{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:55:59Z","timestamp":1782496559307,"version":"3.54.5"},"reference-count":33,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"unspecified","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canadian Chiropractic Research Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,20]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the prevalence and factors associated with pain-related disabilities among First Nations people living off-reserve in Canada in 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>Secondary analysis of the 2017 Aboriginal Peoples Survey, a cross-sectional survey of individuals living in private dwellings throughout Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>First Nations people living off-reserve aged 15 years and older (n=9115; weighted n=482\u2009066).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measure<\/jats:title>\n                    <jats:p>Pain-related disabilities, defined as pain-related activity limitations lasting \u22656 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 22.1% (95% CI 20.9% to 23.4%) of First Nations people living off-reserve reported pain-related disabilities. Prevalence was higher among females (26.1%; 95%\u2009CI (24.3% to 28.0%)), increased with age (34.3%; 95%\u2009CI (30.3% to 38.5%) among those 45 to 54 years) and was similar across geographic areas (ranging from 21.0%; 95%\u2009CI (18.3% to 23.9%) to 22.5%; 95%\u2009CI (20.8% to 24.2%)). Pain-related disabilities increased with the number of coexisting disabilities (96.2%; 95%\u2009CI (94.3% to 97.5%) among those with &gt;3 disabilities) and was highest among those reporting physical disabilities (ranging from 88.2%; 95%\u2009CI (85.6% to 90.4%) for those with mobility disabilities to 91.0%; 95%\u2009CI (88.6% to 92.9%) for those with disability related to flexibility). Regression models suggested that individuals with unmet basic needs, housing dissatisfaction, unmet healthcare needs, a history of mental health consultations, part-time or no employment, chronic conditions, residential school attendance or a low sense of belonging were more likely to report pain-related disabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pain-related disabilities are common among First Nations people living off-reserve, and their aetiology may be multifactorial. Continued collaboration with Indigenous partners is required to contextualise findings and to inform culturally responsive clinical and rehabilitation strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-112054","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T17:10:27Z","timestamp":1771953027000},"page":"e112054","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of and factors associated with pain-related disabilities among First Nations people living off-reserve in Canada in 2017: a secondary analysis of data from the 2017 Aboriginal Peoples Survey"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0050-0956","authenticated-orcid":false,"given":"Astrid","family":"DeSouza","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada"},{"name":"Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Cancelliere","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada"},{"name":"Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheilah","family":"Hogg-Johnson","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada"},{"name":"Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada"},{"name":"Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J","family":"Sheppard","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Indigenous Health Unit, Ontario Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Taylor","sequence":"additional","affiliation":[{"name":"Sacred Water Circle, Peterborough, Ontario, Canada"},{"name":"Curve Lake First Nation, Peterborough, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L","family":"Ward","sequence":"additional","affiliation":[{"name":"Natoaganeg Mi\u2019kmaq Nation, Eel Ground, New Brunswick, Canada"},{"name":"University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Radyk","sequence":"additional","affiliation":[{"name":"Indigenous Advisory Committee, Kitchener, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen","family":"Maher","sequence":"additional","affiliation":[{"name":"Indigenous Advisory Committee, Sydney, Nova Scotia, Canada"},{"name":"M\u00e9tis Nation of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordyn","family":"Garner","sequence":"additional","affiliation":[{"name":"Indigenous Advisory Committee, Penetanguishene, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Lynds","sequence":"additional","affiliation":[{"name":"Indigenous Advisory Committee, St. Catharines, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6986-6676","authenticated-orcid":false,"given":"Pierre","family":"C\u00f4t\u00e9","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada"},{"name":"Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"2026062610413953000_16.2.e112054.1","unstructured":"Rivas Velarde MC . 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