1. Community-engaged research goes upstream How CBPR shaped the direction of an academic- community partnership on violence prevention in Alaska David Driscoll, Ph.D., M.P.H. NICHD Academic-Community Partnership (ACP) Conference Series: Lessons Learned Engaging Diverse Communities in Violence Prevention Research: March 17, 2015 Institute for Circumpolar Health Studies 3211 Providence Drive Anchorage, AK 99508 www.ichs.uaa.alaska.edu

2. Overview: Disparities in Violence www.ichs.uaa.alaska.edu 101/1,000The average violent victimization rate for American Indian and Alaska Native (AI/AN) people aged 12 or older. 41/1,000The average violent victimization rate for U.S. Whites aged 12 or older. 34%Percent of AI/AN women who have been raped during their lifetime. 17.7%Percent of U.S. White women who have been raped. 17%Percent of AI/AN women who have been stalked during their lifetime. 8.2%Percent of U.S. White women who have been stalked during their lifetime.

3. Overview: Context of violence in Alaska www.ichs.uaa.alaska.edu 95%Percent of crimes in rural Alaska in which alcohol is a contributing factor. 75Communities in Alaska with no law enforcement presence 42.2Average number of children per 1,000 in Alaska who have experienced child abuse (three times the national average) 36.6 million Cost of domestic violence in Alaska each year, in dollars 36 million What Alaska spends incarcerating sexual assault criminals, in dollars 18Hours, on average, between sexual assault of a Native woman somewhere in Alaska

4. Background: ICHS www.ichs.uaa.alaska.edu Determinants of health are those upstream factors that determine if an individual remains healthy or becomes ill.

5. 5 Background: Health Disparities

6. 6 Background: Proximate Determinants

7. 7 Background: Distal Determinants

8. 8 Background: Core Resources

9. Specific Study Aims www.ichs.uaa.alaska.edu 1.To enhance the relationship between the University of Alaska Anchorage (UAA) Institute for Circumpolar Health Studies (ICHS) and the Alaska Native Tribal Health System in order to reach out to the AN community in Alaska to explore joint projects related to violence and health disparities. 2. To conduct an assessment of interest in health disparities related to violence involving men, women, and children in AN communities and to identify community research priorities.

10. Specific Study Aims www.ichs.uaa.alaska.edu 3.To provide health education within the AN community on the effects of violence, violence related health disparities, and violence prevention and to educate academic researchers about AN community priorities and traditional approaches to violence prevention. 4.To develop a Memorandum of Understanding between ICHS and one or more AN tribal organizations for the purpose of carrying out a community-based participatory research (CBPR) project in the area of violence prevention.

11. Violence Research in Rural Alaska www.ichs.uaa.alaska.edu

12. The Project Team www.ichs.uaa.alaska.edu Study Partner: Council of Athabascan Tribal Governments (CATG) UAA: David L. Driscoll, PI Janet M. Johnston, Biostatistician External Consultants: Dedra Buchwald Linda Chamberlain

13. Structure of Partnership www.ichs.uaa.alaska.edu Advisory Board (CATG BoD)

14. Role of Partners: Challenges/Solutions www.ichs.uaa.alaska.edu

15. Engaging Stakeholders www.ichs.uaa.alaska.edu

16. CATG Resolution of Support www.ichs.uaa.alaska.edu CATG RESOLUTION 2014-12: Supporting the ICHS NIH Community-Partnership Project Unanimous Consent by the Board CATG Programs Community health needs assessment Trauma-informed care training (with ANTHC) Choose Respect training (with Pathways to Prevention)

17. Directions for Future Research www.ichs.uaa.alaska.edu

18. Future Study Aims www.ichs.uaa.alaska.edu 1.To continue to work with community members and identify factors associated with disparate rates of violence in rural and remote AK communities. 2.To develop and test interventions to prevent violence in rural and remote AK communities. 3.To develop and test interventions to mitigate the effects of, and promote resilience to, trauma from violence in rural and remote communities.

19. Thank You www.ichs.uaa.alaska.edu …to our study partners in the CATG communities, our consultants, and to you. Questions? David L. Driscoll, PhD, MPH University of Alaska Anchorage Institute for Circumpolar Health Studies 3211 Providence Drive, DPL 404 Anchorage, Alaska 99508 DDriscoll@uaa.alaska.edu phone - 907/786-6581 fax - 907/786-6576