Health equity is a global concern. Although health equity extends far beyond the equitable distribution of healthcare, equitable access to healthcare is essential to the achievement of health equity. In Canada, Indigenous Peoples experience inequities in health and healthcare access. Cultural safety and trauma‐ and violence‐informed care have been proposed as models of care to improve healthcare access, yet practitioners lack guidance on how to implement these models. In this paper, we build upon an existing framework of equity‐oriented care for (...) primary healthcare settings by proposing strategies to guide nurses in operationalizing cultural safety and trauma‐ and violence‐informed care into nursing practice at the individual level. This component is one strategy to redress inequitable access to care among Indigenous Peoples in Canada. We conceptualize barriers to accessing healthcare as intrapersonal, interpersonal, and structural. We then define three domains for nursing action: practicing reflexivity, prioritizing relationships, and considering the context. We have applied this expanded framework within the context of Indigenous Peoples in Canada as a way of illustrating specific concepts and focusing our argument; however, this framework is relevant to other groups experiencing marginalizing conditions and inequitable access to healthcare, and thus is applicable to many areas of nursing practice. (shrink)

Realist evaluation has gained prominence in the field of evaluation in recent years. Its theory-driven approach to explaining how and why programmes work or not makes it attractive to many novices, early career researchers, and organizations implementing various programmes globally and relevant to policymakers and programme implementers. While realist evaluation seeks to be pragmatic, adopting principles and methods that can be used to help focus an evaluation, its deep ontological and epistemological foundations make its application in real-life situations challenging. In (...) this paper, we seek to unpack the key tenets scaffolding the practical application of realist evaluation. Although Pawson and Tilley foreground realist evaluation in applied scientific realism, we argue that an amalgam of scientific and critical realist principles underpins realist evaluation. We unpack these principles and illustrate how they fit into each other to provide a cogent theoretical foundation for realist evaluation. (shrink)