Transcript The Family Listening Project: An - HSC

The Family Listening Project: An
Intergenerational Community Based
Participatory Research Prevention Program
Lorenda Belone, Greg Tafoya, Rebecca Rae,
Nina Wallerstein, and John Oetzel
May 23-24, 2011
“ Collaborative approach to research that
equitably involves all partners in the
research process and recognizes the unique
strengths that each brings. CBPR begins
with a research topic of importance to the
community with the aim of combining
knowledge and action for social change to
improve community health and eliminate
health disparities.”
W.K. Kellogg Community Scholar’s Program (2001)
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Recognizes community as unit of identify
Cooperative and co-learning process
Systems development & local capacity building
Long term commitment
Balances research and action
Israel et al, 1998 and 2008
CBPR/TPR Principles for Tribes
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Tribal systems shall be respected and honored
Tribal government review and approval
Tribally specific data shall not be published without prior
consultation; data belongs to tribe
Core Values: trust, respect, self-determination, mutuality of
interests, perspective taking, reciprocity
CDC Grant: 1999-2003
Purpose: To better understand community
strengths/cohesions for health, & identify
cultural measures.
• Qualitative approach
• Over 60 key informants: interviews and
focus groups
Findings:
• Multiple community and cultural strengths
• Concerns: Loss of culture and language
• Need to strengthen communication
between Elders/Youth
NARCH I: 2001-2005
Purpose: To conduct participatory research
with Navajo community to identify
capacities and what keeps tribal members
healthy.
• Quantitative approach
• Over 250 participants
Findings: From the community profile have
proven to be very useful data for each tribe
and has been used for strategic planning
purposes and grant writing to improve
services and health status.
CBPR Process
• Tribal Advisory
Committee
• Co-developed
instruments (Focus
Group & Survey)
• Co-conducted
interviews
• Co-analyzed data
Results:
• Community Voices
Reports
• 2003 JAPH Publication
• Community Profile
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Partnership based on earlier collaborations
◦ CDC and NARCH I
Built upon research evidence from a NIDA-funded
family strengthening curriculum between the
Anishinabe (Ojibwe) people and Dr. Les Whitbeck at
the University of Nebraska
• Anishinabe Listening Project found that parents
and children retained prevention messages and
behaviors when cultural content was most
integrated in the curriculum.
Funding: 2005-2009
 National Institutes of Health
 Indian Health Services > Native American Research
Centers for Health (NARCH III) > AAIHB
◦ UNM MPH
◦ Navajo community
◦ Pueblo community
Research Question: Using CBPR, what is the
effectiveness of a co-adapted intergenerational
intervention for reducing risky behaviors and
substance abuse for 3rd-5th graders?
Year 1
Established tribal research team (Behavior Health/Health Program)
Conducted Training: PH 101, Research 101, CBPR 101
Conducted FG Discussions: Elders, Parents, Service Providers, & Youth
Year 2
Focus Group findings, co-adapted intervention curriculum
Added community service project and Youth Photovoice
Adapted evaluation measures (qual & quant)
Year 3 & 4
Trained facilitators
Human Subjects Training
Recruited and administered pre/post test
Piloted Curriculum – 10 families
Administered Pre/post measures, facilitator logs,
and journals
Dissemination of findings
Curriculum
1. Welcoming
2. My Family
3. Tribal History
4. Tribal Way of Life
5. Our Tribal Vision
6. Community Challenges
7. Communication & Help
Seeking
8. Recognizing Types of
Anger
9. Managing Anger
10. Problem Solving
11. Being Different
12. Positive Relationships
13. Building Social Support
14. Making a commitment
and presentation of
Community Projects
Structure of Each Session
• One day a week
• 2 hour session - evening
• Trained tribal facilitator and
usually in their own language
• Start with Dinner
• Greetings
• Sharing of Home Practice
• Ice Breaker Activity
• Activities: separate adult and
youth groups
• Planning Community Action
Project
• Journals: adults & youth
• Wrap-up and take home
practice activity
• Facilitator logs
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Co-adaptation of a tribal specific 14-session
curriculum, as well as the co-development of evaluation
tools (qualitative and quantitative).
In the Pueblo community, adapted curriculum has been
piloted twice serving approximately 19 families.
In Navajo community, adapted curriculum has been
piloted once with 10 families with intentions of a
second pilot.
At each location, the capacities of tribal members were
developed through facilitation, coordination, and
research skills through training by the UNM team.
Project Outcomes: Increased communication, improved
coping skills, increased parenting skills, and increased
cultural knowledge.
Children
Enhanced pride in culture and language; & Increased self efficacy
and coping
 “I learned not to drink and to ask people for help and have
parents to take care of you.”
 “It felt very good because I finally learned about our
culture”…”We learned our Indian names and what our Indian
names mean.”
Parents
Increased parent/child communication and positive family
dynamics; Increased pride in culture and history
 “I am taking how valuable it is to teach our children the
traditional way of life.”
 “Learned how to handle stressors in a good way.”
Importance of integrating cultural AND family strengthening
evidence for effective intervention program
Funding: 2009-2010
 National Institutes of Health
 Indian Health Services > Native American Research Centers for
Health (NARCH V) and AAIHB
 UNM MPH/Center for Participatory Research
 Apache community
Purpose:
 To collaborate with the Tribe to adapt, pilot, and implement the
Family Listening Project within their cultural values and
community.
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To test our translational methodology of contextualizing
interventions and streamlining the adaptation process of being
true to a Community Based Participatory Research approach.
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Establish a tribal research team to serve as advisory
committee members and to be trained in a CBPR research
approach;
Co-adapt family intervention curriculum for late
elementary aged youth and their families based on the
distinct Apache culture;
◦ Will incorporate additional culturally accepted teachings
into the existing curriculum as well as exclude any
unacceptable practices or materials.
Pilot the Apache specific curriculum with ten families; and
Share learnings from pilot with the NARCH III LEO Navajo
and Pueblo communities.
Thank You
Any Questions?