While the general public is now becoming more aware of health disparities, social workers have always endeavored to address and eliminate them. Tulane University School of Social Work Associate Professor Dr. Catherine McKinley has dedicated her career to collaborating with Indigenous Peoples, which includes Native American, American Indian, Alaska Native, and/or Native Hawaiian in the United States, to address disparities in violence, mental health, substance abuse, and health.
After a rigorous proposal and review process, the National Institutes of Health have awarded a $2.7 million Research Project Grant (R01) to Dr. McKinley as the principal investigator of an effective, sustainable, culturally-relevant, and family-centered intervention for alcohol and other drug (AOD) abuse and violence among Native American families.
AOD abuse and violence in families are co-occurring risk factors that drive health disparities and mortality among Native Americans. “Alcohol abuse is associated with many of the top causes of death among Native Americans as is violence. Both of which are also disproportionately high among these groups,” says Dr. McKinley. “They are associated with mental and physical health disparities, that not only contribute to early death, but to an impaired quality of life.”
The long-term goal of this research is to promote health, wellness, and resilience while preventing and reducing AOD abuse and violence in Native American families. It is centered on the Weaving Healthy Families (WHF) curriculum, which is a cognitive-behavioral, support group model tailored for all ages.
The title of the awarded grant includes the words “Chukka Auchaffi’ Natana,” which translate to “Weaving Healthy Families” in the Choctaw language. That is significant because it connects the research to those it serves. The WHF program is different from current interventions because it integrates a culturally relevant talking circle into each session and infuses the Framework of Historical Oppression, Resilience, and Transcendence (FHORT) into its approach. “It was built from a decade of preliminary research that identified the culturally relevant risk and protective factors related to disparities of alcohol abuse, violence, and overall health and targets these factors to promote wellness and resilience,” says Dr. McKinley. “It contains a holistic approach to promote overall wellness using a medicine wheel, which includes physical, social, emotional/psychological, and spiritual aspects.”
A community advisory board leads this community-based participatory research, and they have shared in the cultural adaptation and decision-making process every step of the way. In addition, tribal community health representatives facilitate the WHF program. “This is important to have tribal practitioners, to train local leaders and practitioners and for sustainability and cultural-relevance, so that this program can persist beyond the funding period,” says Dr. McKinley. “From the original version, WHF has been shortened from 16 to 10 sessions and has been simplified and streamlined to make it more accessible and feasible.”
The WHF program provides a template of not only how to promote healthy families but also the process of how to implement the program effectively across tribal contexts. “Having an effective and sustainable program is important because, even if a program is effective, if it is not feasible or accessible it will not be utilized,” says Dr. McKinley
This interdisciplinary research benefits from Tulane co-investigators Dr. McKinley, Dr. Katherine P. Theall with the School of Public Health and Tropical Medicine, and Dr. Charles Figley with the School of Social Work as well Dr. Karina Walters of the University of Washington School of Social Work and Dr. James Allen University of Minnesota Medical School. Dr. Leia Saltzman of the School of Social Work is also participating in this project as a research scientist/statistician.
“This is a tremendous opportunity for Dr. McKinley and Tulane University to further promote individual, family, and community resilience,” says Dr. Patrick Bordnick, dean of the School of Social Work. “Dr. McKinley is a top-tier behavioral scientist, and this work empowers people in their everyday lives.”
As part of treaty agreements with sovereign tribes, the U.S. government has a federal trust responsibility to provide for the health and well-being of Native Americans. “Given the health inequities that have been imposed and perpetuated for centuries, this trust agreement has fallen short,” says Dr. McKinley. “Government-supported research is important, not only to promote the health of Native Americans but to fulfill their treaty agreements to the communities whose land we all have the privilege of sharing.”