Table 6 Key themes identified as facilitators/strengths and barriers/roadblocks to enhancing health and wellness by and with Indigenous youth in Canada [n = 20]

1.

Promoting strength-based approaches to youth engagement

19 (95.0)

[5, 8, 16, 44, 57, 71,72,73,74,75,76,77,78,79,80,81,82,83,84]

1.

Lack of community support (social, financial, organizational for wellness promotion among Indigenous youth)

11 (55.0)

[5, 44, 57, 72, 74,75,76,77,78, 80, 81]

1a

Peer-to-peer mentoring (Indigenous youth mentored by, and with other Indigenous youth)

15 (75.0)

[5, 8, 44, 57, 71, 73,74,75,76, 79,80,81,82,83,84]

2.

Structural and organizational issues within Indigenous communities with regards to wellness promotion programs

10 (50.0)

[5, 8, 72, 73, 76,77,78, 81,82,83]

1b

Engaging youth in activities that develop and promote self-determination, capacity budling, and empowerment (e.g., guided storyboarding, performative art, arts-based therapy, etc.)

15 (75.0)

[5, 8, 44, 57, 72,73,74, 76,77,78,79,80, 82,83,84]

2a

Community concerns affecting the sustainability of instituted wellness programs/strategies

4 (20.0)

[5, 8, 78, 81]

1c

Building positive relationships with one another, with nature and the environment

14 (70.0)

[5, 8, 44, 57, 72, 73, 76, 77, 79,80,81,82,83,84]

2b

Dogmatism about definitions regarding traditions of health among Indigenous communities

4 (20.0)

[72, 77, 82, 83]

1d

Showing kindness to one another

9 (45.0)

[5, 16, 44, 57, 77, 79,80,81, 83]

2c

Social and structural instability within communities

3 (15.0)

[8, 76, 83]

1e

Engaging youth in discussions/conversations to stimulate critical consciousness, mutual learning, and transformative change.

6 (30.0)

[5, 8, 75, 76, 79, 81]

2d

Low capacity of service providers (e.g., vendors, health service centers, social service centers, etc.) to meet the demands of communities.

3 (15.0)

[73, 78, 81]

1f

Engaging youth in traditional sporting activities

4 (20.0)

[57, 76, 82, 83]

2e

Misperception of a lack of control for self-governance in Indigenous communities

1 (5.0)

[81]

2.

Promoting cultural identity and connectedness by engaging youth in cultural activities during health and wellness programs or pursuits

16 (80.0)

[8, 16, 40, 44, 57, 71, 72, 75,76,77, 79,80,81,82,83,84]

3.

Discrimination and social exclusion of Indigenous youth

8 (40.0)

[5, 8, 44, 57, 74, 76, 80, 83]

3.

Reliance on Elders’ or Knowledge Keepers’ (and Community leaders) wisdom, skills, and teachings in pursuing health and wellness programs by, for and with Indigenous youth

10 (50.0)

[5, 16, 44, 72, 77, 79,80,81, 83, 84]

3a

Racism (personal, interpersonal, structural, and systemic racism)

5 (25.0)

[5, 8, 76, 80, 83]

4.

Taking personal responsibility for one’s wellness journey

8 (40.0)

[44, 57, 72, 74, 79, 80, 82, 83]

3b

Low view of self and self-identity (i.e., self-deprecation and self-exclusion from engaging in youth activities)

5 (25.0)

[8, 44, 76, 80, 83]

5.

Providing access to health services and other wellness supports (including traditional health services)

2 (10.0)

[76, 78]

3c

Mental health stigmatization (personal, interpersonal, structural, and systemic racism)

3 (15.0)

[73, 74, 76]

3d

Lack of inclusivity of Indigenous traditional activities into Canadian teaching institutions

2 (10.0)

[76, 77]

3e

Bullying, hunger and abuse

2 (10.0)

[57, 80]

4.

Cultural illiteracy among Indigenous youth

7 (35.0)

[44, 57, 73,74,75, 83, 84]

5.

Cultural discordance with mainstream health systems and services

6 (30.0)

[5, 8, 43, 44, 74, 76]

5a

Discordance between Western and Indigenous approaches to health and wellness.

4 (20.0)

[8, 43, 44, 76]

5b

Mistrust of mainstream health services leading to hesitancy to receive support when offered

3 (15.0)

[5, 74, 76]

6.

Addictions and risky behaviors (e.g., substance use, gang activity, etc.)

5 (25.0)

[44, 57, 75, 76, 80]