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Pediatric Injury Prevention, Education and Research Program | PIPER
 
 
 

Bridging the Cultural Divide


A PREVENT Case Study from the Alaska
 


If you have ever spent time living in another country you know that speaking the language is helpful, but doesn’t by itself help you understand a different culture. There can be differences in perceptions of time, how to show respect, how to express dissent or disagreement, appropriate behavior by children, when and how to ask for help, etc. Within a country, and even within a community, cultural differences between service providers and service recipients can make it hard for providers to understand the needs and strengths that are being expressed. There can be a cultural chasm that must be bridged in order for appropriate services to be provided and effectively utilized.
 
In Alaska, the percentage of child welfare reports for Alaskan Native children is much higher than in the statewide population. Alaskan Native children are also overrepresented in foster care placements, suggesting a failure to adequately support these families. The Office of Children’s Services is working to increase support to all Alaskan families through an initiative called Strengthening Families. This initiative focuses on increasing the presence of 5 evidence based protective factors shown to reduce the occurrence of child maltreatment within a family. The Alaska Office of Children’s Services was tasked with ensuring the initiative—managed and implemented by mostly non-Native service providers—reached Native Alaskan families. They needed to ensure that Strengthening Families reached Native Alaskan children and families as much as—if not more than—non-Native families.
 
The Alaska Children’s Trust (ACT) wanted to work on addressing this over-representation of Native children in the system. After findings out about the PREVENT Institute, they put together a team represented by state leaders in children’s services, the state coordinator of Strengthening Families and a leader from the Bristol Bay Natives Association. They applied to the PREVENT Institute, proposing a series of community conversations with tribes based on a Strengthening Families model called Community Cafés—a series of conversations among parents and community members, facilitated by trained parent leaders, which aim to “increase community wisdom, build parent voice and facilitate action to improve lives for children”. The PREVENT team planned to use the Cafés to understand traditional Alaska Native cultural practices that could be built upon to strengthen families. Ultimately the team wanted to develop a list of protective factors grounded in the Alaska Native cultural context so that non-Native providers working with Bristol Bay tribes could better support families and prevent child abuse and neglect.
 
The team attended the PREVENT Institute’s first session in Chapel Hill, NC in the Fall of 2008. During this time, they realized that they couldn’t jump right in to holding their Community Cafés. There are 31 tribal communities served by the Bristol Bay Native Association, and the team couldn’t go to everyone. They recognized that they needed to back up and identify which specific communities to work in. PREVENT encouraged them to use a systematic and data driven process for making this decision; so the team developed a community assessment to identify the Native communities that would most likely represent and define strong protective factors in Native families. Once back in Alaska, they created a survey with questions relating to each protective factor and piloted the survey with staff from the Bristol Bay Native Association. The collaboration between native and non-native team members proved to be a learning experience for both parties, allowing each to better understand the opposite culture and communication styles.
 
Survey questions were presented in a Likert scale format, asking respondents to rate characteristics in their community on a scale from strongly disagree to strongly agree. This format was not effective, due to the strong value in the Native culture in Bristol Bay to avoid overt conflict; respondents were not comfortable with saying they strongly disagreed with any characterization of their community. The team ultimately resolved this issue by revising the survey to only include questions with a yes/no responses. They discovered that stating a survey questions about whether a community characteristic did or did not exist was much more culturally acceptable than gauging respondents’ level of agreement or disagreement with a proposed scenario. The final questionnaire was sent out to 31 tribal communities served by the BBNA. From the responses they received, the team was able to identify three communities that were best situated to be able to define all five protective factors. The team returned to Chapel Hill for the second in-person session of the PREVENT Institute ready to plan and implement the Community Cafés in these three tribal communities.
 
The first step for the team was to train two BBNA staff members how to facilitate Community Cafés. The ACT Fund held a training in May 2009 and successfully trained the PREVENT team member from BBNA and one of her colleagues in the community guided conversations used in Community Cafés. A series of circumstances, from illness to the climate related, then slowed the team’s progress. Still, the team maintained their vision, despite the delay in their original timeframe; six months later they were back to their plan.
 
The work to better understand protective factors among Native families in Bristol Bay will directly connect to other state efforts. The team hopes that other tribes will see the value of having the Community Cafés to better understand family and parenting strengths, and invite them in to do a similar process across all tribes in the state. Also, one of the ACT grantees has applied to the state Strengthening Families Program to expand it to six new communities: Anchorage, Juneau, Fairbanks, and three rural communities. The information garnered from the PREVENT team’s project will be directly applicable to this and any other effort to expand Strengthening Families to rural communities. There is also potential for this program to become a model for working with any number of other cultural minority communities across the country as the concept of emphasizing protective factors spreads.
 
The Alaska PREVENT’s team experience has been one of communication and relationship building. Its ultimate goal is to be able to form better bridges between Native families and non-Native service providers. Just the process of working to create a community assessment survey helped with cultural understanding among the team members themselves. The PREVENT experience has also created bridges among the service provider agencies working in the field of child maltreatment prevention across Alaska:
 
It [PREVENT] helped solidify in Alaska a team approach that’s really needed because we tend to get into our little boxes and do our work and plug along, but it really needs to be a team effort. No one organization can do prevention on its own, especially in Alaska where it’s so huge. (Team member interview January 2010)
 
Of course, the ultimate goal of all these agencies is that Alaskan families be strong and Alaskan children be safe. The efforts of the Alaska PREVENT team aim to improve the translation of efforts from state agencies so that they can cross the cultural gaps necessary to reach children in Alaska’s many different Native communities.

MAJOR ACCOMPLISHMENTS
PREVENT Institute 2008 Alaska Team
  • Developed survey and complete assessment of tribal communities in Bristol Bay area.
  • Identified three tribal communities most likely to represent the variety of ways that native families express the five protective factors known to reduce likelihood of child maltreatment.
  • Oriented staff from Bristol Bay Native Association to “Community Cafés”—a model of fostering community discussion that will be used to probe native Alaskan family strengths.
  • Laid the groundwork for training non-native service providers to identify and foster protective factors as they are expressed in native families.
In collaboration with Children's Hospital Colorado 
 
  
School of Medicine
Mailing Address: 13001 E 17th Place, Mailstop B119 | Aurora, CO 80045
Contact Information: Call 303-724-6998 or email sara.brandspigel@ucdenver.edu
 
 
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