NEIHR Research Matrix Report: Directions 1

NEIHR Research Matrix Report: Directions 1 May 2026

Report by the Network Environments for Indigenous Health Research National Coordinating Centre (NEIHR NCC)

Attribution and Contact Information Dr. Robert Henry (Lead, NEIHR NCC) and Tara Erb (Research Manager, NEIHR NCC), in collaboration with and support from the nine regional NEIHRs and the Canadian Institutes of Health Research (CIHR) Institute of Indigenous Peoples’ Health (IIPH), led the development of the NEIHR Research Matrix and production of Final Report: Directions 1.

Final Report authored by Erb, T. and Henry, R (2026).

Chalchi Research and Knowledge Mobilization supported the development and production of the NEIHR Research Matrix: Directions 1 figures and graphs.

NCC Contact Information Dr. Robert (Bobby) Henry, PhD Lead - NEIHR National Coordinating Centre University of Saskatchewan E-mail: Rob.Henry@usask.ca Tara Erb, PhD Candidate Research Manager - NEIHR National Coordinating Centre E-mail: Tara.Erb@usask.ca

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Table of Contents NEIHR Program Background ��������������������������������������������������������������������������������������������������������������������������������������������������������� 5 Figure 1. The NEIHR Networks ������������������������������������������������������������������������������������������������������������������������������������������������ 6

NEIHR Research Matrix: Directions 1 ����������������������������������������������������������������������������������������������������������������������������� 6 Purpose and Intent ������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������ 7 Limitations �������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� 7 Methodology and Methods ����������������������������������������������������������������������������������������������������������������������������������������������������������������� 9 The River Methodology �������������������������������������������������������������������������������������������������������������������������������������������������������������������� 9 Figure 2. River Methodology �������������������������������������������������������������������������������������������������������������������������������������������������������� 9 Upstream/Downstream ���������������������������������������������������������������������������������������������������������������������������������������������������������������10 Animal Relations �����������������������������������������������������������������������������������������������������������������������������������������������������������������������������������11 Seasonal Relations �������������������������������������������������������������������������������������������������������������������������������������������������������������������������������12

Methods ���������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� 14 NEIHR PI-led Projects ���������������������������������������������������������������������������������������������������������������������������������������������������������������������14 CIHR Institute Strategic Priorities ���������������������������������������������������������������������������������������������������������������������������������15 Connecting NEIHR PI-led Projects to CIHR Institute Strategic Priorities �������������������17 Highlight of Topic-focused Community or Specific Engagement �����������������������������������������������18

Data Analysis ���������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� 18 Dataset �������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� 18 Institute of Aging �������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� 19 Institute of Cancer Research ������������������������������������������������������������������������������������������������������������������������������������������������ 20 Institute of Circulatory and Respiratory Research ������������������������������������������������������������������������������ 21 Institute of Gender and Health ������������������������������������������������������������������������������������������������������������������������������������������ 22 Institute of Genetics ���������������������������������������������������������������������������������������������������������������������������������������������������������������������������� 23

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Institute of Health Services and Policy Research ������������������������������������������������������������������������������������ 24 Institute of Human Development, Child and Youth Health ������������������������������������������������������ 25 Institute of Infection and Immunity ���������������������������������������������������������������������������������������������������������������������������� 26 Institute of Musculoskeletal Health and Arthritis �������������������������������������������������������������������������������� 27 Institute of Neurosciences, Mental Health and Addictions ������������������������������������������������������ 28 Institute of Nutrition, Metabolism and Diabetes �������������������������������������������������������������������������������������� 29 Institute of Population and Public Health ������������������������������������������������������������������������������������������������������������ 30 Summary Graph �������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� 31 CIHR-IIPH and Other Projects ������������������������������������������������������������������������������������������������������������������������������������������������� 32 Recommendations and Next Steps ��������������������������������������������������������������������������������������������������������������������������������������� 34 Recommendations ������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������ 34 Next Steps: NEIHR Research Matrix - Directions 2 ������������������������������������������������������������������������������ 35

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NEIHR Research Matrix Report: Directions 1 NEIHR Program Background The Institute of Indigenous Peoples’ Health (IIPH), conceptualized in 1999, was the first national Institute dedicated to advancing Indigenous health research in Canada. Since its establishment, IIPH has played a central role in addressing the unique health priorities of First Nations, Inuit, and Métis communities and in supporting Indigenous-led research initiatives.

A key flagship initiative of IIPH is the Network Environments for Indigenous Health Research (NEIHR) Program, launched in 2007 under the leadership of Dr. Jeff Reading, the first Scientific Director of IIPH. The NEIHR program supports a networked, community-driven approach to Indigenous health research and mentorship across Canada, with currently nine regional networks spanning British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, Atlantic Canada, the Northwest Territories, and Nunavut, alongside a National Coordinating Centre. A tenth network, Yukon NEIHR, is anticipated to be formally established in June, 2026.

Each NEIHR network operates independently while working in partnership with First Nations, Inuit, and Métis communities and non-Indigenous allies to advance research, capacity building, mentorship, and knowledge translation. The program places a strong emphasis on supporting students and emerging Indigenous scholars, including through annual national student gatherings hosted by rotating networks.

The NEIHR program represents a significant and sustained investment in Indigenous health research, with $105.5 million committed over 15 years by all 13 CIHR Institutes. This includes a federal investment of $37.6 million over the current five-year period (announced in October 2024) to support the program’s renewal and expansion. As IIPH’s flagship program, NEIHR exemplifies the importance of Indigenous-led, communityengaged research in addressing health inequities and strengthening research capacity across the country.

