Project Updates: DenYelle Kenyon and Arielle Deutsch

April 17, 2018

DenYelle and Arielle

Center for Health Outcomes and Population Research CoBRE Grant Update from Project Leads

Dr.Kenyon and Dr. Deutsch are giving brief overviews of their CoBRE projects.

Dr. DenYelle Kenyon, PhD

DenYelle’s project is focused on American Indian educational disparity. She had great graphs that really showcase the graduation rates for American Indian, White and the U.S. total. The graphs also highlight the need to understand why these education disparities exist. She is specifically looking at social networks during the transition to college. She focused on education deserts and what that really means is being more than 25 miles from a public college and w/o high-speed internet connection to access online classes. There is 11.8% of AI/AN adults living in complete education deserts. Why is this a problem? It makes it that much harder not having a college close to where they are living. Project goal is to provide more support and resources. Currently they are doing interviews with college staff and faculty. They are also interviewing freshman student’s w/follow-up every 6 months. The students are both Native and non-native. The Kenyon team will also be doing social network analysis. This is important because then we can better understand the relationships and support that the student has during their time in college. Next step is finishing 1^st cohort data collection and began social network analyses. They will look at differences between Native and non-Native. Future steps would be to do qualitative data as well.

Arielle Deutsch, PhD

Arielle just recently got approval to start her CoBRE project . Arielle’s new to this area and South Dakota. She highlighted the story behind her research questions. Instead of doing intervention in FASD she decided to go into intimate partner violence she felt that programming in this area was lacking. She is highlighting the relationship between alcohol misuse, risky unprotected sexual behavior, pregnancy and partner violence. She believes the above is really all cycled together. She is using a community based strategy. How do we change alcohol misuse behaviors? Protected factors that would help contraception use? She is learning how the systems within the community. System dynamic model is really the same things as a community based model. Systems based approaches, really looks at the big picture on a complex issue, how does culture, individual, access come together to influence the above associations. She did a great job of explaining really what systems based approach means. It prioritizes community/indigenous knowledge, requires transfer of models to community, and developed by the community, she stressed the importance of having community by in. More work needs to be done to understand the community. She is developing ties with Native community in both Rapid City and Indian Country. Continuing to be present at community meetings and conversations. She will be doing qualitative coding of CHOICES data for themes related to protective sources of support and risk factors. She will also be doing a health longitudinal relations between IPV,alcohol and sexual risk. She will focus more on developing the relationships with the communities and building the trust and relationship.

By: Char Green-Maximo | Ft.Peck Assiniboine and Sioux Tribes (Montana) | Sanford Research - Research Assistant

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Obesity Prevention Partnerships with AI Communities

April 17, 2018

Dr. Adams

Dr. Alexandra Adams had to Skype in due to some travel restrictions, so thank goodness for technology; otherwise, they probably would have made me speak and I would've just showed pictures of my cats. Dr. Adams began her career working with tribal communities in Wisconsin and now works in Montana. Much of the work Dr. Adams has done has been with healthy lifestyles in American Indian (AI) communities. In Wisconsin, she and her team developed and implemented an obesity prevention toolkit, with the goal of increasing physical activity and decreasing screen time. Interestingly, Dr. Adams utilized child-adult pairs when looking at their weights and healthy lifestyle. They did this intervention via mailed method and in-person mentoring but saw no difference between the two methods. From this work, they saw increased family time and physical activity.

She then expanded this work to include national populations, mailed-only interventions, and social media aspects. From their initial work, they saw some issues with children sleep and safety, which they incorporated into the next phase of the study, with the goal of improving sleep and decreasing stress. They recruited in ways that many of us are familiar with: booths at community events and Facebook. They utilized Facebook for recipe-sharing and group discussions but they noticed there was a lot of “lurkers” with not much activity. Isn’t that what we all do on Facebook, though? I’m an expert “lurker/creeper.”

Food insecurity was something that was reported a lot in her studies. Stress related to this food insecurity was also high, especially for urban populations. We hear a lot about “food deserts” when it comes to AI communities and that was illustrated in some of her projects. One of the things I liked the most about the projects she spoke about, was how she really looked at the family and intervening at the family level. Dr. Adams is doing some great, interesting work with AI communities and I am so glad she was able to Skype in and share her work. It was hard to encompass all of her work because she has done so much!

