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Partnerships for Better Health

September 6, 2019
adults and children in a garden
The Weed-Hurley family shows off their Growing Resilience garden. Photo by Ina Weed

UW researchers are partnering with the Eastern Shoshone and Northern Arapaho to  work on a variety of  health-related issues.

By Micaela Myers

On the Wind River Indian Reservation, the Eastern Shoshone and Northern Arapaho tribes are reclaiming their health and food sovereignty, including growing and gathering more of their own produce, assisting elders, building on caregiver strengths and addressing unmet needs. Individuals and groups are partnering with University of Wyoming researchers on a number of projects.

The statistics are startling—Native Americans suffer a disproportionate disease burden and, with that, a lower life expectancy. This important work by the tribes has the potential to turn the tide.

Growing Resilience

All over the Wind River reservation, you’ll spot home gardens, community gardens and container gardens. The movement is in large part thanks to Growing Resilience, a partnership among Blue Mountain Associates, Eastern Shoshone Tribal Health, the Wind River Development Fund and UW. A community-based research project, Growing Resilience is designed to bring home gardens to tribal families and then to measure the impact on participants’ health.

“Nationally, it’s the first randomized control trial of the health impacts of gardening,” says Christine Porter, Wyoming Excellence Chair in Community and Public Health and principal investigator for the project.

The project began in 2013 with INBRE support and grew to a five-year full-scale randomized control trial with funding from the National Institutes of Health. There are currently 350 participants. The study monitors health impacts including weight, blood pressure, hand strength, waist circumference and blood panels. Surveys address demographics, food security and mental and physical wellness.

However, there’s another side to the work. Research scientist and Northern Arapaho tribal member Melvin Arthur is working on the qualitative research, looking at the tribe’s food-systems story and the larger impact of the gardens. He interviews the gardeners and helps them to share their stories in various mediums. “With the work I’m doing, I’m trying to make sure it becomes something more than just a project that measures health impacts—something that measures the movement along the way and fosters that,” he says. “It’s recreating our sovereign food systems.”

The UW Growing Resilience team also includes Program Manager Alyssa Wechsler and Ph.D. student Rachael Budowle. On the Wind River reservation, a community advisory board also plays a critical role.

Board member Rhonda Bowers says gardens used to be more common when she was a child.

“I like to see the enjoyment of the people,” she says of the project, noting how gardeners have reported to her their positive health benefits and share the bounty of their harvests. Bowers hopes to see the work grow and continue.

Etheleen Potter works as the garden manager for Blue Mountain Associates. She recruits participants and helps them install their gardens. Potter and her staff also host gardening workshops.

“To me, it’s like going full circle to when our grandparents were first farming and raising their own food,” Potter says. “Then it evolved, and fast food came in. Now we’re back to raising our food again. I think it’s healthier, especially for kids to learn that.”

Arthur says, “Almost 100 percent of gardeners said they are going to expand what they were doing, and if they didn’t do well, they were going to retry it and do it again.”

They all want to see momentum continue, something Porter is committed to. Her team is currently applying for additional grants. “I gave the governments of each tribe my word—I’d do this work with them the rest of my life, as long as they want to, as long as I’m welcome to,” she says. “I can’t always promise our funding applications will succeed, but that’s what these new projects are about—this continuous broader investment in the sovereignty of the Northern Arapaho and Eastern Shoshone nations and recovery of health and food sovereignty.”

man and woman in front of a house
Irene Lujan, the Eastern Shoshone Tribal Health chronic disease and aging educator, and David Meyers, the Eastern Shoshone Tribal Health Director.

 

Chronic Disease and Aging

To improve the health of older adults and to support caregivers, the UW Center on Aging has established partnerships on the Wind River reservation. Through its Geriatric Workforce Enhancement Program funding from the Health Resources and Services Administration, the center has partnered with Eastern Shoshone Tribal Health to fund a chronic disease and aging educator who delivers education on aging, chronic disease management and caregiving.

“We are working across the state to integrate geriatrics into primary care and to deliver programs for older adults,” says Christine McKibbin, director of the Wyoming Geriatric Education Center. “Part of that work has been focused on increasing the education and resources for Native elders. We’ve been working with several stakeholders on the Wind River reservation.”

Eastern Shoshone Tribal Health is working with elders to determine their needs and provide education regarding issues such as dementia and living with a chronic disease. Classes and materials have been adapted for Native American elders and adults.

“The future plans are that we’ll really continue to bring in those programs and tailor them for Native Americans,” says Catherine Phillips Carrico, associate director of the Wyoming Center on Aging. “For example, we plan to bring in a program called Wisdom Warriors, which is an adaptation of the chronic disease self-management program, specifically for indigenous people.”

Irene Lujan was hired as the Eastern Shoshone Tribal Health chronic disease and aging educator. Part of her job is visiting home-bound elders and their caregivers.  “I visit with them, get to know them, do assessments on their home, see what they need and then basically help with their caregiving and help them find resources,”  she says. “I love meeting new people and helping the elders.”

Director of Eastern Shoshone Tribal Health David Meyers says that issues such as dementia and falling among the elders were a service area that needed to be addressed. “Right now, we’re trying to identify what the needs are and how many of those individuals and families are going through this type of scenario in their lives and how we can help and be a resource and also identify other resources out in the state and find them support,” he says.

