Define resilience within American Indian health promotion and public health interventions

Identify protective measures of family, culture and storytelling

Describe the benefits of digital storytelling in documenting life narratives

“An ability to recover from or adjust easily to misfortune or change.” (Merriam-Webster 2013)

“...dynamic process that enables the individual to respond or adapt under adverse situations.” (Stumblingbear-Riddle & Romans 2012,

p. 2)

“Resilience is the capacity to adapt successfully in the face of threats or disaster.”(This Emotional Life PBS)

Resilience is used in biological,

physical and social sciences and

in organizational theory and

education. Resilience. Merriam-Webster Online Dictionary, accessed April 1, 2013. http://www.merriam-webster.com/dictionary/resilienceThis Emotional Life. PBS. Accessed April 1, 2013. http://www.pbs.org/thisemotionallife/topic/resilience/what-resilience

• Researchers have provided biological, psychological, and sociocultural explanations for the disparities faced by American Indians.

• Recent research has explored the impact of historical trauma, loss, grief, colonization, genocide, and forced assimilation on American Indian well-being.

• Researchers have suggested that the multiple traumas experienced by American Indians are passed downgenerationally because these past experiences have not yet been grieved.

Berry, Kim, Minde, & Mok, 1987; Brave Heart, 1999, 2003; Brave Heart, Chase, Elkins, & Altschul, 2011; Duran, 2006; Duran & Duran, 1995; Gone, 2007; Whitbeck, Walls, Johnson, Morrisseau, & McDougall, 2009

• Resilience: The concept of resilience in public health research includes individual internal characteristics and external support from family and community.

• Cultural Resilience: For American Indians and other ethnic groups, the role of culture is a strength.

• Culture: Shared rules, beliefs,

attitudes and practices, which perceptions and shape our interpretation

of life events

Intergenerational memories: The family holds values, customs, traditions and memories that guide a person’s actions throughout their lives.

Family/community transmit cultural identity to their children and future generations.

Culture is a key factor in developing personal resilience. Family, mentors, and kin/clan network

guide a person to develop self-esteem, self-reliance, confidence and efficacy by modeling cultural appropriate behaviors via storytelling and ceremonies.

• Scale asks children 20 questions• Do you know where your grandparents grew up? • Do you know where your mom and dad went to high school? • Do you know where your parents met? • Do you know an illness or something really terrible that happened in your

family?

• The more children knew about their family’s history (ups & downs) the more they were resilient: the stronger their sense of control over their lives, the higher their self-esteem and more successfully they believed their families functioned.

• Strong intergenerational self: Children know they belong to something bigger than themselves.

• Sense-making: The building of

a narrative that explains what the group is about

Bruce Feiler, The Stories That Bind Us. New York Times. Accessed March 17,2013. http://www.nytimes.com/2013/03/17/fashion/the-family-stories-that-bind-us-this-life.html?_r=1&

• Research indicates that historical trauma becomes even more painful when it seems to be forgotten, trivialized, or denied: “conspiracy of silence.”

• Sharing stories is a traditional native practice that provides a vehicle for learning and healing.

• Narratives grounded within a strengths-based perspective emphasize how family members are successful in overcoming difficulties and remaining strong in the face of traumatic circumstances or change.

“ If you don ’ tknow your past,you don’t knowyour future.”

Resilience: “First is confronting the historical trauma. Second is understanding the trauma. Third is releasing the pain of historical trauma. Fourth is transcending the trauma.” (Brave Heart, M. Y. H., Chase,

J., Elkins, J., & Altschul, D. B. 2011)

• Resilience and American Indian adolescents– Measures variables of school success (LaFromboise et al., ‘06; Whitesell et al., ‘09)

– Positive relationship among enculturation and resilience in addition to familial, communal and school influences among reservation adolescents (LaFromboise et al.,2006 and 2010)

– Social Support, rather than enculturation, influences resilience in urban American Indian adolescents (Stiffman et al.2007; Stumblingbear-Riddle and Romans)

Results: A prominent sense of culture in family and community could serve as positive force for reservation-dwelling American Indians.

