Beyond the Belmont Principles: A Community-Based Approach to Developing an Indigenous Ethics Model and Curriculum for Training Health Researchers Working with American Indian and Alaska Native Communities

Navigating ethical challenges in psychological research involving digital remote technologies and people who use alcohol or drugs

Digital and remote technologies (DRT) are increasingly being used in scientific investigations to objectively measure human behavior during day-to-day activities. Using these devices, psychologists and other behavioral scientists can investigate health risk behaviors, such as drug and alcohol use, by closely examining the causes and consequences of monitored behaviors as they occur naturalistically. There are, however, complex ethical issues that emerge when using DRT methodologies in research with people who use substances. These issues must be identified and addressed so DRT devices can be incorporated into psychological research with this population in a manner that comports the ethical standards of the American Psychological Association. In this article, we discuss the ethical ramifications of using DRT in behavioral studies with people who use substances. Drawing on allied fields with similar ethical issues, we make recommendations to researchers who wish to incorporate DRT into their own research. Major topics include (a) threats to and methods for protecting participant and nonparticipant privacy, (b) shortcomings of traditional informed consent in DRT research, (c) researcher liabilities introduced by real-time continuous data collection, (d) threats to distributive justice arising from computational tools often used to manage and analyze DRT data, and (e) ethical implications of the "digital divide." We conclude with a more optimistic discussion of how DRT may provide safer alternatives to gold standard paradigms in substance use research, allowing researchers to test hypotheses that were previously prohibited on ethical grounds. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Did text-based news-media coverage about the COVID-19 pandemic increase vaccine uptake? A population-based study in Alaska

COVID-19 vaccinations protect against severe infection, hospitalisation, and death. News media can be an important source of information for the public during a health crisis. This study explores the extent to which local or statewide text-based news coverage of the pandemic was related to the uptake of initial doses of COVID-19 vaccines among adults in Alaska. Multilevel modelling was employed to explore the association between news media intensity and vaccine uptake rates across boroughs and census areas, while controlling for relevant covariates. Results suggest that the intensity of news media did not significantly influence vaccine uptake during the majority of this time period and had a negative affect during the Delta-surge in the fall of 2021. However, the political lean and median age of boroughs or census areas were significantly associated with vaccine uptake. Race, poverty, or education were not significant determinants of vaccine uptake suggesting there are unique differences in Alaska compared to the U.S., particularly amongst Alaska Native people. The political environment in Alaska surrounding the pandemic was polarized. Future research in communications and channels that can cut through this polarized and politicized environment, and reach younger adults is needed.

Indigenous Cultural Safety Training for Applied Health, Social Work, and Education Professionals: A PRISMA Scoping Review

Anti-Indigenous racism is a widespread social problem in health and education systems in English-speaking colonized countries. Cultural safety training (CST) is often promoted as a key strategy to address this problem, yet little evidence exists on how CST is operationalized and evaluated in health and education systems. This scoping review sought to broadly synthesize the academic literature on how CST programs are developed, implemented, and evaluated in the applied health, social work and education fields in Canada, United States, Australia, and New Zealand. MEDLINE, EMBASE, CINAHL, ERIC, and ASSIA were searched for articles published between 1996 and 2020. The Joanna Briggs Institute's three-step search strategy and PRISMA extension for scoping reviews were adopted, with 134 articles included. CST programs have grown significantly in the health, social work, and education fields in the last three decades, and they vary significantly in their objectives, modalities, timelines, and how they are evaluated. The involvement of Indigenous peoples in CST programs is common, but their roles are rarely specified. Indigenous groups must be intentionally and meaningfully engaged throughout the entire duration of research and practice. Cultural safety and various related concepts should be careful considered and applied for the relevant context.

Extracting the practices of paleogenomics: A study of ancient DNA labs and research in relation to Native Americans and Indigenous peoples

OBJECTIVES

The field of paleogenomics has rapidly grown, influencing a range of scientific fields and drawing notice from the public. In the United States, this work is especially salient for Native Americans, who are frequently the subject of ancient DNA analyses, but are less frequently included as researchers, collaborators, or advisors. This article seeks to deepen our understanding of the current state of paleogenomics so that the field can center Indigenous peoples and their experiences, knowledges, and stakes in the research process.

MATERIALS AND METHODS

We conducted 31 semi-structured interviews with researchers from three paleogenomics labs located in North America and Europe. We used a responsive interviewing technique where the interview resembled a conversation around a set of questions that could change depending upon the interviewee's answers and experiences. We then employed a theme-based analysis of the interviews.

