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Rink E, Stotz SA, Johnson-Jennings M, Huyser K, Collins K, Manson SM, Berkowitz SA, Hebert L, Byker Shanks C, Begay K, Hicks T, Dennison M, Jiang L, Firemoon P, Johnson O, Anastario M, Ricker A, GrowingThunder R, Baldwin J. "We don't separate out these things. Everything is related": Partnerships with Indigenous Communities to Design, Implement, and Evaluate Multilevel Interventions to Reduce Health Disparities. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:474-485. [PMID: 38598040 PMCID: PMC11239303 DOI: 10.1007/s11121-024-01668-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
Multilevel interventions (MLIs) are appropriate to reduce health disparities among Indigenous peoples because of their ability to address these communities' diverse histories, dynamics, cultures, politics, and environments. Intervention science has highlighted the importance of context-sensitive MLIs in Indigenous communities that can prioritize Indigenous and local knowledge systems and emphasize the collective versus the individual. This paradigm shift away from individual-level focus interventions to community-level focus interventions underscores the need for community engagement and diverse partnerships in MLI design, implementation, and evaluation. In this paper, we discuss three case studies addressing how Indigenous partners collaborated with researchers in each stage of the design, implementation, and evaluation of MLIs to reduce health disparities impacting their communities. We highlight the following: (1) collaborations with multiple, diverse tribal partners to carry out MLIs which require iterative, consistent conversations over time; (2) inclusion of qualitative and Indigenous research methods in MLIs as a way to honor Indigenous and local knowledge systems as well as a way to understand a health disparity phenomenon in a community; and (3) relationship building, maintenance, and mutual respect among MLI partners to reconcile past research abuses, prevent extractive research practices, decolonize research processes, and generate co-created knowledge between Indigenous and academic communities.
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Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, 312 Herrick Hall, Bozeman, MT, 59715, USA.
| | - Sarah A Stotz
- Department of Food Science and Human Nutrition, Colorado State University, 502 West Lake Street, Fort Collins, CO, 80526, USA
| | - Michelle Johnson-Jennings
- Division of Indigenous Environmental Health and Land-Based Healing, Indigenous Wellness Research Institute, University of Washington, Gergerding Hall GBO, Box 351202, Seattle, WA, USA
| | - Kimberly Huyser
- Department of Sociology, Research, and Development/CIEDAR Center, COVID-19 Indigenous Engagement, University of British Columbia, 310-6251 Cecil Green Park Road, Vancouver, BC, V6T 1Z1, Canada
| | - Katie Collins
- CIEDAR co-Lead. Department of Psychology, University of Saskatchewan, 9 Campus Drive, 154 Arts, Saskatoon, SK, S7N 5A5, Canada
| | - Spero M Manson
- Colorado School of Public Health, Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, Aurora, CO, 80045, USA
| | - Seth A Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 M.L.K. Jr Blvd, Chapel Hill, NC, 27516, USA
| | - Luciana Hebert
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, 1100 Olive Way #1200, Seattle, WA, 98101, USA
| | - Carmen Byker Shanks
- Gretchen Swanson Center for Nutrition, 14301 FNB Pkwy #100, Omaha, NE, 68154, USA
| | - Kelli Begay
- Maven Collective Consulting, LLC, 15712 N Pennsylvania Avenue Cube 5, Edmond, OK, 73013, USA
| | - Teresa Hicks
- Teresa Hicks Consulting, 1107 East Babcock Street, Bozeman, MT, 59715, USA
| | - Michelle Dennison
- Oklahoma City Indian Clinic, 4913 W Reno Ave, 856 Health Sciences Quad, Suite 3400, Oklahoma City, OK, 73127, USA
| | - Luohua Jiang
- Department of Epidemiology and Biostatistics; UCI Health Sciences Complex, University of California Irvine, Program in Public Health, 856 Health Sciences Quad, Suite 3400, Irvine, CA, 92617, USA
| | - Paula Firemoon
- Fort Peck Community College, 605 Indian Ave.,, Poplar, MT, 59255, USA
| | - Olivia Johnson
- Fort Peck Community College, 605 Indian Ave.,, Poplar, MT, 59255, USA
| | - Mike Anastario
- Center for Health Equity Research, Northern Arizona University, P.O. Box 4065, Suite 120, Flagstaff, AZ, 86011-4065, USA
| | - Adriann Ricker
- Fort Peck Tribal Health Department, 501 Medicine Bear Road, Poplar, MT, 59255, USA
| | - Ramey GrowingThunder
- Fort Peck Tribes Language and Culture Department, 603 Court Ave., Poplar, MT, 59255, USA
| | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, P.O. Box 4065, Suite 120, Flagstaff, AZ, 86011-4065, USA
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Held S, Feng D, McCormick A, Schure M, Other Medicine L, Hallett J, Inouye J, Allen S, Holder S, Bull Shows B, Trottier C, Kyro A, Kropp S, Turns Plenty N. The Báa nnilah Program: Results of a Chronic-Illness Self-Management Cluster Randomized Trial with the Apsáalooke Nation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:285. [PMID: 38541285 PMCID: PMC10970069 DOI: 10.3390/ijerph21030285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024]
Abstract
Indigenous people in Montana are disproportionately affected by chronic illness (CI), a legacy of settler colonialism. Existing programs addressing CI self-management are not appropriate because they are not consonant with Indigenous cultures in general and the Apsáalooke culture specifically. A research partnership between the Apsáalooke (Crow Nation) non-profit organization Messengers for Health and Montana State University co-developed, implemented, and evaluated a CI self-management program for community members. This article examines qualitative and quantitative program impacts using a pragmatic cluster randomized clinical trial design with intervention and waitlist control arms. The quantitative and qualitative data resulted in different stories on the impact of the Báa nnilah program. Neither of the quantitative hypotheses were supported with one exception. The qualitative data showed substantial positive outcomes across multiple areas. We examine why the data sets led to two very different stories, and provide study strengths and limitations, recommendations, and future directions.