What's in the heart--Children of the 7th Generation"

Wisdom of the Elders: Healing With The Heroes Journey Model

Resilience is embedded in the culture.

Cultural Resilience is a construct that originated from the traditional life ways of Native American people and provides the theoretical basis for the strength and resilience found in Native cultures.

Wisdom of the Elders. Transcending Historical Trauma . Accessed April 1, 2013 http://discoveringourstory.wisdomoftheelders.org/resources/transcending-historical-trauma; Resilience and Stereotyping: The Experience of Native American Elders http://www.ndsu.edu/fileadmin/hde/research/NIH-D.Grandbois.pdf

• To recover the loss of cultural traditions and family structure across generations, Wisdom of the Elders, Inc. (WISDOM) has produced the Discovering Our Story Project, and is sharing video-recorded stories of resilient Native Americans.

Resilience and Stereotyping: The Experience of Native American Elders

Individual

Family

CultureFuture generations

stressors

Overco

min

g stresso

rs

Resilience research among American Indians is an emerging field.

Current/past research has focused on a deficit model.

There are few studies on

resilience, American Indian

elders, and urban AI populations.

• Co-PIs: Agnes Attakai and Kerstin M. Reinschmidt

• CAIR pilot research uses community-based participatory research (CBPR) principles to document stories of resilience among urban American Indian elders at the Tucson Indian

Center (TIC).

• Defining resilience from the perspective of urban American Indian elders

• Developing a resilience curriculum for youth and families based on the elder digital stories

Developed a partnership between UA MEZCOPH and TIC

Formed community advisory board (CAB): MEZCOPH, TIC, AI elders

Conducted 1 focus group with 15 AI elders

Held CAB member training: Human Subject Protection, qualitative analysis

Conducted 13 elder interviews

Transcribe 1 focus group and 13 elder interviews; code for themes

Create digital stories based on elder interviews

Review digital stories with elders

Conduct focus group on developed digital stories

Develop 12 bi-monthly workshops from qualitative interview themes

Pilot test and evaluate workshops at TIC

Our CAB holds monthly meetings at the Tucson Indian Center

Topics covered during meetings include

Project updates

Demonstration and explanation of digital stories

Discussion about CBPR

Reciprocal relationship building UA staff will assist CAB members

with projects (i.e. family history

books, family digital stories)

Held one 2-hr focus group with

13 females and 2 males, age 55+,

who self-identified as American Indian

Participants were given a $25 gift card

Focus group was voice recorded and transcribed

Two coding workshops were held and attended by UA staff, 1 elder, and 1 TIC staff member

Our team is in the process of coding the transcription to finalize themes that will contribute to digital stories and workshops

11 females and 2 males, age 55+, were interviewed

Interviews lasted 1-3 hours

Participants were given a $25 gift card

Interviews were video recorded and/or voice recorded

UA staff are editing the stories

UA staff will work with participants to create a digital story

What do you think of when you hear the words “historical trauma”?

How have your ancestors’ experiences with historical trauma or historical cultural shock impacted your community (or communities you have lived in)?

What are some examples of community resiliency that have helped your urban community face the challenges related to historical trauma or [term suggested by elder]?

How important are spiritual resources in coping with life’s challenges?

Sense of loss and removal from family Adopted, sent to boarding schools/Mormon

foster programs

Prayer and God are central to getting through hard times (i.e. leaning on a higher power)

Importance of role models

Self-advocacy of individuals It is up to individuals to make a better life for

themselves.

Prayer and God are central to getting through hard times (i.e. leaning on a higher power).

Family is a very important strength. There are differences, but they pull through challenges together.

