Advertisement

American Indian Perspectives on Evidence-Based Practice Implementation: Results from a Statewide Tribal Mental Health Gathering

  • Sarah Cusworth WalkerEmail author
  • Ron Whitener
  • Eric W. Trupin
  • Natalie Migliarini
Original Article

Abstract

Implementation of Evidence-Based Practices (EBP) within American Indian and Alaskan Natives communities is currently an area of debate and contention. There is considerable concern about expanding EBP policy mandates to AI/AN communities as these mandates, either through funding restrictions or other de facto policies, recall past histories of clinical colonization and exploitation by the state and federal government. As a response, work is being done to evaluate indigenous programs and examine strategies for culturally-sensitive implementation. While the literature reflects the perspectives of AI/AN populations on EBP generally, no one has yet reported the perspectives of AI/AN communities on how to feasibly achieve widespread EBP implementation. We report the findings of a statewide Tribal Gathering focused on behavioral health interventions for youth. The Gathering participants included AI/AN individuals as well as staff working with AI/AN populations in tribal communities. Participants identified strengths and weaknesses of the five legislatively fundable programs for youth delinquency in Washington State and discussed strategies likely to be effective in promoting increased uptake within tribes. Analysis of these discussions resulted in many useful insights in program-specific and community-driven strategies for implementation. In addition, two major themes emerged regarding widespread uptake: the importance of a multi-phase engagement strategy and adopting a consortium/learning community model for implementation. The findings from this Gathering offer important lessons that can inform current work regarding strategies to achieve a balance of program fidelity and cultural-alignment. Attending to engagement practices at the governance, community and individual level are likely to be key components of tribal-focused implementation. Further, efforts to embed implementation within a consortium or learning community hold considerable promise as a strategy for sustainability.

Keywords

American Indian Evidence-based practice Implementation Mental health Juvenile justice 

Notes

Acknowledgments

We would like to thank The Washington State Partnership Council for Juvenile Justice for funding the Tribal Gathering referenced in this paper and for all of the participants at this Gathering. We would also like to thank Monica Reeves for her partnership in planning the Gathering, Asia Bishop for her administrative assistance and to the two anonymous reviewers for their helpful suggestions