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Affiliation(s)
- Suzanne Held
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Du Feng
- Department of Nursing, University of Nevada, Las Vegas, NV 89154, USA;
| | - Alma McCormick
- Messengers for Health, Crow Agency, MT 59022, USA; (A.M.); (L.O.M.)
| | - Mark Schure
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | | | - John Hallett
- Petaluma Health Center, Petaluma, CA 94954, USA;
| | - Jillian Inouye
- Manoa School of Nursing, University of Hawaii, Honolulu, HI 96822, USA;
| | - Sarah Allen
- Department of Family Life & Human Development, Southern Utah University, Cedar City, UT 84720, USA;
| | - Shannon Holder
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Brianna Bull Shows
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Coleen Trottier
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Alexi Kyro
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Samantha Kropp
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
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Abu-Saad K, Accos M, Ziv A, Collins F, Shepherd C, Eades S, Kalter-Leibovici O. Development and Functionality of a Parsimonious Digital Food Frequency Questionnaire for a Clinical Intervention among an Indigenous Population. Nutrients 2023; 15:5012. [PMID: 38068870 PMCID: PMC10707983 DOI: 10.3390/nu15235012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Nutrition-related chronic diseases are a major problem among Indigenous populations. Appropriate dietary intake assessment tools are needed for nutritional surveillance and intervention; however, tools designed to measure the habitual dietary intake of Indigenous persons are largely lacking. We developed a digital food frequency questionnaire (FFQ) to measure habitual consumption among Australian Aboriginal adults and support personalized nutrition counseling. The primary contributors to energy, select nutrients, and inter-person variation (83 food groups) were identified from nationally representative 24 h recall (24HR) data, and they accounted for >80% of the total intake and inter-person variation of the nutrients of interest. Based on community input, a meal-based FFQ format was adopted, with a main food/beverage list of 81 items and the capacity to report on >300 additional items via the digital platform. The nutrient database was based on the Australian Food and Nutrient Database. Data for the first 60 study participants (70% female; median age: 48 years) were used to assess the FFQ's utility. The participants' median [IQR] reported energy intake (10,042 [6968-12,175] kJ/day) was similar to their median [IQR] estimated energy expenditure (10,197 [8636-11,551] kJ/day). Foods/beverages on the main FFQ list accounted for between 66% and 90% of the participants' reported energy and nutrient intakes; the remainder came from participant-selected extra items. The digital FFQ platform provides a potentially valuable resource for monitoring habitual dietary intake among Aboriginal adults and supporting chronic disease prevention and management interventions.
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Affiliation(s)
- Kathleen Abu-Saad
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Moran Accos
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Arnona Ziv
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Fiona Collins
- South West Aboriginal Medical Service, Bunbury, WA 6230, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Carrington Shepherd
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Sandra Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Ofra Kalter-Leibovici
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
- Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Dreifuss HM, Yuan NP, Russo Carroll S, Bauer MC, Teufel-Shone NI. Utilizing Digital Storytelling to Develop a Public Health Professions Pathway for Native American High School Students. Health Promot Pract 2023; 24:1174-1182. [PMID: 36565227 DOI: 10.1177/15248399221135586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Digital storytelling is a decentering methodology in health promotion that positions the storyteller as an expert to create a narrative of their lived experiences. This article describes using a two-phase digital storytelling process within the Diné (Navajo) Educational Philosophy framework to guide the development of a culturally grounded curriculum plan that actively engages Diné youth in exploring health professions pathways in their community. The first phase consisted of developing a high school digital storytelling team by training three Diné youth attending high school on the Navajo Nation located in southwest United States, in digital storytelling. In the second phase, the high school digital storytelling team worked collaboratively with seven Diné students enrolled at the local tribal college to develop digital stories about navigating from high school to college. Data from seven completed digital stories were analyzed with assistance from a community advisory board to identify asset-based themes that contributed to positively transitioning from high school to a tribal college. The results revealed several strategies for successful transitions from high school to a public health college major. The culturally relevant strategies and stories were incorporated into a school-based health professions pathway curriculum plan for Diné youth.
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Landers AL, Danes SM, Carrese DH, Mpras E, Campbell AR, White Hawk S. I can still hear my baby crying: The ambiguous loss of American Indian/Alaska Native birthmothers. FAMILY PROCESS 2023; 62:702-721. [PMID: 36117153 DOI: 10.1111/famp.12815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 06/08/2023]
Abstract
This study captures the experiences of American Indian/Alaska Native birthmothers who lost a child to adoption and the impact of said loss on their health and wellbeing. Few studies examine the loss experiences of American Indian/Alaska Native birthmothers despite their increased probability to lose a child to foster care and adoption. American Indian/Alaska Native birthmothers are distinct from birthmothers of other races in their experiences of intergenerational and historical child loss, having disproportionately lost their children to systematic practices of child removal via boarding schools, the adoption era, and child welfare. Interview data from 8 American Indian/Alaska Native birthmothers were analyzed using inductive thematic analysis. Five themes emerged including: (1) the social context of losing a child to adoption for American Indian/Alaska Native birthmothers, (2) the ambiguous loss of a child to adoption, (3) grief reactions to the loss, (4) the impact of the loss on birthmother health and wellbeing, and (5) creating resiliency. Findings suggest that American Indian/Alaska Native birthmothers experience ambiguous loss, as well as elevated mental health problems and substance abuse following the loss of a child to adoption.
