Introduction Shared decision making (SDM) facilitates collaboration between people and their healthcare providers for informed health decisions. Our review identified SDM interventions to support Indigenous Peoples making health decisions.

Methods An Inuit and non-Inuit team of service providers and researchers used an integrated knowledge translation approach with framework synthesis to coproduce a systematic review. We developed a conceptual framework to describe SDM processes and guide identification of studies that describe interventions to support Indigenous Peoples making health decisions. We conducted a search of databases from September 2012 to March 2022, with a grey literature search. Two team members screened and quality appraised included studies for strengths and relevance of studies’ contributions to SDM and Indigenous self-determination. Findings were analyzed descriptively in relation to the conceptual framework.

Results Of 5068 citations screened, nine studies reported in ten publications were eligible for inclusion. We categorized the studies into clusters identified as: inclusive of Indigenous knowledges and governance (‘Indigenous-oriented’)(n=6); and based on Western academic knowledge and governance (‘Western-oriented’)(n=3). The studies were found to be of variable quality for contributions to SDM and self-determination, with Indigenous-oriented studies of higher overall quality. A revised conceptual framework reflects four themes: 1) where SDM takes place impacts decision making opportunities, 2) little is known about the characteristics of health care providers who engage in SDM processes, 3) community is a partner in SDM, 4) the SDM process involves trust- building.

Discussion There are few studies that report on and evaluate SDM interventions with Indigenous Peoples. Overall, Indigenous-oriented studies sought to make health care systems more amenable to SDM for Indigenous Peoples, while Western-oriented studies distanced SDM from the health care settings.

Conclusion Further studies that are solutions-focused and support Indigenous self-determination are needed.