Progress 12/15/23 to 12/14/24

Outputs
Target Audience:The current audience is the NHSC faculty and staff, NHSC student body of approximately 200, Fort Berthold community and tribal partners, tribal colleges, NDSU partners (NDSU Public Health & NDSU Extension), Therapeutic Riding professionals, Tribal and non-tribal Equine Assisted Service providers, MHA Nation Health Administration, Medical Service Providers/Professionals, K-12 Education partners, tribal nations, and horse industry partners/community. Changes/Problems:Increased Focus on Community and Tribal Integration: As we collaborated with partners such as Healing Horse Ranch, Turtle Mountain Schools, and Blackfeet Tribe, we adapted our training and outreach methods to more closely align with the cultural and community-specific needs of each tribal Nation. This required additional adjustments in our curriculum and training strategies, ensuring we remain culturally relevant and responsive to the unique needs of tribal communities. Challenges in Coordination: There were some initial challenges in coordinating with external partners and ensuring alignment across multiple departments and partners. These delays were mainly due to differences in scheduling and priorities, but they have since been addressed through improved communication and regular check-ins. Slow Start Due to Institutional Animal Care Use Committee (IACUC) Requirement: The slow start to some activities was due to the IACUC requirement for this grant. This delayed certain animal-related activities and data collection. However, NDSU mentored and provided approval for the NHSC IACUC, which allowed us to move forward with these activities. Data Sovereignty: One challenge related to Data Sovereignty is that while Turtle MountainTF-EAL K-12 professional development pilotdid not require IRB approval, we are limited in how we can use it for evidence in research. We need to establish a formal process to ensure that we can appropriately utilize this data while respecting sovereignty guidelines. Currently, NHSC does not have an IRB, which can negatively affect data sovereignty. IRB approvals will go through NDSU with oversight from the MHA Nation. Updates on Sustainable Models for Equine Assisted Services Models & Medicaid Billing Efforts: As part of our efforts to pursue sustainable funding sources, which may includeMedicaid reimbursement for Equine Assisted Services/TF-EAL services for Tribal Organizations, we have been engaging with the MHA Health Department and other partners to ensure compliance with reporting and funding processes, which may require additional documentation and follow-ups. What opportunities for training and professional development has the project provided?Jenny Trainor - Level 1-2 Natural Horsemanship (Spring 2024) NHSC Agriculture Department Training: Natural Lifemanship - "Trauma Sensitive Schools" (Spring 2024) NHSC Agriculture Department Training: "Mino Bimaadziwin: Living the Good Life", Healing-Informed Framework Training (Spring 2024) Natural Lifemanship - Trauma-Focused Training/Business Building & Sustainability Seminar (Summer 2024) Institutional Animal Care and Use Committee (IACUC) - NDSU - Basic Course & Working with Horses (Spring 2024) Professional Association of Therapeutic Horsemanship (PATH Int'l)Certification Training (Spring 2024) Lyons Legacy Horsemanship Training Seminar (Summer 2024) How have the results been disseminated to communities of interest?KLOVE Radio Broadcast (Spring 2024) - "Equine Assisted Services" (K. Oakland, 2024) TF-EAL Presentations (Spring 2024) - "Trauma-Focused Equine Assisted Learning" (K, Oakland, L. Nelson, J. White Plume 2024): Bismarck/Mandan Veterans Center, Bismarck 1 Million Cups, Bismarck Public Schools,National Association of EquineAffiliated Academics, Turtle Mountain School Systems University of North Dakota Research Colloquium (Spring 2024) - "Equine Assisted Job Skill Development", mentor: Katie Oakland NHSC Equine Faculty BEK TV Television Program: "Dakota Cowboy" (Summer 2024) - "NHSC Equine Program/Equine Assisted Services", Katie Oakland & Lori Nelson Mentorship/Training Provided: "Integration of Professional Association of Therapeutic Riding (PATH) International standards and Trauma-Focused Equine Assisted Learning intoTribal Horse Programming" for Healing Horse Ranch &Casey Foundation (K. Oakland & L. Nelson, April 2024), "Mishtadim Awakening" Turtle Mountain Band of Chippewa School K-12 staff development(K. Oakland & J. White Plume, June 2024) Site Mentor for UND School of Medicine & Health Sciences - Occupational Therapy Doctoral Experience (K. Oakland, April 2024) What do you plan to do during the next reporting period to accomplish the goals? Expand TF-EAL across NHSC Agriculture Department (Object 2, Activity1). Expand collaborations with NHSC Food Sovereignty program to integrate trauma-focused principles into gardening and food activities and expand Trauma-focused and Healing-Informed training to thedepartment. Community Needs Analysis: Finalize and synthesize the findings from the completed community needs analysis to inform future strategies and initiatives. Advisory Board: Convene the Advisory Board for ongoing collaboration, focusing on refining the model and identifying actionable next steps. In-Person Meeting: Host an in-person meeting in Spring 2025 to further refine the model, address challenges, and plan the next phase of the TF-EAL program's development. TF-EAL/PATH standards training