Conceptualizing Indigenous strengths-based health and wellness research using group concept mapping

Victoria M O'Keefe; Tara L Maudrie; Ashley B Cole; Jessica S Ullrich; Jillian Fish; Kyle X Hill; Lauren A White; Nicole Redvers; Valarie Blue Bird Jernigan; Jordan P Lewis; Amy E West; Charlene Aqpik Apok; Evan J White; Jerreed D Ivanich; Katie Schultz; Melissa E Lewis; Michelle C Sarche; Miigis B Gonzalez; Myra Parker; Sophie E Neuner Weinstein; Celena J McCray; Donald Warne; Jessica C Black; Jennifer R Richards; Melissa L Walls

doi:10.1186/s13690-023-01066-7

Conceptualizing Indigenous strengths-based health and wellness research using group concept mapping

Arch Public Health. 2023 Apr 26;81(1):71. doi: 10.1186/s13690-023-01066-7.

Authors

Victoria M O'Keefe^#¹, Tara L Maudrie^#², Ashley B Cole³, Jessica S Ullrich⁴, Jillian Fish⁵, Kyle X Hill⁶, Lauren A White⁷, Nicole Redvers⁸, Valarie Blue Bird Jernigan⁹, Jordan P Lewis¹⁰, Amy E West¹¹, Charlene Aqpik Apok¹², Evan J White¹³, Jerreed D Ivanich¹⁴, Katie Schultz¹⁵, Melissa E Lewis¹⁶, Michelle C Sarche¹⁷, Miigis B Gonzalez¹⁸, Myra Parker¹⁷, Sophie E Neuner Weinstein^{18

19}, Celena J McCray²⁰, Donald Warne¹⁸, Jessica C Black²¹, Jennifer R Richards¹⁸, Melissa L Walls^{18

22}

Affiliations

¹ Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. vokeefe3@jhu.edu.
² Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. tmaudri1@jhu.edu.
³ Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
⁴ IREACH, University of Washington, Seattle, WA, USA.
⁵ Minneapolis VA Health Care System, Center for Care Delivery and Outcomes Research, Minneapolis, MN, USA.
⁶ Department of Indigenous Health, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA.
⁷ Joint Program for Social Work and Psychology, University of Michigan, Ann Arbor, MI, USA.
⁸ Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada.
⁹ Center for Indigenous Health Research and Policy, Oklahoma State University, Tulsa, OK, USA.
¹⁰ Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth, MN, USA.
¹¹ Keck School of Medicine, Children's Hospital Los Angeles, Department of Pediatrics, University of Southern California, Los Angeles, CA, USA.
¹² Cloudberry Consulting, Anchorage, AK, USA.
¹³ Laureate Institute for Brain Research, Tulsa, OK, USA.
¹⁴ University of Colorado Anschutz Medical Campus, Centers for American Indian and Alaska Native Health, Aurora, CO, USA.
¹⁵ University of Michigan School of Social Work, Ann Arbor, MI, USA.
¹⁶ Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, MO, USA.
¹⁷ School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
¹⁸ Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹⁹ Department of Obstetrics and Gynecology, Oregon Health and Sciences University, Portland, OR, USA.
²⁰ Northwest Portland Area Indian Health Board, Portland, OR, USA.
²¹ Department of Alaska Native Studies and Rural Development, University of Alaska Fairbanks, Fairbanks, AK, USA.
²² Center for Indigenous Health--Great Lakes Hub, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, USA.

^# Contributed equally.

Abstract

Background: In recent years public health research has shifted to more strengths or asset-based approaches to health research but there is little understanding of what this concept means to Indigenous researchers. Therefore our purpose was to define an Indigenous strengths-based approach to health and well-being research.

Methods: Using Group Concept Mapping, Indigenous health researchers (N = 27) participated in three-phases. Phase 1: Participants provided 218 unique responses to the focus prompt "Indigenous Strengths-Based Health and Wellness Research…" Redundancies and irrelevant statements were removed using content analysis, resulting in a final set of 94 statements. Phase 2: Participants sorted statements into groupings and named these groupings. Participants rated each statement based on importance using a 4-point scale. Hierarchical cluster analysis was used to create clusters based on how statements were grouped by participants. Phase 3: Two virtual meetings were held to share and invite researchers to collaboratively interpret results.

Results: A six-cluster map representing the meaning of Indigenous strengths-based health and wellness research was created. Results of mean rating analysis showed all six clusters were rated on average as moderately important.

Conclusions: The definition of Indigenous strengths-based health research, created through collaboration with leading AI/AN health researchers, centers Indigenous knowledges and cultures while shifting the research narrative from one of illness to one of flourishing and relationality. This framework offers actionable steps to researchers, public health practitioners, funders, and institutions to promote relational, strengths-based research that has the potential to promote Indigenous health and wellness at individual, family, community, and population levels.

Keywords: American Indian/Alaska Native; Conceptual framework; Group concept mapping; Indigenous; Public health.