Fall 2022 Newsletter (Plain Text)

The Health of the Land Is the Health of the People

All of us at CAIRHE were so excited to have three Māori colleagues and friends visit us in October. I’ve been privileged to work with Paora Te Hurihanganui, Tai Tin Akeni James (“Hemi”), and Dr. Ihirangi Heke in several Indigenous knowledge exchanges since 2017—here in Montana, in Aotearoa (New Zealand), and in Hawaii. Their last trip here was in 2018, and during that time we were able to visit both the Menominee (WI) and Flathead Reservations. They had less time this trip, so we brought several people to see them here in Bozeman, including: from Blackfeet, Darnell and Smokey Rides at the Door; from Fort Peck, Roxann Smith; and from Flathead, Shelly Fyant, Anna Whiting Sorrell, and Gene Sorrell. We also had Vernon Grant, one of our CAIRHE assistant research professors, travel from Arlee; and our two CAIRHE/INBRE community research associates, Emily Salois from Blackfeet and Erica McKeon-Hanson from Havre, joined us as well. We are so grateful for the work that Erica, Maya Bronston, and our student assistant, Aubrey Ridgebear, put into arranging our visitors’ travel, lodging, and great food!

We kept our guests very busy with speaking at our CAIRHE Roundtable; visiting the Madison Buffalo Jump State Park; touring the Museum of the Rockies and its Apsáalooke Women and Warriors exhibit; and having dinner with Native students at American Indian Hall, where we were also treated to a song. They also spoke with students in the Indigenous and Rural Health Ph.D. program, which was described as “life-changing” by several of the students.

Each time I work with my Māori colleagues I am so impressed by their generosity in sharing their amazing work to improve health for their communities. They do this not by focusing on health promotion or disease prevention—as we tend to do—but by focusing on individual and community connections to land, water, food, natural cycles, and ancestral traditions. Paora gave us a beautiful demonstration of this by teaching us during our CAIRHE Roundtable how different phases of the moon correspond to different energies of being, learning, and doing that, if we pay attention to them, can make life a lot easier. I know this from my days working in the ER during full moons! I also saw this in action when I visited a Māori preschool that uses moon phases to help determine daily activities for the kids that keep them happy, learning, and in sync with what their little bodies need to thrive.

In our Indigenous knowledge exchanges, we’ve found that the most learning comes about when we are outside in the forest, on the water, or eating or singing together. And the Hawaiian saying “the health of the land is the health of the people” gets clearer to me each time we are together. Their use of immersion into the natural world so that the environment leads the teaching is phenomenal. For more on their methods, you can watch this beautiful video they have made.

Lastly, I was extremely honored by Hemi, Ihi, and Paora’s performance of an amazing honor Haka, when they presented me with a patu (a handheld carved wooden weapon) that they named Te Pútahi o te Whitu, meaning “the place where the seven reservations come together” in reference to CAIRHE as a place where this happens. We are very blessed by their inspiring shared words, laughter, songs, Haka, and encouragement for our work. We look forward to visiting them in Aotearoa again soon.

Alexandra Adams, M.D., Ph.D.
Director and Principal Investigator

Adams Awarded MSU Presidential Medallion for Achievement

From MSU News Service

Montana State University President Waded Cruzado announced today that she has awarded the new MSU Presidential Medallion for Achievement to four faculty members in recognition of outstanding contributions to the university, their students and their respective fields.

The honored professors are health care policy experts Alexandra Adams and Peter Buerhaus and College of Letters and Science department heads Joan Broderick and Dana Longcope. It isn’t the first high honor for the faculty members, all of whom were elected recently to national academies on which they serve as national advisers on scientific and policy matters in their fields of expertise.

Adams, Buerhaus, Broderick and Longcope are the first recipients of the new presidential achievement medallion. The award recognizes faculty members who have demonstrated scholarship of an international caliber, an exemplary commitment to teaching and mentoring, and leadership in service at MSU, around the state and beyond.

Adams and the other three honorees were celebrated at an awards dinner on campus on December 13.

