Research in Indian Country

When Julii Green decided to study partner violence in a Native American community living on a reservation in the northern Plains of North Dakota for her dissertation, her mentor Jacque Gray, PhD, had a quick response: Give something of yourself to the tribe before you even approach the tribal leadership to ask if you can conduct research with its members.

Being willing to volunteer, share her expertise and build relationships helps tribal leaders recognize that she is no "helicopter" researcher who drops in, collects information and leaves, without maintaining a relationship and sharing research findings for the tribe's benefit — past experiences that have made many tribal communities wary of cooperating with outsiders.

With that advice in mind, Green, a doctoral candidate in clinical psychology at the University of North Dakota, volunteered her time and skills to help conduct a needs assessment for domestic violence services on the reservation. She hopes that eventually her results will help the tribe advocate for federal grants for a treatment program.

In doing so, she forged relationships with tribal leaders that helped her win approval for her research proposal from the tribal council and get help from tribal health professionals in recruiting participants for her research. Green will share her results with each tribe once her dissertation is finished, and seek permission for any follow-up work using the original data.

"The research project is essentially going to be owned by the tribe," says Green. "It's very much a working relationship, and that's how I'm honoring them."

Green's dissertation is an example of a new paradigm for conducting research in ethnically diverse communities — one that emphasizes collaboration over exploitation, says Gray. Although it's still relatively uncommon for researchers to give participants control over how data are used, such procedures are typical for the Native Health Research Team Gray has helped build at UND in the past three years.

"By better understanding research and how it needs to be done ethically, these students can provide that leadership, so they'll have all kinds of impacts on their communities. And they'll also know how to help other students coming along after them," Gray says.

Building the team

Gray's program is training the next generation of researchers, many of whom are themselves Native Americans. Gray currently works with six undergraduates, three doctoral students and three master's students, who come from a range of disciplines, including counseling and clinical psychology, health, nutrition and nursing. Most are Native American, but the group is open to all students.

The program grew out of an informal group of students who worked with Gray on an ongoing project funded by the Indian Health Service and the National Institute on Drug Abuse that is examining whether existing measures for mood disorders accurately identify Native Americans with depression, anxiety or substance abuse problems.

As more students approached her at UND about three years ago, Gray thought about her own experiences at Oklahoma State University while pursuing a doctorate in counseling psychology.

Like Gray, who is of Choctaw and Cherokee descent, four out of the six students in her cohort at OSU are Native American. As a group, they decided to work as a team to ensure that they all graduated together and on time. For example, she and her fellow students ended up applying at many of the same internship sites, and during the interview process, cohort members made sure to recommend fellow students if there was a good "fit" with the internship site.

She wanted to create that same type of supportive environment within the research team at UND.

"I was getting more and more students, and I needed to find a way to work with them, and get them to work with one another," she says

Gray hosts weekly meetings with the research team, bringing in experts to discuss such topics as grant writing and statistics. Team members update the group on what they're working on. If they've run into problems with a research project, the group discusses possible solutions and seeks feedback from experts, many of whom regularly attend meetings, such as Marilyn Klug, PhD, an associate professor with the Center for Rural Health and an expert biostatistician.

Ethical issues are also stressed, given the need for tribal collaboration and the sad history of past exploitation. One recent case: Last year, the Havasupai, a tribe that lives at the bottom of the Grand Canyon in Arizona, received a $700,000 settlement from Arizona State University. The case against ASU involved university researchers allegedly using blood samples collected for diabetes research to study schizophrenia, inbreeding and human migration without the tribe's permission.

Such incidents understandably make tribal leaders wary of researchers, says Gray. That's why she strives to establish trust, build partnerships and gain approval from the tribes by presenting her case before the tribal councils to explain the research goals and methods. When meeting with tribal leaders, Gray explains the goal of the research, how its results might benefit the tribe, the fact that the tribe actually owns the data, the process for publishing studies drawn from the data and how the community's confidentiality will be protected, all of which is written out in a resolution presented to the council, which they can edit to fit their needs.

"Giving that to them, upfront, builds respect for what we're doing," she says.

When she goes on research visits, she often takes students with her, so they can experience first-hand some of the skills needed to build relationships based on respect, such as acknowledging the troubled history of research in native communities. "Just because you're native doesn't mean you can walk in anywhere and do what you want," she says.

Native American researchers, however, often do have the advantage of knowing about tribal customs, especially if they are working with their own tribe. For Northern Plains tribes, that includes understanding the respect accorded to elders and being a good guest at someone's home. "It doesn't matter if it's a peanut butter sandwich or a glass of water, you accept it, because they're being generous and you're being respectful," Gray says.

Nurturing new scientists

One of Gray's doctoral students, Paula Carter, is exploring resiliency in her home reservation, the Turtle Mountain Tribe of Chippewa in North Dakota. By examining a strength, this dissertation work, she says, will provide balance to the many studies of disease and dysfunction in tribal communities.

"My thought is, what's working for us? What strengths do natives possess that's helped them survive all these years?" she says.

To conduct her work, Carter met with the tribal leaders of the community college serving local students and the reservation-run casino and explained the research question she wanted to pursue, how she hoped to conduct the research and how her results would be used. "The starting point is the tribe, so they can make an informed decision about whether they want to participate and know how the information will be used," Carter says.

Seeking ongoing approval from her study participants, in addition to her dissertation committee and institutional review board, can be trying, but belonging to the Native American research team keeps Carter motivated, she says. Carter also enjoys helping Native American undergraduates adjust to the university environment and seeing their curiosity and potential research skills blossom.

"That's a big part of the success of these students that are away from home and in a different cultural world," she says.

Such support also helps Native American students enter the world of research. Sarita Eastman, a member of the Sisseton-Wahpeton Oyate tribe, is a junior majoring in psychology. Building on her experience in Gray's group and her own work as a research assistant with the Native American Research Center for Health project, Eastman plans to pursue a doctorate in clinical psychology. She's already identified a research topic to explore for her graduate work: whether building a spiritual aspect into mental health interventions improves outcomes for Native American clients.

"My first semester, I did some research with some graduate students and I was thrown into a sink-or-swim situation, whereas with Dr. Gray, it was step-by-step, 'We'll walk you through this.' I think it's made a world of difference," she says.