Strengthening Common Ground in Tribal Health

In this episode, host Mighty Fine talks with guests Christina Ore from Seven Directions and Chris Tallbear from the National Network of Public Health Institutes (NNPHI) about the collaborative work they are doing through their public health infrastructure grant funding received from the CDC. This work, in partnership with Safe States Alliance, is allowing them to provide opioid overdose prevention activities and education through training, technical assistance, and evaluation to both those in Tribes and those who work with Tribes.

Seven Directions

National Network of Public Health Institutes

Resources:

https://www.indigenousphi.org/our-publications

• Models of Tribal Promising Practices Tribal Opioid Overdose Prevention Care Coordination and Data Systems
• An Environmental Scan of Tribal Opioid Overdose Prevention Responses: Community-based Strategies and Public Health Data Structure
• Seven Directions’ Indigenous Evaluation Toolkit Training & Supplemental Briefs

https://www.indigenousphi.org/isdoh/about

• Indigenous Determinants of Health

Transcript

Mighty Fine: 0:01

Welcome to the IVP INdepth podcast, a Safe States Alliance production. I'm your host, Mighty Fine, and I'm thrilled to have you here. This is a space where injury and violence prevention professionals come together to share ideas, spark conversation and dive into some of the most pressing topics shaping the field. Whether you're here to stay in the loop, find inspiration, or to be part of a community that wants to make a difference, you are in the right place. Today's episode will be about a partnership between the National Network of Public Health Institutes, or NNPHI and Seven Directions, exploring the history of this collaboration, discussing their current activities and looking towards the future of their work together. For those of you that don't know, NNPHI is an organization committed to advancing public health practice and improving population health through technical assistance, education, evaluation and stakeholder convenings that give everyone a seat at the table. Learn more about NNPHI at nnphi.org and then we have Seven Directions. They're an Indigenous public health institute at the University of Washington. They work in service of Native nations and Tribal and urban Indigenous serving organizations and entities and support their initiatives and efforts to strengthen existing healing, health and well being systems within their communities, across the US. The Seven Directions that guide their work reflect the values, principles and directives or mandates share with them during their Tribal public health institute, Tribal health leaders forum in 2015 And to learn more about what they're doing, check them out at indigenousphi.org. Now let's get started. I'm so excited to have you both with us today on the podcast, and so that our listeners can learn a little bit more about whom I have the pleasure of speaking with today, some introductions would be great. And so Christina, let's start with you.

Christina Ore: 2:07

Thank you. My name is Christina Ore. I am an Andean descendant of Huancavelica - Ayacucho, Peru and Irish. I was born and raised in southern Arizona. I am an Associate Director with Seven Directions at the University of Washington.

Mighty Fine: 2:25

Thank you and Chris,

Chris Tallbear: 2:28

Good morning or afternoon. Thank you for asking. My name is Chris Tallbear, and I'm the Tribal Public Health Advisor for the National Network of Public Health Institutes. And I'm a full blood Southern Cheyenne. I'm enrolled with the Cheyenne and Arapaho Tribes of Oklahoma, and I'm happy to be here. Thank you.

Mighty Fine: 2:49

Of course, happy to have you here and excited for the conversation today so so that we can give our listeners something to think about, and, you know, hopefully figure out ways that they can engage in some of this work. Talk to us about how NNPHI and Seven Directions came together initially, to do this work.

Christina Ore: 3:10

I can start so we have a long history with NNPHI. Seven Directions, our founder, Aleena Kawe, took good time to meet with Tribal representatives leaders across the country in establishing Seven Directions, and along that way, we work closely with Erin Marzali, with NNPHI. So in a lot of ways, we've been incubated by NNPHI since about 2018.

Chris Tallbear: 3:50

Yeah, I myself was working for a a regional Tribal health board, Oklahoma City area inter Tribal health board at the time, and ourTribal Epicenter director, Tom Anderson, was part of that work group that was exploring the development of the Tribal Public Health Institute, or an Indigenous Public Health Institute. And I remember Aleena and others coming into our area to kind of ask questions and meet about this and getting the development going, but it's really nice to see how it's grown, and, you know, how they're contributing to Indian country.

Mighty Fine: 4:31

Yeah, that's always exciting, right? Where you sort of sit down, you plan, you strategize, and then it actually comes to fruition and you like what, what you're doing, you know? So I think that's a win win all around and as I understand it, there's a focus on opioid overdose prevention. So how did that become sort of integral to the work that you all are doing?

