Investigating the Health and Wellbeing of Alaska Native Elderly in Northwest Alaska through Community Participatory Based Research Methods

阿拉斯加原住民社区对老年居民有着强烈的尊重感。 在许多阿拉斯加农村社区，其主要人口是阿拉斯加原住民，老年人仍然依赖于他们对自然环境，遗产语言和文化习俗的深入了解和理解，这不仅对经济生存而且对社会凝聚力和社区福祉都很重要。 然而，变化正在深刻地影响阿拉斯加原住民社区，阿拉斯加原住民被迫适应影响他们世界的新的环境、经济和社会现实。 本研究项目将探讨阿拉斯加原住民老年人如何通过探索阿拉斯加原住民老年人和他们自己对成功老龄化的理解和定义来适应快速的经济，环境和社会变化。 目前的研究项目将建立一个更好的理解从阿拉斯加州西北部的阿拉斯加土著老年人的角度成功老龄化。作为主要研究者关于这一主题的第二个研究项目，该项目有可能为未来的土著成功老龄化研究提供信息，这些研究允许老年人自己主观地为自己定义什么是好的年龄。 本着以社区为基础的参与性研究的精神，阿拉斯加西北部的几个社区向首席研究员乔丹·P·刘易斯博士（阿留申，纳克内克的原住民村庄）提出了要求，要求在他们的地区进行类似的研究。 他们这样做是在了解了他的“成功老龄化研究”之后，该研究于2011年至2014年在阿拉斯加的布里斯托湾进行，并使人们意识到与老年人进行积极或有成效的重点研究的价值，突出了他们对健康老龄化的经验教训和知识。这项研究将包括对阿拉斯加原住民老年人的60次定性深入访谈，以建立对阿拉斯加西北部阿拉斯加原住民成功老龄化意味着什么以及需要什么样的年龄的土著理解。 将在五个参与社区的家中与阿拉斯加土著老年人及其家庭成员进行访谈，以及那些搬迁到阿拉斯加诺姆Quyanna护理设施的人。通过这些访谈，研究小组将探索成功老龄化的概念，并希望获得阿拉斯加土著人对老龄化的信念，需要什么年龄的地方？以及搬迁到老年设施如何影响成功老龄化的观点？ 在以社区为基础的前瞻性研究（CBPR）的精神，参与者将参与整个研究过程，从概念到数据分析。将在参与社区举行会议，审查调查结果并听取反馈意见;这将确保调查结果反映长老、家庭、社区和区域的独特观点。这些发现也将与以前在布里斯托湾进行的关于成功老龄化的研究进行比较，以比较和对比阿拉斯加这两个农村地区的老龄化经验。这项研究还将探讨在适当的地方养老所需的条件，以减少或消除老年人搬迁的需要-同时考虑社区的语言、文化和历史。 PI先前的研究表明，使老年阿拉斯加原住民留在家中和社区有助于社区的健康和福祉。这项研究将进一步揭示阿拉斯加农村地区良好的衰老意味着什么，并确定他们的社区在阿拉斯加原住民主观定义衰老过程中发挥着什么作用。 这项拟议的研究的重要性通过建立一个当地和文化上知情的阿拉斯加原住民，理解建立在PI以前的项目上的成功老龄化来推进发现。除了为成功老龄化的学术文献做出贡献外，它还促进了阿拉斯加农村老年人健康老龄化的教学和学习。 它还教育研究人员关于CBPR的重要性，并允许老年人主观地定义他们的衰老过程，以及在整个研究过程中参与当地社区，这促进了知识的共同生产和双向学习。这一研究项目扩大了代表性不足的群体（阿拉斯加土著人）的参与，并使他们在解释结果和介绍结果方面与科学家处于平等地位。 这项研究也有可能有助于人类学，老年学，社区心理学，社会学等学科，为未来对土著老龄化感兴趣的研究人员铺平道路。 研究结果可能会影响阿拉斯加的健康和社会政策，以及如何向农村社区的老年居民提供医疗保健和长期支持服务。这项研究的结果将被公布，并传播给其他研究人员，老年学家，人类学家和学生使用的部落管理当局，阿拉斯加土著参与者和他们的社区的许可。这项研究还将强调，老龄化不一定等于健康状况不佳和行动不便;老龄化应该是每个人都可以实现的权利。 这项研究有可能告知卫生专业人员，政策倡导者，地方和州官员关于决定阿拉斯加农村社区是否能够满足老年人需求的因素，并使他们能够按照自己的意愿生活。

Alaska Native communities have a strong sense of respect for their older residents. In many Alaskan rural communities, whose primary population is Alaska Native people, the elderly are still relied upon for their deep knowledge and understanding of the natural environment, heritage languages, and cultural practices which are important not only for economic survival but social cohesion and community wellbeing. However, change is deeply affecting Alaska Native communities and Alaska Native people are forced to adapt to the new environmental, economic and social realities that affect their worlds. This research project will explore how Alaska Native elderly are adapting to rapid economic, environmental, and social change by exploring Alaska Native elderly and their own understanding and definition of what successful aging means to them. The current research project will establish a better understanding of successful aging from the perspectives of Alaska Native elderly in Northwest Alaska. Being the Principal Investigators second research project on this topic, this project has the potential to inform future studies of indigenous successful aging, studies that allow the elderly themselves to subjectively define for themselves what it means to age well. In the spirit of community-based participatory research, several communities in Northwest Alaska reached out to the principal investigator, Dr. Jordan P. Lewis (Aleut, Native Village of Naknek), to request that similar research be conducted in their region. They did so after learning of his "Successful Aging Study," which was carried out in Bristol Bay Alaska from 2011-2014 and brought awareness of the value of positive, or generative, focused research with the elderly, highlighting their lessons and knowledge for healthy aging. This research study will consist of 60 qualitative in-depth interviews with Alaska Native elderly to establish an indigenous understanding of what