Urban American Indian Elders
Sharing Stories of Resilience
25th Annual Native Health Research Conference
June 2014
Documenting and Promoting Stories of
Resilience
Among Urban
American Indians Elders
• Pilot project funded by the Center for American
Indian Resilience
• National Institute On Minority Health And Health
Disparities of the National Institutes of Health under
Award Number P20MD006872
• Partnership between University of Arizona and
Tucson Indian Center
Team Members
Agnes Attakai and Kerstin M. Reinschmidt (Co-PI)
Carmella Kahn-Thornbrugh (UA)
Shannon Whitewater (UA)
Tara Chico (UA)
Marlene Jose (TIC)
Phoebe Mills (TIC)
Nolando Neswood (elder)
Kathryn Foster (elder)
Nicolette Teufel-Shone (PI- CAIR)
CBPR Principles
 Tucson Indian Center-UA co-designed
project
 Research process with elders
 Community Advisory Board
Goal
 The purpose this qualitative pilot research project was to
document and develop a youth health promotion curriculum
on native elders’ stories of resilience.
 Methods
 Develop questionnaire based on literature
 Test with elders and revise
 Recruit 15 elder for interviews
 Video tape, audio tape and transcribe
 Code using NVIVO
 Develop curriculum
 Test, revise and finalize
Elder Interviews
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11 females, 2 males; age 55+
1-3 hour duration; video/voice recorded
Stories edited
2nd interview to review digital story
Analysis Process
 Combined consensus
and thematic analysis
 Consensus approach to develop thematic codes
 NVIVO coding
 Coded texts shared with team for curriculum design
 Complete analysis and interpretation
 (CAB) Team consensus of final analysis
Thematic Codes Used in NVIVO
THEMES
PATTERNS
HISTORICAL TRAUMA
Native Concepts
Oppression, assimilation, fear
Boarding school, broken families, loss of language, loss of tradition, removal from family, removal
Sense of Loss
from land, yearning
Alcoholism/drugs, discrimination, generational gap, ill health, living conditions, loss of family
Adversities
members, lost voice, violence
RESILIENCE
Native Concepts
Survival, life, get through hard times, bounce back, better myself
Individual
Know roots, participation, practicing spirituality, responsibility, strength, volunteerism
Family
Community
Family members as role models, growing up, positive family relations, safe environment for kids,
teaching kids
Culture/traditions/language, economic development, TIC, other community resources, sharing
stories, sovereignty, spirituality, traditional land use
Activities, education, get elders and youth together, know roots/know history
Health now, health then, health of youth, strategies for health
Youth
Health
Strategies
Non-Native Support and Connection
Personal Story
Historical Trauma
 Events of the past led to
 Loss of language, traditions and culture
 Disruption of family life
 Contemporary adversities as continuation past events
 Alcoholism/drugs
 Discrimination
 Loss of family members
 Generational gap
 Untold stories
Strategies to overcome historical trauma
Building positive identities based on culture and tradition
Bringing the generations together
Multiple, Interrelated Levels of Resilience
 At the community level, sources of resilience are
 Culture, language, traditions and sharing stories
 Traditional land use
 Tucson Indian Center and/or other community resources
 The family plays important cultural roles by
 Teaching the younger generation
 Creating positive family relations
 Providing family members as role models
 The individual is a source of resilience as embedded in
family, community and culture/traditions by
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practicing spirituality
practicing responsibility
being strong
participating/volunteering
Resilience Strategies for Youth
 Education
 Activities
 Getting elders and youth together
 Knowing roots/history
Resilience curriculum
4 modules with elder stories to promote resilient
behaviors and strategies among American Indian
youth 12-18.
Draft Curriculum
 Goal 1: Build connections between elders and
youth by enhancing the knowledge of the role of
elders in American Indian communities
 Goal 2: Enhance youth identity through
storytelling
 Goal 3: Increase knowledge among youth about
American Indian resilience
Goal 1: Build connections between elders and youth by
enhancing the knowledge of the role of elders in American
Indian communities
Codes
 health
 generation gap
 spirituality
 values
 culture, tradition, language
 growing up/history
 role models
 volunteerism
Lesson Plans
Voice of Elders
 Volunteerism
 Role Models
 Culture, Tradition,
Language and Spirituality
 Growing-up/History
 Health
Goal 2: Enhance youth identity through
storytelling
Codes
 generation gap
 Culture, language,
tradition
Lesson Plans
Storytelling
 What is storytelling?
 Telling your personal story
 How to share stories
Goal 3: Increase knowledge among
youth about American Indian resilience
Codes
Resilience
 Individual resilience
 Family resilience
 Role models
 Positive family relations
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Community resilience
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Traditions
Economic development
Sovereignty
Spirituality
Historical Trauma
 Adversity: alcoholism, discrimination, generational
gap, ill health, living conditions, loss of family
members, lost voice, violence.
 sense of loss: boarding school, broken families,
language, traditions, removal.
Native Concepts
Health then and now
Lessons Plans
Resilience
 History of American Indian
Resilience
 Personal stories of
resilience
 Native Traditional values
and teachings
 Personal visions
Historical Trauma
 Specific topics: TBD
 Adversity: discrimination,
Sample Lesson: Adversity
Facing Adversity
 To have participants learn about prejudice, discrimination and how
American Indians have faced adversity.
 Show video: Historical Trauma: Discrimination (2:03)
 Reflect: After viewing video, ask the students what they saw.
 Activity: Characteristics and Skills
 Discuss: definitions of prejudice, discrimination and stereotypes.
 Action: Write in journal how they will use their new knowledge.
NEXT STEPS
Completing Project
 Pilot, evaluate and revise curriculum
 Present final curriculum and digital stories to
Tucson Indian Center
Acknowledgements
 Sponsor: National Institute On Minority Health And Health
Disparities of the National Institutes of Health under Award
Number P20MD006872.
 Tucson Indian Center: Jacob Bernal, Marlene Jose, Phoebe
Mills-Cager, CAIR Community Advisory Board members.
 Contact Information:
Agnes Attakai, MPA, Co-PI,
agnesa@email.arizona.edu
Kerstin M. Reinschmidt, PhD, MPH, Co-PI
kerstin@email.arizona.edu