in Montana: Conduct TF-EAL/PATH standards training in February 2025 for the Blackfeet Tribe inBrowning, MT, to continue expansion of TF-EAL services though implementation of the sustainable TF-EAL model, while enhancing local capacities and partnerships. Retrospective Pre/Post Survey: Administer retrospective pre/post surveys to evaluate the impact of the TF-EAL courses, short courses/trainings,and presentations and gather feedback for continuous improvement and learning assessment. Course Survey Data: Review and modify the course survey data to assess its relevance for TF-EAL, ensuring that it aligns with the needs of participants. Determine whether the survey requires IRB approval (likely needed for certain surveys), and proceed with NDSU IRB submission if applicable. Once IRB approval is obtained, seek tribal council approval for the survey process. Start the Case Study: Begin writing and structuring the case study, using the data and feedback from various sources to inform the content and analysis. Research Methodology: A case study allows us to explore NHSC's TF-EAL Program within its real-world context, capturing the complexity of the program, including relevant changes over time. Contextual Conditions: This approach enables us to fully describe the contextual conditions of the program, shedding light on how the program operates and evolves. Process Focus: While the emphasis is often on outcomes, this case study highlights the relevant processes that other research methods typically overlook. It underscores the importance of assessing the origin, purpose, and process of a program to truly understand the final outcomes. Real-World Application: This type of evaluation helps us see the real-world application of interventions, ensuring that the understanding of the program goes beyond just the outcomes. Research Questions: By the end of the case study, we aim to answer key questions, including: Who is involved in the program? What do the different people do, and in what context? When and where do program activities take place? Why do participants engage in the activities they do? What about the actions results in the changes we observe? Theory of How the Program Works: We have already developed a theory of how the program works, which incorporates relevant neuroscience, equine science, and traditional Indigenous ecological knowledge. Additional Data: The case study will integrate both quantitative (including programmatic data) and qualitative data (including interviews and document analysis) to triangulate project outcomes. Program Description: The study team is in the process of thoroughly describing the TF-EAL program. Primary Data Collection: After identifying the primary data to be collected, an IRB will be established with NDSU to ensure the appropriate ethical considerations. Kumu.io Visualizations: To assist in describing the program,Dr. Ramona Danielson from NDSU has been usingKumu.io to organize and visualize the relationships and processes involved. The visualizations are still in progress, but we invite stakeholders to interact with them at the provided URLs.

Impacts
What was accomplished under these goals? O1 - Activity 1)Operationalizing Connection and Relationship as Outcomes: Initiated discussions on defining and measuring Connection and Relationship as key Trauma-Focused Equine-Assisted Learningoutcomes. Integratedevaluation methods into this framework, starting with evaluations for Belcourt Schools, where we provided TF-EAL programming. Developed tangible evaluation components to assess these outcomes. Explored storytelling as a potential tool for capturing qualitative impacts. O1 - Activity 2)Operationalizing additional participant outcomes and identifying strategies for collecting evidence. Conducted evaluation work withpartnerTurtle Mountain Schools, providing 1-week professional development to K-12 teachers and kids horse camp,to refine participant outcome measures. Discussions on MHA Nation Impact of the Horse: Past & Presentvideo project, including the process for elder interviews, historical video collection, and storage strategies. Collaborate with NHSC's library upgrade projectand pair with Knowledge Keepers to support cultural preservation. Conducted a Community Needs Analysis for Equine to assess program impact and opportunities. Progressed in establishing an Equine Advisory Board to guide program development and evaluation. Collected and analyzed course data from Spring 2024 (SP24) & Fall 2024 (FA24)to inform future program decisions. O1 - Activity 3)Specifying essential elements and outcomes of the curricula for training in NHSC's TF-EAL model. Utilized Kumu to develop a process map, visually organizing and defining the essential elements and expected outcomes of the TF-EAL training model. Visualizing Our Process Using Kumu: One of our first visualizations (available to interact with here: Kumu TF-EAL) allowed us to map relationships between overarching programs, large-scale partners, funding sources, key individuals, specific projects, entities, and training components within the TF-EAL model. Key insights from the Kumu map include: Identify funding partners, such as the USDA and the Casey Family Foundation, which is partnering with NHSC to assist in developing a Medicaid billing system for Equine Assisted Services. Highlighting the critical role of MHA Nation as a key partner alongside NHSC and NDSU. Clarifying how different entities contribute to the overall