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Affiliation(s)
- Ashley L Landers
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
| | - Sharon M Danes
- Department of Family Social Science, College of Education and Human Development, University of Minnesota, St. Paul, Minnesota, USA
| | - Domenica H Carrese
- Department of Human Development and Family Science, College of Liberal Arts and Human Sciences, Virginia Tech, Falls Church, Virginia, USA
| | - Evdoxia Mpras
- Department of Human Development and Family Science, College of Liberal Arts and Human Sciences, Virginia Tech, Falls Church, Virginia, USA
| | - Avery R Campbell
- Human Development and Family Science, College of Family and Consumer Sciences, University of Georgia, Athens, Georgia, USA
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Hallett J, Feng D, McCormick AKHG, Allen S, Inouye J, Schure M, Holder S, Medicine LO, Held S. Improving Chronic Illness Self-Management with the Apsáalooke Nation: The Báa nnilah Project, a cluster randomized trial protocol. Contemp Clin Trials 2022; 119:106835. [PMID: 35724843 PMCID: PMC11059207 DOI: 10.1016/j.cct.2022.106835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/26/2022] [Accepted: 06/13/2022] [Indexed: 11/24/2022]
Abstract
Chronic illness (CI) is a major cause of morbidity and mortality for Indigenous people. In Montana, Indigenous communities disproportionately experience CI, a legacy of settler colonialism. For over two decades, Messengers for Health, an Apsáalooke (Crow Indian) non-profit, and Montana State University have partnered to improve community health using a community-based participatory research (CBPR) approach. We developed Báa nnilah, an intervention utilizing community strengths, to improve CI self-management. This manuscript describes the protocol for a cluster randomized trial with two arms: an intervention group and a wait list control group, who both participated in the Báa nnilah program. Enrollment occurred through family/clan networks and community outreach and attended to limitations of existing CI self-management interventions by using an approach and content that were culturally consonant. Participants received program materials, attended seven gatherings focused on improving CI management, and received and shared health information through storytelling based on a conceptual framework from the Apsáalooke culture and incorporating CI self-management strategies. Participant support occurred within partnership dyads during and between gatherings, from community mentors, and by program staff. The study used mixed methods to evaluate the intervention, with qualitative measures including the Short Form Health Survey (SF-12), Patient Health Questionnaire (PHQ-9), Patient Activation Measure (PAM), and a suite of PROMIS measures, various physical tests and qualitative survey responses, semi-structured interviews, and outcomes shared by participants with program staff. We hypothesized that Báa nnilah would significantly improve participant health outcome measures across multiple dimensions with quality of life (QoL) as the primary outcome. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03036189. Registered on 30 January 2017. (From https://clinicaltrials.gov/ct2/show/NCT03036189).
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Affiliation(s)
- John Hallett
- University of California Davis, Department of Family and Community Medicine, 4860 Y St, Ste. 1600, Sacramento, CA 95817, USA; Montana State University, Department of Health and Human Development, 218 Herrick Hall, P.O. Box 173540, Bozeman, MT 59717-3540, USA.
| | - Du Feng
- University of Nevada Las Vegas, School of Nursing, Mail Stop: 3018, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA
| | | | - Sarah Allen
- Southern Utah University, 351 W University Blvd, Cedar City, UT 84720, USA
| | - Jillian Inouye
- University of Hawaii at Manoa, 2528 McCarthy Mall Webster Hall, Honolulu, HI 96822, USA
| | - Mark Schure
- Montana State University, Department of Health and Human Development, 218 Herrick Hall, P.O. Box 173540, Bozeman, MT 59717-3540, USA
| | - Shannon Holder
- Montana State University, Department of Health and Human Development, 218 Herrick Hall, P.O. Box 173540, Bozeman, MT 59717-3540, USA
| | | | - Suzanne Held
- Montana State University, Department of Health and Human Development, 218 Herrick Hall, P.O. Box 173540, Bozeman, MT 59717-3540, USA
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Hess JM, Vasquez Guzman CE, Hernandez-Vallant A, Handal AJ, Huyser K, Galvis M, Medina D, Casas N, Chavez MJ, Carreon Fuentes A, Goodkind JR. Innovative participatory bilingual data analysis with Latinx/@ immigrants: Language, power, and transformation. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2022; 28:389-401. [PMID: 34323510 PMCID: PMC8799768 DOI: 10.1037/cdp0000481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The insights of Latinx/@ immigrants are essential to developing interventions that better address complex multilevel phenomena impacting mental health. Despite important advances in methods that genuinely embody participatory research practices, attention to collaborative data collection, analysis, and dissemination are limited. Our aim is to describe the development and implementation of research practices to address these gaps through an emphasis on and understanding of the centrality of language in collaborative research processes. METHOD Guided from the outset by community-based participatory research principles, our community-academic research partnership recognized the importance of developing and intentionally studying our collaborative processes. As part of an ethnographic interview study with 24 Latinx/@ immigrants, a community-university research team developed innovative methods, including practices related to research team meetings, data collection, analysis, and dissemination, which we documented through ongoing discussion and reflection. RESULTS The resulting participatory research processes were grounded in a theoretical framework of praxis and language and included six innovative and iterative stages: (a) Establishing the research team, (b) planning the interview process/data collection, (c) developing the data analysis methodology, (d) interpreting findings to adapt the intervention, (e) integrating results of the participatory process into the analysis, and (f) data analysis for dissemination. CONCLUSIONS A focus on praxis and language revealed how the language of research structures' power, meaning, feeling, collaboration, analysis, and transformation. We also found that bilingual participatory analytic processes have important implications with respect to achieving genuine inclusion in rigorous research that moves toward equity for Latinx/@ immigrants and other populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Fimbel L, Pitts M, Schure M, McCormick AKHG, Held S. Recruitment, retention, and intervention adherence for a chronic illness self-management intervention with the Apsáalooke Nation. PUBLIC HEALTH REVIEW 2022; 5:4786. [PMID: 35875172 PMCID: PMC9302479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Recruitment, retention, and adherence within health intervention research have been understudied in Indigenous communities, where well-known health disparities exist. The purpose of this paper is to describe planned versus actual recruitment, retention, and adherence strategies and the evaluation of retention and adherence strategies for a community-based research study of a Chronic Illness (CI) self-management intervention within an Indigenous community. A Community-Based Participatory Research (CBPR) approach was used to develop and implement Báa nnilah, a culturally consonant educational intervention to improve CI self-management. Reasons for participant adherence and retention were tracked and recorded over time. A post-intervention survey assessed barriers and facilitators to intervention adherence. Overall, recruitment, retention, and adherence methods were successful in enrolling and maintaining participation. Using a CBPR approach and culturally consonant strategies may assist in meeting recruitment goals and improving sustained participation of community members, thus impacting health disparities among Indigenous communities.