“These four professors have made outstanding contributions to their fields of study and amply demonstrated their dedication to their students and to Montana State University,” Cruzado said. “Montana State is proud to have them in our classrooms and laboratories and to recognize them for their successes.”

Alexandra Adams, M.D., Ph.D., director of MSU’s Center for American Indian and Rural Health Equity, or CAIRHE, has been a faculty member in the Department of Sociology and Anthropology in the College of Letters and Science since 2016. She is credited with building CAIRHE, which was founded in 2014, into a multidisciplinary network of researchers, faculty members and students spanning multiple colleges and a half-dozen departments at MSU. She also founded the Promoting Indigenous Research Leadership workshop, or PIRL, which CAIRHE has presented three times since 2019.

In addition to funding multiple faculty research projects and smaller pilot projects that are working with Native and rural partners across the state, CAIRHE staff members mentor junior faculty investigators to become independently funded researchers who hold the highest level of grant funding from the NIH or other national grant-awarding agencies. In 2019, Adams’ team received a five-year, $10.7 million grant from the National Institutes of Health to advance CAIRHE’s mission to reduce health disparities in Native and rural communities through community-based participatory research that is respectful of community needs.

In 2021, Adams was elected to the National Academy of Medicine, considered one of the highest honors in the fields of health and medicine. Through its domestic and global initiatives, the NAM works to address critical issues in health, medicine and related policy and inspire positive action across sectors.

Before she came to MSU, Adams was a professor in the Department of Family Medicine at the University of Wisconsin School of Medicine and Public Health, where she also served as director of the Collaborative Center for Health Equity from 2008 to 2015 and director of the Cancer Center’s Cancer Health Disparities Initiative from 2009 to 2016.

CAIRHE Hosts Successful PIRL 2022 Workshop in October, Its Third to Date

In October CAIRHE and its partners at the University of North Dakota hosted 18 investigators from across the United States at Promoting Indigenous Research Leadership, or PIRL, a three-day workshop designed to promote the research careers of Indigenous and other early-career faculty working with Native communities.

Faculty traveled from the East and West coasts, the Southwest, and the Midwest to attend the event, held October 10-12 in Grand Forks, N.D.—home of CAIRHE’s first-time PIRL partner and host, the Indigenous Trauma & Resilience Research Center (ITRRC) at the University of North Dakota School of Medicine and Health Sciences.

Twelve senior mentors from across the country—each with a track record of funding success with the National Institutes of Health and other agencies—gave presentations on various career and grant-writing topics and engaged in one-on-one and small-group mentoring with the investigators.

CAIRHE Director Alex Adams, M.D., Ph.D., and CAIRHE External Advisory Committee member Donald Warne, M.D., MPH, led the workshop’s agenda. Warne is the former director of ITRRC and current co-director of the Johns Hopkins Center for Indigenous Health.

“PIRL has really begun to take on a life and reputation of its own,” Adams said. “Even before we began recruiting applicants last spring, faculty from around the country approached us based on strong word of mouth from past participants.”

This year’s participating investigators represented 11 different universities or research organizations, including the University of North Carolina, the University of North Dakota, Johns Hopkins University, Columbia University, the University of Wisconsin, Indiana University, and Northern Arizona University.

The workshop was made possible through generous institutional support from the MSU Office of Research, Economic Development, and Graduate Education; the UND School of Medicine and Health Sciences; and the National Cancer Institute. Three NIH program officials—Shobha Srinivasan and Amy Kennedy from the National Cancer Institute and Sheila Caldwell from the National Institute of General Medical Sciences—attended and served as presenters and mentors during the event.

“Once again, we couldn’t have staged PIRL in the way we did, where investigators aren’t asked to pay to attend, without the support from MSU, UND, and NIH,” Adams said. “It really does show how committed NIH and many program officers are to upholding Native researchers and the important work they will be doing in Indigenous communities for the decades to come.”