Chris Tallbear: 4:54

Well, I can start by saying that this project that we're on, it's the next phase of what was initiated by the Centers for Disease Control and Prevention about six years ago, and the opioid overdose prevention was a top priority at the time there in Indian Country. CDC recognized that Tribal communities needed support tailored to the Tribal experience and many of the resources developed for opioid overdose prevention, they were designed for non Tribal communities, which is kind of typical for a lot of public health resources. So Christina, Seven Directions came together and worked with Indian country and other subject matter experts to tailor this to be more reflective of the needs of Indian Country. Christina, would you like to add anything?

Christina Ore: 5:52

Yeah, I would say we started out with an emphasis on Tribal public health capacity and infrastructure, and with our with our director, Dr Myra Parker and Dr Maya Magarati. They led this initiative with opioid overdose prevention, so which included having an advisory group. So we've had an advisory group since the beginning, advising the training development, the technical assistance and and then in particular, our long, long standing relationship with Dr Joan la France really supported the Indigenous evaluation training that we developed. So it's been six years.

Chris Tallbear: 6:39

Six very fast years

Mighty Fine: 6:43

Absolutely, because if it's six years it was sort of during COVID, well, yeah, it's, you know, at least the shutdown, and where there's a greater attention being paid to to that issue. And it's also great to see that overdose prevention is still being elevated, because it seems like there was a point in time when everybody so it was like, "Hey, this is a major issue". And then it seemed to be not as pressing for folks, or at least in the in the news, and not hearing it as much as we once did. So it's great to hear that the work is still going on, because we recognize that there's still some challenges that we're facing with that issue. And sort of, let's go a little bit deeper, what are some of the specific activities that you all are working on for this project?

Christina Ore: 7:26

Yeah, so we have four projects that we're working on with with our current partnership with Safe States Alliance. So the first is to continue our Tribal overdose prevention training and technical assistance. And the second is in continuing our evaluation capacity building for Tribal injury and overdose prevention, so moving from opioid overdose to to broader injury and and overdose prevention. And then third, we have, we've always worked to represent Tribal and urban Indian health organizations and systems. And so this is actually one of the first projects that we're working on in support of urban Indian organizations and overdose prevention. So it's a pilot program. And then finally, Chris and I are working closely with building the capacity. So a student, recent graduate, injury overdose prevention internship, so an eight week summer, that summer internship paid that. We're we just launched this week, so we're excited. Yes, we're

Chris Tallbear: 8:38

Yes, we're planning on doing some outreach to Indian country and shaking some bushes and seeing, you know, what kind of applicants we can bring into the, you know, into the field that we can start training. We're always looking at opportunities to help further develop the Tribal workforce. So and, you know, provide an opportunity for students to be exposed to the work that needs to be done and being being a part of the solution.

Mighty Fine: 9:09

Yes, I love that. I love that the students are able to engage, and you said paid internships. So really loving that as as well, right? Making sure folks are compensated for their time and their sort of intellectual capital. So kudos to you all for doing that. Folks who are listening - so you can't see us, but maybe you can hear that just inwhat you all talking about it. I'm smiling, and so I feel the passion that you all have for the work, and that always excites me as someone who's been doing public health for some time now. So I'm curious, from your perspective, what are you most proud of about this work that you all are doing?

Chris Tallbear: 9:46

Yeah, if you don't mind, Christina, I'll jump in real quick and just share that for NNPHI, we're most proud of our partnership with Seven Directions. Their leadership on this project has been outstanding and, Me as a tribal person, it's been really nice to see an Indigenous-led organization, you know, take the steps that they've done to kind of break through some of these barriers in Indian Country. I feel like every you know, every one of their staff you know, has represented well and you know, they're willing to shed this light into the darkness that you know sometimes holds some of the hardships that that we face. So they're helping to kind of bring light and open up some of these doors and opportunities so that we can start breaking down the barriers that held us down, you know, and just seeing them thrive, you know, I think a lot of people put forth energy that maybe are not not around anymore for various reasons, but they put a lot of energy and effort into seeing this come alive, and it's alive. So with Seven Directions and their great staff putting energy into this. It's continuing. You know, the work that was started.

Mighty Fine: 11:08

Yeah, absolutely you. You made me think of I went to a panel recently, and a gentleman was talking about his life's work and what made him proud. And sort of what's resonating with me is something that you said he acknowledged that there are doors that he didn't have to open with that were open for him and he was able to walk through. And so now his charge is to bring people through as well as he's opening other doors. So sort of what you're saying is resonating with me in that way. So so thank you for sharing that. What about you, Christina, what's what makes you really proud about this word?