References

  1. Aarons, G. A., Green, A. E., Palinkas, L. A., Self-Brown, S., Whitaker, D. J., Lutzker, J. R., et al. (2012). Dynamic adaptation process to implement an evidence-based child maltreatment intervention. Implementation Science, 7(1), 32–40. doi: 10.1186/1748-5908-7-32.PubMedCentralPubMedCrossRefGoogle Scholar
  2. Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 4–23. doi: 10.1007/s10488-010-0327-7.PubMedCentralPubMedCrossRefGoogle Scholar
  3. Aos, S., Miller, M., & Drake, E. (2006). Evidence-based public policy options to reduce future prison construction, criminal justice costs, and crime rates. Olympia,WA: Washington State Institute of Public Policy.Google Scholar
  4. APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271–285.Google Scholar
  5. Barlow, A., Tingey, L., Cwik, M., Goklish, N., Larzelere-Hinton, F., Lee, A., et al. (2012). Understanding the relationship between substance use and self-injury in American Indian youth. The American Journal of Drug and Alcohol Abuse, 38(5), 403–408.PubMedCrossRefGoogle Scholar
  6. Barnoski, R. (1999). The community juvenile accountability act: Research-proven interventions for the juvenile courts. Olympia, WA: Washington State Institute for Public Policy.Google Scholar
  7. Beals, J., Novins, D. K., Whitesell, N. R., Spicer, P., Mitchell, C. M., & Manson, S. M. (2005). Prevalence of mental disorders and utilization of mental health services in two American Indian reservation populations: Mental health disparities in a national context. American Journal of Psychiatry, 162(9), 1723–1732. doi: 10.1176/appi.ajp.162.9.1723.PubMedCrossRefGoogle Scholar
  8. Bernal, G., & Rodriguez, M. M. (2012). Cultural adaptations: Tools for evidence-based practice with diverse populations. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  9. Bernal, G., & Scharron-del Rio, M. R. (2001). Are empirically supported treatments valid for ethnic minorities? Cultural Diversity and Ethnic Minority Psychology, 7, 328–342.PubMedCrossRefGoogle Scholar
  10. BigFoot, D. S. (2011a). The process and dissemination of cultural adaptations of evidence-based practices for American Indian and Alaska Native children and their families. In M. C. Sarche, P. Spicer, P. Farrell, & H. E. Fitzgerald (Eds.), American Indian and Alaska Native children and mental health: Development, context, prevention, and treatment (pp. 285–307). Santa Barbara, CA: Praeger.Google Scholar
  11. BigFoot, D. S. (2011b). The process and dissemination of cultural adaptations of evidence-based practices for American Indian and Alaska Native children and their families. In M. C. Sarche, P. Spicer, P. Farrell, & H. E. Fitzgerald (Eds.), American Indian and Alaska Native children and mental health: Development, context, prevention, and treatment (pp. 285–307). Santa Barbara, CA: Praeger/ABC-CLIO.Google Scholar
  12. BigFoot, D. S., & Funderburk, B. W. (2011). Honoring children, making relatives: The cultural translation of parent-child interaction therapy for American Indian and Alaska Native families. Journal of Psychoactive Drugs, 43(4), 309–318. doi: 10.1080/02791072.2011.628924.PubMedCrossRefGoogle Scholar
  13. Bumbarger, B., & Campbell, E. (2012). A state agency-university partnership for translational research and the dissemination of evidence-based prevention and intervention. Administration and Policy in Mental Health and Mental Health Services Research, 39(4), 268–277. doi: 10.1007/s10488-011-0372-x.PubMedCrossRefGoogle Scholar
  14. Chaffin, M., Bard, D., Bigfoot, D. S., & Maher, E. J. (2012). Is a structured, manualized, evidence-based treatment protocol culturally competent and equivalently effective among American Indian parents in child welfare? Child Maltreatment, 17(3), 242–252. doi: 10.1177/1077559512457239.PubMedCrossRefGoogle Scholar
  15. Cheung, C. M. K., Lee, M. K. O., & Lee, Z. W. Y. (2013). Understanding the continuance intention of knowledge sharing in online communities of practice through the post-knowledge-sharing evaluation processes. Journal of the American Society for Information Science and Technology, 64(7), 1357–1374. doi: 10.1002/asi.22854.CrossRefGoogle Scholar
