q03

How satisfied were you with the time you had to wait between requesting care and when you spoke with a primary health care provider?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied

Difficulty accessing prescription medications (MEU) - Question identifier:MEU_R25

The next few questions are about prescription medication.

Difficulty accessing prescription medications (MEU) - Question identifier:MEU_Q25

In the past 12 months, did you have any prescriptions for medication?

• 1: Yes
• 2: No

Difficulty accessing prescription medications (MEU) - Question identifier:MEU_Q35

In the past 12 months, did you do any of the following because of the cost of your prescription medications?

Did you:

• 1: Not fill or collect a prescription medication
• 2: Skip doses of your prescription medication
• 3: Reduce the dosage of your prescription medication
• 4: Delay filling or refilling a prescription medication
• 5: Other decision due to cost of prescription medications
• 6: Did not do any of the above because of the cost of your prescription medications

Difficulty accessing prescription medications (MEU) - Question identifier:MEU_Q40

In the past 12 months, were you unable to fill a prescription when you needed it because of any of the following problems?

• 1: Unable to get new prescription from health care provider
• 2: Unable to fill enough prescription due to 30-day limit on prescriptions
• 3: Unable to fill prescription because of challenges going to the pharmacy (e.g., cost of transportation or lack of access to transportation)
• 4: Pharmacist changing dosage or brand of medication
• 5: Medication not available (e.g., shortage)
• 6: Other reason you were unable to fill a prescription when you needed it
• 7: None of the above