142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

American Indian and Alaska Native research ethics: The emergence of tribal review boards

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 8:54 AM - 9:06 AM

Annjeanette Belcourt, PhD-Clinical Psychology , Pharmacy/Public Health Departments, The University of Montana, Missoula, MT
Cheryl Belcourt, BA , Co-Chair of Rocky Mountain Tribal IRB, Montana Wyoming Tribal Leaders Council, Billings, MT
Allyson Kelley, DrPH(c) MPH CHES , Department of Public Health Education, University of North Carolina, Greensboro, Greensboro, NC
American Indian and Alaska Native communities share unique cultural, historical, and political influences that continue to shape contemporary ethical research practices. Where and how AIAN communities live today has been shaped and defined by the federal history of colonial deterministic policy. Unfortunately, this history of systematic oppression has resulted in current inequalities in the overall health status of indigenous communities. Collectively, AIAN populations face significant health, mental health, and mortality disparities compared to other groups within the United States. These disparities include the highest rate of suicide in the nation, mental health problems, and physical health mortality disparities associated with Diabetes Mellitus, unintentional injury, substance abuse, and other chronic health problems. Disparities have attracted researchers interested in advancing scientific knowledge about the underlying etiology of these disparities. AIAN populations have experienced unethical research in the past that has resulted in unanticipated damage to AIAN communities and individuals. This history has resulted in institutional distrust within many AIAN communities toward health research. Community distrust can ultimately limit research within AIAN communities and have subsequent negative consequences toward public health knowledge and practice within underserved indigenous communities.   

The objective of this presentation is to review contemporary AIAN research ethical principles and practices from an indigenous perspective. Authors reviewed the extant literature regarding indigenous research ethics and will provide a discussion of examples of progressive community driven ethical research practices, suggestions for practice, policy, and challenges encountered. As an example, the Rocky Mountain Tribal IRB involved multiple tribal nations working together to extend more adequate human subject protection for AIAN communities. Tribal IRB’s aims are to promote Belmont Principles while advancing community confidentiality and social justice principles requiring research include clearly delineated potential benefits towards the improvement of tribal health. American Indian and Alaska Native ethical principles and practices will be described and defined, challenges and strengths of promoting tribal institutional review boards will be examined, and an analysis of sustainability strategies will be discussed to promote tribal ethical practices. Practical suggestions for improving tribal health disparities by advancing improved funding and indigenous targeted infrastructure capacity development will also be discussed.

Learning Areas:

Diversity and culture
Ethics, professional and legal requirements
Public health or related education
Public health or related research

Learning Objectives:
Define and describe the historical creation of American Indian and Alaska Native ethical principles and practices. Discuss the challenges and strengths of promoting tribal institutional review boards to extend adequate human subject protections to indigenous communities. Explain and identify the process tribal nations have engaged in to create collaborative research review boards. Assess and analyze how sustainable tribal IRBs can help to improve public health within indigenous communities.

Keyword(s): Ethics, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Belcourt-Dittloff (Otter Woman) is an American Indian Assistant Professor at the University of Montana’s Pharmacy Practice and School of Public and Community Health Sciences Departments (enrolled tribal member of the Three Affiliated Tribes: Tribal affiliation Blackfeet, Chippewa, Mandan & Hidatsa). Her doctorate is in clinical psychology and her research and clinical practice priorities include mental health disparities, trauma, posttraumatic stress reactions, risk, resiliency, research ethics, and psychiatric disorder within American Indian communities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.