A paper out of York University is included in a special collection of Health Promotion Practice that focuses on health engagement, knowledge and participating in Indigenous communities.
A journal of the Society for Public Health Education, Health Promotion Practice has curated eight papers published in 2020 that focus on Indigenous health, and has made the collection open access. The papers are available for free download from Nov. 15 to 30.
Featured in the special collection is the paper “The Impact of Indigenous Youth Sharing Digital Stories about HIV Activism,” authored by York University Faculty of Environmental and Urban Change (EUC) Professor Sarah Flicker and EUC alumna Ciann Wilson. The paper reports on the micro-, meso- and macro-level impacts of sharing digital stories created by Indigenous youth leaders across Canada about their HIV activism. In contrast to Western public health messaging on risk and behavior change, this project of the Native Sexual Health Network drew on Indigenous understanding of individual health and well-being as rooted in the health and well-being of the community and environment.
Indigenous communities in North America are burdened by inter-related health disparities associated with histories of trauma and violent displacement, forced assimilation, cultural erasure, and systemic poverty both on and beyond tribal lands. Yet, these communities are also often sites of resistance and resilience, problem-solving, and integrated approaches to health and well-being.
The papers in this special collection highlight collaborative, participatory strategies developed in and with indigenous communities on topics as diverse as youth substance use prevention, community food insecurity, HIV activism, and commercial tobacco use. They also document results across a broad social ecology, from shifts in individual capacities and confidence to concrete changes in policies and systems to better support health. They use a wide variety of tools and frameworks, including community-based participatory research, citizen science, cultural tailoring, retail interventions and environmental audits, reflective evaluation, and multiple ways of knowing.
“The elegance and imagination of these projects are exemplars of health promotion practice and research” says Health Promotion Practice Editor-in-Chief Kathleen Roe.
A summary of the other seven papers is below.
“Formative Research and Cultural Tailoring of a Substance Abuse Prevention Program for American Indian Youth: Findings from the Intertribal Talking Circle Intervention” (Baldwin, et al) describes the participatory process of adapting the Keetoowah-Cherokee Talking Circle, an existing evidence-based substance use prevention intervention for AI youth, to the cultures and local contexts of three diverse tribal communities. Using the Circular Model of Cultural Tailoring, the team incorporated the essential elements of self, time, relationships, and tribes as they worked with each community and its Community Partnership Committee.
“Group Gardening in a Native American Community: A Collaborative Approach” (Brown, et al.) reports on a multi-method participatory study to determine the influences that promote or hinder community gardens and use of locally grown foods on an American Indian reservation, and to assess the feasibility of implementing a group gardening program. A Community Advisory Board guided all stages of the project, which was implemented through a community-academic partnership.
“Native American Youth Citizen Scientists Uncovering Community Health and Food Security Priorities” (Kim, et al.) describes the context, methods, and results of integrating community-based participatory research and citizen science in a collaboration between youth from the Karuk Tribe and university researchers. Based on the findings of the youth leaders’ mobile community health and food security assessment survey, the Tribe has invested in developing community gardens, improving school food quality, and promoting native food practices that incorporate physical activities such as hiking, gathering, and preserving food.
“Impact of a Healthy Retail Intervention on Fruits and Vegetables and Total Sales in Tribally Owned Convenience Stores: Findings from the THRIVE Study” (Williams et al.) offers a follow-up to a previous HPP article on the participatory development of a healthy retail intervention for tribally owned and operated convenience stores in the Chickasaw and Choctaw Nations of Oklahoma. The intervention was designed to increase availability, variety, and convenience of ready-to-eat fruits and vegetables using the Four P’s framework of product, placement, promotion, and pricing. Evaluation of sales data from intervention and comparison stores found that the intervention had no negative impact on overall sales and increased the proportion of fruit and vegetable sales.
“Cigarette and E-Cigarette Retail Marketing On and Near California Tribal Lands (Begay et al.) reports findings from the first study to use store observations to examine availability, exterior advertising, and price promotions of these products in stores on or within a one-mile radius of tribal lands which, as sovereign nations, must follow federal but not state regulations. As part of a larger participatory study of tobacco use in five racial/ethnic communities, community members were trained to administer the Standardized Assessment for Retail Settings – Supplement for Tribal Commercial Tobacco (STARS-TCT) in 96 stores throughout California.
“Capacity Building Together: Shifting Roles for Research and Implementation in Health Resilience Among American Indians in Arizona” (Hardy et al.) describes the development and findings of a deep, post-project reflection process shared by members of a multi-year research team to explore the personal and professional meanings of their experience together. Using the conceptual framework of the Iterative Poly-Knowledge Evaluation Cycle (IPEC), collaborators identified the opportunity to shift roles and power relationships during the project as central to capacity building among all partners, which they recommend be considered a primary outcome rather than side effect of collaborative research.
“Good Health and Wellness: Reflections on Implementing Health Promotion in Indian Country” (Gerber et al.) reports on the findings and recommendations from a qualitative evaluation of stakeholder experiences of a U.S. Center for Disease Control and Prevention multi-year initiative to promote and health and prevent chronic disease in tribal communities. The evaluation found that the initiative made strides towards breaking from past efforts that ignored the sovereignty of tribal communities, forced models of intervention against cultural priorities, and exacerbated tensions between tribes and outside institutions, and that remains room for improvement.