In addition to Adams and Warne, faculty presenters and mentors at the workshop included Melissa Walls from Johns Hopkins University; Julie Baldwin from Northern Arizona University; Valarie Blue Bird Jernigan from Oklahoma State University; Angela Gonzales from Arizona State University; Francine Gachupin from the University of Arizona; David Huh from the University of Washington; Lisa Wexler from the University of Michigan; and Paul Estabrooks from the University of Utah.

“It truly was an all-star assembly,” Adams said.

PIRL is the third such workshop hosted by CAIRHE. The previous event was held in October 2021 in Bozeman, and already CAIRHE is exploring a 2023 workshop next fall—possibly at a “neutral” site such as Tempe, Ariz.

“Because we’re seeing such great demand for PIRL from all corners of the country, it really becomes more efficient and cost-effective if we can fly everyone to a hub city,” said CAIRHE Program Coordinator James Burroughs. “Everyone always loves being in Bozeman, but the prospect of winter weather, even in October, always keeps us up at night as organizers. CAIRHE will always be the leader of PIRL, but staging it elsewhere is testament to how this is a national event now, with national importance.”

As with past events, this year’s participants praised a forum where they felt valued as Indigenous researchers in way that many had never experienced before. In post-event surveys, all participants reported they were “very satisfied” or “satisfied” with the workshop overall.

“I cannot state enough the value of this program,” said one participant in an anonymous evaluation. “I left informed and excited to do more research. I value every connection I was able to make. There isn’t enough professional development specific to Native peoples, and I think that for us to have time to bond is a necessity if we want our field and our people to thrive.”

Said another: “I felt empowered leaving this workshop. … It was also very powerful to be in a room with mostly Indigenous scholars. Being together helps fill my heart with hope and joy, and I don’t get this experience in my institution.”

Information about the PIRL 2023 workshop will appear in early 2023 on the PIRL website at https://www.montana.edu/cairhe/pirl/index.html.

Martin Awarded R21 Grant for Aging Research

Stephen Martin, Ph.D., a CAIRHE assistant research professor and director of the Translational Biomarkers Core Laboratory, received an R21 grant from the National Institute on Aging in August.

The two-year grant (R21AG075402) totaling $398,750 supports Martin’s project titled, “Marrow Adipose Tissue as a Novel Regulator of Systemic Metabolism and Inflammation During Aging.”

A central characteristic of aging is increased adipose tissue, or body fat, Martin explained. Adipose is located in distinct “depots” throughout the body, and it is likely that specific depots contribute to disease vulnerability through complex processes. The role of the bone marrow adipose tissue (MAT) depot in aging-related disease etiology is not well-established, Martin said, so the long-term objective of this research is to define the roles and mechanisms by which MAT influences health and disease throughout the lifespan.

“Our goal with this project is to identify how the quality of MAT changes throughout life and whether aging-related changes in MAT quality influence many common diseases associated with aging such as diabetes, cardiovascular disease, and osteoporosis,” Martin said. “We’re hopeful we can target MAT with drugs or supplements to improve health.”

Martin also has plans for two R01 grant applications in 2023.

CAIRHE Plans for NIH Grant Renewal in 2023, with Funding Through 2029

CAIRHE will spend a large portion of the coming months preparing its second and final renewal of the original Centers of Biomedical Research Excellence (COBRE) grant that launched the center in 2014.

CAIRHE’s current grant, designated as COBRE Phase II and administered by the National Institute of General Medical Sciences at the National Institutes of Health, will expire in August 2024. The new COBRE Phase III award would extend funding for the center through August 2029.

The deadline for the Phase III application is September 26, 2023.

“During Phase II CAIRHE has already begun to position itself for long-term sustainability,” said Director Alex Adams, M.D., Ph.D. “Phase III will only accelerate that process. Over the next seven years we hope to become a permanent fixture of MSU’s biomedical research infrastructure with a more diverse portfolio of external and institutional funding to support our work.”

COBRE Phase III funding is designed primarily to support center core operations, which in CAIRHE’s case means the Montana IDeA Community Engagement Core, shared with Montana INBRE, and the Translational Biomarkers Core. In the coming year both cores will intensify their efforts to serve a broader base of MSU investigators, Adams said.

