Recipient Organization
UNIVERSITY OF MINNESOTA
200 OAK ST SE
MINNEAPOLIS,MN 55455-2009
Performing Department
(N/A)
Non Technical Summary
American Indian (AI) communities havebeen deeply impacted and disproportionately affected by the rise in Opioid Use Disorders (OUD)and overdose fatalities.Data from the Minnesota Department of Health shows that overdose mortality in 2021 increased by 22% from the previous year, becoming the leading cause of injury death in Minnesota. Synthetic opioids (e.g. fentanyl) and stimulants (e.g. cocaine) played a significant role in driving this increase. Geographic and racial disparities exist within the state. Greater Minnesota saw a larger increase in overdose deaths than the Metro area, and drug overdose mortality rates increased dramatically for American Indian (AI) and Black Minnesotans. Over half of AI overdose deaths were opioid related. The complex and mutually-reinforcing relationship between homelessness and Substnace Use Disorder (SUD) in Minnesota's rural and Tribal communities, which is compounded by remote geographies and a stark lack of resources, requires multi-sector collaboration to address. Substance use and homelessness are recognized as critical problems for the Bois Forte Band of Ojibwe and Mille Lacs Band of Ojibwe.The proposed project, Wiidookadadidaa Chinoojimayang (Healing Together), will help fill a gap by moving towards an Indigenous model of healing and wellbeing. This project builds on the concept that knowledge leads to healing and honors the personal lived experience and the culturally rooted science that is woven into the fabric of Tribal communities. Within the center of this model is the traditional Medicine Wheel which symbolizes the essential dimensions of health and the cycles of life. Reducing OUD in Indigenous communities is an important step towards creating healthy and whole families, which in turn helps to heal and strengthen Tribal communities in ways that are appropriate to their cultures and traditions.This project will provide education and training to build knowlege and capacity of harm reduction, pro-recovery, and anti-stigma education and will work with Indigenouscommunites to co-create education and training that is culturally appropriate to support the recovery process and addresss trauma and healing. This model will help to drive the prevention of OUD in Indigenous communities beyond the life of the grant. Indigenous community members are leaders in their own health, and therefore, they will be active agents of change and continue the impact of the grant after it is over. Further this projectwill use an Indigenous evaluation approach that is culturally responsive and grounded within a historical context. This approach engages those who are directly impacted in the evaluation process including the design, analysis/meaning making, developing of recommendations, and sharing the results.
Animal Health Component
100%
Research Effort Categories
Basic
(N/A)
Applied
100%
Developmental
(N/A)
Goals / Objectives
The overarching goal of this project is to help Tribal communities heal through culturally appropriate education, training, and relationships/connections. The project will honor existing knowledge and activities and co-create new education and training to support emerging needs, build capacity and sustainability, and continue community healing. This will lead to sustainable improvements across the interpersonal, family, and community levels that will benefit those in recovery from OUD and have a ripple effect across systems and institutions. Objectives: The following objectives align with the layers of the model but also serve to unite layers bidirectionally (ex. connecting individuals to systems): Interpersonal and Family Objectives: (1) Strengthen knowledge and skills of Indigenous community members in recovery as well as family members with OUD through culturally relevant evidence-based education and training (in-person and telehealth) on topics related to historical trauma, ACEs, culturally grounded healing and wellbeing, mindfulness, and emotional regulation delivered in-person or virtually; (2) Facilitate connection to harm reduction supplies in-person or via telehealth for individuals in the community who are at risk of opioid overdose; Community Objectives: (1) Increase the capacity of Indigenous-serving organizations (train-the-trainer) to address OUDs earlier and more responsively through community driven, trauma-informed, historically aware, culturally relevant education and training; (2) Leverage existing education and resources (opioid.umn.edu) to continue to increase public access to emerging education and technologies related to opioid and substance misuse and abuse prevention; (3) Provide education on culturally appropriate harm reduction practices to professionals and Tribal community members; (4) Continue to disseminate and develop distance learning strategies such as harm reduction mini-courses (opioid.umn.edu); Systems and Institutions Objectives: (1) Connect community agencies that serve Indigenous individuals who are unhoused and have SUD to innovative wrap-around support systems and housing opportunities; (2) Support existing and emerging local, regional, and statewide coalitions and networks aimed at reducing OUD in Indigenous communities; (3) Work collaboratively with other University of Minnesota Extension Departments: Agricultural and Natural Resource Systems, Youth Development and Community Development to connect, share resources, and education, to support and build upon existing work in Tribal communities across Minnesota; (4) Collaborate with Great Lakes Addiction Technology Transfer Center (ATTC), ROTA Regional Center in Region 5, Minnesota Office of Rural Health, SAMHSA SOR and Tribal Opioid Response (TOR) providers to share project outcomes and plan for coordination of programs.
