WEAVE-NW

Wellness for Every American Indian to Achieve and View Health Equity A Good Health & Wellness In Indian Country (GHWIC) funded program

Working hard to help Tribal communities To decrease cardiovascular disease and stroke, commercial tobacco use, obesity, and type 2 diabetes•Employing policy, systems and environment (PSE) approaches•Assuring culturally relevant and appropriate prevention activities[/vc_column_text]

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Meet The Team

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Tam Dixon Lutz

Tam Lutz, MPH, MHA,CPST,Project Director:Tam Lutz is a Lummi Tribal member with ancestral ties to the Quinault, Nooksack, Skagit, Chinook, Cowlitz,Snoqualmie, Suquamish and Duwamish Tribes. She has spentover25years working in public health in Indian Country, including over20years at the NPAIHBin maternal child health, chronic disease and motor vehicle injury focused projects, studies and surveillance.Lutz serves as the NW Tribal EpiCenter’s Project Director forWEAVE-NW, funded through the CDC’s Good Health and Wellness in Indian Country (GHWIC)initiativeand Native Boost:Addressing Barriers to Childhood Immunization through Communication and Education”, a CDC funded Tribal public health capacity project.Additionally, Ms. Lutz iscurrently the Co-Principal Investigator for twoof NW Tribal EpiCenter’sNIH funded studies including “NW Tribal Collaboration to Improve the Use Motor Vehicle Data,” grant, and “Investigating Maternal Opioid Use, Neonatal Abstinence Syndrome and Responsein NW Communities.”Lutz is an experienced field researcher, a developingepidemiologist, with broad experience in maternal child health at the NPAIHB and at home at her Tribe. She has directed other projects at the NPAIHB including the very successful Native CARS Study, Toddler Obesity and Tooth Decay Prevention Studyand the Indian Community Health Profile Project. AsaProject Director, Ms. Lutzhasparticipated in all aspects of theprojectand managedthe project on a day-to-day basis. She has beenresponsible for communicating with tribes, supervising and mentoring staff, provide broad expertise to the subject area approaches of the projects, developing collaborations, and communicating and reporting to funder. Tam, her husband Ed, and their twochildrenand threedogslive in Beaverton, Oregon,where she enjoys cheering from the sidelineas shewatchesher children participate in sports, participating in the annual Tribal canoe journeys, and spending time with family.

Nora Frank Buckner

“Nora Frank-Buckner is a Nez Perce Tribal Member and a Klamath Tribal Descendant. She began working for NPAIHB in January 2015 and is the Food Sovereignty Project Manager. Nora graduated from Oregon State University with a Bachelor of Science degree in Public Health focused in Health Promotion and Health Behavior. In addition, she holds a Masters of Public Health degree focused on Health Management and Policy from PortlandState University. Nora is passionate aboutfood sovereignty/systems,health promotion, nutrition education, youth leadership development, youth engagement, and multi-sector collaboration for public health prevention activities. She is currently coordinating the efforts of the NW Tribal Food Sovereignty Coalitionand is the Chair of the Oregon Community Food Systems Network.”

Jenine Dankovchik

Jenine Dankovchik, BSc. –Program Evaluation Specialist.Ms. Dankovchik has 16 years of experience in Indigenous public health evaluation and research. She has worked for the NWTEC for over 13 years as a biostatistician and program evaluation specialist. Whileat NWTEC, she has served as the research assistant and biostatistician on a multi-site cancer research study, conducted record linkages to improve race data quality in epidemiologic surveillance data systems, and designed and implemented program evaluationsfor a range of chronic disease prevention efforts. As the Program Evaluation Specialist, Ms. Dankovchik provides training and technical assistance to NW tribes to build their capacity in practical evaluation that reflects each tribe’s unique culture and allows the community to assess and improve chronic disease prevention efforts.Ms. Dankovchik was born in Canada but now lives in Southwest Portland with her husband, daughter and son.