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Figure 1. The NEIHR Networks

NEIHR Research Matrix: Directions 1 The NEIHR Research Matrix: Directions 1 (herein to be called Matrix 1) is a national asset mapping initiative that was conducted by the NEIHR National Coordinating Centre (NCC), led by Dr. Robert Henry (Nominated Principal Investigator) and Tara Erb (Research Manager), with the support of the nine regional NEIHR networks and the Canadian Institutes of Health Research (CIHR) Institute of Indigenous Peoples’ Health (IIPH). Matrix 1 maps NEIHR Principal Investigator (NPI and PI) projects across CIHR Institute priority areas. This asset mapping process revealed important insights into areas of alignment, convergence, and gaps that can inform future strategic planning in Indigenous health research. It highlighted substantial cross-cutting work across multiple CIHR Institutes, while also identifying gaps in areas such as clinical trials and cohort research, and misalignment in some CIHR Institute Priorities relative to Indigenous health research needs.

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Purpose and Intent This resource was developed as a relational and strategic planning tool for the TriAgencies (CIHR, SSHRC, NSERC), NEIHR networks, CIHR Institutes, and key partners.

Matrix 1 is not an evaluation tool and is not intended to assess the impact or success of the NEIHR program or individual NEIHRs, nor evaluating each CIHR Institutes Indigenous engagement. Rather, it is designed as a supportive resource to help identify areas of strength and gaps in engagement, with the goal of informing collaboration and strengthening collective efforts in Indigenous health research.

Given that the NEIHR Principal Investigators (PIs) who lead the NEIHRs are directly working with Indigenous communities and partners, the projects that were identified and documented in Matrix 1 reflect priorities emerging from those relationships and are understood as a community-identified priority. The NEIHR Teams identified PI projects to be included in Matrix 1, which was analyzed and confirmed by both NEIHRs and NCC for their alignment to a CIHR Institute and one of its Institute priority areas.

While the data shows clear evidence that there are areas of high density and concentration for community-identified priorities (e.g., in the field of Population and Public Health), the data also shows areas of opportunity for growth and where more collaboration is needed. Therefore, the vision of Matrix 1 is that, in the context of Indigenous health research, it serves as a tool to inform Tri-Agencies strategic planning and priority setting, funding opportunities, and a mechanism for stronger collaboration and relationality between the Tri-Agencies, NEIHRs, and partners. The Matrix can also support ongoing work at the Ministerial level, specifically large national initiatives by identifying areas of contribution, overlap, and opportunity for Indigenous health and wellbeing research. *For further details on Matrix 1 approach, process and methods, please see section Methodology and Methods.

Limitations When reading and interpreting Matrix 1, it is crucial to acknowledge the following limitations: First, the scope of this iteration (Matrix 1) is limited to NEIHR PI-led projects between January 2020 and January 2026. This was due to staffing, budget and time constraints.

As a result, the list of projects is not exhaustive and does not represent the full range of work undertaken by NEIHRs and therefore does not capture the full breadth, depth,

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and scope of the work of the individual NEIHRs. For example, a more fulsome Matrix and asset mapping exercise would include the work of other NEIHR team members (such as partners and key collaborators), NEIHR-funded community-based or community-led projects, and NEIHR-funded Indigenous student-led projects. The NCC aims to secure the appropriate staffing and budget needed to ensure the continued growth of future Matrix iterations to fill these gaps.

Second, Matrix 1 is not designed to measure or assess the impact of the NEIHR program.

Future iterations will need to include more direct impact analysis and assessment.

This would require a different approach to data collection, including information on knowledge mobilization activities, outcomes, or impact statements for each included NEIHR PI-led project.

Third, for each NEIHR PI-led project that was included, the NCC asked each PI to identify the project’s primary alignment with only one Institute priority. In reality, and particularly with Indigenous research, projects are inherently interconnected, often spanning multiple Institutes, priorities and the Tri-Agencies. The NCC recognizes that this approach, which required projects to be matched to a single primary priority, may not fully reflect the relational, interconnected, and cross-cutting nature of Indigenous health research. However, for the purposes of this iteration, the focus on a single primary objective was intended to illustrate where community-identified priorities appear to be concentrated or less visible, to more readily inform strategic planning, and to make potential areas for partnership and relationship-building between the CIHR Institutes and NEIHRs more accessible and visible.

Fourth, Matrix 1 is a point-in-time report and reflects CIHR Institute Strategic Priorities as they stood at the time the analysis was conducted. It does not capture changes or updates that CIHR Institutes may have made to their Strategic Priorities after September 2025. Equally, it does not capture projects that were developed or initiated by NEIHR PIs after January 2026.

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Methodology and Methods The River Methodology

Figure 2. River Methodology The “River Methodology” that guides this asset mapping was conceptualized and developed by Tara Erb (NCC Research Manager, PhD Candidate) as part of her dissertation and was inspired by her community’s cultural connections to and teachings around the Moose River. In 2021, Moose Cree First Nation published the book People of the Moose River Basin, which shares how the Moose River Basin is a model for storytelling: “The Moose River Basin is the place where our story is set, but the way the river flows and the way people travel on it also gives us a model for storytelling” (Simrad et al., 2021, p. 25).

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In applying this methodological framework more broadly, we understand that while cultural connections and teachings are always distinct and place-based, all First Nations, Inuit and Métis continue to have enduring relationships with and knowledge of the land and waters. Furthermore, in the context of Matrix 1 and other iterations, the River Methodology reflects the importance of relational movement, reciprocity, and cyclical learning in Indigenous health research rather than linear mapping or evaluation frameworks. When traveling the river, there are three key aspects to consider: • Positionality: What are the knowledge and skills you have and/or need for the journey? Where are you starting from?

• Relationality: The river is interconnected and interrelated to everything, such as the mountains, animals, seasons, and sea. Some connections are immediate and central, while other connections are more distant and peripheral. Where and how are you connected in this web of relations?

• Intention: To arrive at your destination, you must always travel the river with clear purpose and direction. What brings you to travel the river? What are you seeking? Where is it you are trying to go and why? What do you need to get there?

Upstream/Downstream The flow of the river and direction you travel matters for the journey. It changes the experience, navigation skills, resources, and leadership required to succeed in reaching the desired place and outcomes. In both directions we are travelling the same river, however, perspectives and experiences change with the direction you are traveling.

