Gathering, Learning & Initiating: Setting the Stage for Community-engagement in Women's Health in SW Alaska

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Summary: As in the US, Alaska’s increased maternal mortality (63% between 2014-2018) has been associated with substance use disorders (SUD) at disproportionately higher levels in rural southwest Alaska communities. To address the underlying connections between women with SUD and maternal health services, research and preventative care intervention designs must be tailored to the local community. Development of locally appropriate research and intervention strategies requires engaging the local communities and health care agencies as local stakeholders—particularly with sensitive and unexplored issues of intersectional populations. Aim 1 of this project proposes to lay the groundwork for a maternal health study in southwest Alaska by engaging interested local women and health agencies to prepare for future research in these communities through the creation of a Women’s and Maternal Health Community Advisory Board (WMH CAB), using an adapted NIH-based CAB toolkit (Kubicek & Robles, 2016) as a guide. This toolkit, part of a Resource for Integrating Community Voices into Research Study package, compiled by the NIH-based Southern California Clinical & Translational Science Institute, provides an overview of how to develop and maintain a community advisory board (CAB) for research studies to integrate community perspectives. While there is emphasis on the importance of considering ways to make the CAB a supportive environment to ensure equal participation— the strategies listed for ‘identifying members, integrating them into the research process, maintaining engagement over time, and meeting facilitation’ did not necessarily take into account the remoteness or difficulty of travel in rural Alaska, the importance of observing subsistence or commercial fishing seasons, or the layers of different tribal and regional agencies to be navigated. The use of these strategies, then, are appropriately adjusted to improve the chances of community interest and involvement; and five smaller local-based CABs proposed, instead of one larger one. Project uses already-existing ties with the regional AHEC (Area Health Education Centers) offices in the area for making the introductions and recommendations of WMH CAB members for each respective communities; and focus group or talking circle meetings will take place to engage in addressing how best to approach research on the Women’s and Maternal health issues in their community. Aim 2 of this project is focused on the development and executions of workshops to train a pool of local undergraduates for placement as local interviewers when the resulting designed research begins with subsequent grant funding. Local-based AHEC graduate student(s) are included in this phase to help facilitate the community meetings; research and intervention design; and to conduct workshop activities for the local attendees to become interviewers for the future studies. CABs from five (5) southwest Alaska communities, in the service areas of AHEC regional offices, will be tasked with providing input on research and intervention designs and workshop components.