Chelsea Jensen

Chelsea Jensen–WEAVE-NW Project Assistant:Mrs. Jensen is a tribal member of the Confederated Tribes of Warm Springs. She joined the NPAIHB in October 2018 for the WEAVE-NW team.As a Project Assistant Mrs. Jensen communicateswith NW Tribes regarding funding opportunities, contract support, conferences, website and technical support. Chelsea and her husband live in Oregon City with their daughter, son and dog. As a family they love to go to the beach, camping, hiking, dirt bike ridingbut most of all enjoy family gatherings.

Chandra Wilson

A Klamath, Modoc tribal citizen, health professional and social worker with a clear personal and professional goal to do work that will improve the health status of Native American people, especially members of my own tribal community. My interests and work are committed to developing programs and policies that will support my community and address the persistent health disparities that my community experiences. A current graduate student in the School of Social work at Portland State University, I am determined to become a qualified Indigenous social worker who will lead programs and shape policies that best meet the needs of my people and future generations. I am passionate about social justice, Indigenous rights, and committed to educating others on the commitment to understand and address health inequities experienced by disadvantaged populations of color, especially Native American peoples. When I am not working or in school, I love to spend time with my two young-adult daughters who inspire me to live each moment of my life more mindfully. I live each day by faith, enjoy journaling, dancing, gardening and taking long walks.

Candice Jimenez

Candice Jimenez, MPH –Research Manager –Ms. Jimenez is a citizen of the Confederated Tribes of Warm Springsand joined the NPAIHB beginning with the Native CARS (Native Children Always Ride Safe) study. Ms. Jimenez earned her Bachelor’s degree in Biology from Concordia University and a Master’s ofPublic Health from Oregon Health & Science University (OHSU). Asa Research Managerfor the NPAIHB, Ms. Jimenezsupportstribes in community-led projects, including improving child passenger safety, pre-teen oral health, utilizing motor vehicle injury data to inform tribal road safetyand maternal childhealth. Ms. Jimenez serves as a key person in communicating with Tribal partnersandhelps lead coding and presentation of qualitative data includingfacilitating the development of Tribal-led media materials, which include radio and television public service announcements and social media related to maternal child health.Ms. Jimenez valuesa framework grounded in health equity with a focus on the social determinants of health; a place where collaboration takes place across geography, language and culture –moving from acknowledgement into collective action.Candice and her husband live in Portland, ORwith their familywhere they enjoy the vibrantfood culture and love for nature.

WEAVE-NW History

WEAVE-NW is a program of the Northwest Tribal Epidemiology Center, funded through the CDC’s Good Health and Wellness in Indian Country (GHWIC) initiative. The overall objective is to strengthen and broaden the reach and impact of chronic disease prevention programs that improve the health of Northwest tribal members and communities. WEAVE-NW was originally funded in 2014 for 5 years, and was awarded a second cycle of funding in 2019. In our second cycle of funding, WEAVE-NW hopes to achieve the following outcomes

  • Increased availability and consumption of healthy and traditional foods
  • Increased breastfeedingReduced prevalence of commercial tobacco use
  • Reduced incidence of type 2 diabetes
  • Reduced prevalence of high blood pressure and high blood

cholesterol Since 2014, WEAVE-NW has built capacity and created lasting change through training, technical assistance and collaborative support to aid Northwest tribes in creating policy, systems and environment changes that encourage healthy lifestyles.

Training

Over the past six years, WEAVE-NW has conducted and organized 83different trainings, workshops and webinars to help build capacity in chronic disease prevention, reaching 2,182 participants and 41 of our 43-member tribes. We have brought expert tribal trainers in to build capacity in a wide range of skills.

ONAC-Training1

Techincal Assistance (TA)

Northwest tribes have called upon WEAVE-NW to provide technical assistance 341 times during the first cycle of funding, and we reached 39 of our 43 member tribes through technical assistance. Survey design and implementation, evaluation, and policy development were the most commonly requested technical assistance topics.

Sub-Awards

WEAVE-NW was able to provide direct funding in the form of sub-awards to 22 of our member tribes during the first grant cycle. These amazing projects used a variety of culturally tailored approaches to bring community-level change that supported chronic disease prevention. Examples include starting community gardens, revitalizing traditional foods, using traditional tobacco teachings to prevent commercial tobacco use, implementing health systems change to reach community members at risk for diabetes and heart disease, and working with youth to replace sugary drinks with water at tribal schools.