Christina Ore: 11:41

I'm really proud to hear your words, Chris. It feels in terms of, I'm sitting here representing Seven Directions, and was part of the early days supporting it. It's supporting it even as just an idea of young professionals and students who thought, you know, we we, we needed an institute like this and a way to convene across, you know, really make those connections across, break down those silos that have been imposed. And so I come from a much systems perspective, and the fact that it is Indigenous, grounded and led. And then to hear your words, Chris, that that, I guess it just makes me feel just really happy and content. I don't know. I mean, I'm proud of all everybody who's just put in so much heart and work and and that's Indigenous and non-Indigenous. You know, our team is really cross disciplinary and, and for many different communities that have been able to support us. So I'm happy for that. And also your words, actually too, thinking about we got it launched, it's open doors. And now people are, you know, moving. I mean the growth and and the growth of just indigenous scholarship and is just amazing, and it's really exciting to be part of that and realize that now I'm in that older generation.

Mighty Fine: 13:14

Me too.

Christina Ore: 13:15

You know, like, Okay, keep going.

Mighty Fine: 13:18

Yeah, absolutely, yeah. Very impactful words as well from both you, Christina and Chris. And again, it's just, it resonates with me. I feel it so I can tell that the work isn't just about the work, but there's a lot of love, passion and commitment that undergird it. And just through this conversation, it's, certainly coming through to me. So again, thank you for that. And Chris, you talked about sort of shining the light in the darkness, which I loved. And Christina, you mentioned it being very Indigenous, grounded and led, which I get. Again, thinking about the coupling of those things, it again, is very impactful and necessary. So thinking about sort of where you are, what are some of your continued goals that you have for this work as you're moving forward? And even you mentioned Christina is sort of like setting the ground and like, okay, bringing people through, yeah, just just curious to see what you both think about the what goals you have for this work moving forward.

Chris Tallbear: 14:22

You know, with that, I just wanted to add say that I was listening to a Native educator, Dr Iris, PrettyPaint, HeavyRunner, and she was a Blackfeet and one of the statements that she had made a while back that really resonated with me was, you can't lead where you haven't been. And it made me think about, you know, all the work that we do, kind of pushing the line in the sand and testing our boundaries with what we're capable of and what we can achieve when we come together and. You know, I really love these, oh, communities of practice, the the building common ground that seven directions does with their engagements with Indian country, and their reach that they have all the way, you know, nationwide and even, you know, across, you know, man made boundaries. You know, we, they, they have a reach to many, many other Indigenous communities, whether they're, you know, grounded here or on the other side of the world. So I think that the ability to dream big, and with the advent of technology, you know, that really changes the dynamics of what we're capable of. So we here at NNPHI, you know, look to Seven Directions, you know, for helping to lay that groundwork and push forward. You know, with with these endeavors that we want to achieve for our children. So with that, I'm going to turn it over to Christina to see what her goals might be.

Christina Ore: 16:09

Yeah. So I think for Seven Directions is to continue being able to do the work, the good work that we've been able to do, continue growing those relationships, maintaining them and, and as Chris was saying, we do have and just because of our representation as well, this this kind of reach and grounding to a more global solidarity, global Indigenous solidarity, and, and I mean, speaking personally, It would be bringing the diaspora so the diaspora communities with us, but that's me speaking for Seven Directions, though, right now, it's to maintain and continue, and then also really growing the career internship or the next generation. And you know, having that space too to do the creative, innovative work as well. You know, I think that we're in a time to to build out a lot of times we adapt. And versus adapting is continuing to create from indigenous knowledge and lived experience. As Chris was saying, and I love that we have that the gathering grounds as a place for people to come with their experience and knowledge to share, and that's what we hear over and over. So I'd love to continue that, just creating spaces for Tribal urban health programs. You know this we are, we are conduits, and we're like, holding space. I just see continuing that and growing.

Mighty Fine: 17:41

Yeah, so staying with this notion of growing, and we know that this is a partnership between NNPHI and Seven Directions. Who else are you partnering with? Or again, back to the growth piece. Who else would you like to partner with to support this work and some of this you elevated in some ways already throughout the conversation, but if you want to be more specific again, about who some of your other partners are, and then who you think are some other folks, that would be great to bring in.

Christina Ore: 18:12

One we're partnering with, Safe States Alliance. And that's new.

Mighty Fine: 18:15

Round of applause for Safe States.

Christina Ore: 18:17

Yeah, yeah. So that's great.

Mighty Fine: 18:21

Absolutely

Christina Ore: 18:22

you know, and kind of, that's that

Mighty Fine: 18:24

I think I heard of that organization before,

Christina Ore: 18:29

Yeah, you know, yeah, the State Tribal relationships, I think, have have a history. And so this is, this is, you know, growing in a good way. And then I bring in partnerships, or collaborations, being part of the Collaboratory for Indigenous data governance, the US Indigenous data sovereignty network. So I can see, you know, continuing that as partnerships grow.

