Product Details

Author Information

Corresponding Author
Paul Lachapelle
Montana State University
PO Box 172240
Bozeman, MT 59717
United States
p: 406-994-3620
f: 406-994-6692
paul.lachapelle@montana.edu

Authors (listed in order of authorship):
Paul Lachapelle
Montana State University

Jim Real Bird
Crow Tribe - Apsáalooke Nation

Product Description and Application Narrative Submitted by Corresponding Author

What general topics does your product address?

Public Health, Social & Behavioral Sciences

What specific topics does your product address?

Cancer, Community health , Health behavior, Health education , Men’s health, Minority health, Race & health, Rural health

Does your product focus on a specific population(s)?

American Indian/Alaska Native

What methodological approaches were used in the development of your product, or are discussed in your product?

Community-academic partnership, Focus group , Interview

What resource type(s) best describe(s) your product?

Documentary, Service learning material

Application Narrative

1. Please provide a 1600 character abstract describing your product, its intended use and the audiences for which it would be appropriate.*

Apsaalooke Upsauloouk Bucha Unnaylayda - Crow Men's Health, is an educational film that presents narratives by Crow men directed toward raising awareness of men’s health and preventative treatment options and increasing the participation of adult Native American men in preventative health screenings. Whether they talk about it or not, health is a very important part of all Crow men’s lives. A modern lifestyle of fast-food, sedentary lifestyles, and a general lack of interest in traditional cultural knowledge and practice have jeopardized the overall health of Native American men. In this video, Crow men discuss their feelings about the barriers to health, wellness and health prevention, and the Crow Men’s Health Ride. Footage of the 2008 ride to the Four Dances Vision Site acknowledging the importance of health and recognizing the young Crow men who sacrificed their lives in the eighteenth century by riding their horses over a cliff in order to save the Tribe from smallpox is included. This film is intended to be used as a resource for Crow men and all Native American men for education and inspiration about men’s health. The target audience is Crow men, all enrolled Crow members, Native American men across Montana and the United States, and health professionals involved in Native American health issues.

2. What are the goals of the product?

The Crow Men’s Health film takes a holistic, community-based approach to address health in the context of embracing, celebrating and affirming men’s whole health, enhancing resources available to them, (both information and material resources), and affirming both traditional and nontraditional men’s roles relative to gatherings, men’s activities and cultural traditions. Product goals include identifying central themes and topics relevant to Crow men’s health; educating the population about healthy lifestyles; and inspiring Crow men to actively engage in promoting and protecting their health and the members of their tribe.

3. Who are the intended audiences or expected users of the product?

The intended audience includes Crow men, all enrolled Crow members, Native American men across Montana and the United States and health professionals involved in Native American health issues.

4. Please provide any special instructions for successful use of the product, if necessary. If your product has been previously published, please provide the appropriate citation below.

The film has been sent to the university libraries in Montana and to each of the seven Native American colleges in Montana.

5. Please describe how your product or the project that resulted in the product builds on a relevant field, discipline or prior work. You may cite the literature and provide a bibliography in the next question if appropriate.

Using a Community-Based Participatory Research (CBPR) approach, the Crow Men’s Health Project is a partnership between university researchers and men of the Crow Indian Reservation to address health disparities. The objective in using this approach is to establish trust, share power, foster co-learning, and ultimately address community-identified needs and health problems. The CBPR approach is widely-recognized as an efficacious strategy for conducting research with American Indians because it emphasizes collaboration and has the potential to empower communities to address health disparities in a culturally-relevant manner.

Investing time to build trust and mutual learning in partnerships is critical in any collaborative project, particularly in Native American communities where community members have had many negative experiences with researchers and research processes, resulting in a valid apprehension to engage in research (1,2). Developing trust and maintaining successful community-based health partnerships is dependent on sharing information, responsibilities, power, and funding equitably among partners (3). Critical to a successful CBPR is recognizing and being cognizant of the diversity of cultural values and norms that exist within and between native populations as sovereign tribal governments with distinct needs and issues (4). Of particular importance is establishing mechanisms for formal and informal tribal oversight from both a practical and ethical standpoint (5). These principles were incorporated into the planning and implementing phases of the current project.

In this sense, the CBPR approach can provide remedial action to both historical and continuing experiences of exploitation. The integration of academic perspectives and skills with local experience, knowledge and resources allow more useful and credible interpretation and use of methods and result. In addition, a CBPR approach can build community capacity through community members’ participation in project implementation.