Different precautions and details are needed to navigate the river to the end point, and it is here that we can begin to see the strengths and barriers that impact the travel.

Additionally, whether travelling upstream or downstream, both directions require that you embark in a good way so that the journey is safe.

Upstream moves against the current and is characterized by high effort, strength, resistance, determination, courage, and growth. This direction is associated with starting from community and emphasizes Indigenous community-based knowledges and teachings. While strong in their connection to local knowledge, teachings, and values, those originating from community often find themselves travelling upstream due to social determinants shaped by historical and contemporary colonialism that make the journey challenging.

Downstream is with the current and takes less physical effort but nonetheless requires attentiveness, precision, agility, and focus to navigate. Often originating from positions

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and places of power and resources, those travelling downstream as part of their journey are not up against the same social determinants as those travelling upstream. However, they need to be critically aware of their privileges, so that when they meet with those traveling upstream, they are aware of the energy exerted to meet.

Matrix 1 is a relational tool to support those travelling upstream and downstream to meet in a place of partnership. NEIHRs and their Indigenous partners continue to work upstream toward self-determination and equitable access to resources, and sovereignty, while Tri-Agencies and partners are navigating their way downstream to be closer to and connect with land and community.

Animal Relations The animals found on the land and in the water are part of what makes up a healthy river or ecosystem. With a healthy environment, animals thrive within their roles in shaping the ecosystem. Too many of one animal and the river begins to change, shifting the ecosystem so that the river loses its vibrancy. For this River Methodology, we focus on four animal relations, each with their own elements that can be applied to and symbolic of Indigenous health research: Geese: The river is a protective factor that offers nutrient-rich staging and resting areas during migration. Here the geese symbolize anticipation and preparation as well as cohesiveness due to their V-formation flying pattern that conserves energy and increases efficiency during long migrations.

Moose: The river supports an environment of abundant wetlands and riparian zones for year-round foraging. Here the moose symbolizes subsistence/resources as well as the continuation of cultural identity and spiritual connection.

Bear: All aspects of the river and its surrounding areas are utilized by bear (i.e., bear fishes, hunts and forages). The bear’s relation to the river and environment is one of skill and mastery as it is the bear that shows us how to survive on the lands. Therefore, the bear is a powerful teacher and highlights connection to Indigenous knowledges and perseverance. Here the bear symbolizes leadership, wisdom and strength.

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Fish: The river’s watershed that eventually drains into a larger body of water is a vital habitat for fish, which is central to sustenance and ceremony. Here the fish symbolize intergenerational knowledge, vision and determination.

Seasonal Relations The seasonal relations connected to the river determine the activities and life course of those animals that live both within the river and the surrounding areas, as well as how the river needs to be used by those traveling along it. The Matrix 1 River Methodology includes six seasonal relations, which should not be understood as static, but in a constant motion and change where certain seasons may come earlier or last longer dependant on the activity. Within Indigenous health research seasonal relations are important as they are moments in time that can help us to understand where we are, where we can go, when we need to wait, what do we need to watch for, and what knowledges, tools, or resources are needed to travel safely. For this methodology we have six (6) distinct seasons that highlight specific activities that emphasize reflection and preparation:

Break-up Season: This season is a critical transition period involving hazardous and destructive ice shoves, potential flooding, and rapid, high-volume water flow. There is no travel on the river during this time and here the break-up season symbolizes clearing, reflection, and assessment (i.e., time of waiting and watching).

Spring Season: This season has rapid ecological shifts with high runoff from melting snow and high tide. Here the spring season symbolizes high flow and swift waters, caution, skilled navigation, and a critical though challenging time.

Summer Season: This season has high biodiversity and animal activity and marks the peak of traditional and recreational use of waterways by humans. There is lots of movement and travel during this time. Here the summer season symbolizes open and high environmental dynamism, high vitality on land, but low water and sandbars (i.e., still need to exercise caution).

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Autumn Season: Though there is visibility along waterways, this season has a fast-acting environment and is important for the mating season of moose. Here the autumn season symbolizes rapid change and variable conditions as well as a time of transition.

Freeze-up Season: This season has dangerous and unstable ice conditions but is characterized by high anticipation. There is limited travel during this time. Here the freeze-up season symbolizes patience and waiting (or time), planning, and readiness.

Winter Season: This season has high habitat vulnerability as well as cultural, survival, and practical significance. It is a time for sharing stories and ceremony. Travel is accessible by frozen water to traditional hunting and ceremonial grounds. Here the winter season symbolizes adaptation, access or connectivity, and a focus on traditional activities.

Based on this iteration (Matrix 1), we can understand ourselves to be somewhere within the freeze-up season. Matrix 1 work began in September 2025, and the effort it has taken to develop its concept, plan its methods, collect the data, analyze and confirm the data, and report back its findings has required patience and time. The dedication to understanding how this information can inform our strategic planning and priority setting has put us in a position of readiness for next steps. The insights gained from the mapping and recommendations put forth based on Matrix 1 data and its interpretations leaves us in a moment of high anticipation.

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Methods NEIHR PI-led Projects The NCC requested from each operating NEIHR (9) a list of NEIHR PI-led projects conducted from January 2020 to January 2026. Specifically, only those projects where the NEIHR PI was the Nominated Principal Investigator (NPI) or otherwise held a leading role were included; projects in which the NEIHR PI participated only as a co-applicant, collaborator, or in another non-lead role were excluded. The information collected for each NEIHR PI-led project included, but was not limited to: NEIHR PI name, project or program of research title, funding source, key partners, distinctions-based focus, and/ or primary objective(s). It should be emphasized that this data collection process was more than simple exchanges or collection of curriculum vitae data. Rather, the process was in-depth and relational, where leads from the NCC, when possible, traveled to each province and territory where the NEIHRs are based to talk about the matrix and how the information was to be collected, analyzed, and shared.