Chris Tallbear: 19:01

Yeah, those you know, we're totally supportive of the work that Seven Directions continues to do and on NNPHI's behalf, I also do work in the Tribal data modernization field, and like Christina alluded to, you know, the data sovereignty and Tribal data sovereignty and what those may look like. It's such an evolving field that you know as as a native person, sometimes, you know we tend to shy away from what we don't know or understand. And I think that's just human nature. But you know myself. I've, you know had to teach myself in working in this space of of representing a non Tribal organization, that you have to embrace some of those fears in order to learn and grow from it. And you know, with that, I've been a part of the growth of our data. Modernization outreach and partnering with seven directions, we've got a total of three Indigenous public health institutes. Seven Directions help me out here, Christina, North Dakota is at American Indian Prevention Resource Center, and then with UNM Center for Native American Health, Cena, and with those, you know, we've got great partnerships with them. But we also know that the landscape is shifting and changing, you know, in the foreseeable future, and we do know that things will evolve and that there may be new partners, new partnerships, new strategies that have to be adopted moving forward. So keeping an open mind and an open slate with what those dynamics might look like. Yes, American Indian Public Health Resource Centers, the one that's represented through North Dakota State University, and we've had a great relationship with him over the years. And, you know, we look forward to many more. You know, I also talked a little bit about those partnerships, but also, you know, as a tribal person, and you know, really coming from a community background. It's good to see these it's great to see these resources coming, and seeing how they trickle down to the local community, the local Tribal community, and getting to sit with you know, my fellow tribal people, and see the impact of, you know, Indigenous determinants of health, of opioid overdose prevention, you know, too many times in our tribal communities, many of the announcements you know, of of people being their lives being taken at such an unfortunate young age. And you know, it's been heartening to see the efforts that are being done to curb that trend that's been going on. So, you know, we don't expect results overnight, although we may pray that way. Sometimes these things take time and, you know, patience. So we're beginning to realize the fruits of those, those labors that were made. You know, hopefully in the next coming years, those trends will continue to go down.

Mighty Fine: 22:25

Yeah, absolutely, yeah, no. Commend you all for the necessary work that you are you all are doing, and I share that sentiment, looking forward to seeing this partnership continue to flourish, and also seeing the impact that the work that you all are doing, that the impact that it will make in protecting these communities. So again, kudos to you all for the work that you all are doing. Those are the questions that I have for you all, and just want to hold space if there's any parting words that you have for our listeners and or if folks are interested to learn more about this fantastic work that that you're doing, where can they check check that out?

Christina Ore: 23:07

So we can drop the link for the seven directions website page to see our work. We have our Gathering Grounds, which is a community of practice. I encourage people to sign up our listserv. And then also, I guess last words would be to encourage people, if they know students and early career professionals that are interested in our inspire internship this summer, we do have a launch of our social media campaign with applications, and have reached out to the selected sites to start matching.

Mighty Fine: 23:42

So make sure that that link is available for folks and Chris. Anything from you?

Chris Tallbear: 23:46

Yeah, we're very grateful for this opportunity to talk a little bit on the relationship and partnership that we have with seven directions and this new partnership that we have with Safe States. We're looking forward to the next several years of growing together and walking together and seeing what comes out of this. So thank you for your time and for thinking about

Christina Ore: 24:10

Thank you for inviting us.

Mighty Fine: 24:12

Yeah, absolutely. Thank you for saying yes to the invitation and again, sharing space with us to elevate this critically important partnership and the fantastic work that you all are doing, as I mentioned to you all, sort of offline, I enjoy these conversations because I get to learn. Our listeners get to learn, and it just sort of simulates my appetite to dig deeper into some of these issues in the work that you all are doing. So again, thank you, and I look forward to being in touch and continue to watch this work grow and flourish. That's a wrap for this episode of IVP in depth, and thanks for listening. I have to thank Chris and Christina for a great conversation today. I've learned so much, and I'm hoping that you all as listeners learned a lot as well. I'd also like to thank our. Sponsor the University of Iowa Injury Prevention Research Center. They work to keep you safe in your home, on the road, in your workplace and in your community. They collaborate with partners, locally, nationally and internationally to put research into action, and they train current and next generation researchers and public health professionals, we want to thank them for their unwavering support for this conversation and Safe States overall, and their commitment to injury and violence prevention. Learn more about the outstanding work that they're doing by checking out their website at iprc.public-health.uiowa.edu if you're not already a member of Safe States, now is the perfect time to join be part of a community working to create safer, healthier communities for everyone. Check out our website at safestates.org for a range of resources, including tool kits, training opportunities, and other useful information designed to support your work in the field of injury and violence prevention. And lastly, don't forget to hit that subscribe button so you never miss an episode, whether you listen to us on Google podcasts, Apple or Spotify. And while you're at it, leave us a review and let us know how we're doing as always. Thanks for tuning in, and we'll see you next time. Until then, stay safe and in injury free.