RESULTS

Through this analysis, we are able to identify practices in the field related to training, the structuring of labs and projects, consent, data control, Ancestor care, and funding that influence various forms of engagement with Indigenous peoples, and which foster or delimit ethical commitments to descendant communities.

DISCUSSION

This research not only elucidates contemporary practices in paleogenomics labs but also identifies specific areas of potential intervention to help researchers work toward ethical and collaborative paleogenomic research with Indigenous peoples. Using these results, researchers and community advocates can work toward reorienting the field of paleogenomics toward ethical research with Indigenous peoples.

Using experiential learning and authentic assessments to support students to become competent health promotion practitioners

TITLE

Using experiential learning and authentic assessments to support students to become competent health promotion practitioners.

ISSUE ADDRESSED

The aim of this article is to describe how experiential learning, authentic assessments, community development and ethical principles were consolidated in the design and delivery of a health promotion planning and evaluation subject (HPE) during 2019 to 2021. Experiential learning and authentic assessments were used to guide the development of health promotion competencies in line with the International Union for Health Promotion and Education (IUHPE) Core Competencies and Professional Standards for Health Promotion. Students were required to complete three sequential authentic assessments. Ethics approval was granted for students to undertake a needs/assets assessment with a local community group following which, students completed a literature review and planned a community development program.

METHODS

The subject comprises 10 h of weekly engagement over a 12-week semester with weekly topics following a program logic model. Working in teams and individually, students work with a local community group to assess their needs/assets and establish priority areas regarding health and wellbeing. This then informed the development of a health promotion program and evaluation plan. Students undertook three sequential authentic assessment tasks: (i) needs/assets report, (ii) a literature review and (iii) a program folio. Retrospective anonymous student feedback on subject (SFS) data from 2019 to 2021 was used to evaluate HPE.

RESULTS AND DISCUSSION

HPE provides students with the opportunity to understand ethical principles and processes, engage with stakeholders in the community and develop qualitative research skills, to plan and evaluate health promotion programs. SFS scores have improved with an overall score of 3.7 (response rate 49.44%) in 2019 to 4.3 (response rate 39.58%) in 2020 and 4.04 (response rate 28.57%) in 2021.

CONCLUSION

Students acquire a broad range of knowledge and skills in line with IUHPE Core Competency and Professional Standards for Health Promotion preparing them for their future professional practice. SO WHAT?: These teaching and learning experiences show that students can develop health promotion competencies through sound pedagogical approaches, both online and face-to-face and in challenging environments.

Indigenous Mentorship in the Health Sciences: Actions and Approaches of Mentors

Phenomenon: Indigenous and non-Indigenous scholars have called for mentorship as a viable approach to supporting the retention and professional development of Indigenous students in the health sciences. In the context of Canadian reconciliation efforts with Indigenous Peoples, we developed an Indigenous mentorship model that details behavioral themes that are distinct or unique from non-Indigenous mentorship.Approach: We used Flanagan's Critical Incidents Technique to derive mentorship behaviors from the literature, and focus groups with Indigenous faculty in the health sciences associated with the AIM-HI network funded by the Canadian Institutes of Health Research. Identified behaviors were analyzed using Lincoln and Guba's Cutting-and-Sorting technique.Findings: Confirming and extending research on mainstream mentorship, we identified behavioral themes for 1) basic mentoring interactions, 2) psychosocial support, 3) professional support, 4) academic support, and 5) job-specific support. Unique behavioral themes for Indigenous mentors included 1) utilizing a mentee-centered approach, 2) advocating on behalf of their mentees and encouraging them to advocate for themselves, 3) imbuing criticality, 4) teaching relationalism, 5) following traditional cultural protocols, and 6) fostering Indigenous identity.Insights: Mentorship involves interactive behaviors that support the academic, occupational, and psychosocial needs of the mentee. Indigenous mentees experience these needs differently than non-Indigenous mentees, as evidenced by mentor behaviors that are unique to Indigenous mentor and mentee dyads. Despite serving similar functions, mentorship varies across cultures in its approach, assumptions, and content. Mentorship programs designed for Indigenous participants should consider how standard models might fail to support their needs.

Precision medicine research with American Indian and Alaska Native communities: Results of a deliberative engagement with tribal leaders

PURPOSE

Amid calls for greater diversity in precision medicine research, the perspectives of Indigenous people have been underexplored. Our goals were to understand tribal leaders' views regarding the potential benefits and risks of such research, explore its priority for their communities, and identify the policies and safeguards they consider essential. This article reports on the participants' perspectives regarding governance and policy, stewardship and sharing of information and biospecimens, and informed consent.

