2011 1 st annual university of new mexico national health disparities conference hotel albuquerque n.
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2011 1 st Annual University of New Mexico National Health Disparities Conference Hotel Albuquerque. The Family Listening Project: An Intergenerational Community Based Participatory Research Prevention Program Lorenda Belone, Greg Tafoya, Rebecca Rae, Nina Wallerstein, and John Oetzel

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2011 1 st annual university of new mexico national health disparities conference hotel albuquerque

2011 1st Annual University of New MexicoNational Health Disparities ConferenceHotel Albuquerque

The Family Listening Project: An Intergenerational Community Based Participatory Research Prevention Program

Lorenda Belone, Greg Tafoya, Rebecca Rae,

Nina Wallerstein, and John Oetzel

May 23-24, 2011

cbpr definition
CBPR Definition

“ Collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community with the aim of combining knowledge and action for social change to improve community health and eliminate health disparities.”

W.K. Kellogg Community Scholar’s Program (2001)

cbpr principles
CBPR Principles
  • Recognizes community as unit of identify
  • Cooperative and co-learning process
  • Systems development & local capacity building
  • Long term commitment
  • Balances research and actionIsrael et al, 1998 and 2008

CBPR/TPR Principles for Tribes

  • Tribal systems shall be respected and honored
  • Tribal government review and approval
  • Tribally specific data shall not be published without prior consultation; data belongs to tribe
  • Core Values: trust, respect, self-determination, mutuality of interests, perspective taking, reciprocity
ten year history building partnerships

CDC Grant: 1999-2003

  • Purpose: To better understand community strengths/cohesions for health, & identify cultural measures.
  • Qualitative approach
  • Over 60 key informants: interviews and focus groups
  • Findings:
  • Multiple community and cultural strengths
  • Concerns: Loss of culture and language
  • Need to strengthen communication between Elders/Youth
  • NARCH I: 2001-2005
  • Purpose: To conduct participatory research with Navajo community to identify capacities and what keeps tribal members healthy.
  • Quantitative approach
  • Over 250 participants
  • Findings: From the community profile have proven to be very useful data for each tribe and has been used for strategic planning purposes and grant writing to improve services and health status.
Ten Year History - Building Partnerships
  • CBPR Process
  • Tribal Advisory Committee
  • Co-developed instruments (Focus Group & Survey)
  • Co-conducted interviews
  • Co-analyzed data
  • Results:
  • Community Voices Reports
  • 2003 JAPH Publication
  • Community Profile
  • Partnership based on earlier collaborations
    • CDC and NARCH I
  • Built upon research evidence from a NIDA-funded family strengthening curriculum between the Anishinabe (Ojibwe) people and Dr. Les Whitbeck at the University of Nebraska
      • Anishinabe Listening Project found that parents and children retained prevention messages and behaviors when cultural content was most integrated in the curriculum.
family listening circle program
Family Listening/Circle Program

Funding: 2005-2009

  • National Institutes of Health
  • Indian Health Services > Native American Research Centers for Health (NARCH III) > AAIHB
    • UNM MPH
    • Navajo community
    • Pueblo community

Research Question: Using CBPR, what is the effectiveness of a co-adapted intergenerational intervention for reducing risky behaviors and substance abuse for 3rd-5th graders?

research path 2005 2009
Research Path: 2005-2009

Year 1

Established tribal research team (Behavior Health/Health Program)

Conducted Training: PH 101, Research 101, CBPR 101

Conducted FG Discussions: Elders, Parents, Service Providers, & Youth

Year 2

  • Focus Group findings, co-adapted intervention curriculum
    • Added community service project and Youth Photovoice
  • Adapted evaluation measures (qual & quant)

Year 3 & 4

  • Trained facilitators
    • Human Subjects Training
    • Recruited and administered pre/post test
    • Piloted Curriculum – 10 families
    • Administered Pre/post measures, facilitator logs,
    • and journals
    • Dissemination of findings


  • Welcoming
  • My Family
  • Tribal History
  • Tribal Way of Life
  • Our Tribal Vision
  • Community Challenges
  • Communication & Help Seeking
  • Recognizing Types of Anger
  • Managing Anger
  • Problem Solving
  • Being Different
  • Positive Relationships
  • Building Social Support
  • Making a commitment and presentation of Community Projects

Structure of Each Session

  • One day a week
  • 2 hour session - evening
  • Trained tribal facilitator and usually in their own language
  • Start with Dinner
  • Greetings
  • Sharing of Home Practice
  • Ice Breaker Activity
  • Activities: separate adult and youth groups
  • Planning Community Action Project
  • Journals: adults & youth
  • Wrap-up and take home practice activity
  • Facilitator logs
  • Co-adaptation of a tribal specific 14-session curriculum, as well as the co-development of evaluation tools (qualitative and quantitative).
  • In the Pueblo community, adapted curriculum has been piloted twice serving approximately 19 families.
  • In Navajo community, adapted curriculum has been piloted once with 10 families with intentions of a second pilot.
  • At each location, the capacities of tribal members were developed through facilitation, coordination, and research skills through training by the UNM team.
  • Project Outcomes: Increased communication, improved coping skills, increased parenting skills, and increased cultural knowledge.
qualitative results
Qualitative Results


Enhanced pride in culture and language; & Increased self efficacy and coping

  • “I learned not to drink and to ask people for help and have parents to take care of you.”
  • “It felt very good because I finally learned about our culture”…”We learned our Indian names and what our Indian names mean.”


Increased parent/child communication and positive family dynamics; Increased pride in culture and history

  • “I am taking how valuable it is to teach our children the traditional way of life.”
  • “Learned how to handle stressors in a good way.”

Importance of integrating cultural AND family strengthening evidence for effective intervention program

apache family listening program
Apache Family Listening Program

Funding: 2009-2010

  • National Institutes of Health
  • Indian Health Services > Native American Research Centers for Health (NARCH V) and AAIHB
      • UNM MPH/Center for Participatory Research
      • Apache community


  • To collaborate with the Tribe to adapt, pilot, and implement the Family Listening Project within their cultural values and community.
  • To test our translational methodology of contextualizing interventions and streamlining the adaptation process of being true to a Community Based Participatory Research approach.
apache flp aims
Apache FLP Aims
  • Establish a tribal research team to serve as advisory committee members and to be trained in a CBPR research approach;
  • Co-adapt family intervention curriculum for late elementary aged youth and their families based on the distinct Apache culture;
    • Will incorporate additional culturally accepted teachings into the existing curriculum as well as exclude any unacceptable practices or materials.
  • Pilot the Apache specific curriculum with ten families; and
  • Share learnings from pilot with the NARCH III LEO Navajo and Pueblo communities.

Thank You

Any Questions?