Talking Circle Interview: Linking historical trauma to diabetes prevention with Jan Vasquez (PAAW Re
- Feb 16, 2018
- 4 min read
Jan Vasquez, MPH, CHES, PAAW Research Director
Q. Can you tell us a little bit about your professional background?
I’m currently the Clinical Research Director at Pathways to American Indian and Alaska Native Wellness (PAAW) and serve as a Research consultant for several projects at Stanford University School of Medicine. I hold a Master’s degree in Public Health, Specializing in American Indian Public Health from North Dakota State University. Prior to PAAW, I served as the Diabetes Prevention Director at a local Indian medical clinic and was the recipient of 8 National Awards for program excellence and innovation. My first work experience in the Indigenous community was as a program coordinator for Washoe Native TANF in Capitola, CA.
Q. Can you tell us about Pathways to American Indian & Alaska Native Wellness?
While Directing the Special Diabetes Program for Indians, I noticed there were gaps in the program that did not address some common issues in our community including mental health, spirituality and urban Indian identity. To address these needs, in 2010 I co-founded PAAW. PAAW is a research partnership that brings together several organizations including Stanford Prevention Research Center and members of our American Indian community in Santa Clara Valley. Our focus is on improving health through research for American Indians with an emphasis on addressing the impact of historical and inter-generational trauma.
Q. How did you and your team first make the connection between Historical Trauma and Diabetes in Native American Communities?
There were several historically traumatic events that occurred in our local community. First, San Jose was a major American Indian relocation site from the 1950’s-1970’s. Many of our community members came to San Jose with the promise of resources such as housing, healthcare, jobs etc. that never materialized. Second, many of our community members were removed from their family homes as children and placed in boarding schools. Third, due to US government policies of extermination, there are no federally recognized tribes in the San Francisco Bay Area. These are critical events in our local community history that impact the health of our community members, but have not being addressed. When we began looking into the connection between these historically traumatic events and the role they played in the health of our community, there was no real empirical evidence linking them. Because of this, PAAW decided to take on the challenge of generating evidence by conducting a 3- year Randomized Controlled Trial to better understand this relationship.
Q. Can you explain why or why not community collaboration is important for your program?
Like many American Indian communities, our community has experienced research in a very negative light and understandably, lack trust in research. Most research is started when a researcher at a University chooses a question and then goes into the community and begins conducting research ON the community. PAAW is different! Our research is guided by our American Indian Community Action Board and uses a Community Based Participatory Research model. Our board is trained in research and involved in every phase including: 1. Choosing a research question that is important to the community
2. Developing a study design that best answers the questions
3. Implementing the research study
4. Choosing how to evaluate and interpret the data
5. Sharing the results of the study
By initiating the research, our community members became decision makers in all areas of the partnership including having a voice in how grant money would be used.
Q. What results have you experienced so far?
We’ve just completed a Randomized Controlled Trial with 205 participants. In this study, we compared a standard Diabetes Prevention Program with one that was enhanced by our American Indian community. Digital storytelling, a photo project, talking circles and a cultural retreat were added to the enhanced program to address historical trauma. We’re now analyzing the data and will soon be publishing our results. Two of our board members serve as co-authors on each published paper.
Important lessons learned include strategies to develop a skilled, empowered community board who are able to work together to improve the health of the community. Our board members serve not only as decision makers, but they are also trained and hired to do the research at every phase.
Q. What are the next steps for the program?
Our next goal is to document and share our strategies with other American Indian communities who would like to start their own research and may not know how to go about it.
Q. As someone who has worked in Tribal TANF what advice can you give those looking to incorporate Historical Trauma and or Diabetes education and prevention into their programs?
Genocide has been waged against American Indians for more than 500 years and continues on in many forms. Unfortunately, historical trauma is not always an accepted concept. However, just because people don’t talk about historical trauma or understand it, doesn’t mean it doesn’t exist or that it’s not at the root of many American Indian health issues.
My advice is: Be patient, calm, quiet, non-judgmental and listen to your clients! Each person experiences and reacts to trauma in their own way. It’s important to remember that every single person has a story, including providers. So be kind to others and be kind to yourself! There’s more there than meets the eye!!
For more information on PAAW visit:
https://www.facebook.com/PAAW4healing/
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