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Project Name: Family Professional Partnership/CSHCN (H84)
Applicant Title: INDIAN COUNTRY GRASSROOTS SUPPORT
Abstract Text: PROBLEM The Navajo Family Voices Tribal F2F HIC will serve Target Area 3: American Indians/Alaska Natives with children and youth with special healthcare needs (CYSHCN) on the Navajo Nation. Specifically, the New Mexico side of the reservation, a rural, impoverished, and infrastructure-challenged area of more than 12,000 sq, miles. The area is a complex socio-economic and medical environment with 7 distinct internal land zones, and with medical care and non-medical wellness care provided by complex federal, state and tribal delivery systems that remain obscure to state agencies and even the Tribe itself. Tribal CYSHCN families in rural reservation communities are beyond the physical and cultural resources of state F2F HICs based in Albuquerque, NM and Phoenix, AZ to reach. Methods of family engagement used for non-tribal families, even the language, and assumptions of motivation and connection used in non-indigenous communities, do not neatly apply. GOALS & OBJECTIVES NFV’s mission is to improve quality of life health outcomes for Diné CYSHCN through activities that support culturally meaningful partnered healthcare decision-making by CYSHCN families and healthcare professionals. Our mission is expressed as álchíní hózhóójí bá Nahat'á (planning for our kids in a Blessing Manner). We aim to support access of both families and health professionals to the Navajo Nation’s complex, multi-system healthcare environment through information gathering and training; to support partnered decisions by supporting family strengths and enhanced culturally meaningful communications between families and health professionals; and support the pooling and non-duplication of limited resources, innovative solutions, and inter-program application of the SNBH framework. METHODOLOGY Our program activities will provide one-on-one and group information, education and training to families and health professionals—relating to families through their strengths, providing cultural tools for health professionals to better communicate with families, and involving state and tribal agencies/programs and non-profits in planning, innovating, and implementing through engagement and input of families themselves. Meetings will be in-person, via zoom and phone. Our core team of tribal CYSHCN family leaders will be using, as our cultural service and relational framework, Sa’ah Naaghái Bikéh Hózhóón (SNBH), the Diné-specific whole-person health framework used and emphasized in the 2020 Navajo Nation Maternal and Child Health Needs Assessment. COORDINATION We have formal agreements in place for mutual support, outreach and training with the AZ and NM state F2F HICs—RSK and PRO. We will continue working with Children’s Medical Services, NM Pediatric Society, and UNM to develop a SNBH syllabus and provide SNBH trainings focused primarily on enhanced family-provider communications. Presentations and outreach are partnered with Indian Health Service, Growing in Beauty, Mountain States Regional Genetics Network, and Central Consolidated School District. EVALUATION Our evaluation policy is rooted in the need for innovation. Evaluation is treated as an on-going and frequent problem-stating and problem-solving process. Meanwhile, the annual HRSA report provides the annual requirement to measure and report. Methods to address culture haven’t yet been tried and tested. We use spreadsheet service sheets, scheduling sheets, sign-in sheets, surveys, toolkit products developed with families, family feedback from direct contact, and program self-evaluations through weekly team evaluative engagements.