To develop Matrix 1, NCC team members visited in-person with eight of the nine NEIHRs and spent a full day engaged in Matrix discussion with PIs, Directors, staff, Elders, and community partners (due to availability, there was not an in-person visit for one of the NEIHRs). This level of high engagement further contributes to the quality, credibility, and integrity of the data, framed by the River Methodology, which centres on relationality and holds the perspective that knowledges and understandings are directly connected to the strength of our relations. The cross-country relationship-building process that was intentionally built into the development of Matrix 1 is crucial to the outcome.

To respect Indigenous (First Nations, Inuit or Métis) data sovereignty, the full Matrix 1 raw dataset of NEIHR PI-led projects is not shared or distributed outside of the NCC. Nonetheless, while the full dataset is housed by the NCC, each NEIHR is in full control of their data that is included in Matrix 1 and how it is interpreted, and receives their own data for review, revision, and/or confirmation. Furthermore, Indigenous data sovereignty in action means that travel on the river requires collective consent and that we only move forward when there is collaboration from everyone involved.

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CIHR Institute Strategic Priorities The Matrix 1 process began in September 2025, when the NCC collected information from each CIHR Institute based on their publicly available Strategic Plans and the Strategic Priorities available on their websites. This was done because these are the public-facing sources that are readily available and inform researchers and communities about specific priorities. Of note, IIPH was excluded from this data collection and analysis because the NEIHRs are the flagship program of IIPH, and each project is tied to the Strategic Priorities of IIPH, which focus on the improvement of Indigenous health and wellbeing.

That is, all NEIHR PI-led projects documented involve Indigenous Peoples, communities, or territories, and would therefore fall under the IIPH Strategic Plan of improving the health and wellbeing of Indigenous Peoples. For this iteration of the Matrix, including IIPH would have created redundancy and offered little additional insight within the Matrix 1 design.

It must be emphasized that Matrix 1 is a snapshot in time and that CIHR Institute strategies are in constant flow, as priorities shift to reflect research needs. For Matrix 1, the timeframe for CIHR Institute Strategic Plans was September 2025. In the research environment, Institute Strategic Plans and investments are dynamic and always changing, and the NCC was aware that several CIHR Institutes were in the process of updating their Strategic Plans at the same time that Matrix 1 was being developed. Accordingly, Matrix 1 was limited to strategic information that was publicly available as of September 2025 and does not include updated strategic information. If we continue to invest in this work, documenting these moments over time and through multiple Matrix iterations will provide an opportunity to evaluate growth and waterways as well as ongoing challenges (for example, changes or stagnation in river flow and direction). It is this data over time that has evaluative potential to inform future Indigenous health research decisionmaking and planning.

A three-step process to collecting and connecting information from the CIHR Institutes was undertaken to develop the Institute Research Priorities and Indigenous Engagement Strategies Matrix 1.

The first step focused on a thorough review of each CIHR Institutes’ Strategic Plan.

Each Institute’s Strategic Plan was reviewed at least twice. After this close review, each Institute’s general Engagement Strategy including key priority areas, programs of research, and engagement activities were highlighted. Due to their design to address specific Institute Priorities, an Institute’s general Engagement Strategy was not specific to Indigenous Peoples (although each strategy could and should be applied to Indigenous Peoples). For example, an Institute may mention ‘dementia’ or ‘sleep conditions’ in general but do not name an Engagement Strategy that is specific to Indigenous

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experiences of dementia or Indigenous-focused sleep conditions research (although the general engagement should still be applied to Indigenous contexts). Once the general engagement summaries were complete, Artificial Intelligence (AI) ChatGPT was used to generate the headings “Institute Strategic Priorities” based on the general engagement summaries, which are located in the far-left column for each Institute graph. For each heading generated, the NCC then carefully reviewed and cross-referenced it against the Institute’s general engagement summary, and edits and changes were made by the team to better reflect what was documented in the general summary. All AI prompts and results, as well as edits and changes, have been recorded and filed.

The second step focused on each Institute’s stated commitments and approaches to Indigenous Engagement. Each Institute’s Strategic Plan was reviewed to understand their Indigenous engagement plan or priorities. After this close review, each Institute’s Indigenous Engagement Strategy was summarized with specific focus on key priority areas, programs of research, and engagements. This included information that was specific only to Indigenous Peoples and to Equity, Diversity and Inclusion (EDI) generally (with EDI being included only where it was mentioned in conjunction with Indigenous Peoples). Once the Indigenous engagement summaries were complete, AI ChatGPT was again used to generate the headings for the “Indigenous Engagement Strategy” based on the Indigenous engagement summaries (as seen in the middle of the graphs). Each heading was carefully reviewed and cross-referenced against the Institute’s Indigenous engagement summary, and edits and changes were made by the NCC to more accurately reflect Institute specific Indigenous engagement summaries. All AI prompts and results have been recorded and filed. It is also recognized that several Institutes have recently appointed new Scientific Directors and other Institutes are in the early stages of initiating or developing updated Strategic Plans. Again, this emphasizes the importance of the Matrix as a living document that should be updated and reviewed as Institute Strategic Plans change or update.

The third and final step focused on the connections between Institute Strategic Priorities and the Indigenous Engagement Strategy. The River Methodology was used as a framework to analyze the “river flows” and connections between the Institute’s Strategic Priorities headings and the Indigenous Engagement Strategy headings. This relational analysis became the lines connecting the two columns together, and highlights how specific Institute Strategic Priorities align or do not align with their Indigenous Engagement Strategy. What was found was that there is clear variance in the ways in which an Institute’s general priorities are connected to its Indigenous Engagement Strategies. In some cases, the “river flow” is wide and open (the Institute priority connects to several Indigenous Engagement Strategies), while in others it is narrower (the Institute priority connects to only one or two Indigenous Engagement Strategies) or there is no clear or visible flow at all where the Institute priority does not connect to an Indigenous Engagement Strategy.