6. Please provide a bibliography for work cited above or in other parts of this application. Provide full references, in the order sited in the text (i.e. according to number order). .

1. Christopher, S., Watts, V., Knows His Gun, M.A., & Young, S. (2008). Building and maintaining trust in a community-based participatory research partnership. American Journal of Public Health, 98(8), 1398-1406.
2. Holkup, P.A., Rodehorst, T.K., Wilhelm, S.L., Kuntz, S.W., Weinert, C., Stepans, M.B., Salois, E.M., Hand Bull, J.L., & Hill, W.G. (2009). Negotiating three worlds: Academia, nursing science, and tribal communities. Transcultural Nursing 20(2), 164-175.
3. Beil, M., Evans, S., & Clarke, P. (2009). Forging Links between nutrition and healthcare using community-based partnerships. Family and Community Health, 32(3), 196-205.
4. LaVeaux, D., & Christopher, S. (2009). Contextualizing CBPR: Key principles of CBPR meet the indigenous research context. Pimatisiwin, 7(1), 1-25.
5. Baldwin, J., Johnson, J., & Benally, C. (2009). Building partnerships between indigenous communities and universities: Lessons learned in HIV/AIDs and substance abuse prevention research. American Journal of Public Health, 99(1), 77-82.

7. Please describe the project or body of work from which the submitted product developed. Describe the ways that community and academic/institutional expertise contributed to the project. Pay particular attention to demonstrating the quality or rigor of the work:

• For research-related work, describe (if relevant) study aims, design, sample, measurement instruments, and analysis and interpretation. Discuss how you verified the accuracy of your data.
• For education-related work, describe (if relevant) any needs assessment conducted, learning objectives, educational strategies incorporated, and evaluation of learning.
• For other types of work, discuss how the project was developed and reasons for the methodological choices made.

Several years ago, a number of Crow men approached faculty at Montana State University about a project devoted to men’s health disparities, after seeing great success with improved rates of cervical cancer screening among Crow women on the Reservation using “Messengers for Health” or lay health advisors. Initial meetings were arranged between the faculty and tribal community members to engage Crow men in in-depth conversations about health issues and social, economic and cultural barriers to improving health status and addressing health disparities among them. The first Crow Men’s Health Project meeting was attended by tribal members and key leaders in the community including individuals from Little Big Horn College, Indian Health Service, and the Crow Tribe governing bodies. The group established a five-member Crow Men’s Health Project Advisory Council made up of Crow tribal members who determined the objectives of the project. Funding was provided by the Center for Native Health Partnerships (CNHP), and Exploratory Center of Excellence funded by the National center on Minority Health and Health Disparities located at Montana State University.

Community members, tribal organizational representatives, and researchers were equal partners in all components and phases of the research process and outcome. The active involvement of all community stakeholders including tribal leaders, elders, various clan interests and youth, was critical to forming strong partnerships and ensuring the success of the project.

A series of community meetings and focus groups were held to begin to identify central themes and relevant topics of the Crow men’s health project. This was done by establishing trust and building relationships in a safe environment where personal issues could be brought forward, discussed and debated through in-depth conversations on health issues of concern to men. The Council also felt that establishing an education and outreach component of the project would be critical. As a result of the community meetings and focus groups, the Crow Men’s Health Project Advisory Council determined that the focus of the project would be on the health topic of prostate, testicular and colorectal cancer and factors that could contribute to low preventative screening rates.

The focus group recruitment process involved email, phone call and word-of-mouth notifications of pending meeting times and locations. Men and women were invited and encouraged to attend. The meetings were held on the Reservation with representation of the Advisory Council, a doctor from Indian Health Services, and faculty from Montana State University. The discussions would begin with general topics pertaining to health for all Crow members, with specific examples and stories told related to personal heath stories from men.

The film was made to provide a general overview of barriers to health, wellness and health prevention through interviews with select Crow men, and footage of the Crow Men’s Health Ride in 2008. The film documents a health ceremony performed by Crow men at the Four Dances Vision site acknowledging the importance of health and recognizing the young Crow men who sacrificed their lives in the eighteenth century by riding their horses over a cliff in order to save the Tribe from smallpox is included. Film screenings have taken place at select locations on the Reservation (open to the public) and at Montana State University. Overwhelmingly, community support for the project has been positive with no stated concerns about the format or content of the film. This film is intended to be used as a resource for Crow men and all Native American men for education and inspiration about men’s health.

8. Please describe the process of developing the product, including the ways that community and academic/institutional expertise were integrated in the development of this product.

