Suzanne Christopher

Building and Maintaining Trust in a Community-Based Participatory Research Partnership

Although intervention research is vital to eliminating health disparities, many groups with health disparities have had negative research experiences, leading to an understandable distrust of researchers and the research process. Community-based participatory research (CBPR) approaches seek to reverse this pattern by building trust between community members and researchers. We highlight strategies for building and maintaining trust from an American Indian CBPR project and focus on 2 levels of trust building and maintaining: (1) between university and community partners and (2) between the initial project team and the larger community. This article was cowritten by community and academic partners; by offering the voices of community partners, it provides a novel and distinctive contribution to the CBPR literature.

Lessons Learned From Community-Based Participatory Research in Indian Country

The purpose of this article is to share lessons learned from implementing community-based participatory research (CBPR) in Indian Country that may be generalizable to other medically underserved communities. CBPR is currently included in multiple grant announcements by the National Institute of Health and Centers for Disease Control and Prevention, but information about this methodology vs traditional research methodology is often misleading. This article addresses some common mistakes made by academic research institutes by sharing what we have learned about how CBPR can be implemented in a respectful manner. The majority of tribal Nations prefer, if not mandate, that CBPR be used in most proposed studies involving their communities today.

Teaching Self-Care Through Mindfulness Practices: The Application of Yoga, Meditation, and Qigong to Counselor Training

Faculty in counseling training programs often give voice to the importance of self-care for students during the training period and into practice after training is completed. However, few programs specifically address this issue in their curricula. To address this perceived need, a course was developed to provide students with (a) personal growth opportunities through self-care practices and (b) professional growth through mindfulness practices in counseling that can help prevent burnout. A focus group assessed course impact on students who reported significant changes in their personal lives, stress levels, and clinical training.

Adapting Western Research Methods to Indigenous Ways of Knowing

Indigenous communities have long experienced exploitation by researchers and increasingly require participatory and decolonizing research processes. We present a case study of an intervention research project to exemplify a clash between Western research methodologies and Indigenous methodologies and how we attempted reconciliation. We then provide implications for future research based on lessons learned from Native American community partners who voiced concern over methods of Western deductive qualitative analysis. Decolonizing research requires constant reflective attention and action, and there is an absence of published guidance for this process. Continued exploration is needed for implementing Indigenous methods alone or in conjunction with appropriate Western methods when conducting research in Indigenous communities. Currently, examples of Indigenous methods and theories are not widely available in academic texts or published articles, and are often not perceived as valid.

Applying indigenous community-based participatory research principles to partnership development in health disparities research.

This case study of community and university research partnerships utilizes previously developed principles for conducting research in the context of Native American communities to consider how partners understand and apply the principles in developing community-based participatory research partnerships to reduce health disparities. The 7 partnership projects are coordinated through a National Institutes of Health–funded center and involve a variety of tribal members, including both health care professionals and lay persons and native and nonnative university researchers. This article provides detailed examples of how these principles are applied to the projects and discusses the overarching and interrelated emergent themes of sharing power and building trust.

Apsáalooke Women's Experiences With Pap Test Screening

BACKGROUND Cervical cancer mortality rates are among the highest in the United States for Northern Plains Native American women compared with white and other Native American women. The aims of Messengers for Health, a community-based participatory research project based on the Apsáalooke (Crow Indian) Reservation, are to decrease cervical cancer screening barriers, improve knowledge regarding screening and prevention, and increase the proportion of women receiving Pap tests. This paper presents results from a survey assessing womens perceptions of the level of comfort and care received by health care providers in their most recent Pap test appointment. METHODS A survey assessing patient communication and satisfaction with their health care providers was conducted with a random sample of 101 Apsáalooke women. Qualitative and quantitative methods were utilized to analyze the survey data. RESULTS Women reported both positive and negative experiences with their provider regarding their Pap test appointments. They noted positive experiences when trust was established and when the provider offered information, reassured or encouraged them, was personable, was familiar or consistent, maintained confidentiality, and was a woman. The women reported negative experiences when the examination was too short, when they did not have a consistent or female provider, and when they did not feel comfortable with the providers nonverbal communication. CONCLUSIONS Continued work with both providers and patients is necessary to decrease communication barriers and increase satisfaction with Pap test appointments.

Development of an Interviewer Training Manual for a Cervical Health Project on the Apsáalooke Reservation

This article describes strategies used to develop a survey interview training manual for use on the Apsáalooke (Crow Indian) Reservation and delineates how this process and product differed from those discussed in the extant literature on survey interview training. Working to ensure cultural appropriateness is especially important due to past research improprieties with Native American populations. This manual was developed as a part of a cervical health intervention program, Messengers for Health. Areas covered include goals of survey research, recruitment and enrollment, manner of the interviewer, nonverbal behavior, beginning the interview, and language use. Limitations of this work and suggestions for conducting survey research with Native American populations are also included.

Helping Families Toward the Goal of Self-Support: Montana's EDUFAIM Program

This article on a self-reliance education program describes the development, implementation, and elements of success of Educating Families to Achieve Independence in Montana (EDUFAIM) as a model for statewide integration of efforts to help families dependent on public assistance move toward a more self-supporting lifestyle. An overview of the EDUFAIM program, from its beginnings to implementation strategies, open the article, followed by a discussion of the evidence of EDUFAIMs success, including effective collaboration, effective educational materials and teaching strategies, effective evaluation strategies, and effective use of evaluation data. The article concludes with a discussion of program limitations.

Determining client need in a multi-state fetal alcohol syndrome consortium: from training to practice

BackgroundA multi-state consortium was developed in the US to conduct baseline data collection and intervention research on fetal alcohol syndrome. Each state employed support specialists whose job it was to reduce or eliminate alcohol consumption in women who were at high risk for drinking alcohol during their pregnancy. The purpose of this paper is to report how support specialists in three primarily rural/frontier states were trained to assess client need and how client need was actually assessed in the field.MethodsA qualitative process evaluation was conducted using semi-structured interviews. Interviews were conducted with state staff involved in support specialist training and consortium activities and the support specialists themselves. Inductive analyses were conducted with interview data.ResultsNeed determination varied by state and for one state within the state. How support specialists were trained to assess need and how need was assessed in the field was mostly congruent.ConclusionProcess evaluation is an effective method for providing practical and useful answers to questions that cannot be answered by outcome evaluation alone.