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There is also variance in the integration between Institute Priorities and Indigenous Engagement Strategies. For some, all the Institute’s Priorities were connected to its Indigenous Engagement Strategy and the connections go across the Institute and are highly integrated. For others, only a few of the Institute’s Priorities were connected to its Indigenous Engagement Strategy (connections are more concentrated and less integrated). This is not to say that an Institute is doing a poor job with Indigenous engagement; rather, it suggests that the alignment between Strategic Priorities and the Indigenous Engagement Strategy may not be or may not be clearly articulated. This information then allows CIHR Institutes to reevaluate how their specific Indigenous Engagement Strategies align with Institute strategic research priorities.

Connecting NEIHR PI-led Projects to CIHR Institute Strategic Priorities The key purpose of Matrix 1 was to find the connections (or disconnections) between the NEIHR PI-led projects and an Institute’s general priorities. The intention is to create a critical reflective tool for illustrating areas of activity and identifying strategic alignments and opportunities for increased relationality between the NEIHRs and CIHR Institutes. As a centralized data resource, Matrix 1 enables quick identification of overlapping research areas, which strongly supports collaboration, strategic planning, and opportunities or directions for funding or programming. This creates visibility for how to better bridge understanding and increase waterways between the Tri-Agencies, NEIHRs, and other key partners.

To map out these connections, the NCC and/or individual NEIHRs assigned each NEIHR PI-led project to an Institute, depending on the topic area and primary objectives. It is important to acknowledge that many NEIHR PI-led projects often connect to multiple CIHR Institutes; however, for Matrix 1, we isolated the project to what would be the primary Institute relation. Once the project was assigned to an Institute, it was then determined what Institute priority it was most connected to. As stated, often the project connected to multiple Institute Priorities, but the NCC emphasized to the NEIHRs that they should only focus on one primary connection. However, because of the breadth and size of some of the projects, some had multiple overlapping connections.

The connections can be seen in the plot graphs (on the right of each graph): rhombus for 1-5 projects; circle for 6-10 projects; square for 11-15 projects; and pentagon for 16-20 projects. The last row of the plot graphs is for NEIHR PI-led projects categorized as exceeding. Projects were documented as exceeding if they either connected to three or more Institute Priorities and could not justly be isolated to only one priority, or if the topic or focus area was a community-identified priority that was not included in the Institute’s Strategic Plan.

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Highlight of Topic-focused Community or Specific Engagement This section of the graphs (bottom left) provides a bullet list of some NEIHR PI-led examples of NEIHR PI-led, topic-focused projects or specific engagements that are related to each Institute, as determined by the NEIHR PI’s research. This is intended to highlight and showcase community priority areas and achievements in Indigenous health research.

It captures and shares only high-level, non-identifiable information.

Data Analysis Dataset In total, 402 NEIHR PI-led projects were included in this iteration of the Matrix. Across CIHR Institutes, project concentrations reflected strong areas of existing engagement and alignment with Indigenous health research priorities. The highest concentrations of aligned projects were found within the Institute of Population and Public Health, the Institute of Health Services and Policy Research, and the Institute of Human Development, Child and Youth Health, highlighting established areas of strength and leadership. Other Institutes, including the Institute of Cancer Research, the Institute of Genetics, and the Institute of Circulatory and Respiratory Health, represent important and promising areas for continued relationship-building and expanded engagement in Indigenous health research.

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Institute of Aging RELATIONSHIP MATRIX

3,4,7

Figure 3. Institute of Aging & NEIHRs Research Relationship Matrix The CIHR Institute of Aging’s (IA) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present a mixed pattern of integration: 2 Institute Strategic Priorities have wide and open connections to the Indigenous Engagement Strategies (a, b,), 6 have narrow connections (c, d, f, i, j, k), and 3 are not clearly visible (e, g, h). All Indigenous Engagement Strategies are connected to one or more Institute’s Strategic Priorities flows.

The graph illustrates 8 areas of NEIHR-led research activity, identifies 5 strategic alignments with the Institute’s Strategic Priorities (a, d, f, i, k), while some show no visible activity (b, c, e, g, h, j). It also highlights 1 community-priority, topic-focused research effort that exceeds the Institute’s Strategic Priorities (by NT NEIHR).

Within the IA, there is an opportunity to further advance balance and engagement across the Strategic Priorities and Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects emerging strengths, with potential to expand into additional areas.

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Institute of Cancer Research RELATIONSHIP MATRIX

Figure 4. Institute of Cancer Research & NEIHRs Research Relationship Matrix The CIHR Institute of Cancer Research’s (ICR) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present an emerging pattern of integration: 3 Institute Strategic Priorities have narrow connections (d, e, f), while the others are not clearly visible (a, b, c, g, h). All Indigenous Engagement Strategies are connected to one or two Institute Strategic Priorities flows.

The graph illustrates 2 areas of NEIHR-led research activity and identifies 1 strategic alignment with the Institute Strategic Priorities (b), and the remaining Institute Strategic Priorities show no visible activity (a, c–h). It also highlights 1 community-priority, topicfocused research effort that exceeds the Institute Strategic Priorities (by SK NEIHR).

Within the Institute, there is an opportunity to further develop engagement across the Institute Strategic Priorities to strengthen alignment with Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects early-stage development, with strong potential to expand cancer research activity.

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Institute of Circulatory and Respiratory Research RELATIONSHIP MATRIX INSTITUTE STRATEGIC PRIORITIES

INDIGENOUS ENGAGEMENT STRATEGY INDIGENOUS ENGAGEMENT STRATEGY

7

7

7

1

1,2,3,4,5,6

1,2,6

Figure 5. Institute of Circulatory and Respiratory Research & NEIHRs Research Relationship Matrix The CIHR Institute of Circulatory and Respiratory Health’s (ICRH) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present a developed pattern of integration: 1 Institute Strategic Priority has a wide and open connection to an Indigenous Engagement Strategy (e), while 5 have narrow connections (a, b, c, d, f). Connections are concentrated in Equity and Community Engagement (e). All Indigenous Engagement Strategies are connected to one or more Institute Strategic Priorities flows.