  16. Dionne, R., Davis, B., Sheeber, L., & Madrigal, L. (2009). Initial evaluation of a cultural approach to implementation of evidence-based parenting interventions in American Indian communities. Journal of Community Psychology, 37(7), 911–921. doi: 10.1002/jcop.20336.CrossRefGoogle Scholar
  17. Duran, B., Harrison, M., Shurley, M., Foley, K., Morris, P., Davidson-Stroh, L., et al. (2010). Tribally-driven HIV/AIDS health services partnerships: Evidence-based meets culture-centered interventions. Journal of HIV/AIDS and Social Services, 9(2), 110–129. doi: 10.1080/15381501003795444.CrossRefGoogle Scholar
  18. Echo-Hawk, H. (2011). Indigenous communities and evidence building. Journal of Psychoactive Drugs, 43(4), 269–275. doi: 10.1080/02791072.2011.628920.PubMedCrossRefGoogle Scholar
  19. Fixsen, D. L., Blase, K. A., Timbers, G. D., & Wolf, M. M. (2007). In search of program implementation: 792 replications of the teaching-family model. Behavior Analyst Today, 8(1), 96–110.Google Scholar
  20. Fox, K. A. (2003). Collecting data on the abuse and neglect of American Indian children. Child Welfare, 82(6), 707–726.PubMedGoogle Scholar
  21. Gilman, W. E., Breslau, J., Conron, K. J., Koenen, K. C., Subramanian, S. V., & Zaslavsky, A. M. (2008). Education and race-ethnicity differences in the lifetime risk of alcohol dependence. Journal of Epidemiological Community Health, 62(3), 224–230. doi: 10.1136/jech.2006.059002.CrossRefGoogle Scholar
  22. Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Publishing Company.Google Scholar
  23. Gone, J. P. (2009). A community-based treatment for Native American historical trauma: Prospects for evidence-based practice. Journal of Consulting and Clinical Psychology, 77(4), 751–762.PubMedCrossRefGoogle Scholar
  24. Gone, J. P., & Calf Looking, P. E. (2011). American Indian culture as substance abuse treatment: Pursuing evidence for a local intervention. Journal of Psychoactive Drugs, 43(4), 291–296. doi: 10.1080/02791072.2011.628915.PubMedCrossRefGoogle Scholar
  25. Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 82(4), 581–629.PubMedCentralPubMedCrossRefGoogle Scholar
  26. Larios, S. E., Wright, S., Jernstrom, A., Lebron, D., & Sorensen, J. L. (2011). Evidence-based practices, attitudes, and beliefs in substance abuse treatment programs serving American Indians and Alaska Natives: A qualitative study. Journal of Psychoactive Drugs, 43(4), 355–359. doi: 10.1080/02791072.2011.629159.PubMedCrossRefGoogle Scholar
  27. Lucero, E. (2011). From tradition to evidence: Decolonization of the evidence-based practice system. Journal of Psychoactive Drugs, 43(4), 319–324.PubMedCrossRefGoogle Scholar
  28. Maccartney, S., Bishaw, A., & Fontenot, K. (2013). Poverty rates for selected detailed race and Hispanic groups by state adn place: 2007–2011. Washington, DC: US Department of Commerce Economics and Statistics Administration.Google Scholar
  29. Miranda, J., Bernal, G., Lau, A., Kohn, L., Hwang, W. C., & LaFromboise, T. (2005). State of the science on psychosocial interventions for ethnic minorities. Annual Review of Clinical Psychology, 1, 113–142.PubMedCrossRefGoogle Scholar
  30. Mmari, K. N., Blum, R. W., & Teufel-Shone, N. (2010). What increases risk and protection for delinquent behaviors among American Indian youth? Findings from three tribal communities. Youth and Society, 41(3), 382–413. doi: 10.1177/0044118X09333645.CrossRefGoogle Scholar
  31. Morsette, A., Van den Pol, R., Schuldberg, D., Swaney, G., & Stolle, D. (2012). Cognitive behavioral treatment for trauma symptoms in American Indian youth: Preliminary findings and issues in evidence-based practice and reservation culture. Advances in School Mental Health Promotion, 5(1), 51–62. doi: 10.1080/1754730X.2012.664865.CrossRefGoogle Scholar
  32. National Indian Health Board. (2004). Fiscal Year 2005 AI/AN National Budget Perspective. Washington, DC: National Indian Health Board.Google Scholar
  33. Novins, D. K., Fleming, C. M., Beals, J., & Manson, S. M. (2000). Quality of alcohol, drug, and mental health services for American Indian children and adolescents. American Journal of Medical Quality, 15, 148–156. doi: 10.1177/106286060001500405.PubMedCrossRefGoogle Scholar
