The Co-Existence of Traditional and Western Medicine Ways of Healing
Native tribes embrace a worldview that encompasses the notions of connectedness (with the past and with others), strong family bonds,...
What is Evidence-Based Research?
Evidence-based research (EBR) is the use of prior research in a systematic and transparent (open) way to generate new knowledge or to validate existing knowledge based on a theory which is important in a valid, efficient and accessible manner. EBR is based on sound knowledge, not opinion when making vital decisions in health care. For research results to be considered reliable and valid, researchers must use the scientific method in orderly, sequential steps. An example of the anatomy of a research article is shown in Figure 1.
The two main study methods in research are quantitative (numeric) and qualitative (verbal), although mixed methods using both are increasing:
Quantitative studies tend to explore relationships among a set of variables related to the phenomenon, whereas,
Qualitative studies seek to understand the deeper meaning of those involved for example, studies that explore life experiences to give them meaning.
An important step in the research process is the publication of study results with a description of how the results contribute to the body of knowledge and clinical practice. However, research programs have been mostly developed and evaluated for the general population with very limited Native community engagement. Thus, translating and applying the results of studies are truly unproven in Native communities and are often viewed with distrust by Tribal community members. Overall, Native communities have expressed a preference to evidence-based research and practice that have been developed with or adapted specifically for their communities through Community-based Participatory models. However, practices and programs developed and used by Native communities may not necessarily meet the definition of “evidence-based” according to the principles of Western medicine. There is a need to discuss the concepts of evidence-informed culture-based interventions and Tribal best practices such as respecting and accommodating culture-based knowledge and ways of knowing and practice in these communities, while also including the uptake of Western science-based knowledge. Moving forward, it has been suggested to create a Native -specific inventory of EBPs, as well as partnerships with funding agencies to develop population-specific EBPs (Warne & Nadeau, 2017).
The National Council on Aging released a report earlier this year, titled, “Evidence-Based Health Promotion Programs Among American Indian, Alaska Native, and Native Hawaiian Communities: A Call to Action to Improve Cultural Relevance and Accessibility,” (See pdf). Recommendations were provided on applying cultural adaptations when engaging the participation of the Tribal members in research; which can also be applicable to the participation of Native women, shown as follows:
Program Adaptations Identified in the Literature for American Indian Participants:
Use talking circles for participant engagement
Create educational materials in Indigenous languages
Train Indigenous program leaders
Incorporate cultural traditions into the research setting
Begin and end class with a blessing
Pass trading sticks to designate speakers in a group (specific to Navajo participants)
Have flexibility to start class late to accommodate participant emergencies.
Program Adaptations Identified in the Literature for Native Hawaiian and other Pacific Islander
Create linguistically relevant material and session titles
Use images of Native Hawaiian characters on educational materials
Disseminate educational materials in a lauhala (a plant fiber) bag
Use pule (prayer) at the start of all sessions
Utilize kūkākūkā (talk story) during discussion to exchange information
Incorporate ethnic music in class
Share meaʻai (food) as an entity to fuel the spirit among participants
Feel free to browse the following documents that will also help to provide some insight from other Native researchers.