METHODS

After informal local dialogs with 21 tribal leaders, we convened a 2.5-day deliberation with tribal leaders (N = 10) in Anchorage, Alaska, in June 2019 using a combination of small group and plenary discussion, ranking, and voting exercises to explore the perspectives on precision medicine research.

RESULTS

Tribal sovereignty was central to participants' ideas about precision medicine research. Although views were generally positive, provided that the appropriate controls were in place, some kinds of research were deemed unacceptable, and the collection of certain biospecimens was rejected by some participants. Differences were observed regarding the acceptability of broad consent.

CONCLUSION

Tribal leaders in this study were generally supportive of precision medicine research, with the caveat that tribal oversight is essential for the establishment of research repositories and the conduct of research involving Indigenous participants.

Perspectives of Region XI Head Start Federal, Research, and Program Partners in Carrying out a National Study of American Indian and Alaska Native Head Start Children, Families, and Programs

The American Indian and Alaska Native Head Start Family and Child Experiences Survey (AIAN FACES) 2015 was the first national study of children served by Region XI Head Start programs, which are those operated by federally recognized AIAN tribes. Until 2015, Region XI programs had not been included in national studies of Head Start children's experiences and development, leaving them without this critical source of data to inform policy and practice as is available to other Head Start regions. To address this gap, four groups of stakeholders gathered to plan for a study that put the needs of Region XI Head Start at the forefront, was informed by the historical context of research with AIAN communities, and was guided by community psychology and community-based and tribal participatory approaches. Engaged partnership is a common practice in research with AIAN communities, but rarely on a national scale across diverse communities. The study's success speaks to the success of the unique national partnership between the Region XI Head Start, research, and federal stakeholders who formed the AIAN FACES Workgroup. This first-person account documents the perspective of each group as they undertook this seminal effort and reviews connections with, and lessons learned for, the broader field of community psychology.

Lessons on Resilient Research: Adapting the Tribal Turning Point Study to COVID-19

Tribal Turning Point (TTP) is a community-based randomized controlled trial of a lifestyle intervention to reduce risk factors for type 2 diabetes in Native youth. TTP began in 2018 and was interrupted by the COVID-19 pandemic in 2020. In this paper we aimed to understand 1) how the pandemic impacted TTP's operations, and how the TTP team successfully adapted to these impacts; 2) how the effects of COVID-19 and our adaptations to them were similar or different across TTP's research sites; and 3) lessons learned from this experience that may help other Native health research teams be resilient in this and future crises. Using a collaborative mixed methods approach, this report explored five a priori domains of adaptation: intervention delivery, participant engagement, data collection, analytic strategies, and team operations. We derived three lessons learned: 1) ensure that support offered is flexible to differing needs and responsive to changes over time; 2) adapt collaboratively and iteratively while remaining rooted in community; and 3) recognize that relationships are the foundation of successful research.

Strategies for culturally safe research with Native American communities: An integrative review

Background:

A history of unethical research and deficit-based paradigms have contributed to profound mistrust of research among Native Americans, serving as an important call to action. Lack of cultural safety in research with Native Americans limits integration of cultural and contextual knowledge that is valuable for understanding challenges and making progress toward sustainable change.

Aim:

To identify strategies for promoting cultural safety, accountability, and sustainability in research with Native American communities.

Method:

Using an integrative review approach, three distinct processes were carried out: (1) appraisal of peer-reviewed literature (Scopus, PubMed, and ProQuest), (2) review of grey literature (e.g. policy documents and guidelines), and (3) synthesis of recommendations for promoting cultural safety.

Results:

A total of 378 articles were screened for inclusion, with 55 peer-reviewed and grey literature articles extracted for full review. Recommendations from included articles were synthesised into strategies aligned with eight thematic areas for improving cultural safety in research with Native American communities.

Conclusions:

Research aiming to understand, respect, and acknowledge tribal sovereignty, address historical trauma, and endorse Indigenous methods is essential. Culturally appropriate, community-based and -engaged research collaborations with Native American communities can signal a reparative effort, re-establish trust, and inform pragmatic solutions. Rigorous research led by Native American people is critical to address common and complex health challenges faced by Native American communities.

Impact statement:

Respect and rigorous methods ensure cultural safety, accountability, and sustainability in research with Native Americans.