Although Phase III does not support multiyear research projects, CAIRHE’s current pilot project program will continue.

“We will always depend on a pipeline of new faculty interested in health equity research in order to keep the center growing,” Adams said.

CAIRHE’s current Request for Proposals is now open with a deadline of April 3, 2023.

Grant and Schure Lead New Projects for 2022-23; Four Others Continue

CAIRHE has added two new projects for the 2022-23 funding year that began September 1.

Leading a Center-funded project for the first time is Vernon Grant, Ph.D., CAIRHE assistant research professor. His project, Assessing Sleep in Blackfeet Families with K-3rd Grade Children, aims to develop a 9-week sleep intervention to increase total sleep time in young children. In concert with his current K01 grant from the National Heart, Lung, and Blood Institute, now in Year 3, Grant hopes to develop and submit an NIH R01 grant by the end of his two-year CAIRHE study.

“Sleep strategies will be combined with Blackfoot culture and will be delivered through text messaging and a closed Facebook page,” Grant said of the CAIRHE project. “Focus groups with Blackfeet families and interviews with Blackfoot elders last winter provided the framework that has been used to guide and direct this work.”

Mark Schure, Ph.D., associate professor in the Department of Health and Human Development, leads a new pilot project titled Daasachchuchik ("Strong Heart"): Engaging Apsáalooke Community Voices for Mental Health Support. With longstanding partners on the Crow Reservation, Schure and his team will develop an Apsáalooke-specific, strengths-based, trauma-informed mental health intervention. The new project will draw on the successes of the Baá nnilah program, a chronic illness self-management program designed for Apsáalooke tribal members. Schure has served as a member of that study team in recent years.

“This project will allow for the Crow community’s voices to be heard in regard to the emotional and mental health needs of the community,” Schure said. “The resulting program that we’ll develop will be community-led and use Crow community cultural strengths to effectively address these needs.”

The intervention will take a deeper, trauma-informed approach to reaching community members who are facing emotional and mental health issues, Schure added.

“We hope to have an impact on community members by providing tools to positively cope with stress and grief that have all stemmed from trauma,” he said.

Now in their second year as research project leaders are Lauren Davis, Ed.D., of the Department of Education and Brandon Scott, Ph.D., of the Department of Psychology. Both have NIH R01 grants in early development.

CAIRHE’s other pilot project leaders, each in their second and final year, are Miranda Margetts, Ph.D., of the Department of Land Resources and Environmental Sciences, and Emily Tomayko, Ph.D., of the Department of Health and Human Development.

CAIRHE Requests Proposals for Pilot Projects, with April 2023 Deadline

CAIRHE has again issued its annual Request for Proposals for one-year pilot projects from MSU faculty engaged in public health research. Proposals should be consistent with CAIRHE’s mission of reducing health disparities in Native and/or rural communities, and they should have a high likelihood of leading to independent funding from external (non-MSU) sponsors.

Funding usually ranges from $20,000 to $50,000 in direct costs for the project year, beginning September 1, 2023. The deadline for a required letter of intent is February 1, 2023, with an application deadline of April 3.

“CAIRHE is a multidisciplinary center, so we’re again reaching out to faculty in departments across campus,” said James Burroughs, CAIRHE program coordinator. “For health researchers who maybe don’t yet have a well-funded research agenda of their own, our pilot projects offer the benefit of NIH funding with application review and project administration all handled here locally by your peers at MSU.”

In addition to funding from the National Institutes of Health, being a CAIRHE project leader offers faculty a range of support services from the Center, including mentoring by senior investigators and collaboration with a community of scholars who share similar research interests, Burroughs said.

For complete details and instructions, visit https://www.montana.edu/cairhe/rfp/index.html. Burroughs welcomes inquiries and one-on-one information sessions with interested faculty.

CAIRHE Research in Print

Here’s a snapshot of some recent publications resulting from CAIRHE-supported research.

