Welcome to CAIR Investigator Partnership Workshop

1. Welcome to CAIR Investigator Partnership Workshop July 10-11, 2014 Native American Cultural Center Northern Arizona University

2. CAIR is an Exploratory Center of Excellence funded by the National Institutes of Health’s National Institute of Minority Health and Health Disparities (NIH-NIMHD) (award numberP20MD006872) CAIR is a collaborative effort • Northern Arizona University, Flagstaff AZ (PI: P Sanderson) • University of Arizona, Tucson AZ (PI: N Teufel-Shone) • Diné College, Shiprock NM (PI: M Bauer) • Executive Advisory Board working at federal and university levels • Community Advisory Board working at the community level

3. Why a Center for American Indian Resilience (CAIR)? • American Indian Public Health tends to take a disease and/or deficit approach • The goals of CAIR are to provide an opportunity: • to examine community assets, e.g., the role of traditional knowledge, collective memory and cultural strategies in teaching health behaviors and supporting positive health outcomes • to document these health strategies and positive behaviors oftentimes not collected in public health research • to transfer and integrate collective native wisdom, knowledge and experience into contemporary public education and health promotion intervention

4. Center for American Indian Resilience NIMHD Exploratory Center Of Excellence Principal Investigators/ Directors: Sanderson PhD and Teufel-Shone PhD Support Personnel: J Kerata (NAU), J Assini (UA) and Whitewater (UA) Executive Advisory Board (EAB) Core Directors Community Advisory Board (CAB) • Administration • Directors • Sanderson, PhD (NAU) • Teufel-Shone, PhD (UA) • Aim: Provide the administrative structure, coordination and resources for a trans-disciplinary, multi-institutional team to collectively advance resilience research, education and application for their purpose of reducing health disparities specifically in American Indians. • Evaluation • Trotter, PhD and Laurila,, MA (NAU) • Executive Advisory Board • EAB Chair • Dutton, PhD (NAU) Research Directors Teufel-Shone, PhD (UA)* Trujillo, PhD (NAU) Aim: Use a community-based participatory research approach to identify, assess, translate and apply models of resilience associated with positive outcomes in American Indians. Sub Research Projects Hardy, PhD and Begay, PhD (NAU) Attakai, MBA and Reinschmidt (UA) Research Training & Education Directors Hamill, PhD (NAU) Bauer, PhD (Diné College) Ehiri, PhD (UA) Aim: Use a summer research enhancement program that provides intensive research coursework and field experiences, graduate research assistantships an seminars to guide and cultivate the exploration an application of resilience models among predominantly American Indian undergraduate and graduate students at NAU, UA and Diné College. Community Engagement & Outreach Directors Sanderson, PhD (NAU) Chico, MPH (UA) Aim: Leverage existing and new tribal and institutional partnerships to establish and advisory board with expertise in community-based American Indian public health practice to build local capacity to integrate evidence-based models of resilience in 9-12 science education, health promotion and practice and health policy.

5. Strength Based Thinking and Community Based Participatory Research (CBPR) Nicolette Teufel-Shone, PhD and Octaviana Trujillo, PhD CAIR Investigator Partnership Workshop July 10-11,2014

6. Strength or Asset Based Thinking • Aligns with a resilience approach and research • Focuses and identifies on what is going well • Taking stock of what we already have in terms of resources, abilities, and commitment • Using Cramer acronym – You ROC • R - Resilience • O - Optimism • C - Confidence

7. Asset based statements • American Indian/Alaska Native (AI/AN) adolescent females were 30% more likely to receive an HPV vaccine in 2011, as compared to non-Hispanic whites • The 32 tribally controlled colleges experience a greater increase in AI/AN student retention than all other colleges (Trujillo and Alston 2005) • A tribe-specific social service program documented a decrease in intimate partner violence over the last 5 years

8. Asset based thinking • Does not ignore the challenges • Identifies successes • Explores resilience strategies • Documents processes and lessons to be learned from positive outcomes • Tests application of successful approaches to other challenges • Encourages us to thinking outside of the box

