Allyson Kelley

Research ethics and indigenous communities

Institutional review boards (IRBs) function to regulate research for the protection of human participants. We share lessons learned from the development of an intertribal IRB in the Rocky Mountain/Great Plains Tribal region of the United States. We describe the process through which a consortium of Tribes collaboratively developed an intertribal board to promote community-level protection and participation in the research process. In addition, we examine the challenges of research regulation from a Tribal perspective and explore the future of Tribally regulated research that honors indigenous knowledge and promotes community accountability and transparency. We offer recommendations for researchers, funding agencies, and Tribal communities to consider in the review and regulation of research.

American-Indian diabetes mortality in the Great Plains Region 2002–2010

Objective To compare American-Indian and Caucasian mortality rates from diabetes among tribal Contract Health Service Delivery Areas (CHSDAs) in the Great Plains Region (GPR) and describe the disparities observed. Research design and methods Mortality data from the National Center for Vital Statistics and Seer*STAT were used to identify diabetes as the underlying cause of death for each decedent in the GPR from 2002 to 2010. Mortality data were abstracted and aggregated for American-Indians and Caucasians for 25 reservation CHSDAs in the GPR. Rate ratios (RR) with 95% CIs were used and SEER*Stat V.8.0.4 software calculated age-adjusted diabetes mortality rates. Results Age-adjusted mortality rates for American-Indians were significantly higher than those for Caucasians during the 8-year period. In the GPR, American-Indians were 3.44 times more likely to die from diabetes than Caucasians. South Dakota had the highest RR (5.47 times that of Caucasians), and Iowa had the lowest RR, (1.1). Reservation CHSDA RR ranged from 1.78 to 10.25. Conclusions American-Indians in the GPR have higher diabetes mortality rates than Caucasians in the GPR. Mortality rates among American-Indians persist despite special programs and initiatives aimed at reducing diabetes in these populations. Effective and immediate efforts are needed to address premature diabetes mortality among American-Indians in the GPR.

Fathers’ Perspectives on Supports and Barriers That Affect Their Fatherhood Role

This qualitative study explored resident and nonresident fathers’ perspectives about factors that facilitated and inhibited their ability to play a positive and active role in their children’s lives. A total of 30 fathers were recruited from a support/mentoring group and from the general population to complete a semi-structured, audio-taped interview. A content analysis revealed that both groups of fathers were committed to maintaining a relationship with their children, and that by being present, they protected their children, helped them emotionally and financially, helped in their overall development, acted as a role model, and shared parenting responsibilities with their children’s mothers. Factors that facilitated parenting for resident and nonresident fathers included receiving proper guidance about fathering, a positive mother−father relationship, support from family, and church. Inhibiting factors were more prevalent for nonresident fathers that included mothers obstructing the father−child relationship, negative views/remarks about them as fathers, father−child visitation that is contingent upon child support, and fathers’ financial difficulties. The findings suggest a need for coparenting counseling, faith-based interventions, and employment services to address the complex socio-economic challenges that fathers face.

Establishing the reliability and validity of the sources of strength in one American Indian community.

Strength-based approaches that explore resilience and health among Native communities are needed. This report highlights the results from a sources of strength inventory reported over a 2-year period by participants (N = 48) from a Montana tribe who attended cultural camps. The authors found the sources of strength scale to be a reliable and valid measure for the population (N = 11 items, α = .945). The community plans to use the results of this study to inform and promote strength-based measures grounded in the resilience of youth, families, and culture.

Critical reflections from a community-based participatory research course.

INTRODUCTION Training for new and existing researchers in community-based participatory research (CBPR) approaches requires flexibility and a departure from traditional research methods courses. The literature has not fully reported how universities teach CBPR or the impact of CBPR courses on students and researchers. METHOD In this paper, I use a reflective, inquiry-based methodology to find meaning from my experience in a doctoral level CBPR course offered by a southeastern university. RESULTS Five recommendations, complementary to guiding CBPR principles emerge. These include: Know the inherent challenges, find meaning and purpose, seek to understand complexities, recognize the implications, and use CBPR as a means to redress power. DISCUSSION The reflection process and recommendations may be useful for institutions, funding agencies, policy makers, and community-engaged researchers.

Defining Cultural Resilience to Strengthen Native Youth: A Brief Report from the Intergenerational Connection Project

Abstract Native American youth are placed at greater risk for suicide than any other age or ethnic population in the United States. Resilience has helped Native Americans overcome adversity. In this paper, authors provide an example of how intergenerational mentoring can moderate or reduce these risk factors. The Intergenerational Connection Project at Native PRIDE (ICP) works with advisory councils in four Native communities in Montana and South Dakota. To better understand resilience, this paper answers two questions: (1) how do communities define cultural resilience, and (2) how can cultural resilience be operationalized in a cultural context? The ICP team worked with community advisory councils to develop a cultural resilience scale that was administered at the beginning of the project and six months later, at the end of the Project. An independent samples t-test demonstrated a significant increase in all scale items from baseline and at six-month follow-up. Results indicate that all community definit...

Feasibility Testing a Family-Level Intervention to Prevent Risky Sex Behaviors Among Middle School–Age Latinas

Purpose: In this article, we report a pilot study that tested the feasibility and initial efficacy of a culturally, linguistically, and developmentally tailored risky sex prevention intervention for middle school–age Latinas and their mothers. Design: We used a one-group pre-test, post-test, and 3-month post-intervention follow-up design. Data were collected at three points on aspects of the girls’ communication, beliefs, and behaviors. Results: Promising results included improvements in girl’s self-efficacy regarding condom communication and condom consistent use, and in mother–teen sexual risk communication. There were also trends in demonstration of fewer risky sex behaviors. Discussion: These findings suggest that the “Latina–Girls Empowered through Mind and Mission” (L-GEMM) intervention for young Latinas and their mothers is feasible and warrants further testing. Implications: Nurses are uniquely positioned to deliver risky sex preventive interventions to young Latinas. Including mothers and tailoring interventions to build on cultural strengths are important for success.

Recommendations from an American Indian reservation community-based suicide prevention program

Purpose – Effective community-based suicide prevention strategies require culturally relevant contextually driven approaches, validated by community members. Existing literature, funding agencies, and polices do not adequately address the differences in community vs non-community definitions and approaches to suicide prevention. These differences and the process must be articulated to fully understand the complexities of effective American Indian community-based suicide prevention strategies. This paper aims to discuss these issues. Design/methodology/approach – This study uses a qualitative methodology to understand the process and meaning of an American Indian reservations community-based approach to suicide prevention. Findings – Seven recommendations emerge. These include: expand the understanding of suicide; plan activities and outreach early; uphold cultural values; build administrative and community capacity; prepare and respond to community needs and situations; anticipate challenges and develop ...