Extending Research Protections to Tribal Communities

The history of research in American Indian/Alaska Native (AI/AN) communities has been marked by unethical practices, resulting in mistrust and reluctance to participate in research. Harms are not limited to individual persons-tribal communities experience harmful misrepresentation and generalizations disrespectful of AI/AN groups' heritage, cultures, and beliefs. The Belmont Report's research ethics principles are applied primarily to protect individual research participants. The principles of sovereignty and solidarity are argued to be important concepts in extending Belmont's research protections to tribal communities. Sovereignty, an expression of respect for autonomy at a group level, is the basis for tribal self-determination. The principle of solidarity provides an ethical underpinning for tribes' obligations to protect community interests and culture. Extension of Belmont through these principles should serve to minimize harms to AI/AN groups in research.

Enacting Treaty Rights through Restoring Shoshone Ancestral Foods on the Wind River Indian Reservation

Despite great loss in gathering and consumption of traditional foods among Indigenous communities, there is great hope for reclaiming and preserving knowledge. The Restoring Shoshone Ancestral Food Gathering (RSAFG) is a community group leading grassroots efforts on the Wind River reservation to reclaim Shoshone ancestral foods and promote food sovereignty. The story of the RSAFG promotes equitable, decolonized, and community empowered methods of reclaiming Indigenous foods by sharing three of RSAFG's acts of decolonization: 1) enacting treaty rights through gathering traditional plants, 2) demanding equitable partnerships in community-based research, and 3) sharing the story through radical authorship via layered narratives. A pesar de la gran pérdida en la recolección y el consumo de alimentos tradicionales entre las comunidades indígenas, existe una gran esperanza para recuperar y preservar el conocimiento. El Restoring Shoshone Ancestral Food Gathering (RSAFG) es un grupo comunitario que lidera los esfuerzos de base en la reserva wind river para recuperar los alimentos ancestrales shoshone y promover la soberanía alimentaria. La historia de la RSAFG promueve métodos equitativos, descolonizados y empoderados por la comunidad para recuperar los alimentos indígenas al compartir tres de los actos de descolonización de RSAFG: 1) promulgar los derechos de los tratados mediante la recolección de plantas tradicionales, 2) exigir asociaciones equitativas en la investigación basada en la comunidad, y 3) compartir la historia a través de la autoría radical a través de narrativas en capas.

Prevalence of Moderate and Acute Suicidal Ideation among a National Sample of Tribal College and University Students 2014-2015

OBJECTIVES

To examine the relationship between suicide risk and hazardous drinking, depression, and anxiety, adjusting for demographics, among tribal college students across the United States. Methods. We invited tribal college students enrolled in 22 tribal colleges from fall 2014 and 2015 to participate in the Creating Campus Change study, a cross-sectional online/paper survey assessing alcohol use patterns and mental health outcomes. 3,239 students participated in the survey, yielding a response rate of 31.3%. We assessed alcohol use, depression, and general anxiety, along with demographic characteristics. We used the Mini-International Neuropsychiatric Interview to assess suicide risk. Results. 8.5% indicated moderate or high suicide risk. In the final adjusted model, moderate/high depression was significantly associated with moderate/high suicide risk (OR = 6.64; 3.91-11.28, p < 0.001), as was moderate/high general anxiety (OR = 2.80; 1.58-4.97, p < 0.001), and moderate/high hazardous drinking (OR = 2.09; 1.19-3.66, p < 0.001). Conclusions. Students attending tribal colleges who report moderate/high levels of depression, anxiety, or hazardous drinking have a greater risk of suicidality. Identifying factors buffering the risk of suicidality could support policy changes necessary to address this critical public health issue.

Urban American Indian and Alaska Native Data Sovereignty: Ethical Issues

This paper examines the ethical issues underlying research with urban American Indians and Alaska Natives (AI/ANs) through the lens of tribal sovereignty. There are 574 federally recognized tribes within the United States. Each of those tribes is recognized by the federal government as having sovereign status, an important political designation that ensures that decisions impacting tribal peoples must be made after consultation with those nations. Most AI/AN people live away from their designated tribal lands, yet their sovereign rights are frequently only recognized when living on tribal lands. These urban AI/ANs are still considered citizens of their sovereign nations, yet they lack the protections afforded to those who live on tribal lands, including protections surrounding research with their tribal communities. We explore the Belmont Report and related documents and demonstrate their inadequacy in considering the cultural and ethical concerns specific to protecting urban AI/ANs. We also provide several solutions to help guide future institutional policies regarding research with urban AI/ANs that honors Indigenous data sovereignty, including consultation, partnership with community advisory boards, employment of data use agreements, and ensuring informed consent.