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Affiliation(s)
- Laurel Fimbel
- Montana State University, Department of Health and Human Development, Bozeman, Montana
| | - Mikayla Pitts
- Montana State University, Department of Health and Human Development, Bozeman, Montana
| | - Mark Schure
- Montana State University, Department of Health and Human Development, Bozeman, Montana
| | | | - Suzanne Held
- Montana State University, Department of Health and Human Development, Bozeman, Montana
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Walsh K, Carroll B, MacFarlane A, O’Donovan D, Cush P. Life-Course Marginalities of Positive Health and Aging: A Participatory Approach Integrating the Lived Experiences of Older Irish Travelers and Older Homeless Adults in Multistakeholder Research Processes. QUALITATIVE HEALTH RESEARCH 2022; 32:1139-1152. [PMID: 35578753 PMCID: PMC9254379 DOI: 10.1177/10497323221100346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There is increased emphasis on adopting positive health and aging policy goals for heterogeneous older populations, and recognition of the role that participatory research approaches can play in supporting their implementation. However, questions remain about how to represent the marginalized experiences of some older populations within such processes. With a focus on older Irish ethnic Travelers and older homeless adults as two vulnerable populations in Ireland, this article presents and critically discusses a participatory approach developed to integrate marginalized older adult perspectives on positive health and aging in a multistakeholder research and development process. The qualitative methodology is first detailed, incorporating methods that harness collaboratively derived views and individual narratives (e.g., focus groups; consultation forums; in-depth interviews). Critical reflections on research implementation and specific considerations relevant to these populations are presented (e.g., trust building; one-to-one facilitation), with lessons then drawn for the design of multistakeholder participatory approaches with marginalized older populations.
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Affiliation(s)
- Kieran Walsh
- Irish Centre for Social Gerontology,
Institute for Lifecourse and Society, National University of Ireland
Galway, Galway, Ireland
| | - Brídín Carroll
- Irish Centre for Social Gerontology,
Institute for Lifecourse and Society, National University of Ireland
Galway, Galway, Ireland
| | - Anne MacFarlane
- School of Medicine, and Health Research
Institute, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Diarmuid O’Donovan
- School of Medicine, Dentistry and
Biomedical Sciences, Queens University, Belfast, Antrim, UK
| | - Peter Cush
- Irish Centre for Social Gerontology,
Institute for Lifecourse and Society, National University of Ireland
Galway, Galway, Ireland
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Allen S, Held S, Milne-Price S, McCormick A, Feng D, Inouye J, Schure M, Castille D, Howe RB, Pitts M, Keene S, Belone L, Wallerstein N. Community sharing: Contextualizing Western research notions of contamination within an Indigenous research paradigm. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 69:145-156. [PMID: 34534371 PMCID: PMC8926935 DOI: 10.1002/ajcp.12552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/26/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
Báa nnilah is a chronic illness self-management program designed by and for the Apsáalooke (Crow) community. Arising from a collaboration between an Indigenous nonprofit organization and a university-based research team, Báa nnilah's development, implementation, and evaluation have been influenced by both Indigenous and Western research paradigms (WRPs). Báa nnilah was evaluated using a randomized wait-list control group design. In a WRP, contamination, or intervention information shared by the intervention group with the control group, is actively discouraged as it makes ascertaining causality difficult, if not impossible. This approach is not consonant with Apsáalooke cultural values that include the encouragement of sharing helpful information with others, supporting an Indigenous research paradigm's (IRP) goal of benefiting the community. The purpose of this paper is to address contamination and sharing as an area of tension between WRP and IRP. We describe how the concepts of contamination and sharing within Báa nnilah's implementation and evaluation are interpreted differently when viewed from these contrasting paradigms, and set forth a call for greater exploration of Indigenous research approaches for developing, implementing, and evaluating intervention programs in Indigenous communities. (Improving Chronic Illness Management with the Apsáalooke Nation: The Báa nnilah Project.: NCT03036189), ClinicalTrials. gov: NCT03036189).
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Affiliation(s)
- Sarah Allen
- Family Life and Human Development, Southern Utah University, Cedar City, Utah, USA
| | - Suzanne Held
- Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Shauna Milne-Price
- Contra Costa Health Services, Contra Costa Family Medicine Residency, University of Washington School of Medicine, Martinez, California, USA
| | - Alma McCormick
- Executive Director of Messengers for Health, Messengers for Health, Crow Agency, Montana, USA
| | - Du Feng
- Department of Nursing, University of Nevada, Las Vegas, Nevada, USA
| | - Jillian Inouye
- John Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | - Mark Schure
- Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Dottie Castille
- National Institute on Minority Health and Health Disparities, Division of Community Health and Population Sciences, National Institutes of Health, Bethesda, Maryland, USA
| | - Rae B Howe
- Executive Director of Messengers for Health, Messengers for Health, Crow Agency, Montana, USA
| | - Mikayla Pitts
- Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Shannen Keene
- Division of the Seattle Indian Health Board, Urban Indian Health Institute, Seattle, Washington, USA
| | - Lorenda Belone
- Health Sciences Center: Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico, USA
| | - Nina Wallerstein
- Health Sciences Center: Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico, USA
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Abu-Saad K, Daoud N, Kaplan G, Ziv A, Cohen AD, Pollack D, Olmer L, Kalter-Leibovici O. A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study. PLoS One 2021; 16:e0261030. [PMID: 34890440 PMCID: PMC8664199 DOI: 10.1371/journal.pone.0261030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022] Open
Abstract
Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a 'deficit-based' discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants' knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men's, 5 women's) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants' communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09-4.63), people with disabilities (OR: 2.43; 95% CI: 1.28-4.64), and unemployed people (OR: 2.64; 95% CI: 1.28-5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25-4.09), unemployment (OR: 4.07; 95% CI: 1.64-10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03-1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants' knowledge, experience, and strengths has the potential to improve individuals' diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths.