Project Methods
Host Learning Circles in each Tribal communityCreate two Tribal Community Advisory Boards (TCAB)Recruit and facilitate meetings.Tribal Community Facilitators and Tribal members deliver responsive education to meet community emerging needs.Up to 20 community identified education and training eventsUp to 15 trainings on harm reduction or opioid overdose; 5 train-the-trainer events using the ROTA-RC SAMHSA Harm Reduction toolkit.Implement culturally appropriate, community-identified evaluation methods after each activity (art-based, case studies, surveys, interviews)Indigenous, community-driven evaluation: Collaborate with TCABs to identify, plan, implement, and report culturally appropriate evaluation.Host up to three initial meetings with existing and new community partners.Engage TCABs and other Tribal members to analyze evaluation data after each activity (ie, LC, educational programming)Collaborate with TCAB and other Tribal members on project results.Collaborate with national state, county, local partners.Gather OUD/SUD population-level data from MDH (baseline and Year 2-3)Host up to three virtual meetings State Offices of Rural Health, SOR & TORHost up to three virtual meetings with ROTA-RC SAMHSA in Region 5Provide one to two educational training for Tribal communities statewide.Build relationships with Tribal Colleges, local public health, and Tribal high schools.The proposed project will use an Indigenous evaluation approach that is culturally responsive and grounded within a historical context. This approach engages those who are directly impacted in the evaluation process including the design, analysis/meaning making, developing of recommendations, and sharing the results. To evaluate the proposed project, the project team (led by Marczak and MartinRogers) will collaborate with the Boise Forte and Mille Lacs tribal communities to find out what they would like to learn from the evaluation and what methods are (or are not) appropriate in their communities. The project team will collaborate with the TABCs through this and will follow other tribal community check points (e.g., their own research review committee and/or tribal council.) The project team will engage the TCABs and/or other tribal stakeholders in analyzing the evaluation results and writing the recommendations. Community stakeholders will be involved in dissemination of the evaluation results including determining WHOM and HOW the results are released, and what key messages are shared. In collaboration with the TABCs and other Tribal members, the project team will offer a variety of evaluation data gathering methods examples include participant surveys, talking circles (Year 2), interviews and/or case studies with project partners (Year 2 and 3) and observation of events and activities (Year 1-3.) Because of the formative nature of an Indigenous evaluation approach, the exact method(s) will be determined with the community. Typically evaluation tools will be used right after a program activity or event is completed as well as 6-12 months after the activity, to assess longer-term impacts. Decisions on which method to use will be determined in collaboration with TCAB and other Tribal members to ensure which are most appropriate, impactful and which parts resonate with or affect participants in which ways. In addition to the methods above, we will also use graphic recording art, harvest poems, case studies and/or other arts-based methods to allow participants to express what they got out of the experience. These methods can also help community members identify and document what their family or community needs to heal (used in Year 1-3.) Another possible evaluation tool that will be considered is the use of case studies to help the tribes learn more and share the story of how OUD/SUD impacts their community, and to hopefully highlight educational programs and trainings have been successful at positively impacting the OUD/SUD situation in these communities. Finally, we will work with the tribes, as well as the counties/state to determine what population-level data exists about the extent of the OUD/SUD problem in their communities (for example, number of drug arrests, number of overdoses, number of drug-related deaths, number of drug related child protection cases/out-of-home placements, etc.) We will gather this data at baseline and again every year during the course of the community's work with the project team to assess changes over time.