By: Michaela Seiber, MPH

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Storytellers of Health

April 17, 2018

Abigail

The day we have all been waiting for has finally come! The 2018 Population Health Research Summit kicked off a little later than expected. Our first speaker was the poignant Abigail Echo-Hawk. Abigail is the director of the Urban Indian Health Institute and my new best friend (I hope she likes the best friend necklace I got her). Her talk was a beautiful story filled with rich narratives of how she got to where she is today. She began with an introduction and background of her family, sprinkling pictures of herself and her family throughout the presentation. She spoke warmly of the land she was on and has been on. Abigail grew up in Alaska and attended college at the University of Washington, and I related very much with her story about finally getting health insurance and no longer needing to depend on I.H.S. because I had a major culture shock when I moved away from my home and could no longer utilize I.H.S. but had to use the clinic in my college town. I felt lost and had no idea you had to pay for medicine!

When Abigail began her research journey, she conducted focus groups with elders. In doing these focus groups, she followed all the procedures of the focus group but found it was hard to bridge the gap between what the elders knew and showing it in numbers and I think many Native researchers struggle with this when they conduct research. Next, she gave some insight on scientific rigor and cultural rigor. Cultural rigor may be new to some of you; I know I had never heard much about it until recently. In short, cultural rigor is our way of incorporating local cultural protocol into our work. Scientific and cultural rigor do not have to contradict each other, though, even though it may seem that way.

Sometimes when things are easy (i.e. research), it may cause damage to the things surrounding it. This occasionally happens when research is done in Indian Country; researchers will take the easy way around their projects, putting their subjects at risk. As soon, as I typed that last sentence, Abigail said that actually calls research participants “storytellers of health” rather than human subjects. I like that. People who take part in our research are storytellers of health and everything they share with researchers, tells a beautiful story about themselves, their communities, and their land.

She left us with some questions that I think we all need to consider. What if we all did research because we loved our people? That is something many Native researchers struggle with; traditional, Western science tells us to not look at our research participants as people but as data and, as Natives, it’s hard to do that. I love my people and that’s why I do research. I think that everything Abigail says speaks to my heart. She talked to us a little about generosity. When we do research, what are we giving back? Researchers should think about this concept; if you are a researcher, are you doing it to get something or are you actively working to give back to the community that you are working with?

By: Michaela Seiber, MPH

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Important Update

April 15, 2018

Cecilia typewriter

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National Public Health Week: Injury and Violence Prevention

April 06, 2018

On November 22, 2014, I woke up to my mom speaking quietly but urgently to my sister. I was home for Thanksgiving, slowly waking up to get ready to watch my little brother and cousins play basketball in a town nearby. It’s funny how you can always tell when something serious has happened just by the tone of someone’s voice. My mind began racing, playing out the different tragedies that may have prompted my mom’s serious tone but I was not prepared for the coming news.

In the early hours of that morning, a young man shot four people and then himself outside a home that I had many happy memories in and my cousin was one of the people shot. She did survive after serious injuries and a lengthy recovery, and as we came to know more of the details of the horrific events, I struggled with how something like this could happen in my community and to my family. But isn’t that what everyone says when a tragedy touches them?

Intentional and unintentional injury and violence can take many forms but gun violence has been at the forefront of news lately from incredible motivation from our next generation of leaders. Generation Z is picking the rest of us up on their backs and acting with unmatched maturity and passion to combat gun violence and promote gun safety. They may not be aware of it but they are looking at and approaching this issue with a public health lens because, frankly, gun violence is a public health issue. In America, thousands of people are killed each year from guns, and when other things take lives in this capacity, we implement laws to prevent it or some of us put on our research hats and figure out what the problem is and how to fix it.

The American Public Health Association gives some great suggestions on what we need to do to tackle this public health issue:

Increase research on gun violence
Advocate for smarter gun policies
Increase gun safety education and technology
Expand mental health services

Not only does gun violence result in thousands of lives lost each year, it also costs the U.S. billions of dollars and can have a lasting impact on the survivors. At the heart of all of this is mental health and the lack of mental health services in the U.S., especially in rural areas. What is most significant about all of this is that gun violence is preventable but it will take hard work, hard conversations, and a public health approach.

MichaelaSeiber

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