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Affiliation(s)
- Kathleen Abu-Saad
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
- * E-mail:
| | - Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Giora Kaplan
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Arnona Ziv
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Arnon D. Cohen
- Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Daphna Pollack
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Liraz Olmer
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Ofra Kalter-Leibovici
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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12
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Smith K, McLeod J, Blunden N, Cooper M, Gabriel L, Kupfer C, McLeod J, Murphie MC, Oddli HW, Thurston M, Winter LA. A Pluralistic Perspective on Research in Psychotherapy: Harnessing Passion, Difference and Dialogue to Promote Justice and Relevance. Front Psychol 2021; 12:742676. [PMID: 34552542 PMCID: PMC8450328 DOI: 10.3389/fpsyg.2021.742676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/05/2021] [Indexed: 11/23/2022] Open
Abstract
The adoption of a pluralistic perspective on research design, processes of data collection and analysis and dissemination of findings, has the potential to enable psychotherapy research to make a more effective contribution to building a just society. A review of the key features of the concept of pluralism is followed by a historical analysis of the ways in which research in counselling, psychotherapy and related disciplines has moved in the direction of a pluralistic position around knowledge creation. Core principles of a pluralistic approach to research are identified and explored in the context of a critical case study of contemporary research into psychotherapy for depression, examples of pluralistically oriented research practices, and analysis of a pluralistic conceptualisation of the nature of evidence. Implications of a pluralistic perspective for research training and practice are discussed. Pluralistic inquiry that emphasises dialogue, collaboration, epistemic justice and the co-existence of multiple truths, creates opportunities for individuals, families and communities from a wide range of backgrounds to co-produce knowledge in ways that support their capacities for active citizenship and involvement in open democratic decision-making. To fulfil these possibilities, it is necessary for psychotherapy research to be oriented towards social goals that are sufficiently relevant to both researchers and co-participants to harness their passion and work together for a common good.
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Affiliation(s)
- Kate Smith
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - John McLeod
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | | | - Mick Cooper
- Department of Psychology, Roehampton University, London, United Kingdom
| | - Lynne Gabriel
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Christine Kupfer
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Julia McLeod
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | | | - Hanne Weie Oddli
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Mhairi Thurston
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Laura Anne Winter
- Manchester Institute of Education, Schools of Environment, Education, and Development, University of Manchester, Manchester, United Kingdom
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13
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Samuel CA, Ortiz DL. “Method and meaning”: Storytelling as decolonial praxis in the psychology of racialized peoples. NEW IDEAS IN PSYCHOLOGY 2021. [DOI: 10.1016/j.newideapsych.2021.100868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Waddell CM, de Jager MD, Gobeil J, Tacan F, Herron RV, Allan JA, Roger K. Healing journeys: Indigenous Men's reflections on resources and barriers to mental wellness. Soc Sci Med 2021; 270:113696. [PMID: 33465597 DOI: 10.1016/j.socscimed.2021.113696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/27/2020] [Accepted: 01/07/2021] [Indexed: 11/19/2022]
Abstract
Indigenous peoples in Canada and other settler colonial nations experience barriers to healing in the health care system and their communities. Drawing on four sequential sharing circles and indepth interviews with 11 Indigenous men, this article shares the stories of Indigenous men and their healing journeys with the aim of improving culturally safe support in the community. In sharing their stories, these men identified coping with colonialism, as well as trauma and grief, as barriers in their healing journey. They also described finding strength in cultural role models, fathering, as well as ceremony and connecting to the land. We discuss the implications of these findings for service provision and decolonizing community health services.
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Affiliation(s)
| | | | - J Gobeil
- Brandon Urban Aboriginal Peoples' Council, Brandon, MB, Canada
| | - F Tacan
- Brandon Friendship Centre, Brandon, MB, Canada
| | | | - J A Allan
- Brandon University, Brandon, MB, Canada
| | - K Roger
- University of Manitoba, Winnipeg, MB, Canada
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15
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Martin C, Simonds VW, Young SL, Doyle J, Lefthand M, Eggers MJ. Our Relationship to Water and Experience of Water Insecurity among Apsáalooke (Crow Indian) People, Montana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E582. [PMID: 33445579 PMCID: PMC7827827 DOI: 10.3390/ijerph18020582] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/04/2020] [Accepted: 01/06/2021] [Indexed: 11/17/2022]
Abstract
Affordable access to safe drinking water is essential to community health, yet there is limited understanding of water insecurity among Native Americans. Therefore, the focus of this paper is to describe Apsáalooke (Crow Indian) tribal members' experiences with water insecurity. For Apsáalooke people, local rivers and springs are still vitally important for traditional cultural activities. We interviewed 30 Native American adults living on the Crow Reservation in Southeastern Montana. Participants answered six open-ended interview questions about their water access, costs of obtaining water and changes in their domestic and traditional water uses. Participants emphasized how the use of water has changed over time and described the complex challenges associated with addressing water insecurity in their community, including the importance of considering the spiritual and cultural impacts of water insecurity on health. Water insecurity is a growing global problem and more attention and efforts are needed to find appropriate and affordable solutions.
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Affiliation(s)
- Christine Martin
- Crow Tribe of Indians, Crow Agency, MT 59022, USA; (S.L.Y.); (J.D.); (M.L.)
- Crow Water Quality Project, Little Big Horn College, Crow Agency, MT 59022, USA
- Crow Environmental Health Steering Committee, Little Big Horn College, Crow Agency, MT 59022, USA;
| | - Vanessa W. Simonds
- Crow Tribe of Indians, Crow Agency, MT 59022, USA; (S.L.Y.); (J.D.); (M.L.)
- Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA
| | - Sara L. Young
- Crow Tribe of Indians, Crow Agency, MT 59022, USA; (S.L.Y.); (J.D.); (M.L.)
- Crow Environmental Health Steering Committee, Little Big Horn College, Crow Agency, MT 59022, USA;
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ 86001, USA
| | - John Doyle
- Crow Tribe of Indians, Crow Agency, MT 59022, USA; (S.L.Y.); (J.D.); (M.L.)
- Crow Water Quality Project, Little Big Horn College, Crow Agency, MT 59022, USA
- Crow Environmental Health Steering Committee, Little Big Horn College, Crow Agency, MT 59022, USA;
- National Environmental Justice Advisory Council, Environmental Protection Agency, Washington, DC 20460, USA
- Department of Microbiology & Immunology, Montana State University, Bozeman, MT 59717, USA
| | - Myra Lefthand
- Crow Tribe of Indians, Crow Agency, MT 59022, USA; (S.L.Y.); (J.D.); (M.L.)
