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Coming January 2018, Evaluation in Rural Communities

Evaluation in Rural Communities Flyer PDF

This book is an introductory guide for programs, people, and communities. A must have for anyone wanting to know more about the basics of program evaluation in community settings.

“Is culturally based prevention effective?”

2018, in the Journal of Evaluation and Program Planning

Abstract: American Indian youth substance use is a major public health concern. To date, there has been limited evaluation of American Indian youth substance use prevention programs. Evaluation of prevention programs is necessary to understand the aspects of programming that are effective or not effective. This mixed-methods evaluation focuses on select outcomes of a 3-year culturally-based prevention program located in six American Indian communities in the Rocky Mountain Region. The primary research questions this outcome evaluation sought to answer were as follows: 1) Are there differences in American Indian youth who participate in culturally-based prevention activities compared with American Indian youth who do not participate in these activities? 2) Was the prevention program effective in increasing community readiness over a 3-year period? 3)Did community involvement in prevention activities increase overtime? Results from this evaluation indicate that substance use was similar among intervention (n=200) and non-intervention youth (n=369). Community readiness decreased −.81 point from 2015 to 2017. The reach of prevention activities increased 365% from 2015 to 2017. We provide lessons learned that may help other communities as they document outcomes related to prevention efforts. Substance use is a multi-faceted problem facing our communities, families, schools, and nation. Innovative, effective, culturally-based prevention programs like the one highlighted in this paper underscore the need for primary prevention strategies.

“Substance Use and Mental Health: Preliminary surveillance findings from an American Indian population”

2018, in the Journal of Public Health Policy and Planning

Abstract: Substance use and mental health disorders have increased in the last 15 years and impact public health. Public health surveillance of substance use and mental health (SUMH) is needed to inform planning, implementation, and evaluation of SUMH programs and policies. The Rocky Mountain Tribal Epidemiology Center (RMTEC) implemented a 1-year pilot study to examine SUMH surveillance in American Indian populations. The main objectives of this pilot study were to: 1) determine what kinds of SUMH surveillance is occurring in communities served by the RMTEC, and 2) document the strengths and challenges of SUMH surveillance in this population. Using an evaluative case study design, the authors used a mixed-methods approach to examine multiple data sources.  Results indicate that limited SUMH surveillance is occurring in communities and programs served by RMTEC. Challenges and strengths are identified along with recommendations for future SUMH surveillance in American Indian populations.

“Integrating Students into Interdisciplinary Health Research Teams”

2017, in the Journal of Health Disparities Research and Practice

AbstractMajor initiatives by the U.S. Department of Health and Human Services as well as the World Health Organization have produced a large and compelling body of evidence on how to reduce health disparities, which entails having a clear understanding of how social factors shape health and healthcare outcomes. Specifically, there is a need for healthcare professionals to understand social determinants of health (e.g., low socioeconomic status, lack of health insurance, and poor education) and how these lead to disparities in health for people of minority racial and ethnic groups. Little is known about how students are developed as health disparities researchers or how their research experiences impact their views about addressing social determinants of health as a career goal. The purpose of this paper is to describe how health and human sciences students were integrated into three minority HIV prevention and testing projects using the lifelong learning for health professionals (LLHP) principles and activities framework, which entails a focus on: (a) education, (b) community, and (c) organization in the planning, development, implementation, and evaluation of interdisciplinary research.

“Assessing the Impact of American Indian Peer Recovery Support on Substance Use and Health”

2017, in the Journal of Groups in Addiction and Recovery

Abstract: Peer Recovery Support (PRS) is emerging as a key intervention for communities and individuals as they address high rates of substance abuse and limited recovery resources. American Indian populations were among the first people to use concepts of PRS through abstinence-based revitalization movements and ceremonies. The present study examined the impact of PRS on substance use, emotional and psychological problems, and social connections among urban and reservation American Indian peers involved in a 3-year PRS program. A total of 224 individuals, 110 male and 114 female completed baseline GPRA. Of these, 65 peers completed baseline and 6-month follow-up GPRAs. Involvement in PRS decreased substance use significantly among peers. Peer attendance at voluntary self-help groups and support from family and friends increased as a result of PRS.

“A Review of Tribal Best Practices in Substance Abuse Prevention”

2017, in the Journal of Ethnicity in Substance Abuse

Abstract: American Indian youth experience higher rates of substance use than non-American Indian youth. Researchers, clinicians, and treatment programs embrace evidence-based practices (EBPs) and practice based evidence (PBE) as a primary method for addressing substance abuse and advancing behavioral health. However, less is known about the use of tribal best practices (TBPs) and how they are implemented in American Indian substance use prevention contexts. Objective: The main objective of this systematic review was to determine how TBPs are implemented and shared in the context of tribal substance use prevention. The second objective was to document TBP examples from three tribal communities involved in a 5-year substance use prevention initiative. Methods: A systematic review of published and grey literature was conducted using funding agencies websites, EBSCO Host and national registries. Three tribal communities involved in the initiative documented current TBPs to highlight characteristics of TBPs, costs, and approval processes. Results: TBPs are very limited in the literature. Despite tribal use for thousands of years, TBPs are underrepresented and misunderstood. This review found that the terminology used to describe TBPs is not consistent across agencies, publications, websites, or reports. There is also variation in how TBPs originate in substance use prevention contexts and there is not a primary resource or protocol for sharing TBPs. Continued efforts are needed to support the use and dissemination of TBPs in substance use prevention.