9. Draw 9 DotsConnect using 4 straight lines

10. Solution

11. Words can be powerful • Health promotion • Protective factors • Heart disease • Opportunities • Learning from mistakes • Disease prevention • Risk factors • Heart health • Problems • Failure Reflect on the way you see and talk about everything

12. Result • Asset/Strength based thinking • Supports creativity and problem solving • Contributes to resilience and confidence • ROC • Deficit based thinking • Creates a mentality of fear and hopelessness • Supports an environment of low morale and repressed motivation • Assets Success breeds confidence

13. Community-Based Participatory Research is built on the notion that research can be a force for social change

14. Community Based Participatory Research (CBPR) • Partnership approach to research that equitably involves community members and researchers in all aspects of the research process • Partners contribute their expertise, share responsibilities and integrate knowledge to improve the community • Engages the community as an entity that makes decisions and shares in the responsibility for the research • Evidence-based? (Wallerstein and Duran 2010)

15. CBPR is distinct from….. • Community-based research in which the community is engaged as the setting or place of research • Community outreach which emphasizes service

16. Key Principles of CBPR • Recognizes the shared roles of the community and research institute/university • Builds on the strengths and resources within the community • Facilitates collaborative, equitable involvement of all partners in all phases of research • Integrates knowledge and intervention for mutual benefits of all partners

17. Key principles of CBPR • Promotes co-learning and empowering process that addresses social inequalities • Involves a cyclical and iterative process • Address challenges from both positive and holistic perspectives • Disseminates findings and knowledge gained to all partners’ constituents/stakeholders • Involves a long-term commitment by all partners

18. Why use CBPR over more classic research approaches? • Addresses the needs of the community • Enhances local relevance of the approach • Enhances acceptability of the approach • Builds local skills and assumedly would improve sustainability of an intervention

19. CBPR faces methodological challenges • Who is the community? • Who represents the community (McKenna et al. 2011) • Differential partner goals: knowledge production vs improving programs • Time • Integrating different skills and “ways of knowing” (e.g., problem solving) • Are communities ready? (Readiness Tool 2010) • Are researchers ready?

20. CBPR faces philosophical challenges • Balance of power and privilege between the community and university partners • Tribal community context (e.g., priority of outcome application, need for research capacity) (Fisher and Ball 2005) • Institutional Review Board (IRB) process • Community members are researchers • Expertise of the IRB review?

21. Exercises • Identify assets in your setting/program/ community • Employee skill sets • Measured successful outcomes • Communication channels

22. Questions? Nicky Teufel-Shone teufel@email.arizona.edu

23. Support and Dissemination of CBPR efforts

24. Support for Collaborative Work “important not to bark up the wrong tree” • Federal funding Agencies • National Institutes of Health (NIH) (27 Institutes, variable receptivity to CBPR) • Center for Disease Control and Prevention (CDC) support Prevention Research Centers that use CBPR • Substance Abuse and Mental Health Service Administration (SAMSHA) • Foundations • Robert Wood Johnson Foundation • Annie E. Casey Foundation

25. Dissemination of Outcomes • Community venues • Newspaper and Newsletters (Gamyu? example) • Gatherings (ppts?) – general or specific audience • Radio • Practitioner venues • Newsletters • Association website sites • Journals (peer reviewed/index) • Scientific venues • Conferences • Journals (peer reviewed/index)

26. Products • Power point presentations available on websites • Journal articles (Teufel-Shone et al. 2006; Sanderson et al. 2012; ) • Evaluation or Assessment instruments • Digital media – film, photo voice, moviemaker • Manuals and curriculum

27. Partner goals • Community • Program credibility • Program outcomes and impact • Increased skills → to make a change & promotion • Academic • Program outcomes and impact • Increased skills • Dissemination to academic peers → to make a change & promotion (Teufel-Shone 2011)

28. Your Thoughts and Experiences