Product Details

Author Information

Corresponding Author
Fay Fletcher, PhD
University of Alberta
1-024 Enterprise Square
10230- Jasper Avenue
Edmonton, AB
Canada
p: 780-492-2283
f: 780-492-9439
fay.fletcher@ualberta.ca

Authors (listed in order of authorship):
Cecelia Zoe-Martin
CEO, Tlicho Community Services Agency

Jim Martin
CEO, Tlicho Community Services Agency

Nancy Gibson, PhD
Senior Research, CIET

Rose James, PhD
UW Dept Medical History & Ethics

Randy Elliott
Northwest Indian College

La Belle V. Urbanec
Northwest Indian College

Pamela L. James
University of Washington

Greg Miller, Producer
Bearpaw Media Productions

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?

Community health , Health disparities, Partnership building

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

American Indian/Alaska Native, Indigenous/Aboriginal

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

Community-academic partnership, Community-based participatory research

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

Case study

Application Narrative

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

Role models and leaders in Indigenous health research in Canada and the United States share their stories of work with First Nations and American Indian colleagues in community based research. Acknowledging the impact of history and resiliency while capturing the passion of emerging leaders in Indigenous health research, the videos provide a starting point for discussion on the roles and responsibilities of community and university partners in collaborative and community-based research. “The Partnership” video explores how Aboriginal communities are working with health researchers for the community’s benefit. Told through the eyes of Tlicho community-based researchers, “The Partnership” demonstrates that no matter what the issue, solutions always lie within the community. From the rural campus of the Northwest Indian College in Bellingham, Washington to the hustle of the University of Washington in Seattle, “Bridging Worlds” takes a look at the varying roles of American Indian post-secondary students. Reflecting on their own life journeys, three students discuss how their desire to participate in making decisions that affect their communities has inspired them to engage in community-based research. Dr. Rose James discusses the potential change generated by CBPR in the interface between community partners and leaders and members of post secondary institutions.

2. What are the goals of the product?

A scan of community based research training for non-academic audiences revealed that little attention has been paid to the interests and learning needs of traditionally underserved adult learners. In light of these findings and in meeting colleagues in the United States, it became obvious that community researchers across Canada and the United States faced similar challenges in learning about CBPR and accessing models for CBPR in First Nations and American Indian health research.

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

Community researchers

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.

NA

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 current literature in CBPR, core principles were identified and placed within the matrix below. Based on the core principles we wanted to communicate in the videos, 5 possible sites and video shoots were planned. Although the original intent was to produce five short videos of 4-5 minutes, two videos, lasting approximately 10 minutes each, were produced. The decision was made based on the choice to capture the stories of individual’s experiences more fully.

Note: The original matrix also included possible partners and timeline. Both have been removed from the matrix in order to protect the identity of communities and individuals who are not in the final product.

CBPR Guiding Principles Matrix
“The Partnership”
CBPR Principles
1. Historical mistrust
2. Power dynamics and other sources of insider-outside tensions and misunderstanding
3. Differential rewards (ie: academic and community - Who benefits the most from the research?)
4. Defining, designing and doing community research requires partnership and consultation with the community
5. CBPR sets priorities based on the needs/desires/ of and potential benefits to community
6. CBPR research is community defined and community led
7. Participation requires constant negotiation of ideas, values, identities and interests
8. Community liaisons facilitate early interactions
9. The skills and knowledge of individuals are used when appropriate throughout the research process.

“Bridging Worlds”
CBPR Principle
1. The importance of community participation in defining the research question and in decisions made about the use of findings and actions for social change.
2. The community is actively involved throughout the research process and learns skills in order to participate in data collection and analysis.
3. The importance of building the capacity of the academic team members and academy
4. The research facilitates access to resources external to the community.
5. Community participants and communities benefit from the research outcomes.

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). .

References for “The Partnership”- References speak to multiple principles
Israel, B. A., Schulz, A. J., Parker, E. A., & Becker, A. B. (1998). Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health, 19, 173-202.

Israel, B. A., Schulz, A. J., P., Parker, E. A., Becker, A. B., Allen, A. J., & Guzman, J. R. (2003). Critical issues in developing and following community-based participatory research principles. In M. Minkler & N. Wallerstein (Eds.), Community-Based Participatory Research for Health (pp. 56-73). San Francisco, CA: Jossey-Bass.