  34. Novins, D. K., Moore, L. A., Beals, J., Aarons, G. A., Rieckmann, T., & Kaufman, C. E. (2012). A framework for conducting a national study of substance abuse treatment programs serving American Indian and Alaska Native communities. American Journal of Drug and Alcohol Abuse, 38(5), 518–522. doi: 10.3109/00952990.2012.694529.PubMedCentralPubMedCrossRefGoogle Scholar
  35. Perry, S. W. (2004). American Indians and crime: A BJS statistical profile 1992–2002 (NCJ203097). Washington, DC: US Department of Justice Office of Justice Programs.Google Scholar
  36. Ranmuthugala, G., Plumb, J. J., Cunningham, F. C., Georgiou, A., Westbrook, J. I., & Braithwaite, J. (2011). How and why are communities of practice established in the healthcare sector? A systematic review of the literature. BMC Health Services Research, 11, 273–289.PubMedCentralPubMedCrossRefGoogle Scholar
  37. Rhoades, B., Bumbarger, B., & Moore, J. (2012). The role of a state-level prevention support system in promoting high-quality implementation and sustainability of evidence-based programs. American Journal of Community Psychology, 50(3–4), 386–401.PubMedCrossRefGoogle Scholar
  38. SAMHSA. (2010). Results from the 2009 national survey on drug use and health: Summary of national findings. Rockville, MD: Substance Abuse and Mental Health Services Administration.Google Scholar
  39. Sarche, M. C., Spicer, P., Farrell, P., & Fitzgerald, H. E. (2011). American Indian and Alaska Native children and mental health: Development, context, prevention, and treatment. Santa Barbara, CA: Praeger.Google Scholar
  40. Schoenwald, S. K., Henggeler, S. W., Brondino, M. J., & Rowland, M. D. (2000). Multisystemic therapy: Monitoring treatment fidelity. Family Process, 39(1), 83–103.PubMedCrossRefGoogle Scholar
  41. Sexton, T. L., & Alexander, J. F. (2000). Functional family therapy. Washington, DC: US Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.Google Scholar
  42. Sexton, T., & Turner, C. W. (2011). The effectiveness of functional family therapy for youth with behavioral problems in a community practice setting. Couple and Family Psychology: Research and Practice, 1, 3–15.CrossRefGoogle Scholar
  43. Spicer, P., Beals, J., Mitchell, C. M., Novins, D. K., Croy, C. D., & Manson, S. M. (2003). The prevalence of DSM-III-R alcohol dependence in two American Indian reservation populations. Alcoholism, Clinical and Experimental Research, 27, 1785–1797. doi: 10.1097/01.ALC.0000095864.45755.53.PubMedCrossRefGoogle Scholar
  44. Strauss, A. L., & Corbin, J. M. (1997). Grounded theory in practice. Thousand Oaks: Sage Publications.Google Scholar
  45. The Snyder Act (1921).Google Scholar
  46. Torpy, J. M. (2006). Evidence-based medicine. Journal of the American Medical Association, 296(9), 1192.PubMedCrossRefGoogle Scholar
  47. Trupin, E. J., Kerns, S. E. U., Walker, S. C., DeRobertis, M. T., & Stewart, D. G. (2011). Family integrated transitions: A promising program for juvenile offenders with co-occurring disorders. Journal of Child and Adolescent Substance Abuse, 20(5), 421–436.CrossRefGoogle Scholar
  48. Walker, R. D., & Bigelow, D. A. (2011). A constructive Indian country response to the evidence-based program mandate. Journal of Psychoactive Drugs, 43(4), 276–281.PubMedCrossRefGoogle Scholar
  49. Walker, S. C., Trupin, E. W., & Hansen, J. (2011). A toolkit for applying the cultural enhancement model to evidence-based practice. Seattle, WA: University of Washington.Google Scholar
  50. Willging, C. E., Goodkind, J., Lamphere, L., Saul, G., Fluder, S., & Seanez, P. (2012). The impact of state behavioral health reform on Native American individuals, families, and communities. Qualitative Health Research, 22(7), 880–896. doi: 10.1177/1049732312440329.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Sarah Cusworth Walker
    • 1
    Email author
  • Ron Whitener
    • 2
  • Eric W. Trupin
    • 3
  • Natalie Migliarini
    • 4
  1. 1.Division of Public Behavioral Health & Justice PolicyUniversity of Washington School of MedicineSeattleUSA
  2. 2.Native American Law CenterUniversity of Washington School of LawSeattleUSA
  3. 3.University of Washington School of MedicineSeattleUSA
  4. 4.University of Washington School of LawSeattleUSA

Personalised recommendations