The graph illustrates 5 areas of NEIHR-led research activity and identifies 3 strategic alignments with the Institute Strategic Priorities (a, d, e). Some priorities show no clear activity (b, c, f). It also highlights 1 community-priority, topic-focused research effort that exceeds the Institute Strategic Priorities (by ON NEIHR).

Within the Institute, there is an opportunity to strengthen and expand connections between the Institute’s Strategic Priorities and Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects a strong opportunity to expand Circulatory and Respiratory Health research activity.

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Institute of Gender and Health RELATIONSHIP MATRIX

Figure 6. Institute of Gender and Health & NEIHRs Research Relationship Matrix The CIHR Institute of Gender and Health’s (IGH) Strategic Priorities and the Institute Strategic Priorities “river flows” present a strongly balanced and developed pattern of integration: 2 Institute Strategic Priorities have wide connections, each linking to 4 Indigenous Engagement Strategies (b, d), while others have narrow connections (a, c, e, f). Connections are concentrated in 3 areas (b, c, d). All Indigenous Engagement Strategies are connected to one or more Institute Strategic Priorities flows.

The relationship matrix illustrates 15 areas of NEIHR-led research activity and identifies 5 strategic alignments with the Institute’s Strategic Priorities (a, b, c, d, e). Only 1 priority shows no clear activity (f).

Within the Institute, there is an opportunity to strengthen existing connections and engagement between the Institute’s Strategic Priorities and Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects strong and balanced development in Gender and Health research with opportunities of growth.

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Institute of Genetics RELATIONSHIP MATRIX

Figure 7. Institute of Genetics & NEIHRs Research Relationship Matrix The CIHR Institute of Genetics’ (IG) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present a mixed balanced, emerging pattern of integration: 1 Institute Strategic Priority has wide and open connection to the Indigenous Engagement Strategies (e), 5 have narrow connections (a, b, d, f, g), and 1 is not clearly visible (c). Connections are concentrated in 1 specific area (e). All Indigenous Engagement Strategies are connected to one or two Institute Strategic Priorities flows.

The graph illustrates 7 areas of NEIHR-led research activity and identifies 5 strategic alignments with the Institute Strategic Priorities (a, b, c, e, f). Two priorities are not clearly visible (d, g).

Within the Institute, there is an opportunity to further develop balanced connections across the Institute’s Strategic Priorities and Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects growing alignment, with opportunities to expand into additional areas.

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Institute of Health Services and Policy Research RELATIONSHIP MATRIX

Figure 8. Institute of Health Services and Policy Research & NEIHRs Research Relationship Matrix The Institute of Health Services and Policy Research’s (IHSPR) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present an emerging balanced pattern of integration: 1 Institute Strategic Priority has wide and open connection to the Indigenous Engagement Strategies (d), 6 have narrow connections (a, b, c, e, f, i), and 2 are not clearly visible (g, h). All Indigenous Engagement Strategies are connected to one or two Institute Strategic Priorities flows.

The graph illustrates 37 areas of NEIHR-led research activity and identifies strategic alignment with all the Institute Strategic Priorities (a to i). It also highlights numerous community-priority, topic-focused research efforts across 3 NEIHRs that exceed the Institute Strategic Priorities (by AT, MB, and ON NEIHRs).

Within the Institute, there is an opportunity to develop connections and strengthen integration between the Institute’s Strategic Priorities and Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects strong and well-distributed engagement across priority areas.

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Institute of Human Development, Child and Youth Health RELATIONSHIP MATRIX

Figure 9. Institute of Human Development, Child and Youth Health & NEIHRs Research Relationship Matrix The CIHR Institute of Human Development, Child and Youth Health’s (IHDCYH) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present an emerging pattern of integration: 5 Institute Strategic Priorities have narrow connections (a, c, d, e, f), while 3 are not clearly visible (b, g, h). All Indigenous Engagement Strategies are connected to one or two Institute Strategic Priorities flows.

The graph illustrates 24 areas of NEIHR-led research activity and identifies 5 strategic alignments with the Institute Strategic Priorities (a, b, c, d, f). Only 3 priorities show no clear activity (e, g, h).

It also highlights numerous community-priority, topic-focused research efforts across 5 NEIHRs that exceed the Institute Strategic Priorities (by MB, NT, NU, QC and SK NEIHRs).

Within the Institute, there is an opportunity to develop connections and strengthen integration between the Institute’s Strategic Priorities and Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects strong and well-distributed engagement across Institute priority areas.

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Institute of Infection and Immunity RELATIONSHIP MATRIX

Figure 10. Institute of Infection and Immunity & NEIHRs Research Relationship Matrix The CIHR Institute of Infection and Immunity’s (III) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present an emerging, balanced pattern of integration: 1 Institute Strategic Priority shows a strong and wide connection (a), 6 Institute Strategic Priorities have narrow connections (b, c, e, g, h, i), and 2 are not clearly visible (d, f).

Connections are evenly distributed across these 7 areas. All Indigenous Engagement Strategies are connected to one or two Institute Strategic Priorities flows.

The graph illustrates 8 areas of NEIHR-led research activity, identifies 5 strategic alignments with the Institute Strategic Priorities (a, b, d, g, i), and shows 1 community-priority, topicfocused research effort that exceed the Institute Strategic Priorities (by SK NEIHR).

Within the Institute, there is an opportunity to develop new connections between the Institute’s Strategic Priorities and Indigenous Engagement Strategies and strengthen existing ones. The distribution of NEIHR research efforts reflects growing alignment, with opportunities to expand activity across additional priorities.

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Institute of Musculoskeletal Health and Arthritis RELATIONSHIP MATRIX

Figure 11. Institute of Musculoskeletal Health and Arthritis & NEIHRs Research Relationship Matrix The CIHR Institute of Musculoskeletal Health and Arthritis’s (IMHA) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present an emerging pattern of integration: 3 Institute Strategic Priorities have narrow connections (d, e, f), while many are not clearly visible (a, b, c, g, h). All Indigenous Engagement Strategies are connected to one or two Institute Strategic Priorities flows.

