Momentum and Longevity for Tribally-Driven Health Equity Science: Evidence from the Gathering for Health Project

American Indian (AI) health disparities have reached crisis levels, and there is a need to develop culturally congruent interventions through meaningful tribal involvement and ethical community-oriented approaches. Hence, it is imperative that researchers and university administrators better understand how research translation occurs for tribally-driven, health equity research projects. Utilizing thematic analysis methods, we examined documents from a 12-year community-based participatory research partnership called the Gathering for Health Project to elucidate factors that ignite momentum and support partnership longevity. The overarching finding was that trust and respect provide a foundation for momentum and longevity and are closely intertwined with other themes identified in analyses. Seven themes were extrapolated and classified into two domains: 1) investments, which are catalyzing factors that advance research, and 2) intermediate processes, which link investments to success. Investment themes include Indigenous scholar involvement, time and effort, establishing rapport, and clear and appropriate communication. Generative co-learning, active participation, and recognition and celebration were themes classified into the domain of intermediate processes. Community-based participatory research principles were reflected in our findings. This study also upholds prior published work on Indigenous research methodologies, promotes the lived experiences of Indigenous people, and contributes to Indigenous theory building and science

Recognizing the Cumulative Burden of Childhood Adversities Transforms Science and Practice for Trauma and Resilience

The Adverse Childhood Experiences (ACEs) studies transformed our understanding of the true burden of trauma. Notable elements of Felitti and colleagues’ findings include theinfluence of adversity on many physical as well as psychological problems and the persistenceof impacts decades after the traumas occurred. In this article, we make the case that themost revolutionary finding was the discovery of a strong dose-response effect, with markedincreases in risk observed for individuals who reported four or more adversities. Over the pasttwo decades, our understanding of the cumulative burden of trauma has expanded further,with recognition that experiences outside the family, including peer victimization, communityviolence, and racism, also contribute to trauma dose. Recent research has provided evidencefor the pervasiveness of trauma, which we now realize affects most people, even by the endof adolescence. Extensive scientific evidence has documented that more than 40 biopsychosocialoutcomes, including leading causes of adult morbidity and mortality, are associatedwith adverse childhood experiences, measured by dose. We summarize the state of scienceand explain how ACEs built a movement for uncovering mechanisms responsible for theserelationships. Perhaps unexpectedly, the pervasiveness of trauma also expands our understandingof resilience, which is likewise more common than previously recognized. Emergingresearch on positive childhood experiences and poly-strengths suggests that individual,family, and community strengths may also contribute to outcomes in a dose-responserelationship. We close with an agenda for research, intervention, and policy to reduce thesocietal burden of adversity and promote resilienc