Participation in social networks Volunteer, help with family, help at schools, in

community

The Tucson Indian Center is a key resource in many elders lives (i.e. programs for families and youth, sobriety)

Short Clip

Berry, J. W., Kim, U., Minde, T., & Mok, D. (1987). Comparative studies of acculturative stress. International Migration Review,21(3), 491-511. doi:10.2307/2546607

Brave Heart, M. Y. H. (1999). Oyate Ptayela: Rebuilding the Lakota nation through addressing historical trauma and loss amongLakota parents. Journal of Human Behavior & Social Environment, 2(1/2), 109-126. doi:10.1300/J137v02n01_08

Brave Heart, M. Y. H. (2003). The historical trauma response among Natives and its relationship to substance abuse: A Lakota illustration. Journal of Psychoactive Drugs, 35, 7-13. doi: 10.1080/02791072.2003.10399988

Brave Heart, M. Y. H., Chase, J., Elkins, J., & Altschul, D. B. (2011). Historical trauma among Indigenous peoples of the Americas: Concepts, research, and clinical considerations. Journal of Psychoactive Drugs, 43(4), 282-290. doi:10.1080/02791072.2011.628913

Duran, E. (2006). Healing the soul wound: Counseling with American Indians and other Native peoples. New York, NY: Teachers College Press.

Duran, E., & Duran, B. (1995). Native American postcolonial psychology. Albany, NY: State University of New York Press.

Gone, J. P. (2007). “We never was happy living like a Whiteman”: Mental health disparities and the postcolonial predicament in American Indian communities. American Journal of Community Psychology, 40(3-4), 290-300. doi: 10: 1007/s10464-007-9136-x

Grandbois D. M. and Sanders G.F. (2012) Resilience and Stereotyping: the Experience of Native American Elders. J Transcult Nurs.Oct; 23(4); 389-96

LaFromboise, T. D., Hoyt, D. R., Oliver, L., & Whitbeck, L. B. (2006). Family, community, and school influences on resilienceamong American Indian adolescents in the upper Midwest. Journal of Community Psychology, 34(2), 193-209. doi:10.1002/ jcop.20090

LaFromboise, T. D., Albright, K., & Harris, A. (2010). Patterns of hopelessness among American Indian adolescents: Relationshipsby levels of acculturation and residence. Cultural Diversity & Ethnic Minority Psychology, 16(1), 68-76. doi: 10.1037/a0016181

Stumblingbear-Riddle, G. and Romans, JSC. (2012)Resilience among urban American Indian adolescents: Exploration into the role of culture, self-esteem, subjective well-being, and social support. American Indian Alaska Native Mental Health Research , 19(2). doi: 10.5820/aian.1902.2012.1

Whitbeck, L. B., Walls, M. L., Johnson, K. D., Morrisseau, A. D., & McDougall, C. M. (2009). Depressed affect and historical loss among North American indigenous adolescents. American Indian and Alaska Native Mental Health Research, 16(3), 16-41. doi: 10.5820/aian.1603.2009.16

Whitesell, N. R., Mitchell, C. M., Spicer, P., & The Voices of Indian Teen Project Team. (2009). A longitudinal study of self-esteem, cultural identity, and academic success among American Indian adolescents. Cultural Diversity and Ethnic Minority Psychology,15(1), 38-50. doi:10.1037/a0013456

Agnes Attakai, MPA

Tara Chico, MPH

Felina Cordova, MPH

Rebecca Drummond, MA

Carmella Kahn-Thornbrugh, MPH

Kerstin M. Reinschmidt, PhD, MPH

Nancy Stroupe, MA, MPH

Julie Tippens, MA, MPH

Shannon Whitewater

Nolando Neswood

Nicolette Teufel-Shone, PhD

(Co-PI NAU/UA CAIR Grant)

Research reported in this publication was supported by the National Institute On Minority Health And Health Disparitiesof the National Institutes of Health under Award Number P20MD006872. The content is solely the responsibility of theauthors and does not necessarily represent the official views of the National Institutes of Health.”