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Multi-Sector Partnerships

Northwest Tribes Gather To Celebrate Food Sovereignty

At A Glance

The Northwest Tribal Food Sovereignty Coalition 2019 Annual Gathering was an opportunity for tribes from around the region to come together and share knowledge. support each other in their efforts to improve food systems, reclaim tribal food ways, and strengthen relationships. The majority of participants rated the event “excellent” and said they would “definitely use” the knowledge they gained. Comments included:

      • “Collaborative, intentional, and uplifting “
      • “An annual reunion”
      • “So many ideas and opportunities…I always leave wanting more”
      • “Hearing from other natives was powerful and enlightening”

Find Out More

For more information about the NTFSC, please visit our website at http://www.npaihb.org/ntfs-coalition/

To view a video about the 2019 NTFSC Gathering, visit https://tinyurl.com/y5xcxj7q

What did you like best about the gathering?

“Being together with like-minded native people all focusing on food sovereignty, the information presented, the discussions that happened both formally and informally. I’ve been home two days and have already passed on many of the teachings to our youth”

Public Health Challenge

American Indians and Alaska Natives are at higher risk than the general population for many health problems, and experience higher rates of death from many causes. Much of this disparity can be attributed to higher prevalence of chronic diseases including diabetes, cardiovascular disease, stroke, and obesity. While there are many contributing factors, lack of access to healthy foods plays a critical role in creating these disparities.For many Northwest Tribes, historical displacement has resulted in changes in dietary practices and loss of cultural and social traditionsaround stewardship of the land, harvest, and preparation of foods. These changes have been linked to chronic disease; in addition, the cultural impact of the loss of traditional food systemsand decreased food sovereignty has had wide ranging consequences forthe overall wellbeing of tribal communities.

Contact

Tam Lutz, Project Director

Nora Frank-Buckner, NTFSC Coordinator

Northwest Tribal Epidemiology Center

2121 SW Broadway

Suite 300

Portland, OR

Phone: 503-228-4185

Approach

In 2017, several Northwest tribal communities put out the call to create a coalition of tribes working towards food sovereignty.They recognized the tremendous potential fortribes to empower each other throughknowledge sharing, fostering ideas, pursuing joint projects, and finding innovative solutions to common challenges. In response, WEAVE-NW, a Good Health & Wellness in Indian Country program based at the Northwest Tribal Epidemiology Center,helped to create the Northwest Tribal Food Sovereignty Coalition (NTFSC).The coalition has a mission to reclaim indigenousknowledge of plants, land, and natural environments to maintain and improve health and quality of life for today and future generations.A primary goal of the NTFSC was to hold a gathering where members could learn from one another, build hands-on skills, and discuss their collective vision for the future of tribal food sovereignty in the Northwest.

Results

In June 2019, members of the NTFSC gathered on the traditional homelands of the Skokomish Indian Tribe north of Olympia, Washington.In all, 110 participants representing 24 Northwest tribes, 17 tribes from outside the Northwest, and 7 tribaland non-tribal organizations attended the event. The Skokomish Indian Tribe graciously hosted the gathering and community members prepared healthy, traditional meals from ingredients that were harvested, gathered, and grown locally. Skokomish community members also shared stories about their own journey to restore food sovereignty though community gardens, medicinal gardens, and restoration of lands which had historically been the habitat of native plants and animals.Participants learned from experts and each other about breastfeeding, policy development, conducting food sovereignty assessments, indigenous knowledge-informed care, and identification/use of traditional plants for food and medicine. Highlights from the evaluation results include:

  • 72% rated the event “excellent”
  • 63% said they would “definitely use” the information received
  • Participants prefer an equal mix of hands on skills and didactic or panel sessions
  • For many, hearing from other tribal communities about their challenges and successeswas the most valuable part of the experience

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What’s Next

The NTFSC’s leadership team is reconvening this fall to discuss another year of exciting activity including a 2020 gathering, further development of the strategic plan,and dissemination of media produced over the last year.Coalition members are also working with other regional efforts such as the those of the Affiliated Tribes of Northwest Indians to increase the visibility of the tribal food sovereigntymovement outside of public health and work towards common policy goals regionally and nationally.