McCullen, JR, Counts, CJ, & John-Henderson, Neha. (2022). Childhood adversity and emotion regulation strategies as predictors of psychological stress and mental health in American Indian adults during the COVID-19 pandemic. Emotion. Aug 11;. doi: 10.1037/emo0001106.

Davis, Lauren, & Buchanan, R. (2022). Strength in numbers: The promise of community-based participatory research in rural education. Theory & Practice in Rural Education. Spring;12(1):105-115.

Palmer, Cara, Powell, SL, Deutchman, DR, Tintzman, C, Poppler, A, & Oosterhoff, B. (2022). Sleepy and secluded: Sleep disturbances are associated with connectedness in early adolescent social networks. Journal of Research on Adolescence. Jun;32(2):756-768.

John-Henderson, Neha, Kampf, TD, Alvarado, G, Counts, CJ, Larsen, JM, & Palmer, Cara. (2022). Childhood adversity is associated with heightened inflammation after sleep loss. Sleep Health. Jun;8(3):283-287.

John-Henderson, Neha, Oosterhoff, BJ, Johnson, LR, Ellen Lafromboise, M, Malatare, M, & Salois, Emily. (2022). COVID-19 and food insecurity in the Blackfeet Tribal Community. Food Security. 14(5):1337-1346.

Skewes, Monica, Gameon, JA, Grubin, F, DeCou, CR, & Whitcomb L. (2022). Beliefs about causal factors for suicide in rural Alaska Native communities and recommendations for prevention. Transcultural Psychiatry. Feb;59(1):78-92.

Thorsen, Maggie, Harris, S, McGarvey, R, Palacios, J, & Thorsen, Andreas. (2022). Evaluating disparities in access to obstetric services for American Indian women across Montana. The Journal of Rural Health. Jan;38(1):151-160.

Thompson, MJ, Drain, PK, Gregor, CE, Hassell, LA, Ko, LK, Lyon, V, Ahmed, Selena, Bishop, S, Dupuis, V, Garza, L, Lambert, AA, Rowe, C, Warne, T, Webber, Eliza, Westbroek, W, Adams, Alex. (2022). A pragmatic randomized trial of home-based testing for COVID-19 in rural Native American and Latino communities: Protocol for the "Protecting our Communities" study. Contemporary Clinical Trials. Aug;119:106820.

John-Henderson, Neha, Grant, Vernon, Johnson, LR, Lafromboise, ME, Malatare, M, Salois, Emily, & Oosterhoff B. (2022). Historical loss: Implications for physical activity levels in American Indian adults.The Journal of Rural Health. May 4; doi: 10.1111/jrh.12673.

Profile of Erica McKeon-Hanson

Name: Erica McKeon-Hanson, MPH, MSEd

Home: Havre, Mont.

Position: Community Research Associate (CRA) in the Montana IDeA Community Engagement Core, shared by CAIRHE and Montana INBRE

What have you and the Core been focusing on during your first months on the job?

The Community Engagement Core had the honor of hosting Māori colleagues from New Zealand this fall on campus at MSU (see p. 5). Alex Adams and a few other members of the Core had met and collaborated with them in the past, and it was wonderful for the rest of us to meet them. Their visit to MSU also provided CAIRHE investigators and others across campus and from tribal communities in Montana the opportunity to learn about ancestral Māori concepts of health using environmental knowledge and wisdom, while also sharing local Indigenous knowledge with the Māori.

In addition, the Core is also working with the University of Washington’s Institute of Translational Health Sciences (ITHS) to develop training modules centered on our community engagement work to be available to investigators on the ITHS website. The Core also continues to assist investigators in their work with communities while also exploring and developing relationships with new communities and partners to expand our network.

We’ve also been engaged in work with Region 4 of the National Library of Medicine. Furthermore, the Core has received regional recognition for our community engagement work and, as a result, has been invited to develop new collaborations.

You’re a fourth-generation Montanan, raised in a rural agricultural community. How does that shape your views of the health equity challenges our state faces today?