- Crow Environmental Health Steering Committee, Little Big Horn College, Crow Agency, MT 59022, USA;
| | - Margaret J. Eggers
- Crow Environmental Health Steering Committee, Little Big Horn College, Crow Agency, MT 59022, USA;
- Department of Microbiology & Immunology, Montana State University, Bozeman, MT 59717, USA
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Schure M, Allen S, Trottier C, McCormick A, Medicine LO, Castille D, Held S. Daasachchuchik: A Trauma-Informed Approach to Developing a Chronic Illness Self-Management Program for the Apsáalooke People. J Health Care Poor Underserved 2021; 31:992-1006. [PMID: 33410820 DOI: 10.1353/hpu.2020.0073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In Montana, American Indians with chronic illnesses (CIs) die 20 years earlier than their White counterparts highlighting an urgent need to develop culturally consonant CI self-management programs. Historical and current trauma places Indigenous peoples at increased health risk relative to others, and negatively influences CI self-management. The Apsáalooke Nation and Montana State University worked together to develop and implement a trauma-informed CI self-management program to improve the Apsáalooke community's health. This paper describes the origins and development of the trauma-informed components of the program. Using community stories and a literature review of trauma-informed interventions, partners co-developed culturally consonant trauma materials and activities grounded in community values and spirituality. Trauma-informed content was woven throughout three intervention gatherings and was the central focus of the gathering, Daasachchuchik ('Strong Heart'). Apsáalooke ancestors survived because of their cultural strengths and resilience; these cultural roots continue to be essential to healing from historical and current trauma.
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17
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Dáakuash I, Birdhat-Howe R, McCormick AKHG, Keene S, Hallett J, Held S. Developing an Indigenous Goal-Setting Tool: Counting Coup. TURTLE ISLAND JOURNAL OF INDIGENOUS HEALTH 2020; 1:49-57. [PMID: 33163902 PMCID: PMC7644064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Chronic illness self-management best practices include goal-setting; however, the goal theory that many tools employ relies on individualistic principles of self-efficacy that are not culturally consonant within many Indigenous communities. During the creation of the Báa nnilah program, a chronic illness self-management intervention, we developed a goal-setting tool specific to the Apsáalooke Nation. Emerging from an Indigenous paradigm and methodology, Counting Coup serves as a goal-setting tool that promotes the Apsáalooke culture, connects individuals with their ancestors, and focuses on achievement of goals within relationships. Future research and practice should be grounded in the historical and cultural contexts of local communities when designing and implementing goal-setting tools. Limitations to Counting Coup as a goal-setting tool include the need for program facilitators to have a relationship with participants due to Counting Coup's foundation in relational accountability and that the environmental context may pose difficulties for participants in moving towards healthy behavior change.
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Affiliation(s)
- Iitáa Dáakuash
- Department of Health & Human Development, Montana State University
| | - Rae Birdhat-Howe
- Department of Health & Human Development, Montana State University
| | | | - Shannen Keene
- Department of Health & Human Development, Montana State University
| | - John Hallett
- Department of Health & Human Development, Montana State University
| | - Suzanne Held
- Department of Health & Human Development, Montana State University
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18
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Dissemination of an American Indian Culturally Centered Community-Based Participatory Research Family Listening Program: Implications for Global Indigenous Well-Being. GENEALOGY 2020. [DOI: 10.3390/genealogy4040099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We introduce a culture-centered indigenous program called the Family Listening Program (FLP), which was developed through a long-standing community-based participatory research (CBPR) partnership involving tribal research teams (TRTs) from three American Indian communities (Apache, Navajo, and Pueblo) with the University of New Mexico’s Center for Participatory Research (UNM-CPR). This paper provides background information on the TRT/UNM-CPR multi-generational FLP intervention funded by the National Institute on Drug Abuse and how it is poised to take the next steps of dissemination and implementation (D&I). In preparing for the next steps, the TRT/UNM-CPR team piloted two FLP dissemination activities, first at the state-level and then nationally; this paper describes these activities. Based on the learnings from the pilot dissemination, the TRT/UNM-CPR team developed an innovative D&I model by integrating a community-based participatory research culture-centered science (CBPR-CCS) approach with the Interactive Systems Framework (ISF) to examine the uptake, cultural acceptance, and sustainability of the FLP as an evidence-based indigenous family program.