successful aging means for Alaska Natives in Northwest Alaska and what is required to age in place. Interviews will be conducted with Alaska Native elderly and their family members in their own homes in five participating communities, as well as those who have relocated to the Quyanna Care facility in Nome, Alaska. Through these interviews the research team will to explore the concept of successful aging and hope to gain a sense of Alaska Native beliefs about aging, what is required to age in place? and how relocation to facilities for the elderly impacts views of successful aging? In the spirit of Community-Based Participatory Research (CBPR), participants will be engaged through the entire research process, from conception to data analysis. Meetings will be held in participating communities to review the findings and receive feedback; this will ensure the findings reflect the unique perspectives of the Elders, families, communities, and region. These findings will also be compared with the previous study on successful aging conducted in Bristol Bay to compare and contrast experiences of aging in these two rural regions of Alaska. This study will also explore what is required to age in place to reduce or eliminate the need for the elderly to relocate - taking with them the language, culture, and history of the community. Previous research by the PI has shown that enabling older Alaskan Native people to remain in their homes and communities contributes to the health and wellbeing of the communities. The research will shed additional light on what it means to age well in rural Alaska and determine what role their community plays in how Alaska Native people subjectively define their aging process. The significance of this proposed research advances discovery through the establishment of a locally and culturally informed, Alaska Native, understanding of successful aging that builds on the PI's previous projects. In addition to contributing to the academic literature on successful aging, it promotes teaching and learning from the Elders on healthy aging in rural Alaska. It also educates researchers on the importance of CBPR and allowing the elderly to subjectively define their aging process, as well as engaging the local community throughout the entire research process, which promotes the coproduction of knowledge and bi-directional learning. This research project broadens the participation of underrepresented groups (Alaska Natives) and puts them on equal footing with the scientists in interpreting results and in presenting the results. This research also has the potential to contribute to the disciplines of anthropology, gerontology, community psychology, sociology, and others by paving the way for future researchers interested in indigenous aging. The research findings can influence health and social policy in Alaska and how healthcare and long-term support services are delivered to older residents in rural communities. The results of this research will be published and be disseminated for other researchers, gerontologists, anthropologists, and students to use with the permission of the tribal governing authorities, the Alaska Native participants and their communities. This study will also highlight that aging does not have to equal poor health and immobility; aging well should be a right that can be attained by everyone. This research has the potential to inform health professionals, policy advocates, local and state officials about the factors that determine whether or not rural Alaska communities are able to meet the needs of their elderly and enable them to live their remaining years as they may wish.