TAKING UP CULTURE IN DIABETES
TRANSLATION RESEARCH
Insights Gleaned from an AI/AN Depression
Treatment Research Agenda
Tassy Parker, PhD, RN
March 21, 2013
COMMUNITY-BASED
METHODS & ORIENTATIONS
History
Culture
Methods:
Photovoice
Storytelling
Orientation:
CBPR
Indigenous
Planning
Resources
Traditions
TRANSLATIONAL SCIENCE: DEVELOPING DEPRESSION
TREATMENT FOR AI/AN IN PRIMARY CARE (Parker, v.2013)
Proposed depression treatment – Bidirectional
Contextualization of
Knowledge:
Global Knowledge
evidence-based
Current depression treatment Unidirectional
T1
Biopsychiatric
Interventions
Quality
Improvement
(QI)
Interventions
T2
T3
Primary
Care
Practice
T4
Culture, Traditions,
Resources, History
- Cultural core values
- Beliefs, explanatory
models, preferences
- Resources (community,
personal)
- Historical perspectives
T4
Culturallycentered, practicebased
interventions
AI/AN
depression
treatment model
Clinical Practice
- Providers’ resources,
support, motivation
Translation & Application of Knowledge
CBPR: Focus Group, Survey, In-Depth Interviews, Consensus Panel, Vignettes, Community Report Out, Process and Outcomes Evaluation
•
Cultural Core Values (DAH):
•
women-decision makers, children-sacred.”
 “…harness the power of these value systems”
•
Beliefs, Explanatory Models (VS):
•
fried foods
 “the way American Indians cook”
•
Preferences (VG, DAH):
•
children, parents, community members – children’s
health
 barriers and enhancers to PA at elementary school
 Weight management preferences of pregnant AI/AN
women
•
Resources (community, personal) (DJ)
•
photovoice
 identifying community needs
•
Historical Perspectives (RH)
•
“Why has Pathways not gone beyond study sites…”?
 T3 pathway discovery