Lantz, P. M., Israel, B. A., Schulz, A. J., & Reyes, A. (2005). Community-based participatory research: Rationale and relevance for social epidemiology. (2005). In J. M. Oakes & J. Turner (Eds.), Methods for Social Epidemiology. CA: Jossey-Bass.

Wallerstein, N., & Duran, B. (2003). The conceptual, historical and practice roots of community-based participatory research and related participatory traditions. In M. Minkler & N. Wallerstein (Eds.), Community-Based Participatory Research for Health (pp. 27-53). SanFrancisco: Jossey-Bass.

References for “Bridging Worlds” – References speak to multiple principles
On cultural humility: Linda Hunt (Retrieved January 8, 2007 from: http://www.parkridgecenter.org/Page1882.html

Boelen C. Adapting health care institutions and medical schools to societies' needs. Acad Med. Aug 1999;74(8 Suppl):S11-20.

Demarest DJ, Sokoloff J. Tribal education: reflections from the Pine Ridge Indian reservation. J Cult Divers. Fall 1994;1(4):70-73.

Dower C, McRee T, Briggance B, O'Neil EH. Diversifying the nursing workforce: A California imperative. San Francisco, CA: California Workforce Initiative at the UCSF Center for the Health Professions; 2001.

Grumbach K, Mendoza R. Disparities in human resources: addressing the lack of diversity in the health professions. Health Aff (Millwood). Mar-Apr 2008;27(2):413-422.

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.

“The Partnership”
Dr. Nancy Gibson, a senior researcher with CIET (a non-profit research and training organisation that focuses on community-based research, see http://www.ciet.org), had been working with the Tlicho Community Services Agency as they prepared for the settlement of their self-government Agreement with the federal governance, around integration of traditional values into emergent policies and programs. The leaders of the community became concerned about the rising incidence of sexually transmitted infections, and requested facilitation skills to prepare the community to conduct a wide-ranging survey to measure the knowledge base regarding STIs. Approximately 16 community-based researchers were trained to conduct the survey, which reached approximately 60 percent of the overall population of the four Tlicho communities. Dr. Gibson offered to approach individuals and leaders in the community about the possibility of documenting their story for the purpose of demonstrating CBPR The participants were very willing to do so for the purpose of teaching, and also to document their project. The video addresses core principles of CBPR (See Matrix above).

“Bridging Worlds”
In the fall of 2007, Dr. Rose James (University of Washington) brought participants in the program “Launching Native Health Leaders” to the University of Alberta for a 4 day course on community based participatory research. During a follow up visit to University of Washington and Northwest Indian College, participants were asked to reflect on their personal experiences and future plans to participate in shaping their community’s futures. The quality of the content is a reflection of long-standing relationships between academic and community partners.

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.

Two videos provide snapshots of role models and leaders in Indigenous health research; first, in the stories of community researchers in Tlicho, Northwest Territories and, second, in the stories of American Indian academic and community scholars in Washington State. Acknowledging the impact of history and resiliency while capturing the passion of emerging leaders in Indigenous health research, the videos provide a starting point for discussion on the roles and responsibilities of community and university partners in collaborative and community-based research.

“The Partnership” (9:00 minutes)
Set in the beautiful Northwest Territories, “The Partnership” explores how Aboriginal communities are working with health researchers for the community’s benefit. Told through the eyes of Tlicho community-based researchers, “The Partnership” demonstrates that no matter what the issue, the solutions always lie within the community.

Discussion Questions:

1. What motivates the individuals in the video to participate in community based research? And how do those motives impact the research process?

2. What are critical aspects of successful research mentioned by the community based researchers that have been overlooked in the past and hint at the challenges of building relationships between communities and universities?

3. Why were the individuals and organizations willing to partner in this project? The reasons will provide insight to strategies for moving beyond historical mistrust.

4. Exploring the benefits of community based research:
a. How did the community benefit from doing the project collaboratively?
b. How were the research outcomes affected by working with the community members?

