Brockie Teresa, Decker Ellie, Barlow Allison, Cwik Mary, Ricker Adriann, Aguilar Theresa, Wetsit Lawrence, Wilson Deborah, Haroz Emily E
Johns Hopkins School of Nursing, 525 North Wolfe St, Baltimore, MD, 21205, USA.
Johns Hopkins Bloomberg School of Public Health, Center for Indigenous Health, 415 North Washington St., 4th Floor, Baltimore, MD, 21231, USA.
Implement Sci Commun. 2023 Jan 4;4(1):1. doi: 10.1186/s43058-022-00376-1.
Native American youth, primarily living on reservations, suffer the highest burden of suicide of any racial group in the USA. Implementation and sustainability of culturally grounded, evidence-based interventions are needed to address suicide in Native American populations. For nearly 40 years, Montana has ranked at or near the top nationwide for suicide. Fort Peck Tribal leadership declared a state of emergency in 2010 after six suicides and 20 attempts that occurred over a 5-month period.
We used a community-based participatory research approach for adapting the Celebrating Life (CL) program with a specific focus on long-term sustainability, which has demonstrated efficacy in addressing suicide with the White Mountain Apache. The aims were to (1) adapt the CL program intake forms through roundtable discussions, (2) conduct asset and resource mapping to identify community and cultural resources to leverage for the CL program within the Fort Peck context, and (3) develop a sustainability plan for CL in Fort Peck through qualitative approaches informed by the Program Sustainability Assessment Tool.
Roundtable discussions resulted in adapted intake forms that capture variables relevant to the Fort Peck context. Asset mapping identified 13 community assets and 10 cultural resources to incorporate within the CL implementation process. Focus group discussions yielded four key themes that were incorporated into a plan for sustainability: (1) strategic partnerships, (2) long-term funding, (3) communication planning, and (4) workforce planning and engagement.
This paper outlines an avenue for using culturally adapted tools to design an implementation system driven by community and cultural assets within tribal communities and for integrating program planning for sustainability early in the implementation process.
主要居住在保留地的美国原住民青年，承受着美国所有种族群体中最高的自杀负担。需要实施基于文化且有证据支持的干预措施，并确保其可持续性，以解决美国原住民中的自杀问题。近40年来，蒙大拿州的自杀率在全国一直名列前茅或接近榜首。2010年，在5个月内发生了6起自杀事件和20起自杀未遂事件后，福特佩克部落领导层宣布进入紧急状态。
我们采用基于社区的参与性研究方法，对“庆祝生命”（CL）项目进行调整，特别关注其长期可持续性。该项目已证明在解决白山阿帕切部落的自杀问题上具有成效。目标是：（1）通过圆桌讨论调整CL项目的 intake forms，（2）进行资产和资源映射，以确定福特佩克地区内可用于CL项目的社区和文化资源，（3）通过基于项目可持续性评估工具的定性方法，为福特佩克的CL项目制定可持续性计划。
圆桌讨论产生了经过调整的 intake forms，能够捕捉与福特佩克地区相关的变量。资产映射确定了13项社区资产和10项文化资源，将纳入CL实施过程。焦点小组讨论产生了四个关键主题，并纳入了可持续性计划：（1）战略伙伴关系，（2）长期资金，（3）沟通规划，（4）劳动力规划与参与。
本文概述了一条途径，即使用文化适应性工具来设计一个由部落社区内的社区和文化资产驱动的实施系统，并在实施过程早期将项目可持续性规划整合进去。
