Connection and Community: Diné College Emphasizes Real-World Experience in Public HealthMay 1st, 2016 | By Mark Bauer | Category: 27-4: Good Medicine, Features
Ever wonder how to empower students to explore research in their own communities? The Summer Research Enhancement Program (SREP) at Diné College provides students with a solid foundation of public health research methods and includes a hands-on internship in their home community to test their newly acquired skills while enhancing the communities’ health. Focusing on health issues prioritized by Navajo health leaders, from diabetes to cancer, the program has documented steady improvement in student engagement, cultural competency of instruction, and collaboration with local health programs and services.
SREP is a collaboration between Diné College and the colleges of public health at the Universities of Arizona and Colorado. With this support the program engages many accomplished public health professionals in work that impacts Navajo communities. Support from the Center for American Indian and Alaska Native Health at the University of Colorado, and additional funding provided by the Center for American Indian Resilience, enhanced students’ research training. The SREP program emphasizes teaching students about the importance of individual and community resilience in health, how resilience can be assessed in research contexts, and how their own community internships can foster such resilience. Involvement of Navajo graduate students and health professionals in instruction and mentoring is also critical.
HOW IT WORKS
The SREP program recruits students from across the Southwest, with the majority of students being Navajo from Arizona, New Mexico, and Utah. Students may be from any academic institution and from a variety of majors involved in public health, including biology, health science, social science, education, and Native studies, among others. All students come together at the Tsaile campus of Diné College for the three-week research methods course that prepares them for the activities and responsibilities of the six-week practicum. During the practicum, students live with their families in their own communities and are placed in a local clinic, health agency, or research project chosen in relation to factors of distance, interest, and level of expectations of the student.
At the practicum site, students gather and manage data, resulting in a data set relevant to the work at that site and to some extent the students’ interest. Students gather for one final week back at Diné College for sharing, reflection, consolidation of learning, and data analysis that culminates in the presentation of their results to fellow students and site mentors.
Academically, the program’s seven credits are integrated into the college’s Public Health Certificate and Associate Degree in Public Health Program requirements. Relevant topics include understanding types of data, sampling procedures, hypothesis development, research study design, research ethics, questionnaire and protocol development, and extensive data management and analysis practice using Microsoft Excel. Because many of the practicum sites are not actual research projects, students also learn how to apply research methods and data analysis skills to similar tasks in program evaluation, an activity that is more relevant in many local settings.
KEY PROGRAM ELEMENTS
In keeping with Diné educational philosophy and the college’s mission, the program is based on an Indigenous four directions model, and begins and ends with a blessing ceremony to create a safe space for the students to learn about topics involving the morbidity and mortality of the Navajo population. The curriculum follows a Navajo research and program development model presented in a variety of ways, by different voices from different perspectives.
Using resources of the Center for American Indian Resilience, SREP has integrated a number of topics and activities using the concept of resilience to create a more authentic and meaningful approach to public health for our students. This starts with an activity for the students on their individual resilience, then progresses to teaching approaches to community health improvement through resilience, and finally results in mentoring internships to help students discover and apply resilience thinking in community public health settings.
A key resource for the SREP program is a network of mentors for the students consisting of tribal, Indian Health Service (IHS), and county and regional health professionals. The mentorships take place in clinics, health promotion programs, tribal health programs, and some university-based research projects in tribal communities. These mentors provide the sites, the guidance, and the experiences for our students as they grow in their connections to their local communities. As one staff member says, “Our program gained valuable, fresh ideas from the interns and renewed enthusiasm. Many of us have been working on the projects for several months and teaching the interns about what we do reignited our enthusiasm for our work.”
STORIES OF ENGAGEMENT
Our student projects at practicum sites often have positive impacts on those programs and their ability to address local health needs and activities. At some sites there have been a series of SREP student projects that have taken place over several summers, such as at the San Juan Regional Medical Center Cancer Outreach Program, the Tsaile IHS Clinic, and the Navajo Epidemiology Center. Student contributions include working with the cancer center of a local hospital and conducting surveys to explore issues of perception and knowledge of cancer screening; collaborating with the Navajo Special Diabetes Program to conduct a survey of beverage choices with special consideration given to age, body mass index, sugar content, and knowledge of sugar content; and partnering with the IHS Health Promotion Program to examine how gender and residence differences impact nutrition among Navajo youth.
Overall, students found that the program strengthened them, connected them to community, and helped them network with professionals in their communities and in the academic world beyond. One student testifies, “I was able to network so much, so when I return to the Navajo reservation, I know what opportunities are there and will have an established rapport with them.” But, as another student indicates, perhaps the program’s greatest strength was instilling a sense of empowerment in the students: “I learned that making a difference in Native communities is easier since I am a part of the solution.”
PUBLIC HEALTH AT DINÉ COLLEGE
Diné College’s Summer Research Enhancement Program is part of a broader effort in the areas of public health research, community outreach, workforce development/training, and program development that has been evolving for over 30 years. Moreover, the program is a collaboration with a great number of partners, including the Navajo Department of Health, IHS, and other institutions and agencies. Curriculum is organized according to the Diné educational philosophy and reflects the four directions model of Nitsáhákees (thinking), Nahat’á (planning), Iiná (implementing), and Siihasin (evaluating).
Coursework focuses on positive aspects of Navajo life and health, as well as ways in which those positive aspects can be celebrated and strengthened. Public health in the context of Navajo philosophy seeks to improve the cultural relevancy and effectiveness of public health programs that serve the Diné. The program is based upon an approach that includes research, outreach, workforce development, and partnering.
Diné College faculty have pursued research on topics of concern to Navajo communities for the past 40 years, providing opportunities for student research training and experience while engaging students with community and using the results to enrich the curriculum. More accurate cancer descriptions in the Navajo language have been developed and are being tested in cancer-screening outreach efforts in a major collaborative effort with tribal, IHS, and Mayo Clinic professionals. Another major focus is environmental concerns of water quality and other exposures from the history of uranium mining. College faculty, staff, and students have worked to assess exposures and impacts in a variety of studies.
Some of the college’s research has resulted in outreach efforts such as presentations and the development of new programs like gardening interventions. Funds have been acquired to provide community outreach in key areas such as HIV, Hepatitis C, and substance abuse prevention and testing. Students studying public health education methods use video equipment to develop materials on a variety of health topics for local use.
Diné College’s public health program is designed for working health professionals as well as students wishing to pursue a profession that emphasizes community and population health. Over 150 employees of the Navajo Department of Health have completed the certificate program. In the future, as the Navajo Division of Health takes on the responsibilities of a state department of health, the Navajo Nation will need many more people with Bachelor of Science and Master of Public Heath degrees. The college is working with partners to bring needed coursework to the Navajo Nation.
An exemplary partnering relationship exists between the college and the Navajo Nation, including significant faculty and research staff collaboration with the Navajo Environmental Protection Agency, Head Start, and other tribal programs. The college is also a co-host of the biannual Navajo Research Conference where all researchers working in the Navajo Nation are expected to present results to the tribe and the communities. The college also has strong partnering relationships with a variety of universities, IHS health promotion programs, funding agencies, and the Centers for Disease Control and Prevention.
Mark Bauer, Ph.D., has been a Diné College faculty member for 35 years and is head of the Summer Research Enhancement Program.