Browsing by Author "Holder, Shannon"
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Item Development and Feasibility Pilot Study of Indigenous Recovery Planning: A Community-Engaged Approach to Addressing Substance Use in a Native Community(SAGE Publications, 2023-02) Skewes, Monica C.; Gonzalez, Vivian M.; Gameon, Julie A.; Ricker, Adriann; Martell, Shannon; Reum, Martel; Holder, ShannonAlthough Native (American Indian [AI] and Alaska Native [AN]) populations have high rates of abstinence from alcohol, health problems associated with substance use remain a pressing concern in many AI/AN communities. As part of a longstanding community-based participatory research project involving 5 years of relationship building and three preliminary studies, our team of academic and community coresearchers developed a culturally grounded intervention to facilitate recovery from substance use disorders among tribal members from a rural AI reservation. Our Indigenous Recovery Planning (IRP) intervention consists of six weekly sessions and is designed to provide inroads to existing resources in the community, affirm and enhance Native identity, address culturally relevant risk factors, and build on strengths. Results from a feasibility pilot study (N = 15) suggest that IRP is feasible to implement and acceptable to the community. Although there was insufficient statistical power to conduct hypothesis testing, there were changes between pretest and posttest scores in the expected directions. Future directions and limitations of this research are discussed.Item Improving Chronic Illness Self-Management with the Apsáalooke Nation: The Báa nnilah Project, a cluster randomized trial protocol(Elsevier BV, 2022) Hallett, John; Feng, Du; McCormick, Alma Knows His Gun; Allen, Sarah; Inouye, Jillian; Schure, Mark B.; Holder, Shannon; Other Medicine, Lucille; Held, SuzanneChronic illness (CI) is a major cause of morbidity and mortality for Indigenous people. In Montana, Indigenous communities disproportionately experience CI, a legacy of settler colonialism. For over two decades, Messengers for Health, an Apsáalooke (Crow Indian) non-profit, and Montana State University have partnered to improve community health using a community-based participatory research (CBPR) approach. We developed Báa nnilah, an intervention utilizing community strengths, to improve CI self-management. This manuscript describes the protocol for a cluster randomized trial with two arms: an intervention group and a wait list control group, who both participated in the Báa nnilah program. Enrollment occurred through family/clan networks and community outreach and attended to limitations of existing CI self-management interventions by using an approach and content that were culturally consonant. Participants received program materials, attended seven gatherings focused on improving CI management, and received and shared health information through storytelling based on a conceptual framework from the Apsáalooke culture and incorporating CI self-management strategies. Participant support occurred within partnership dyads during and between gatherings, from community mentors, and by program staff. The study used mixed methods to evaluate the intervention, with qualitative measures including the Short Form Health Survey (SF-12), Patient Health Questionnaire (PHQ-9), Patient Activation Measure (PAM), and a suite of PROMIS measures, various physical tests and qualitative survey responses, semi-structured interviews, and outcomes shared by participants with program staff. We hypothesized that Báa nnilah would significantly improve participant health outcome measures across multiple dimensions with quality of life (QoL) as the primary outcome.