“Tied Together Like a Woven Hat.” Community Based Participatory Research to discover resilience among Alaska Natives.

1. “Tied Together Like a Woven Hat.” Community Based Participatory Research to discover resilience among Alaska Natives. People Awakening Project Samuel Demientieff People Awakening Coordinating Council Gerald Mohatt, EdD Principle Investigator

2. WHO ARE WE? • People Awakening (PA) was a four-year study designed to provide a strengths based Alaska Native understanding of the sobriety process. • PA’s research has included community members and participants as co-researchers. • Ciuliat Group of Yup’ik Consultants • An Alaska Native Coordinating Council comprised of members of each cultural group guided the project as well as various groups of Yup’ik experts.

3. ROBERT CHARLIE, Athabascan SAM DEMIENTIEFF, Athabascan KAREN STICKMAN, Athabascan COOKIE ROSE, Athabascan JUDY SIMEONOFF, Alutiiq DAVID SAM, Lingit MARY I. MILLER, Lingit VALERIE NAQUIN DOREEN SIMMONDS, Inupiat ELVINA TURNER, Yup’ik ANNIE WASSILIE, Yup’ik COORDINATING COUNCIL

4. Alaska Native context • 229 tribes • Five basic tribal groups with multiple languages • Huge geographic area and diverse environments. • Had to represent this diversity and complexity.

5. History of People Awakening • In response to the research done • without partnership with Alaska Native people and communities and • primarily focused on problems • Mostly survey and/or questionnaires Therefore, Alaska Natives wanted research that explored in detail the life experience of sober Native people

6. Legacy of Mistrust • Exploitation • Piracy of intellectual property • No results given back

7. CULTURALLY ANCHORED PARTICIPATORY RESEARCH Becoming Co-researchers: Moving beyond advising to collaboration, relationships, and empowerment.

8. The beginning process • How we named it? Awakening as individuals and as communities.

9. Origin of the Question • The reason there are windows all around in a Pilot house on a boat is to be able to see all around and to see where we came from. • Resilience and protection. • Kept talking about pathology. • We all had to come to terms with our own experiences together to know what to look for.

10. Finding a methodology • 1.5 years of planning, submitting, and resubmitting to NIH/NIAAA – met twice a year and then had short meetings if necessary. • Narrative life history rather than survey. • Stories to associate with rather than numbers. • Rejection by NIH/NIAAA on second round. • Returning to the Council: • Should we compromise?

11. Persistance and conviction • Resubmit with advice of NIAAA and continually rethinking to reach a consensus of the council. • Key advocacy of an Alaska Native leader who was on the NIAAA External Council—Joan Hamilton.

12. Who to interview and how? • Enhancing choice and comfort. • Participant chooses the type of interviewer. • Participant chooses place for interview. • Ethical dilemmas. • Should we interview people who were non-problem drinkers—implications for the community. • If they had never had a problem but drank-Yes • If they had had a problem and recovered but still drank-No

13. If it doesn’t fit then don’t use it • Adapting the survey approach: Ciuliat Group. • Yup’ik Language and translation. • Scaling: five to three point scales. • Using a slide rule

14. Dilemmas • Dropping an entire survey tool that did not work. • Questions: • How important for your sobriety is Native Dancing? • Very important, important, not at all important. • Consistently very important even though the people never danced and rejected it because of religious beliefs. Why?

15. Hearing a co-researcher INTERVIEWER: You have a very positive sense of what a healthy life, a spiritual life, is. Alcohol doesn’t seem to have a place in that. PARTICIPANT: It doesn't… I’m beyond that. I guess you’d say I coped with it in the past tense and it’s done. INTERVIEWER: So this new life opened up to you? PARTICIPANT: It’s not a new life. This is the way life is supposed to be. (200) BEYOND SOBRIETY

16. Beyond Sobriety This is the way life is supposed to be lived. • Learning his language • Spiritual pursuits • Community activities • Family: children and grandchildren

17. Interpreting the data—getting it right. • Our interpretation or hunches were sent to participants for their feedback. • Extensive changes

18. Further interpretations • Our theory--Does it hold up? • Gave the same transcripts to the council. • In cultural groups the council analyzed the life history. • Compared researchers and council’s interpretations. • Council pointed out examples that we missed: • Contributing to the community as protective and a recovery factor. • People reach back to their culture to the find strength to recover.

19. Wanting to be a role model • And I had made a choice when I was ten or eleven to not drink alcohol, to remain sober and to show my brother, my sister that there is something different to do besides drinking and alcohol.

20. Awareness of consequences Ellanqneq • But at that time I had already decided for myself that I wasn’t going to drink. Part of that had to do with getting out into the woods. And that was part of my reason for refusal. Why would you want to go out and drink and kind of get out of your mind, loose mental control?…I wanted to be aware of what I was doing.

21. How to present it? • Need a cultural symbol and not a diagram. • What makes sense across all the Tribes. • Council decided upon a river image.

23. How to share the results? • To community. • To scientific community. • To practitioners.

24. Dissemination • Interactive CD ROM • Website with CD ROM and booklet on it. • Final report • Need a non-electronic version for the people—booklet. • Workshops locally and nationally. • Journal articles • Planning a prevention project with one community using the model. • Vision of planning a treatment program using the recovery model.

25. Participatory Approach of People Awakening Project • Scientists and Community Partners • Planning together • Sensitivity to concerns of participants -- consensus • Ongoing communication • Anticipation of problems and misunderstandings • Return results to participants

26. Reactions to this approach • Goal of 36 participants • 152 volunteer and had to cut it off. • Interviewed 103. • Requests for CD ROM • One region wants to do a follow-up prevention project.

27. Acknowledgements • We thank all of our volunteers who shared their lives with us. • We thank the members of the PA Coordinating Council, our co-researchers, colleagues, and relatives. • Support for this project is through the National Institute of Alcoholism and Alcohol Abuse and the Center for Minority Health Disparities of NIH. (1RO1-446-03 2A2) • This was only possible through the work of Mary Stachlerodt, Jim Allen, Michelle Rasmus, Lisa Thomas, Kelly Hazel, Dante Foster, Chase Hensel, Dolly Scoville, Sharon Lindley, Carolyn Brown, Carol Yakish, Jamie Mohatt, Tony Cantil, Jen Vetch, Kelly McQuire, Gwen White, James Walsh, Fred Beauvais, Robert Trotter, and Alan Marlatt.