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

阿拉斯加土著社区对他们的老居民有着强烈的尊重感。在许多以阿拉斯加原住民为主要人口的阿拉斯加农村社区，老年人仍然依靠他们对自然环境、传统语言和文化习俗的深刻认识和理解，这些不仅对经济生存很重要，而且对社会凝聚力和社区福祉也很重要。然而，变化正在深刻地影响着阿拉斯加土著社区，阿拉斯加土著人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适应快速的经济、环境和社会变化，通过探索阿拉斯加原住民老年人以及他们自己对成功老龄化意味着什么的理解和定义。本研究将从阿拉斯加西北地区原住民老人的角度，建立对成功老龄化的更好理解。作为首席调查员在这个主题上的第二个研究项目，这个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定义自己的年龄意味着什么。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联系了首席研究员乔丹·p·刘易斯博士（阿留申人，纳克内克土著村庄），要求在他们的地区进行类似的研究。2011年至2014年，他在阿拉斯加布里斯托尔湾（Bristol Bay）进行了一项名为“成功老龄化研究”（Successful Aging Study）的研究，该研究让人们意识到积极的、或生成的、专注于老年人的研究的价值，突出了他们在健康老龄化方面的经验和知识。本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的土著理解，以及老龄化需要什么。访谈将在五个参与社区的阿拉斯加原住民老年人及其家庭成员的家中进行，以及那些已经搬迁到阿拉斯加诺姆Quyanna护理机构的人。通过这些访谈，研究团队将探索成功衰老的概念，并希望获得阿拉斯加本地人关于衰老的信念，衰老需要什么？迁往安老设施会如何影响人们对成功安老的看法？本着以社区为基础的参与性研究（CBPR）精神，参与者将参与从概念到数据分析的整个研究过程。将在参与社区举行会议，审查调查结果并收到反馈；这将确保调查结果反映老年人、家庭、社区和地区的独特观点。这些发现还将与之前在布里斯托尔湾进行的成功老龄化研究进行比较，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，在考虑到社区的语言、文化和历史的情况下，需要采取哪些措施来减少或消除老年人搬迁的需要。私家侦探先前的研究表明，使阿拉斯加土著老年人能够留在他们的家庭和社区有助于社区的健康和福祉。这项研究将进一步阐明阿拉斯加农村的老龄化意味着什么，并确定他们的社区在阿拉斯加原住民如何主观地定义他们的老龄化过程中所起的作用。这项研究的意义在于，通过建立一个当地的、有文化背景的、阿拉斯加原住民的、对建立在PI以前的项目上的成功老化的理解，促进了发现。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关于健康老龄化的教学和学习。它还教育研究人员CBPR的重要性，让老年人主观地定义他们的衰老过程，并让当地社区参与整个研究过程，促进知识的共同生产和双向学习。这个研究项目扩大了代表性不足的群体（阿拉斯加原住民）的参与，并使他们在解释结果和展示结果方面与科学家处于平等地位。这项研究也有可能对人类学、老年学、社区心理学、社会学和其他学科做出贡献，为未来对土著老龄化感兴趣的研究者铺平道路。研究结果可以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。这项研究的结果将发表并传播给其他研究人员、老年学家、人类学家和学生，在征得部落管理当局、阿拉斯加土著参与者及其社区的许可后使用。这项研究还将强调，衰老并不一定等于健康状况不佳和行动不便；好好的老去应该是每个人都能享有的权利。这项研究有可能使卫生专业人员、政策倡导者、地方和州官员了解决定阿拉斯加农村社区是否能够满足老年人的需求并使他们能够按照自己的愿望度过余生的因素。

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.