Sunday, July 8, 2007

Dinner speaker -- Kathleen Alexis from the Alexis Nakota Sioux First Nation

Nimi Icinohabi - a life skills training program for Alexis Nakota Sioux First Nation youth
There are two dinner speakers, let me try to catch some of the story of one of those two... Kathleen Alexis is a leader in first nation tribe in Canada, she told the story of a CBPR research project they developed and implemented, Nimi Icinohabi.

The tribe knew of problems with high substance abuse rates among their members, and were worried adult practices would be passed onto the kids. But their school could not find a substance abuse prevention program that reflected their cultural beliefs. As their first step, the Alexis Nakota Sioux National invited researchers from University of Alberta to collaborate on this problem. Eventually, they ended up with a workgroup with representatives from the band's education department, health department, the University of Alberta, the Alberta mental health board, and community elders. After a series of consultations through the workgroup meetings and community interviews they decided upon the proposed solution to their problem... tailor a current Life Skills Training (Botvin's LST) to this community. This program provided trainings in resistance to drugs, self-esteem and personal management.

In phase one of program development, the community workgroup (she referred to them in shorthand as "The Elders") met regularly to modify the existing intervention, while restoring and preserving their Isga culture. The tailored intervention included the following community-specific components:
  • Alexis Nakota Sioux Nation teachings, ceremonies, prayer, storytelling, & sharing circles.
  • the Alexis Stoney language
  • a naming ceremony (this was a challenge, because it is not traditional to this culture so it took some thinking but it worked very well)
  • Isga artists graphics and pictures
  • students drawings
  • community volunteers.
Where are they now? They have fielded this intervention once in their school (phase 2), and are anxiously awaiting the evaluation results (phase 3) from "the doctors".

Community Impacts?
The process of bringing the elders together to help the youth has been invigorating, the meetings are well attended and the members have a "sense of pride and strength in what they do to help our community." It's also facilitated a lot of skills building for the members, they have reached out to organizations they haven't reached before (recruiting help from the Edmonton School Board and others), they are asked to present on this success to others ("I never guessed I'd be asked to speak to academics"), they have expanded their inreach to allies in the band (parents and volunteers). There have been challenges, including variations in the understanding of their language. It's also expanded the horizons of health issues that the elders think about. In Kathleen Alexis' words.... "For me, it's a spiritual journey and even being in prayer with the elders makes me feel very connected." "And you know I can't thank the doctors enough to come and help us... the encouragement... they are really good teachers and good leaders."
In sum? Engaging so many people in a project that incorporated their history, language, community stewardship, youth, elders, and all inbetween had benefits well beyond the development of tailoring of one life skills training program.

Second speaker - William Freeman - Director of Tribal Community Health Program, Northwest Indian College. Lummi Nation.

Ok, just a bit of his wisdom too....

The ten standard steps of CBPR
  1. identify problem
  2. identify solution
  3. develop plan
  4. generate protocol
  5. co-fund and get approvals
  6. co-implementation of protocols
  7. co-collect data
  8. co-analyze data
  9. co-drafting results
  10. co-report results
He told a few stories about making sure you engage community colleagues in all the steps, and proceeded to regale us with stories of when researchers did it wrong (the Navaho Nation once suspended all research for 13 months when researchers ignored their request and published an article that named the places where research was conducted).

Some of his other good thoughts...

In CBPR, the community is a co-investigator on the research project. CBPR can be a continuum, from minimal to maximal. Ask yourself if the community is a co-investigator, if not, you're just doing research "in community". Here are some possible measures to help understand if the community is a co-investigator:
  • % of plan/proposal/analysis that is shaped by them
  • frequency of all team meetings
  • % of time community members are talking v. scientist
  • # of times scientist is learning something new
He had a bunch more slides with great CBPR info... let me see if I can get them from him to post.

The audience moved into a spirited discussion of compensation for CBPR community partners. I think I can summarize it quickly by saying most all supported compensation for the time and wisdom of the partners, but there were some community-members who had chosen not to in accordance with their cultural mores, and there was some concern on how it might change partnerships to employer relationships... no big clarity on that thought... but to end with a quote from a coming speaker, "Money is a measure of power and justice... And I have yet to see money come in and spoil a relationship between a community and researchers."

(And sorry, but no pictures yet, my camera is in my "delayed" luggage right now, but I have high hopes it might return soon... or else this one outfit will get kinda boring!).

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