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Good Health and Wellness in Indian Country

The WEAVE NW Program is funded by the Center of Disease Control and Prevention’s (CDC) Good Health and Wellness in Indian Country (GHWIC) Program. GHWIC is in its second 5-year cycle of funding from CDC. GHWIC’s current 5-year $98 million funded program is CDC’s largest investment to improve health among American Indians and Alaska Natives. This program aims to do the following:

  • Support a coordinated, holistic approach to healthy living and chronic disease prevention.
  • Reinforce the work already underway in Indian Country to make healthy choices and lifeways easier for American Indians and Alaska Natives.
  • Build off the previous GHWIC cycle to emphasize strategies in Native communities, reduce obesity, prevent type 2 diabetes, reduce commercial tobacco use, and other risk factors for heart disease and stroke.

GHWIC (2019-2024) funds 27 awards across three components:

  • Component 1recipients are tribes and Urban Indian Organizations (UIO) who implement strategies to prevent obesity, prevent and control commercial tobacco use and exposure to secondhand smoke, and prevent type 2 diabetes and heart disease and stroke.
  • Component 2recipients are tribal organizations who allocate at least half of their award to Area tribes and UIOs to implement Component 1 strategies, expanding the reach of GHWIC funds and technical assistance to many more tribes and UIOs.
  • Component 3recipient is a tribal organization that will establish the GHWIC Coordinating Center to support evaluation, peer learning, and communication strategies.(The NPAIHB’s WEAVE-NW Project is funded under Component 2.)GWHIC awardees implement evidence-based strategies adapted to fitthe needs of their community with long term goals to:
  • Increase availability of healthy foods
  • Increase physical activity
  • Increase breastfeeding
  • Reduce prevalence of commercial tobacco use
  • Reduce incidence of type 2 diabetes
  • Reduce prevalence of high blood pressure
  • Reduce prevalence of high blood cholesterol

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Commercial Tobacco Prevention/Control

Commercial Tobacco Cessation and Prevention:

The tobacco prevention and control project focus on policy development, tobacco cessation and prevention by using culture as a prevention and education. Building and strengthening tribal capacity, developing culturally responsive/appropriate strategies and program opportunities, and providing education about the effective tobacco control measure. Are area of health promotion that is funded out of the Good health and Wellness in Indian Country (GHWIC) program. The GHWIC program is funded by CDC’s investment to improve tribal health. CDC reports that American Indian/Alaska Natives have the highest prevalence of cigarette smoking compared to all other racial/ethnic groups in the United States commercial smoking rates remain higher than 50% while recent studies share that the overall smoking rates have dropped to 14%. Traditional tobacco has a cultural and spiritual importance to tribal people and in the Northwest region (Idaho, Oregon, and Washington) it has been used in our tribal communities or traditional ceremonies or for medicinal purposes. The use of traditional tobacco various from tribe to tribe. The Northwest Portland Area Indian Health Board supports this work by providing trainings, technical assistance, and meeting facilitation to the NW tribes.

Learn More!!

Training, Technical Assistance and Meeting Examples

  • Tobacco 101
  • Traditional Tobacco
  • Tobacco Cessation Training
  • Tobacco policy implementation
  • E-cigarettes, vaping
  • Quit kits Technical Assistance
  • Policy Development
  • Program Planning
  • Clinical Program Evaluation and Assessments
  • Media/ Messaging/ Campaign Meetings
  • Grantee
  • Tribal Site Visits

“We do not inherit the earth from our ancestors, we borrow it from our children”

Mission statement (edit as needed to reflect board version for NW Tribes): Redefine unity to promote, educate, support and respect the diverse American Indian/Alaska Native (AI/AN) communities present across the Northwest–reclaiming breastfeeding and first foods.