“Establishing the Reliability and Validity of the Sources of Strength in One American Indian Community”

2016, in the journal American Indian and Alaska Native Mental Health Research

Abstract:  Strength-based approaches that explore resilience and health among Native communities are needed. This report highlights the results from a sources of strength inventory reported over a 2-year period by participants (N = 48) from a Montana tribe who attended cultural camps. The authors found the sources of strength scale to be a reliable and valid measure for the population (N = 11 items, α = .945). The community plans to use the results of this study to inform and promote strength-based measures grounded in the resilience of youth, families, and culture.


“Participatory Visual Methods for American Indian Communities and Mental Health Conversations”

2016, in the journal American Indian and Alaska Native Mental Health Research

Abstract:   “Visual methods serve a unique purpose in that they help generate data that uncover experiences, knowledge, and contextual factors that lead to a greater shared understanding about a topic. We describe the process and results of one American Indian community-based organization’s success using visual methods to prompt community conversations about mental health and substance abuse. We uncovered community members’ mental health perspectives and experiences through visual vignettes. Our hope is that other communities and funding agencies see the value and promise of visual methods as a valid approach that promotes shared dialogue, decision making, and conversations for future generations.”


“Recommendations from an American Indian Reservation Community-Based Suicide Prevention Program”

2015, in the International Journal of Human Rights in Healthcare

Abstract:   “Effective community-based suicide prevention strategies require culturally relevant contextually driven approaches, validated by community members. Existing literature, funding agencies, and policies do not adequately address the differences in community vs non-community definitions and approaches to suicide prevention. These differences and the process must be articulated to fully understand the complexities of effective American Indian community-based suicide prevention strategies. This paper aims to discuss these issues.”


“Indigenous Methodologies in Research: Social Justice and Sovereignty as the Foundations of Community-Based Research”

2015, in the book Critical Issue in Indigenous Studies: Mapping Indigenous Presence: North Scandinavian and North American Perspectives

Excerpt:  “Throughout time Indigenous communities have used their own cultural expertise to assess, validate, and apply experiential knowledge to improve the health of their communities and members.  These inferential methods were based on generations of lived experiences gained within the context of a myriad of American Indian and Alaska Native (AIAN) communities surviving, and even thriving, within challenging and diverse geographic conditions.  These Indigenous methodologies mirrored aspects of Western science by sharing principles of hypothesis testing to assess reliability, generalizability, and a variety of differential forms of validity or accuracy.  They were based on the premise that health and survival require a balance of physical, spiritual, emotional, social, and economic factors, and to achieve and maintain this balance, Indigenous methodologies were needed to test, validate, and experiment…”


“Research Ethics and Indigenous Communities”

2013, in the American Journal of Public Health

Abstract: “Institutional review boards (IRBs) function to regulate research for the protection of human participants. We share lessons learned from the development of an intertribal IRB in the Rocky Mountain/Great Plains Tribal region of the United States. We describe the process through which a consortium of Tribes collaboratively developed an intertribal board to promote community-level protection and participation in the research process. In addition, we examine the challenges of research regulation from a Tribal perspective and explore the future of Tribally regulated research that honors indigenous knowledge and promotes community accountability and transparency. We offer recommendations for researchers, funding agencies, and Tribal communities to consider in the review and regulation of research.”


“Peer Recovery Support in American Indian Communities: A Qualitative Intrinsic Case-Study Approach”

2015, in the Journal of Groups in Addiction & Recovery

Abstract: “Peer recovery support (PRS) offers significant benefits for individuals in recovery from substance abuse disorders. This research describes the experiences of the first 12months of a tribally led, American Indian community-based PRS project in two American Indian communities. An intrinsic qualitative case-study design was used to answer the research question, “What are some considerations for implementing PRS services in an American Indian reservation community?” Results showed PRS services fill a much-needed gap in American Indian communities where recovery support resources are limited and substance abuse is pervasive.”


Past Projects

Community Health Consultant (2011- 2018)

Rocky Mountain Tribal Epidemiology Center


Transitional Recovery and Culture Project Lead Evaluator (2014-2016)

Rocky Mountain Tribal Leaders Council


Community Health Consultant (2011-2016)

Northern Cheyenne Tribal Board of Health


Research and Evaluation Consultant (2014-2015)

Second Season Northern Cheyenne Tribe


Research and Evaluation Consultant (2014-2015)

Fort Belknap Domestic Violence Prevention Initiative


Research and Evaluation Consultant (2011-2015)

Boys and Girls Club of the Northern Cheyenne Nation


Research Consultant (2011)

Fort Belknap Indian Community Environmental Department


Co-Investigator (2010-2013)

Montana Wyoming Tribal Leaders Council NARCH Project