Documenting and Promoting Resilience In Urban American Indians

1. Documenting and Promoting Resilience In Urban American Indians Carmella Kahn-Thornbrugh, MPH Shannon Whitewater June 5, 2014

2. CAIR Team

3. Tucson Indian Center • Vision Statement • To have a prosperous, healthy, unified, and politically strong urban American Indian Community that promotes and preserves our culture

4. Background • Role of American Indian (AI) elders • Keepers and transmitters of knowledge (Wexler, 2011) • Endured many adversities (Grandbois & Sanders, 2009) • Life stories hold life lessons and foundational knowledge to better understand resilience • Youth in today’s society • Disconnect between elders and youth (Wexler, 2011) • Urban AI youth face greater challenges connecting with elders (Stumblingbear-Riddle, 2012) • Previous research acknowledges that ties to culture and other variables (i.e. social support) may be protective and lead to resilient outcomes for positive youth development ((LaFromboise et al., 2006; Wexler, 2011)

5. Protective intergenerational strategies • Spirituality • Tribal identity • Elders • Ceremonies and rituals • Humor • Oral tradition • Family • Support networks (HeavyRunner and Morris, 1997) • What protective strategies can elders offer to enhance resiliency among urban American Indian youth?

6. Goal of the project • Document life narratives and develop digital stories on resilience of urban American Indian (AI) elders that will be incorporated into 12 bi-monthly workshops for youth and family programs at the Tucson Indian Center (TIC), Tucson, Arizona

7. Methodology: • ; • Develop a partnership between UA MEZCOPH and TIC • Form community advisory board (CAB): UA MEZCOPH and TIC staff members and urban AI elders • Conduct one focus group with 15 AI elders • 2 hours – 13 females and 2 males – age 55+ • Voice/audio recorded and transcribed • Used to revise elder interview questions

8. Sample questions from our interview guide • What do you think of when you hear the words “historical trauma”? • How have your ancestors’ experiences with historical trauma or historical cultural shock impacted your community (or communities you have lived in)? • What are some examples of community resiliency that have helped your urban community face the challenges related to historical trauma or [term suggested by elder]? • How important are spiritual resources in coping with life’s challenges?

9. Methodology continued: • Hold CAB member training in Human Subject Protection and qualitative data analysis • Conduct 13 elder interviews • Video/audio recording • Structured, open-ended questionnaire with 26 questions • 2 sections: Historical Trauma – Resilience

10. Elder Interviews • 11 females, 2 males; age 55+ • 1-3 hour duration; video/voice recorded • UA staff edited stories • 2nd interview for digital story

11. Methodology continued: • Transcribed13 elder interviews • Combined consensus and thematic analysis • Consensus approach to develop thematic codes (based on focus group) • NVIVO coding • Codes were shared with the team for curriculum design • (CAB) Team consensus of final analysis and draft curriculum outline

12. Thematic Codes Used in NVIVO

13. Methodology continued: • Create digital stories based on themes/codes from elder interviews for the youth curriculum • Review digital stories with elders (future step) and CAB • Develop 12 bi-monthly workshops around the digital stories and the qualitative interview themes • Pilot test and evaluate workshops at TIC • Target age: 8th grade to 11th grade

14. Qualitative Interview Process • Build trust and comfort • Address appearance concerns • Refreshments and time for breaks • Learning process • Technical difficulties (camera, memory cards, lighting, microphones, minimize noise) • Room issues

15. Digital stories for curriculum

16. Conclusion • This pilot project offers an opportunity for AI elders, UA staff, and TIC staff to join together to explore the resilience of urban AI elders and to develop a culturally appropriate intervention to benefit youth and families through TIC programs.

17. Thank you • Sponsor: National Institute On Minority Health And Health Disparities of the National Institutes of Health under Award Number P20MD006872. • Tucson Indian Center: Jacob Bernal, Marlene Jose, Phoebe Mills-Cager, CAIR Community Advisory Board members. • Contact Information: Carmella Kahn-Thornbrugh, ckahn@email.arizona.edu Agnes Attakai, MPA, Co-PI, agnesa@email.arizona.edu Kerstin M. Reinschmidt, PhD, MPH, Co-PI kerstin@email.arizona.edu

18. References • Gandbois, D. M., & Sanders, G. F. (2009). The resilience of Native American elders. Issues in Mental Health Nursing, 30, 569-580. • HeavyRunner, I., & Morris, J. S. (1997). Traditional Native culture and resilience. CAREI Research/Practice Newsletter, 5(1). • LaFromboise, T. D., Hoyt, D. R., Oliver, L., & Whitbeck, L. B. (2006). Family, community, and school influences on resilience among American Indian adolescents in the upper midwest. Journal of Community Psychology, 34(2), 193-209. • Stumblingbear-Riddle, G., & Romans, J. S. C. (2012). Resilience among urban American Indian adolescents: Exploration into the role of culture, self-esteem, subjective well-being, and social support. American Indian and Alaska Mental Health Research, 19(2), 1-19. • Wexler, L. (2011). Intergenerational dialogue exchange and action: Introducing a community-based participatory approach to connect youth, adults and elders in an Alaskan Native community. International Journal of Qualitative Methods, 10(3), 248-264.