GATHER: Growing a Tribal Healing Effort through Research

American Indians and Alaska Natives (AIAN) face some of the highest rates of substance use disorders and related mortality in the nation. AIAN may also face a host of mental health and substance use issues related to multigenerational exposure to historical trauma, personal trauma, poverty, and unemployment. Concomitantly, despite the effects of AIAN health disparities and social inequities, tribal communities have retained their language, culture, and community connectedness, which offer unique and important strengths that have yet to be fully integrated in tribal research efforts.

The University of Washington Seven Directions (UW-7D) team proposes to partner with Drs. Melissa Walls (Professor, Johns Hopkins University Center of Indigenous Health (JHU-CIH) to provide a four-pronged approach to provide GATHER: Growing a Tribal Healing Effort through Research, designed to support N CREW funded research teams for the purpose of ensuring health equity within AIAN communities using a strengths-based, culturally grounded approach to grow tribal research in the areas of overdose, substance use, mental health, and pain research.

The University of Washington Seven Directions (UW-7D) team will serve as the core support (Prong 1), supporting the documentation and monitoring of tribal research grants, along with building the initial relationships with tribal and other Native American Serving Organizations (NASO) research teams to develop trust, identify research capacity needs, readiness to engage in research and enhance research capacity of T/NSAO. In our technical assistance work, we recognize the importance of authentic relationship building, and this will inform our approach to working closely with T/NSAO research teams (Prong 2 – Technical Assistance Approach).

JHU-CIH will provide the research support core (Prong 3), drawing from a wealth of experience and expertise to support the technical research capacity development and/or data enhancement capacity of T/NSAO grantees. They will provide training in grant writing, specific aims development, identification of study designs and measures, and data access and quality improvement.

UW-7D and JHU-CIH will both serve as the translation and communication core (Prong 4), supporting the dissemination of opportunities, trainings on translating research findings to program content and other implementation materials, and supporting the annual convenings of T/NSAO research teams.

GATHER’s purpose is to substantively contribute towards building research capacity among and provide instrumental research support to tribally led overdose, substance use, mental health, and pain research projects towards the improvement of the health and wellbeing of AIAN populations through fostering and growing Indigenized approaches to substance use research. The GATHER initiative aims to:

1) Conduct, stimulate, coordinate, and support collaborative research on the etiology and prevention of harmful alcohol use and related risks in the transition to adulthood, within an overarching developmental framework emphasizing social, cognitive, contextual, personality/temperament, and affective influences.

2) Provide the necessary administrative support and shared resources to facilitate the successful completion of component research projects contributing to the Central Theme.

3) Provide an administrative infrastructure, intellectual environment, and access to resources and initial support for young investigators and those new to the field of alcohol etiology and prevention.

4) Provide clinical and research training for students, fellows, staff, and faculty in the areas of cognitive, motivational, and behavior therapies targeting prevention and treatment of alcohol use and related risks.

5) Serve as a local, national, and international resource for dissemination of information and training to the public, trainees, and academic audiences, to foster the application of new knowledge to the reduction of harmful alcohol use and related risks in diverse EA populations.

Benefits to AIAN Communities: This innovative multimethod approach will have important methodological, prevention, treatment, and environmental impact among AIAN communities, because it will a) offer key research supports for tribally-grounded substance use research; b) address research capacity needs at the individual, team, and community levels; c) provide groundwork to for a holistic, culturally informed research training and TA approach, and d) refine the methods of effective CBPR in tribal and NASO settings. Given the disproportionate effect of substance use, mental health issues, and lack of clinical capacity to effectively support pain management, and the far-reaching dissemination plan developed by the GATHER partnership, this innovative initiative has the potential for wide range impact among the funded and yet-to-be-funded N CREW research projects and across Indian Country in general.

This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions for the opioid crisis and overdose epidemic, including opioid use disorder and stimulant use disorder. The NIH HEAL Initiative bolsters research across NIH to address the national opioid public health crisis and improve treatment for opioid misuse and addiction.