Content areas:

  • Overall Breastfeeding Support (Peer Counseling Training + Lactation education)
  • Prenatal Preparation + Postpartum support (resources including breastfeeding supplies)
  • Peer Support-Full-Circle Doula services; return to tribal midwifery practices+ add’l training opps
  • Traditional ways of knowing-Placenta encapsulation and tribal supplementationMonthly cooking class w/ credits for WIC participantsled by tribal community
  • Periodic Coalition calls (allows building community resources –development of toolkit)
  • Research and Data sovereignty resources for tribal communities
  • Media resources (posters etc.) – media education and outreach

Needs:

  • Part-time position at the health board to assist and sustain this progress
  • Larger NW Tribal Breastfeeding and Maternal Health Conference
  • Consistent researching of information and updating current resources
  • Learn how community and health providers access and share resources
  • Consideration of data literacy in dissemination of resources on website
  • Consider impact of how this data can

– Changing food allowances for WIC recipients

                   – of Better quality data in general that amplifies community voice

  • Supporting Ryan (WA/OR/ID survey with Tribal WICoffices)oFNDI providing $1,000 forgift cardsto complete approx. 50 surveysoIs WIC meeting your needs for breastfeeding?oDoes it feel culturally appropriate/responsive?
  • Fact: We can’t talk about breastfeeding w/o talking about the MCH,birthing practicesetc.
  • The need for ‘Baby-friendly’hospitals considering social determinants of health

-Conversation around racism and culturally responsive staff/providers

-Development of MOUs and staff cultural responsiveness training

  • i.e. Yakamaor Madras where mothers leave tribal clinics to off-reservation care

Resources in general:

  • Founder > Roberta Eaglehorse-Ortiz
  • Dropbox> Breastfeeding articles and assessment tools
  • Box > Breastfeeding proofs
  • Server > Breastfeeding coalition
  • Server > WEAVE 2.0 > Media > Breastfeeding posters Website Notes from Meeting with Jeff Fitzpatrick:
  • Reach out to Jefferson on circle images for WEAVE-NW website
  • Bank of images for scrolling screen
  • Top copy wording
  • Names of the tabs
  • Content for each tabs (copy, video, images)
  • Social media links for the breastfeeding coalition Meeting notes from June 23rdCoalition Building Gathering (Nora, Rosa, Candice):
  • Melino: New to the board and starting the program from the beginning
  • Lael: THRIVE, native youth and health, planning conference in July, develop mental health media campaign in partnership with WRN delegates and tribal youth delegates (July sessions for 2-3 hour sessions), working with group on facilitation (Boston facilitation lab) –how to keep youth engaged, hosting and supporting THRIVE conference, art session with SPJ
  • Tanya: work with DHAT, Behavior Health Aides and Community Health Aides initiatives along with advisory groups (met monthly then to quarterly). Piggyback advisory group times with QBMs via zoom. Attending National webinars and keeping notes from those. Virtual Elder’s Gathering.
  • Think about roles of community members as well–coalition vs network.
  • By-laws: imagery and language instead of western model.
  • Think about gatherings where not everyone on Zoom but also via phone to zoom call

Tribal Policy Guide

This guide was developed through a collaboration between the Northwest Portland Area Indian Health Board (NPIHB) and the National Indian Child Welfare Association (NICWA) to support community-driven and culturally-informed policy development within a tribal context. Its intention is to support tribal leaders, employees, youth, and other tribal community members in utilizing NICWA’s Relational Worldview model and apply it through the policy development phases. The content applies tribal knowledge, practice, culture, and sovereignty.What you’ll find inside:

  • Conceptual framework
  • Policy development phases
  • Policy guide checklist
  • Sample policies
  • Tools and resources

NPAIHB Policy Guide link

NW Tribal Food Sovereignty Coalition

For decades, tribes in the Northwest region (Idaho, Oregon, and Washington) have implemented food sovereignty and traditional food projects to reclaim their food systems and to improve the health of their communities. The Northwest Portland Area Indian Health Board supports this work by providing trainings, technical assistance, and meeting facilitation to the NW tribes.

Some tribal community members have defined food sovereignty as “…the most important work we can be doing in these times. Being able to feel independent, healthy, and intimately connected to what nourishes us and gives us life. It involves respect for old ways, and adapting to, caring for, and protecting what is available today”. At the 2019 NW Tribal Food Sovereignty Coalition Gathering, we asked some of Food Sovereignty Leaders in the Northwest the importance of food sovereignty to them and their communities. This is what they had to say

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