“Bridging Worlds” (12:00 minutes)
From the rural campus of the Northwest Indian College in Bellingham, Washington to the hustle of the University of Washington in Seattle, “Bridging Worlds” takes a look at the varying roles of American Indian post-secondary students. Reflecting on their own life journeys, three students discuss how their desire to participate in making decisions that affect their communities has inspired them to engage in community-based research. Dr. Rose James, in turn, talks about the potential change generated by CBPR in the interface between community partners and leaders and members of post secondary institutions.

This video provides viewers with the opportunity to reflect on the role of institutions as academic and community scholars share their reflections on the importance of CBPR and their participation in the decision making processes that directly affect their health and the health of their communities. The role of academic institutions in promoting the authentic community participation is discussed as well as the importance of building the capacity of academic partners to follow the principles of CBPR. The video addresses core principles of CBPR.

Discussion Questions:

1. What is motivating these individuals to take on leadership roles in health research in their own communities?

2. What skills and knowledge do they bring to the research world?

3. How does collaboration and partnering improve knowledge generation and mobilization?

4. What challenges do the individuals identify when they consider returning to community and school? How do they overcome those challenges?

5. Why is it important to bring these two worlds together and how does community based research serve as a tool for doing so?

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 communities and partners who participated in the video production gained personally from the experience in that we captured the principles of CBPR as intended but also recognized important aspects of the relationship between community and university that are also critical to moving CBPR in Indigenous communities forward. These lessons are shared with viewers and made available as widely as possible through an agreement with the Faculty of Extension at the University. The Faculty has streamed the videos of ease of access and download capabilities. The number of hits and downloads is also tracked (without identifiers) in order to determine how extensively the videos are used. The launch of the video was announced to partners and through listservs.

Both videos provide snapshots of role models for future Indigenous health leaders; first, in the stories of community researchers in the Tlicho community and, second, in the stories of American Indian students in Washington, specifically why they have chosen to return to school and to their communities. Acknowledging the impact of history and resiliency while capturing the passion of emerging leaders in Indigenous health research, the videos provide a starting point for discussion on the roles and responsibilities of community and university partners in collaborative and community-based research.

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

Videos were chosen because of their accessibility and their potential for prompting discussion among viewers. It was also important to capture the images and the land of the people who spoke as it made the messages more poignant. Extraordinary efforts were made to video participants on the land and to provide educational, inspirational stories.

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.

In each case, those who participated were provided information prior to filming about the video series so that they understood that their contribution was part of a larger project. Perhaps the greatest strength is that the videos were done in collaboration with communities with whom the principal researcher (or colleague) had an on-going relationship. For that reason, the participants were very relaxed and felt able to speak from the heart. As a result, the content is truly reflective of the principles of CBPR.

In addition, all who participated pre-viewed the videos to confirm that their messages were accurately portrayed, were not pulled out of context, and delivered a message that they would endorse.

There were some challenges to getting the partners and to getting the footage. I was not able to secure additional partners from local communities for a variety of reasons. One partner institute was overwhelmed with obligations and we were not able to negotiate a time within the funding parameters. Another organization was interested, but only if we used their video and production people. Because I already had a contract for that work and because it was important to me that we be consistent in terms of the quality and tone of the videos, that was not an option. As a result, we were not able to include some of the methods of data collection that are particularly appropriate to Indigenous research, for example, sharing circles and the negotiation of research questions and objectives.

The other challenge (only in terms of commitment and cost) was the filming of the videos on the land. The first video was shot on site and the second was, originally, shot at the University of Alberta. While viewing the first drafts, it became obvious that it was not only important, but critical that we capture the people on the land and in the places that are important to them. That presented a challenge in that it delayed the completion of the project. However, the end result was significantly stronger in its impact and presentation. Had we NOT done this, we would have left out something we felt was critical.

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.

In both cases, communities and individuals were asked about their interest in participating in the making of videos based on an existing relationship. The relationships, the research, the experiences that are shared are based on lived experience and are candid discussions or live footage of research processes. I believe this approach embodies the respect between partners and a desire to share the credit for the product. Upon completion, the videos were sent to all the participants for their feedback and gave permission to use the footage, their images and their words and to release the final product. The participants expressed their pleasure and support of the respective videos. Those who led the project in Tlicho and all who participated in Washington are credited as co-authors.