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CTEC Success Story: Tribal Adverse Childhood Experiences Project

Success Stories, TEC News
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At a Glance

Historical trauma among American Indian and Alaska Natives (AI/AN) can negatively impact health. Tools to assess Adverse Childhood Experiences (ACE) can help healthcare providers intervene earlier to prevent harmful health outcomes. The California Rural Indian Health Board’s Tribal Epidemiology Center (CRIHB CTEC) piloted a Tribal Adverse Childhood Experiences (TACE) tool based on tribal health program data to create a culturally responsive tool for providers to adapt trauma-informed care (TIC) to meet patient needs. The TACE survey was piloted to 526 patients with positive community response.

Challenge

ACE exposure can impact physical and mental health across the lifespan. Increased screening for ACEs early in age helps healthcare providers prevent and treat associated health outcomes. Trauma is not experienced equally and people with higher ACE scores may be at greater risk for substance misuse, risky behaviors, and other poor health outcomes that worsen health disparities. Current ACE screening tools do not account for AI/AN cultural contexts, including the intergenerational impacts of historical trauma stemming from colonialism, displacement from ancestral lands, forced cultural assimilation, and more. ACE tools also do not account for protective factors that mediate associated health outcomes, resulting in incomplete representations of trauma and health among AI/AN communities.

Approach

CRIHB CTEC wanted to understand unique experiences of trauma and resilience in California AI/AN communities served by three pilot tribal healthcare programs. The original ACE screening tool was adapted to incorporate key informant interview data from tribal healthcare providers on how TIC and trauma assessment tools can be adapted to Indigenous communities. The TACE tool was piloted to patients and providers at the three sites and later validated through a data and action approach for future use in tribal healthcare programs. Providers were surveyed on culturally responsive TIC and findings informed tailored TIC interventions towards providers based on their individual communities’ needs.

Results

The TACE survey included the original 10 questions from the ACE assessment and additional indicators measuring resiliency, chronic stress, and cultural connection. Over 275 tribal health program staff were reached by the TIC survey and associated interventions. 526 total patients were surveyed on TACEs, with over 170 reached through community engagement processes. Project staff identified that participants with higher TACE scores were more likely to find comfort in their religious or spiritual beliefs and higher TACE scores were associated with greater intergenerational connection. The impact and positive community response of this project show its potential to impact Indigenous communities across the United States by effectively identifying and addressing trauma to improve health.

 

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CTEC Success Story: Austin Boykin

Success Stories, TEC News
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Austin Boykin is a member of the Bridgeport Indian Colony’s Paiute tribe and was raised in the Eastern Sierra mountains of California. His tribe is a member of the Health Consortium of the Toiyabe Indian Project, Inc., a valued member of the California Rural Indian Health Board, Inc. (CRIHB)

Haskell Indian Nations University granted Austin a Bachelor of Science in Business Administration with an Emphasis in Management in 2019. Prior to joining the California Tribal Epidemiology Center (CTEC), he worked for CRIHB’s Health Systems Development Department as an administrative assistant, gaining valuable insight into American Indian Alaska Native health issues.

In 2020, Austin joined CTEC as an outreach coordinator. The majority of his time is spent gathering data sharing agreements in tribal communities and attending outreach events throughout California to promote and educate about CTEC services. Additionally, Austin coordinates the biannual CTEC Advisory Council meetings, designs and distributes the CTEC newsletter, and oversees the Summer Research Assistant Program (SRAP). Above all, he enjoys the SRAP the most since he meets a variety of qualified candidates during the recruiting phase of the project.

 

Austin Boykin

Austin Boykin

 


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NCC Success Story: Partnership with Dr. Charlotte Huntley

Success Stories, TEC News
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Over the last two years of the Tribal Epidemiology Centers Public Health Infrastructure (TECPHI) Program, the Network Coordinating Center (NCC) has partnered with Dr. Charlotte Huntley to facilitate 24 TEC-specific episodes for her “Public Health Epidemiology Conversations” Podcast. Each of these podcast episodes features a TEC staff sharing their career path and work at one of the 12 TECs.

One of these conversations featured the new CDC Director of Healthy Tribes, Dr. Julianna Reece to complete the collection. The podcast episodes have been a fun and impactful way to spread awareness of the services and expertise offered by the TECs. The episodes have received many positive reviews that emphasize the value they have had to listeners.

 

One reviewer said “Thank you for these episodes on native health because representation matters! Kudos for the outstanding work you are doing” and another shared “I loved your episode with Joshua and the discussion about the importance of communication and health surveillance data in the tribal communities. The data sharing toolkit he talked about gave me an idea for something I can try with my community. I think I’m going to discuss it with my supervisor.”

 

For more information about Dr. Huntley and her podcast, visit https://www.drchhuntley.com/about.


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View/Listen to more TEC related podcasts from Dr. Huntley HERE.

 

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ANEC Success Story: Healthy Alaskans 2030

Success Stories, TEC News
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Healthy Alaskans provides a framework for health improvement. Every decade, the Alaska Native Tribal Health Consortium (ANTHC) and Alaska Department of Health work together to identify the state’s health priorities and set new targets. The team released its first annual scorecards showing progress made toward reaching the goals of Healthy Alaskans 2030 –the statewide health improvement plan outlining health outcomes for Alaska to reach by the year 2030.

Using data compiled and analyzed by ANTHC’s Alaska Native Epidemiology Center (ANEC), the most recent progress summary on Healthy Alaskans 2030 objectives (for 2018-2021 data) shared that of the 30 health objectives listed on the Alaska Native population scorecard one met or surpassed the target (“Percentage of adults who could not afford to see a doctor in the last 12 months,” which went down from 15.3% in 2018 to 88.1% in 2019), 11 others showed improvement from baseline.

 

Healthy Alaskans is the only state health improvement plan in the nation co-led by a state and Tribal partnership and, as stated by Valerie Nurr’araluk Davidson, President/CEO of ANTHC, “These achievements translate into safer and healthier kids, stronger families, and vibrant communities.”

 

To learn more about Healthy Alaskans, click HERE.


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Indian Health Service Support for Tribal Epidemiology Centers

TEC News, TECs in the Media
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Sage Journals

This editorial provides background information on the Tribal Epidemiology Centers (TECs) program. The program was authorized by Congress in 1992 to provide public health support to multiple Tribes and Urban Indian communities in each of the Indian Health Service (IHS) administrative areas.

Lisa C. Neel, MPH and Jeffrey T. McCollum, DVM, MPH
March 9, 2023

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