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Lisa Rey Thomas

Building Partnerships with American Indian and Alaska Native Communities

Posted on January 25, 2012

Lisa Rey Thomas (bio) shares practical advice for conducting collaborative research with Tribal and Native American communities.

 

Q: What were the goals of the NIDA Clinical Trials Network study, "Methamphetamine and Other Drugs in American Indian and Alaska Native Communities"?
A: This five-site exploratory study, funded by the NIDA Clinical Trials Network (CTN), aimed to create and maintain effective, culturally-grounded collaborative research partnerships between academic institutions and American Indian and Alaska Native (AIAN) communities. Through these partnerships, using a community-based/tribally-based participatory research approach, researchers hoped to gain a better understanding of substance abuse in the study communities as well as the existing community resources available to address these issues.

The five sites, or nodes, included California/Arizona, Ohio Valley, Oregon/Hawaii, the Pacific Northwest, and the Southwest. Each node partnered with regional AIAN communities and organizations such as Tribes, treatment agencies, health consortia, and urban health centers.

The academic institutions included the Alcohol and Drug Abuse Institute at the University of Washington, Oregon Health Sciences University, University of New Mexico, University of Cincinnati, University of Oklahoma, and University of California San Francisco. Distances between the academic institutions and the AIAN communities ranged from less than an hour to more than eight hours round-trip. The most remote community required the research team to travel via airplane to collect data.
Q: Were you able to establish and implement common processes across all five sites?
A: Initially, that was our plan, but we were actually unable to come up with standardized protocols that would work for all of the sites in the study because of significant differences among the communities. These unique factors included health disparities, access to resources, geography, culture, tradition, exposure to post-colonial trauma, and substance abuse issues.

However, we did follow some common key steps across the sites.
Q: What steps were applicable to all of the sites in the study?
A: The steps we followed at each site included:
  1. Negotiating Tribal council and/or other Tribal leadership approval, including memoranda of understandings and data sharing and ownership agreements outlining the roles and responsibilities of the partners and standards for use and ownership of data
  2. Assembling community advisory boards to help guide the projects, including providing input on the development and implementation of the research protocols. Assembling community advisory boards (CABs) to help guide the projects, including providing input on the development and implementation of the research protocols. Each community followed its own process for appointing the CABs as well as establishing the responsibilities and roles of the CAB members. For example, some CABs participated in the development of the protocols while others served as reviewers/approvers of protocols developed by the academic researchers.
  3. Obtaining university and, when applicable, Tribal and/or Indian Health Service Institutional Review Board (IRB) approvals
  4. Formulating a set of 15 guiding principles to ensure that the research partnerships were ethical and respectful of the unique status of AIAN partners as sovereign entities
  5. Conducting focus groups (in addition to using other data collection techniques—e.g., stakeholder interviews and telephone surveys—that varied depending on the site)
Q: Based on your experience in this study, what are some key considerations for researchers seeking to collaborate with Tribes and AIAN organizations?
A: We identified a number of common themes in the process of establishing and sustaining research partnerships between academic institutions and AIAN Tribes and organizations. In addition to the considerations and common steps outlined above, these themes include the following:
  • The focus of the research should be driven by the community.
  • Native partners in the study noted that they would like researchers to document the community strengths and resources rather than simply focusing on problems such as substance abuse.
  • Native partners also expressed interest in collaborating with researchers to study cultural practices that have been effective in preventing and treating community health problems.
  • Given the complexity of the processes involved as well as factors such as weather conditions and seasonal cultural/spiritual activities, researchers should allow ample time—in our case, it took a year or longer—to develop partnerships with sovereign Tribal Nations and obtaining approval for research activities.
  • Researchers should not assume that the processes for conducting research in one Tribal community are transferrable to other Tribal communities.
  • Due to the often remote and isolated locations of AIAN communities, travel challenges are par for the course when working these groups and can sometimes significantly affect research protocols.
  • Some AIAN community members assume multiple roles, such as service provider, Tribal and/or cultural leader, and extended family member. Researchers should consider the impact of these complex relationships on both the participating community partners and the scientific integrity of the research.
  • Academically-based research teams often require training and time to acquire the skills needed in research partnerships with AIAN communities.
  • In many cases, Tribal community members feel more comfortable participating in study if the research team includes AIAN investigators.

 

 


Thomas, L. R., Rosa, C., Forcehimes, A., & Donovan, D. M. (2011). Research partnerships between academic institutions and American Indian and Alaska Native tribes and organizations: Effective strategies and lessons learned in a multisite CTN study. The American Journal of Drug and Alcohol Abuse, 37, 333-338.

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