Meyers wants the program to strongly support caregivers as well, as home health care is limited in  the area.

“That’s part of our job—to work with communities and partners and bring the resources to address the concerns that they have,” Carrico says.

 

Caregiving and Early Intervention

If a child needs early intervention for issues such as speech or language delays, those interventions need to be culturally appropriate. That led Division of Communication Disorders Professor Mark Guiberson and two Northern Arapaho students from UW to their current project.

“We’re looking at Native American caregiver interaction styles, specifically during naturalistic interactions like shared storybook reading,” says speech-language pathology graduate student Kyliah Ferris. They also use ethnographic interviewing to learn about and understand each family’s priorities and routines and how they prefer to interact with their child.

“The information we get from both can lead us to culturally responsive language intervention for Native American toddlers for early intervention,” Ferris says.

The project began a little over a year ago with INBRE funding, and Ferris and undergraduate Taryn Jim also received Social Justice Research Center grants for their work. The team traveled multiple times to partner sites on the reservation to interview families and to video caregiver-child interactions.

Caregivers and their children play with toys and read two books, one of which UW Arapaho language instructor Robyn Lopez and Wayne C’Hair, one of the first UW Arapaho language instructors, helped translate into Arapaho. They hope soon to make an Eastern Shoshone translation of the book as well.

“A lot of early interventions are based upon European-American parent-child interaction styles, and there are cultural differences in parenting styles that influence how we teach and interact or what might be a developmental priority for a caregiver  or a family,” Guiberson says. “The bigger goal is to really look at what assets and strengths families already have in their interactions that support language development. We want to build upon these strengths.”

Ferris says that there’s very little research in this area and that early language  is key for school success. “It makes me feel like I’m giving back to the community and helping the children, especially with language intervention,” she says. “We plan on going back once it’s all done and present our findings to the councils and also share it with the speech-language pathologists.”

 

Addressing PCOS

Last fall, UWyo Magazine featured Fay W. Whitney School of Nursing Assistant Professor Rebecca Carron and her work studying polycystic ovary syndrome (PCOS) in Native American women. Through her work, she learned that many Native American women with PCOS didn’t feel like they’d been given enough information about it. They also didn’t feel there was enough community awareness or early diagnosis. Based on that information, Carron sought funding for her new proposal, “A Pilot Arrangement Plan for Women with Polycystic Ovary Syndrome.” It was funded under the Wyoming INBRE Developmental Research Project Program.

“This new project builds on the results from our previous INBRE 3 Thematic Research project,” Carron says. “Our pilot project has three aims: develop a self-management program for American Indian women with PCOS; develop a PCOS community-awareness program for tribal reservation committees to increase awareness about PCOS; and test the feasibility of implementing a validated PCOS-screening tool in reservation clinics to see if it increases the number of Native women diagnosed with PCOS.”

Impacting approximately one in 10 women, PCOS is the most common endocrine disorder in reproductive-age women and can impact fertility and cause higher risk for cardiovascular disease and type 2 diabetes.

women holding food and plants
Members of the Restoring Shoshone Ancestral Food group: UW Assistant Professor Jill Keith, Caroline Mills holding chokecherry patties, Carmen Underwood with biscuitroot and Vernetta Pantzetanga with bluebells.

 

Restoring Shoshone Ancestral Food

By L’Dawn Olsen

Food sovereignty is more than just the right to healthy food and the right to define one’s own food and agricultural systems, including production and markets. It also includes culturally appropriate foods. Indigenous food sovereignty is a pathway for many tribes in reclaiming, restoring and healing the past, as present health is regained toward a tribal self-determined future. Restoring Shoshone Ancestral Food project is one example of this.

For many years, Shoshone elders had been talking about ways to reclaim and restore ancestral foods that intersect with so many other important tribal issues and needs. The problem was that there was desire and will, but assimilation has been so successful that much knowledge was lost and forgotten. The Shoshone elders reached out and spoke with southern relatives who had started and sustained a successful indigenous food sovereignty project in the mid-2000s—the Tohono O’odham, also known as the Desert People, living on the border of Arizona and in Mexico. They advised the Shoshone elders.

In the fall of 2016, tribal elders put into practice the advice when tribal members, along with non-Indian botanist John Mionczynski and UW Assistant Professor of Family and Consumer Sciences Jill Keith, got together and sat in circle around a table. On the table were plants, tea and tinctures brought in from both tribal members and scientists. Since then, traditional recipes, stories and other food knowledge have been shared among the group. With new faces each time the group gathers, it has brought the community together and preserves food such as biscuitroot, bitterroot, sego lilies and game.

In partnership with UW, a National Institutes for Health IDeA Networks for Biomedical Research Excellence (INBRE) Program pilot grant was secured in 2018 to study the effects of Shoshone ancestral foods on health, identity, culture and well-being. The project has unmasked and fleshed out ways in which the university can better work with the Eastern Shoshone Tribe in advocating for tribal sovereignty, community participation and data-sharing. It has also inspired the tribe to write policy in protection of tribal lands and ancestral foods.

It is the hope that, through this collaboration, future grants can be secured to study the benefits and practice of reclaiming an ancestral Shoshone diet.

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