The graph illustrates 5 areas of NEIHR-led research activity and identifies 4 strategic alignments with the Institute Strategic Priorities (a, b, d, g). The remaining Institute Strategic Priorities show no clear activity (c, e, f, h).

Within the Institute, there is an opportunity to further develop engagement across the Institute Strategic Priorities to strengthen alignment with Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects early development, with strong potential to expand research activity.

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Institute of Neurosciences, Mental Health and Addictions RELATIONSHIP MATRIX

Figure 12. Institute of Neurosciences, Mental Health and Addictions & NEIHRs Research Relationship Matrix The CIHR Institute of Neurosciences, Mental Health and Addiction’s (INMHA) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present an emerging, balanced pattern of integration: 7 Institute Strategic Priorities have narrow connections that link to all Indigenous Engagement Strategies (a to g), while only 1 appears to have no clear connection (h).

The graph illustrates 17 areas of NEIHR-led research activity and identifies 6 strategic alignments with the Institute Strategic Priorities (b, c, e, f, g, h) with 1 having a greater concentration (h; 6-10 projects). Only 2 priorities show no clear activity (a, d). It also highlights many communitypriority, topic-focused research efforts across 4 NEIHRs that exceed the Institute Strategic Priorities (by AB, BC, NT and SK NEIHRs).

Within the Institute, there is an opportunity to strengthen existing connections between the Institute’s Strategic Priorities and Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects strong alignment, with opportunities to expand into the 2 priorities where activity is not yet visible.

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Institute of Nutrition, Metabolism and Diabetes RELATIONSHIP MATRIX

Figure 13. Institute of Nutrition, Metabolism and Diabetes & NEIHRs Research Relationship Matrix The CIHR Institute of Nutrition, Metabolism and Diabetes’ (INMD) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present 2 strong and wide Institute Strategic Priorities connections (d, e), linking to 4 and 5 Indigenous Engagement Strategies respectively. 3 Institute Strategic Priorities connections are not clearly visible (a, b, c). All Indigenous Engagement Strategies are connected to one or two Institute Strategic Priorities flows.

The graph illustrates 10 areas of NEIHR-led research activity, identifies 2 strategic alignments with the Institute Strategic Priorities (b, d), with a strong concentration in priority area (d), and shows that 3 priorities have no clear activity (a, c, e). It also highlights 2 communitypriority, topic-focused research effort that exceeds the Institute Strategic Priorities (by NU and QC NEIHRs).

Within the Institute, there is an opportunity to develop connections that are not yet visible among the Institute Strategic Priorities to strengthen alignment with Indigenous Engagement Strategies efforts and research activities. The distribution of NEIHR research efforts reflects strong development in Social, Environmental and Policy Intervention Strategies (d), with opportunities to expand activity in other areas.

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Institute of Population and Public Health

Figure 14. Institute of Population and Public Health & NEIHRs Research Relationship Matrix The CIHR Institute of Population and Public Health’s (IPPH) Strategic Priorities and the Indigenous Engagement Strategies “river flows” present a balanced, emerging pattern of integration: 2 Institute Strategic Priorities have wide connections, linking to 4 and 5 Indigenous Engagement Strategies respectively (a, b), while others have narrow connections (c, d, e, f, h, i). Only 1 Indigenous Engagement Strategy has no clear connection to the Institute Strategic Priorities flows (g).

The graph illustrates 36 areas of NEIHR-led research activity and identifies 9 strategic alignments with the Institute Strategic Priorities (a–i). It also shows numerous community-priority, topicfocused research efforts across 5 NEIHRs that exceed the Institute Strategic Priorities (by AB, MB, NT, ON and SK NEIHRs).

Within the Institute, there is an opportunity to strengthen emerging connections between the Institute’s Strategic Priorities and Indigenous Engagement Strategies. The distribution of NEIHR research efforts reflects strong and balanced development in Population and Public Health research, with clear alignment to Institute Strategic Priorities.

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Summary Graph

Figure 15. Summary Graph The distribution of NEIHR-led research activity reflects a diverse and complementary range of engagement across CIHR Institutes, with clear areas of strong concentration alongside opportunities for continued expansion. Institutes such as Health Services and Policy Research, Population and Public Health, and Human Development, Child and Youth Health demonstrate particularly strong and well-established engagement, indicating robust alignment with Indigenous health research priorities.

Other areas, including Cancer Research, Genetics Research, and Musculoskeletal Health and Arthritis, represent emerging and important opportunities to further strengthen connections and broaden engagement across the full spectrum of health research.

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CIHR-IIPH and Other Projects As for CIHR’s Institute of Indigenous Peoples’ Health (IIPH), the Institute’s overarching goal is to support research that contributes to the improvement of Indigenous Peoples’ health and wellbeing. While the NEIHR PI-led projects included in Matrix 1 were not directly funded by IIPH, they nonetheless reflect this broader intention through their focus on Indigenous health, wellness, community priorities, and relationships-based research. In this way, Matrix 1 helps demonstrate the breadth of work being undertaken across the NEIHR network that is aligned with IIPH’s overall purpose and mandate.

There were several NEIHR PI-led projects that were ‘other’, that is, they did not fit within any single Institute’s mandate or were ‘cross-cutting’ across multiple Institutes (i.e., they fit into three or more Institutes and could not justly be isolated to one primary Institute).

This is particularly important, as these projects still reflect the broader intention of improving Indigenous Peoples’ health and wellbeing, even where they do not fit neatly into a single CIHR Institute mandate or cut across several Institutes. These other or crosscutting projects were not part of the 402 projects documented in Matrix 1 and were instead treated separately. In total, 22 other or cross-cutting projects were documented.

