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Looking at the Positives: Resilience in the Face of Chronic Illness

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Resilience: from the Latin meaning to jump back or recoil; an ability to recover from or adjust easily to misfortune or change. This concept is most often used to describe responses to emotional trauma, such as post-traumatic stress disorder, childhood neglect and abuse, or, in recent months, global economic conditions.

Researchers at Northern Arizona University in Flagstaff have won a $6 million grant from the National Institutes of Health to establish the Center for American Indian Resilience, which will look at resilience in another context. They will explore why some American Indians facing significant health challenges, such as chronic illnesses, seem to thrive despite less-than-ideal living conditions, while others do not. The university will work in partnership with the University of Arizona in Tucson and Diné College in Shiprock, New Mexico.

Dr. Nicolette Tuefel-Shone describes the rationale behind this approach. "Native American health research usually focuses on health problems. There's lots of talk about the environment in terms of not-so-good-outcomes. This project will look at what goes right for people. Despite Native Americans' low socio-economic status [and consequent problems such as] lack of housing and plumbing, some succeed in living healthy, productive lives. We'll look for health and social indicators that allow people to do well despite health challenges. What's going on for folks who have good outcomes? For those folks who have figured it out?" Teufel-Shone is an associate professor in the Family and Child Health Section of the Health Promotion Sciences Division and an affiliated faculty member of the Departments of Anthropology and Nutritional Sciences at the University of Arizona.

Northern Arizona University: Standing in front of the hogan, the Applied Indigenous Studies department faculty members show their support at the Diabetes Prevention Walk on November 27. Left to right: Dr. Marina Vasquez, Dr. Octaviana Trujillo, Dr. Lomatemyuma Ishii, Dr. Priscilla Sanderson, and Karen Jarratt-Snider.

The five-year research project has several components: research, education and community outreach. The research component includes two projects. One, to be conducted at NAU, focuses on health and lifestyle choices in relation to obesity and asks, "How do some people avoid obesity?" The researchers plan to interview adults about their own lives, as well as parents of children with healthy lifestyles. Health care providers will also be asked to describe what they see as the factors that help patients maintain a healthy weight. Research subjects will be volunteers from the urban area of Flagstaff recruited through the Flagstaff North Country Clinic and Flagstaff Medical Center.

The second project, digital storytelling, will be conducted at the University of Arizona. Elders, clients at the Tucson Indian Center, will record narratives of their lives in order to provide qualitative data for the project.

The education component will be conducted at Diné College's Shiprock campus and led by Dr. Mark Bauer, co-director of the training and education core at the college.

"We'll focus on getting American Indian students involved in research in their own communities." This summer research program will recruit up to 12 American Indian college students. "The first part of the experience will be learning research methods. The students will learn hands-on interviewing techniques, how to administer surveys, procedures for entering data on spreadsheets, data analysis, different research designs and how to conduct research in Native communities. Then students will work on some project in their community, with a community health agency, for example. Over the six-week span of this work, they'll learn what it is like to serve within their communities, gathering data they can bring back to the academic setting. Finally, they will input and analyze the data they have gathered."

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Dr. Lomatemyuma Ishii

Another students shows her support for the Diabetes Prevention Walk

Dr. Priscilla Sanderson, Navajo, is principal investigator for the project, along with Teufel-Shone. "We'll have a strong community outreach component, with an executive advisory board composed of academics and a community advisory board. We have some senior, i.e., successful, American Indian researchers as well as community practitioners," says Sanderson. "The community will drive the research agenda." Sanderson is Assistant Professor of Health Sciences and Applied Indigenous Studies at NAU.

"We're building on our existing partnerships, which was one of the greatest strengths of our application for funding from NIH's National Institute on Minority Health and Health Disparities. We don't have to use the first years of the grant learning how to work with each other," says Teufel-Shone.

College students interested in learning more about the summer research component of the program should contact Mark Bauer, 505/368-3589;

The National Institute on Minority Health and Health Disparities' 2012 Summit on the Science of Eliminating Health Disparities has been rescheduled to December 17-19 in Maryland.

Dr. Lomayumetewa Ishii

Bob Lomadafkie and Audrey Goldtooth in front of the NAU Native American Cultural Center