It’s one of the filters I use to understand our current health inequities in Montana and in other rural states. I saw a real struggle with access to health care for my small community growing up, whether it was due to the struggle to attract and keep health care providers; the distances we had to travel for routine and specialized health care, with school and workdays lost; or the plethora of other reasons rural populations experience health inequities. I think of my family and those just like them who are still making their living farming the land and raising livestock. These families often can’t afford to be absent from their homeplace to receive medical care without risking loss to their livelihood. Many have also found themselves uninsured or underinsured as a result of the declining agriculture markets, further complicating their ability to stay healthy.

I’ve also spent the better part of my career working in two tribal communities as a tribal college faculty member. I hold the lessons I learned during that time from my students, my colleagues, and their families very near and dear. They helped me to understand the history and health inequities their communities have faced for generations. It was clear to me early on in my career how each community faces their own unique challenges, even when they may only be a few miles apart and share similarities. It was during my time as a tribal college faculty member that I learned about community-based participatory research and was able to work with my students using these principles to address health needs identified by their community.

Why is community engagement so important to the work our center is doing?

During my childhood, I can remember having the sense that state and national decisions were made for people and places that didn’t look like my hometown. In all honesty, I can remember feeling that we didn’t matter because we were too small and the people making decisions didn’t understand us. This is why community engagement is such important work. We’re committed to listening and seeking guidance from the community members themselves. The communities tell us what their needs are and how we can help to address them. It’s my hope as we do this work that communities that are historically underrepresented will begin to feel heard and valued while we make progress toward addressing the health disparities they face.

Part of your job is knowing the right people. After your many years of working at tribal colleges, the Little River Institute, MSU-Northern, and the Hill County Board of Health, among other roles, is there anyone you don’t know in rural Montana?

That makes me laugh! Well, when you add my regional work history to that, and the fact that my family on both my mother’s and father’s sides have been in north central Montana for generations, as well as my husband and his family, there really aren’t many people left that I don’t have a connection with! It’s one of the reasons that I love this work with the Community Engagement Core. I returned to Montana and the Hi-Line after college with a commitment to making a difference in the lives of the people that I grew up with. I’m in my dream job as a rural community research associate with the Core. I enjoy using my lifetime of rural Montana connections to facilitate the work of CAIRHE and INBRE investigators while also relying on my graduate education in public health to move closer to our goal of health equity.

What’s next for the Montana IDeA Community Engagement Core in the coming year?

We’re at the beginning stages of our work to develop training modules in collaboration with the ITHS. Looking ahead, we’ll be transforming our experience and knowledge of the role that community engagement plays in research to develop modules that will guide investigators toward interactions with communities that are built upon genuine relationships, respect, and reciprocity (Emily Salois’s “three Rs”). In addition, the Core will also be working on the Community Engagement Core sections of both the INBRE and CAIRHE proposals for renewed NIH funding. We will continue, as always, to be a resource for investigators as they develop proposals for funding, as well as during their projects post-award. The Core is continuously updating and developing new resources for investigators that can be found on our Core website through both CAIRHE and Montana INBRE, in addition to the weekly resources we provide to our listserv.

How do you and your family like to spend your spare time?

My family at home in Havre includes my husband, Todd, and three daughters: Sylvie, Finley, and Emme. We also have three adult daughters who have already begun their own professional careers. Meredith and Avery live in Montana, and Madie lives in Kansas. Our favorite thing to do as a family is spend time at the lake in our camper. For us, that’s either Bull Lake in Western Montana, where my husband’s side of the family has a cabin; Nelson Reservoir in north central Montana, where my side of the family has a cabin; or 15 minutes from home in the Beaver Creek Park, where we have a cabin site. We spend most of our time at the lake fishing, swimming, and hiking. When we’re not working or at the lake, we like to spend time at home, where we have two acres of yard work—I mean, yard enjoyment—along with three dogs (a corgi, toy Australian shepherd, and Jack Russell terrier), one cat who adopted us, and three fish.