The Advisory Council was instrumental in the development of the film. They were involved in all aspects including organizing the Crow Men’s Health Ride and setting up interviews with Crow men who were willing to share their feelings about health, wellness, health prevention and treatment. The Advisory Council was also involved in the filming, post production and marketing of the product. For example, the Council determined the details of the health ride including the location, time, theme, and participants; the Council took care of all permitting necessary for the event and filming. The Council also co-wrote the story line and chose the questions for the interviews. In addition, the Council reviewed early drafts of the film and commented on ways to edit key segments. Two community viewing events also allowed pre-screening evaluations to take place and feed back to the Advisory Council before the final edited version was released. The project had the full support of the Crow Tribe’s Executive and Legislative branches of government and other key individuals and organizations in the region. Partnerships within and outside of the Tribe were also established including medical personnel at area hospitals, additional faculty at both Montana State University and Little Big Horn College, and Tribal representative across the state of Montana to garner additional support and guidance. This support and the key partnerships that have resulted have been critical to promoting the project and ensuring that the program is seen as legitimate and valid.

9. Please discuss the significance and impact of your product. In your response, discuss ways your product has added to existing knowledge and benefited the community; ways others may have utilized your product; and any relevant evaluation data about impact, if available. If the impact of the product is not yet known, discuss its potential significance.

The film was viewed at several community events that were held on the Crow Reservation. On April 1, 2010, a Native American Men’s Health Summit was held at Montana State University to raise awareness of men’s health issues. In addition to viewing the film, the summit provided an opportunity for Native American men to share personal health stories, learn more about preventative measures, and inspire others to be more health conscious. Qualitative survey work about the awareness raised as a result of this film shows that audiences have viewed the work positively, said it inspires healthy behaviors and lifestyles, and provides role models, particularly for the younger Crow audiences that have viewed and commented after screenings.

10. Please describe why you chose the presentation format you did.

The idea of creating a film to increase health awareness and inspire others to become more health conscious was initiated by the Crow men. They felt that this format would be the most effective form of communication in part because of the illiteracy rates on the reservation and the importance of capturing the ceremonial and cultural event of the Crow Men’s Health Ride at the Four Dances Natural Area near the Reservation.

11. Please reflect on the strengths and limitations of your product. In what ways did community and academic/institutional collaborators provide feedback and how was such feedback used? Include relevant evaluation data about strengths and limitations if available.

Perhaps one of the greatest strengths of this product has been the ability to capture in perpetuity the unique cultural event of the Crow Men’s Health Ride at the Four Dances Natural Area near the Reservation. The ceremony was a colorful and poignant event with over 70 Crow men participating, many of whom were riding bareback on horses in traditional dress. The ride signified the importance of health and the need for Crow men to actively engage in promoting and protecting their health and the members of their tribe. This location holds great significance for the Crow people in general as the site of the death of several Crow warriors in the eighteenth century who contracted small pox and decided to sacrifice themselves by riding their horsed over a cliff in order to save the Tribe from the disease. The event was filmed in its entirety and received a great deal of media attention.

Conversely, due to a relatively small budget, the effectiveness of the project was limited by the inability to include the native language in subtitles in the finished product.

12. Please describe ways that the project resulting in the product involved collaboration that embodied principles of mutual respect, shared work and shared credit. If different, describe ways that the product itself involved collaboration that embodied principles of mutual respect, shared work and shared credit. Have all collaborators on the product been notified of and approved submission of the product to CES4Health.info? If not, why not? Please indicate whether the project resulting in the product was approved by an Institutional Review Board (IRB) and/or community-based review mechanism, if applicable, and provide the name(s) of the IRB/mechanism.

Co producer, Jim Real Bird, who is also the chair of the Advisory Council and an enrolled member of the state committee, reviewed the edits of the film before completion. Full approval was received before the film was produced. The project also received formal approval and support from the Tribal Chair of the Crow Nation.
The project also demonstrated good principles of partnership; for example, the film planning and production, including all budgetary matter were determined collaboratively between University faculty and Crow Advisory Council members. We operated under the principle of consensus when making decisions so that all information and power would be shared. This consensus-oriented approach to decision making led to mutual respect with shared benefits in terms of recognition and accolades for this project.

Ultimately, trust has increased, not only amongst Advisory Council members but also between members of the tribe and University faculty. Future planned events are being discussed now regarding new methods of promoting the film to a wider audience and additional innovative projects to raise awareness of health and well-being on the Reservation.