A few examples include: • The Québec NEIHR project “Skennenko:wa - A Narrative Inquiry into Experiences of Collaboration” is a publication in the International Journal of Qualitative Methods. This is a CBPR-grounded narrative inquiry to document and make sense of the relational and ethical complexities of collaborating with a Knowledge Keeper (Amelia McGregor) to co-compose shared understanding for a culturally grounded physical health education program.

• The Nunavut NEIHR is involved in finalizing a new app that provides wave height information for boating. This is based on research utilizing their community weather station network in collaboration with Carleton University and the Angunasuktiit. Currently, the team is focused on local testing of the app.

• Atlantic NEIHR is conducting a scoping review of Indigenous health research conducted within the past five years within the Atlantic region that is looking at the level of community engagement, nature and type of research being conducted, with which Indigenous communities, and in which areas of the Atlantic region is research being done. This scoping review is a re-evaluation of progress since the previous one was conducted and published in 2020.

• Northwest Territories NEIHR has an applied theatre project about youth perspectives of mental wellness and climate change in their communities (2022).

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They worked closely with an Anishnaabe playwright and educator to design the curriculum for a two-day theatre workshop with Indigenous youth (10-18 years old) in Fort Smith, Northwest Territories. The workshop used theatre to explore the youth’s experiences with climate change.

• Manitoba NEIHR project “Opening Spaces and Places for the Inclusion of Indigenous Knowledge, Voice and Identity: Moving Indigenous People out of the Margins” aims to highlight health inequities, disrupt racism, and improve health and healthcare quality for Indigenous People, including developing a national network of Indigenous researchers.

• BC NEIHR project “Critical Indigenous Relationalities Network,” is a Partnership Grant from Social Sciences and Humanities Research Council of Canada that will design and deliver graduate student training opportunities, building on experience with the cascading mentorship model from the Indigenous Mentorship Network of the Pacific Northwest (IMN-PN).

• Alberta NEIHR Indigenous Primary Health Care policy studies: 1) Building Indigenous Primary Health Care (PHC) Infrastructure and 2) Comparative policy analysis on Indigenous Primary Health Care (PHC) models in Canada.

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Recommendations and Next Steps Recommendations • To keep and grow the Matrix, including the development of future iterations, it must be resourced with funding for proper staffing. Matrix 1 was a significant undertaking for the NCC and demanded several hours of overtime by staff to be completed. Furthermore, it took several hours by staff from each of the individual regional NEIHRs to participate. As these networks are often constrained by time, budget, and staff, it is not feasible to continue the Matrix without resourcing the NCC to hire staff and compensate the individual regional NEIHRs. • In partnership, find the balance between supporting those areas of high concentration (e.g., Population and Public Health), which clearly shows evidence that these are areas of community identified priorities across all regional NEIHRs, and supporting those areas where there is room for growth and opportunity (e.g. Cancer). Some examples may include: encouraging Indigenous students and Indigenous early career researchers to pursue studies in cancer, genetics, or circulatory health; hosting an annual fully funded ‘summer institute’ or training/ networking camp; hosting a fully funded gathering that connects regional NEIHR PIs and other Indigenous trainees to health authorities, universities, and other bench scientists who are doing work in these areas; developing funding calls specific to Indigenous cancer, genetics, or circulatory health research; and opening more research and Funding Opportunities in these areas to encompass social determinants. To ensure that these goals for growth are being met, a benchmark can be set to measure progress. For example, a proposed benchmark might be six more projects in these areas by the next Matrix iteration.

• CIHR Institutes can develop Institute-specific Master’s and Doctoral awards, including capacity development or travel funds, to help build Indigenous trainee pathways in areas where Matrix 1 identified gaps, lower concentrations, or opportunities for growth.

• Conduct an impact analysis of NEIHR Research Matrix: Directions 1 (for example, through a future iteration such as NEIHR Research Matrix: Directions 3), which would require more data collection and analysis and/or conduct a statistical analysis of the 402 NEIHR PI-led projects in NEIHR Research Matrix: Directions 1.

• Create trainings for non-Indigenous researchers who have not done or have limited experience in Indigenous research, with a particular focus on bench scientists, clinicians, and healthcare authorities.

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• Use Matrix 1 as a communications and relational tool to build the language and relationships needed to connect CIHR Institutes and their scientific priorities with the NEIHR program’s mission of advancing Indigenous science, mentorship, training, and capacity. This could include identifying areas of expertise within the NEIHRs that highlight the breadth and depth of research across the NEIHR network, including methodologies and methods, as well as external funding for projects.

• Increase communications and shared information between the Tri-Agencies, NEIHRs and other key partners, emphasizing NEIHR perspectives and current projects/community-identified priorities to help create relationships. Part of an improved communications plan could be an environmental scan or meta-analysis of the research environment in the areas where there are gaps and opportunities for growth, including a measurement or tracking system to monitor data and progress.

• Increase focus on global connections in the context of advancing Indigenous health research.

• Develop a plan for the regular updating, stewardship, and strategic use of future Matrix iterations so that the Matrix can continue to serve as a living, relational, and planning tool for the NCC, NEIHRs, CIHR Institutes, Tri-Agencies, and key partners.

Next Steps: NEIHR Research Matrix - Directions 2 For next steps, our goal is to work directly with each of the CIHR Institutes to develop NEIHR Research Matrix: Directions 2 (herein to be called Matrix 2). The purpose and intent of Matrix 2 is to have each of the Institutes validate their Strategic Priorities and Indigenous Engagement Strategies that were included in Matrix 1 (i.e., headings left and middle of graphs) as well as document how they are meeting those priorities and engagements. For those Institutes that have new publicly available Strategic and Indigenous Engagement Strategies, that information can be included in the data collection and analysis. Then, based on the NEIHR PI-led projects and their leadership in Indigenous health research, Matrix 2 will offer insights into extent of progress to meeting Indigenous Engagement Strategies as well as alignment between those strategies and community identified priorities. Provided there is interest in engagement from CIHR Institutes, the NCC aims to have Matrix 2 completed and circulated by October 2026.

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