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19
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Using narrative analysis to explore traditional Sámi knowledge through storytelling about End-of-Life. Health Place 2020; 65:102424. [DOI: 10.1016/j.healthplace.2020.102424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 11/20/2022]
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20
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Vasquez Guzman CE, Hess JM, Casas N, Medina D, Galvis M, Torres DA, Handal AJ, Carreon-Fuentes A, Hernandez-Vallant A, Chavez MJ, Rodriguez F, Goodkind JR. Latinx/@ immigrant inclusion trajectories: Individual agency, structural constraints, and the role of community-based organizations in immigrant mobilities. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2020; 90:772-786. [PMID: 32853008 DOI: 10.1037/ort0000507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Immigration is at the forefront of national, state, and local policy struggles in the United States, and Latinx/@ immigrants have experienced increased deportations, detention, and individual threats. A mobilities perspective allows analysis to extend our view of migration beyond frameworks confined to pre- and postmigration, examining trajectories of social inclusion and exclusion that are influenced by multiple factors in the receiving country. The Immigrant Well-being Project, a community-based participatory research project involving university faculty, students, staff, and representatives from 4 community-based organizations (CBOs), was initiated in New Mexico in 2017 to better understand and promote Latinx/@ immigrant mental health and integration by creating change at multiple levels. We began these efforts by conducting an in-depth study of the mental health needs, stressors, current socioeconomic, legal, and political context, and local solutions as experienced by 24 Latinx/@ immigrants and their mixed status families. Five trajectories of immigrant integration emerged: continuous exclusion, simultaneous exclusion and inclusion, continuous inclusion, movement from exclusion to inclusion, and movement from inclusion to exclusion. These diverse mobilities were shaped by participants' social locations, agency, and experiences with CBOs, which played critical roles in creating, maintaining, and/or transforming immigrants' trajectories. However, CBOs could not completely buffer immigrants from the current hostile climate and related stressors that resulted in experiences of exclusion or movement from inclusion to exclusion. These findings add to understandings of immigrant mental health, complex ongoing mobility, and mechanisms of resilience and resistance within the United States and have important implications for policy and practice. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | - Alexis J Handal
- Department of Epidemiology, University of Michigan School of Public Health
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21
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Feng D, Laurel F, Castille D, McCormick AKHG, Held S. Reliability, construct validity, and measurement invariance of the PROMIS Physical Function 8b-Adult Short Form v2.0. Qual Life Res 2020; 29:3397-3406. [PMID: 32812143 DOI: 10.1007/s11136-020-02603-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE The National Institutes of Health established the Patient-Reported Outcomes Measurement Information System (PROMIS) to assess health across various chronic illnesses. The standardized PROMIS measures have been used to assess symptoms in studies that included Native American participants, although the psychometric properties of these measures have not been assessed among a solely Native American population. This study aimed to assess the reliability, construct validity, and measurement invariance of a widely used PROMIS Physical Function survey among Native Americans residing on or near the Apsáalooke (Crow) Reservation who were living with chronic illnesses. METHODS Participants aged 24 to 82 years and living with at least one chronic illness were recruited for a community-based participatory research project. Baseline data were used for the current study (N = 210). The 8-item PROMIS Physical Function 8b-Adult Short Form v2.0 was used to assess the function of upper and lower extremities, central core regions, and the ability to complete daily activities on a 5-point Likert scale. RESULTS Results indicated that the above PROMIS survey had high internal consistency (Cronbach's α = 0.95) and split-half (r = 0.92, p < 0.001) reliabilities. Confirmatory factor analyses supported construct validity among females of the above population and when the two sex groups were combined. Results also indicated that corresponding thresholds and factor loadings were invariant across male and female groups. CONCLUSIONS The above PROMIS measure had good psychometric properties in females and when the two sex groups were combined among Native American adults living on or near the Apsáalooke reservation with chronic illnesses. Thresholds and factor loadings appeared to be invariant by sex. Future studies with a larger sample size among males and more studies on the psychometric properties of other PROMIS measures among Native American populations are needed.
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Affiliation(s)
- Du Feng
- School of Nursing, University of Nevada, Las Vegas, NV, USA.
| | - Fimbel Laurel
- Department of Health and Human Development, Montana State University, Bozeman, MT, USA
| | - Dorothy Castille
- National Institute on Minority Health and Health Disparities/National Institutes of Health, Bethesda, MD, USA
| | | | - Suzanne Held
- Department of Health and Human Development, Montana State University, Bozeman, MT, USA
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Anastario M, FireMoon P, Rink E. Sexual risk behaviors and the legacy of colonial violence among Northern plains American Indian youth: A mixed methods exploratory study. Soc Sci Med 2020; 258:113120. [PMID: 32574888 PMCID: PMC7971236 DOI: 10.1016/j.socscimed.2020.113120] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/21/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In this article, we honor the tribal remembering of two Northern Plains tribes to illustrate how the legacy of colonial violence frames the way in which substance use and mental health affect sexual risk behaviors among American Indian youth on the reservation today. METHODS We used a multi-phase, mixed quantitative and qualitative methods design within a community based participatory research framework to illustrate how the legacy of colonial violence frames epidemiological links between substance use, mental health, and sexual risk behavior among American Indian youth. We conducted semistructured interviews with 29 individuals and administered questionnaires to 298 American Indian youth living in a reservation environment. RESULTS Our findings explicate how a legacy of colonial violence underlies epidemiological links between mental health and substance use with sexual risk behavior among youth. Salient facets of colonial violence included systematically altered living arrangements, the boarding school era, eroded traditional practices, and the entry of extractive industries onto native lands. DISCUSSION The colonial violence enacted against the ancestors of Northern Plains tribal peoples materializes in the health of those living on the reservation today. Community interventions, which seek to address the role of substance use and mental health in sexual risk behavior, could benefit from delineating tribal perceptions regarding the legacy of colonial violence on public health outcomes through the use of a CBPR framework.
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Affiliation(s)
| | | | - Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, MT, USA.
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23
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Held S, Hallett J, Schure M, Knows His Gun McCormick A, Allen S, Milne-Price S, Trottier C, Bull Shows B, Other Medicine L, Inouye J. Improving chronic illness self-management with the Apsáalooke Nation: Development of the Báa nnilah program. Soc Sci Med 2019; 242:112583. [PMID: 31622915 PMCID: PMC6927405 DOI: 10.1016/j.socscimed.2019.112583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 08/16/2019] [Accepted: 09/29/2019] [Indexed: 01/01/2023]
Abstract
RATIONALE Since 1996, members of the Apsáalooke (Crow) Nation and faculty and students at Montana State University have worked in a successful community-based participatory research (CBPR) partnership, leading to increased trust and improvements in health awareness, knowledge, and behaviors. As major barriers to health and healthy behaviors have caused inequities in morbidity and mortality rates for multiple chronic diseases among the Apsáalooke people, community members chose to focus the next phase of research on improving chronic illness management. OBJECTIVE Existing chronic illness self-management programs include aspects inconsonant with Apsáalooke culture and neglect local factors seen as vital to community members managing their health conditions. The aim of this study was to use CBPR methods grounded in Apsáalooke cultural values to develop an intervention for improving chronic illness self-management. METHOD Community members shared stories about what it is like to manage their chronic illness, including facilitators and barriers to chronic illness management. A culturally consonant data analysis method was used to develop a locally-based conceptual framework for understanding chronic illness management and an intervention grounded in the local culture. RESULTS Components of the intervention approach and intervention content are detailed and similarities and differences from other chronic illness management programs are described. CONCLUSIONS Our collaborative process and product may be helpful for other communities interested in using story data to develop research projects, deepen their understanding of health, and increase health equity.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jillian Inouye