structure and implementation of TF-EAL training. O1 - Activity 4)Identifying the ideal delivery mechanism and credentialing for the TF-EAL curricula by NHSC, inclusive of non-traditional students. Conducted a Needs Analysis to assess the requirements of diverse learner populations, including nontraditional students, ensuring accessibility, relevance, and feasibility of credentialing options. Utilized Kumu to map out key relationships, structures, and pathways for delivering the TF-EAL curriculum, helping to clarify how different entities and stakeholders interact within the training framework. Key Findings: In addition to the needs assessment process within MHA Nation, visualizations with Kumu.io have helped identify different potential audiences and delivery mechanisms for training. Our current two-year programEquine Studies and potential TF-EAL credential have been mapped out to explore pathways for learners with various backgrounds (**Strategy 2, Activity 4; Kumu Brainstorming TF-EAL). Considerations include: Individuals with no higher education vs. those with two- or four-year degrees. Pathways for those proficient in working with horses vs. those new to equine work. Differentiation between people who want to facilitate healing with horses and those aiming to become equine professionals. TF-EALmethods areintegrated withTherapeutic Horsemanship throughProfessional Association of Therapeutic Horsemanship (PATH International) standards to ensure culturally relevant, high-quality, ethical, safe, and evidence-based equine-assisted learning and therapy servicesare provided across MHA nation and beyond. Outcomes: Developed a pilot 2-week Trauma-Focused Equine-Assisted Learning & Therapeutic Horsemanship hybrid training for apartner organization, Casey Foundation,providing a structured, hands-on introduction to the TF-EAL model and PATH standards. Trained and provided continued education credit to MHA Nation Equine Assisted Service providers in TF-EAL and Professional Association of Therapeutic Horsemanship (PATH International)standards to ensure culturally relevant, high-quality, safe, ethical, and evidence-based equine-assisted learning and therapy services are provided across MHA Nation. Developed a pilot 1-week Trauma-Focused Equine-Assisted Learning professional development training for K-12 teachers at Turtle MountainSchools, supporting educators in integrating TF-EAL principles into their work with students. Created and implementeda continuing education curriculum called "Equine Assisted Job Skill Development" for MHA Nation's Good Road Recovery Addiction & Recovery Center. This program integrates TF-EAL with job skill development through Trauma-informed principles of Relationship, Rhythm, and Relevanceto provide wrap-around services for addiction recovery and workforce preparation. The curriculum offers hands-on experiential education, developing horse skills, job skills, andsoft skills, such as time management, planning, leadership, communication, problem-solving, critical thinking, adaptability, and interpersonal skillsto equip residents for both personal and professional growth, while preparing them for re-entry to the workforce. Integration of PATH International Standards and MHA cultural practices intoTF-EAL for NHSC Equine Studies courseworkandongoing mentorship of Equine Studies students, globally preparing them for the Equine Assisted Services workforce to serve MHA Nation and communities worldwide. Two NHSC Equine Studies studentspassed credentialing tests and were certified through PATH International as Certified Therapeutic Riding Instructors (CTRI). Three additional NHSC Equine Studies students are currently in the process of obtaining their PATH International certification as Certified Therapeutic Riding Instructors (CTRI). O1 - Activity 5)Disseminating information and research findings about the TF-EAL model and services. NHSC Equine Student involved in the Turtle Mountain pilot program shared the results with the Turtle Mountain community, which helped establish her new role as Director of Equine Assisted Services at Turtle Mountain Schools. See dissemination activities below O1 - Activity 6)Establish a model for setting up and supporting TF-EAL services in locations across North Dakota. Pursuing Sustainable TF-EAL Models: Actively working to create sustainable TF-EAL models that can be scaled and adapted for use within NHSC and other tribal organizations, ensuring long-term support and financial sustainability for these programs. Conversations with MHA Health Department, Dr. Tami Decoteau, Healing Horse Ranch, and NHSC Administrationon Medicaid Billing for Tribal Equine Assisted Service programming: Pursuing approvalfor Medicaid billing and exploring other potential reimbursement pathways forEquine Assisted Services/TF-EAL services. Ongoing Mentorship to NHSC Equine Students: TF-EAL & PATH CTRI certification training provided to MHA Nation Healing Horse Ranchand Turtle Mountain Equine Assisted Services Director, focusing on certifying staff in TF-EAL and PATH standards practices. Equine Assisted Services (EAS) programming at Healing Horse Ranch was established, with support from an NHSC Equine student working on CTRI certification. Mentored an NHSC Equine student through CTRI certification and TF-EAL integration, who recently opened "Hoof it Forward" near the Standing Rock Indian Reservation. Established Therapeutic Riding services at NHSC mentor site, Twin Buttes

Publications