Improving Chronic Illness Self-Management with the Apsáalooke Nation: The Báa nnilah Project, a cluster randomized trial protocol

John Hallett; Du Feng; Alma Knows His Gun McCormick; Sarah Allen; Jillian Inouye; Mark Schure; Shannon Holder; Lucille Other Medicine; Suzanne Held

doi:10.1016/j.cct.2022.106835

Improving Chronic Illness Self-Management with the Apsáalooke Nation: The Báa nnilah Project, a cluster randomized trial protocol

Contemp Clin Trials. 2022 Aug:119:106835. doi: 10.1016/j.cct.2022.106835. Epub 2022 Jun 18.

Authors

John Hallett¹, Du Feng², Alma Knows His Gun McCormick³, Sarah Allen⁴, Jillian Inouye⁵, Mark Schure⁶, Shannon Holder⁶, Lucille Other Medicine³, Suzanne Held⁶

Affiliations

¹ University of California Davis, Department of Family and Community Medicine, 4860 Y St, Ste. 1600, Sacramento, CA 95817, USA; Montana State University, Department of Health and Human Development, 218 Herrick Hall, P.O. Box 173540, Bozeman, MT 59717-3540, USA. Electronic address: johnhallett13@gmail.com.
² University of Nevada Las Vegas, School of Nursing, Mail Stop: 3018, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA.
³ Messengers for Health, PO Box 940, Crow Agency, MT 59022, USA.
⁴ Southern Utah University, 351 W University Blvd, Cedar City, UT 84720, USA.
⁵ University of Hawaii at Manoa, 2528 McCarthy Mall Webster Hall, Honolulu, HI 96822, USA.
⁶ Montana State University, Department of Health and Human Development, 218 Herrick Hall, P.O. Box 173540, Bozeman, MT 59717-3540, USA.

Abstract

Chronic 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. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03036189. Registered on 30 January 2017. (From https://clinicaltrials.gov/ct2/show/NCT03036189).

Keywords: CBPR; Chronic illness; Cluster randomized trial; Community resilience; Indigenous; Self-management.

Publication types

Clinical Trial Protocol
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Chronic Disease
Community-Based Participatory Research
Humans
Quality of Life
Randomized Controlled Trials as Topic
Self-Management*
Surveys and Questionnaires

Associated data

ClinicalTrials.gov/NCT03036189

Abstract

Publication types

MeSH terms

Associated data

Grants and funding