- University of Hawaii, Department of Complementary & Integrative Medicine, United States
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24
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McMahon TR, Griese ER, Kenyon DB. Cultivating Native American scientists: an application of an Indigenous model to an undergraduate research experience. CULTURAL STUDIES OF SCIENCE EDUCATION 2019; 14:77-110. [PMID: 30976360 PMCID: PMC6455958 DOI: 10.1007/s11422-017-9850-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
With growing evidence demonstrating the impact of undergraduate research experiences on educational persistence, efforts are currently being made to expand these opportunities within universities and research institutions throughout the United States. Recruiting underrepresented students into these programs has become an increasingly popular method of promoting diversity in science. Given the low matriculation into postsecondary education and completion rates among Native Americans, there is a great need for Native American undergraduate research internships. Although research has shown that Western education models tend to be less effective with Native populations, the implementation of indigenous epistemologies and pedagogies within higher education, including research experiences, is rare. This study explores the applicability of a cognitive apprenticeship merged with an indigenous approach, the Circle of Courage, to build a scientific learning environment and enhance the academic and professional development of Native students engaged in an undergraduate research experience in the health sciences. Data were drawn from focus groups with 20 students who participated in this program in 2012-2014. Questions explored the extent to which relational bonds between students and mentors were cultivated as well as the impact of this experience on the development of research skills, intellectual growth, academic and professional self-determination, and the attachment of meaning to their research experiences. Data were analyzed via deductive content analysis, allowing for an assessment of how the theoretical constructs inherent to this model (belonging, mastery, independence, and generosity) impacted students. Findings suggest that engaging Native students in research experiences that prioritize the needs of belonging, mastery, independence, and generosity can be a successful means of fostering a positive learning environment, in which students felt like significant members of a research team, developed a greater understanding and appreciation for the role of science in education and its various applications to socially relevant health issues, made more informed decisions about a career in research and the health sciences, and worked toward improving the health and well-being of others while also inspiring hope among their people back home. This study represents an extension of the application of the Circle of Courage to an undergraduate research experience and provides evidence of its ability to be used as a framework for cultivating Native scientists.
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Affiliation(s)
| | - Emily R Griese
- Population Health, Sanford Research, Sioux Falls, SD, USA
- Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
| | - DenYelle Baete Kenyon
- Population Health, Sanford Research, Sioux Falls, SD, USA
- Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
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Colclough YY, Brown GM. Moving Toward Openness: Blackfeet Indians' Perception Changes Regarding Talking About End of Life. Am J Hosp Palliat Care 2018; 36:282-289. [PMID: 30556405 DOI: 10.1177/1049909118818255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study was conducted to examine cultural appropriateness and readiness for the Blackfeet people in the United States talking about end of life. In the past, a taboo perception of Blackfeet traditional belief in end-of-life discussion was identified as a core barrier for hospice use. However, a recent anecdotal increase in hospice interest triggered the research team to investigate community-wide interest as well as traditional appropriateness of hospice introduction. The community-based participatory research approach was used to conduct the study. Using convenience sampling, we interviewed 10 tribally recognized Elders and surveyed 102 tribal members who were over 18 years old using a modified Duke End-of-Life Care Survey. Here, our report focused on the perception changes on end-of-life discussion. The elders' statements were divided into two, saying that an end-of-life discussion was not against tradition and that sickness and death would break the living spirit, thus no such discussion. Despite, the importance of a family gathering and the need for knowledge about end-of-life care were confirmed. The survey (response rate 100%; n = 92) showed that 90% of the respondents thought dying was a normal part of life and 76% felt comfortable talking about death. In conclusion, there was a shift in the Blackfeet Indians' attitude toward end-of-life discussion from reluctance to at ease. Recommendations specific to the Blackfeet-related entities are presented.
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Affiliation(s)
| | - Gary M Brown
- 2 Eagle Shield Center, Blackfeet Nation, Browning, MT, USA
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Kyoon-Achan G, Lavoie J, Avery Kinew K, Phillips-Beck W, Ibrahim N, Sinclair S, Katz A. Innovating for Transformation in First Nations Health Using Community-Based Participatory Research. QUALITATIVE HEALTH RESEARCH 2018; 28:1036-1049. [PMID: 29484964 DOI: 10.1177/1049732318756056] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Community-based participatory research (CBPR) provides the opportunity to engage communities for sustainable change. We share a journey to transformation in our work with eight Manitoba First Nations seeking to improve the health of their communities and discuss lessons learned. The study used community-based participatory research approach for the conceptualization of the study, data collection, analysis, and knowledge translation. It was accomplished through a variety of methods, including qualitative interviews, administrative health data analyses, surveys, and case studies. Research relationships built on strong ethics and protocols to enhance mutual commitment to support community-driven transformation. Collaborative and respectful relationships are platforms for defining and strengthening community health care priorities. We further discuss how partnerships were forged to own and sustain innovations. This article contributes a blueprint for respectful CBPR. The outcome is a community-owned, widely recognized process that is sustainable while fulfilling researcher and funding obligations.
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Affiliation(s)
- Grace Kyoon-Achan
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Josée Lavoie
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathi Avery Kinew
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Wanda Phillips-Beck
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Naser Ibrahim
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stephanie Sinclair
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Alan Katz
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
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Bird SR, Held S, McCormick A, Hallett J, Martin C, Trottier C. The Impact of Historical and Current Loss on Chronic Illness: Perceptions of Crow (Apsáalooke) People. INTERNATIONAL JOURNAL OF INDIGENOUS HEALTH 2016; 11:198-210. [PMID: 28989931 DOI: 10.18357/ijih111201614993] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The purpose of this research was to gain a better understanding of perceptions about the impact of historical and current loss on Apsáalooke (Crow) people acquiring and coping with chronic illness. This study took a qualitative phenomenological approach by interviewing community members with chronic illness in order to gain insight into their perceptions and experiences. Participants emphasized 10 areas of impact of historical and current loss: the link between mental health and physical health/health behaviors; resiliency and strengths; connection and isolation; importance of language and language loss; changes in cultural knowledge and practices; diet; grieving; racism and discrimination; changes in land use and ownership; and boarding schools. The findings from this research are being used to develop a chronic illness self-care management program for Crow people.
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