Culturally Tailoring a Web-Based Intervention for Native American Women

Background & Purpose: American Indian and Alaskan Native (AI/AN) women report greater incidence of intimate partner violence (IPV) and intimate partner homicide (IPH). In 16 states—3 with high concentrations of Indigenous women—the homicide rate for AI/AN women was 7.3/100,000, higher than for any other racial/ethnic group (Karch, Dahlberg, & Patel, 2010). The aims of this research were (1) to identify culturally specific risk factors for actual/near lethal IPH, as well as protective factors predictive Indigenous women’s empowerment and safety and (2) to further develop and refine the myPlan intervention with culturally relevant risk & protective factors.

Methods: We conducted individual interviews with Indigenous survivors (n = 43) as well as focus groups and key informant interviews with practitioners who worked with Indigenous survivors (n = 29). Participants were recruited from three regions of the United States: Northeast, Southeast, and Southwest with proper tribal and IRB approvals. Interviews and focus groups were audio-recorded and transcribed verbatim, and analyzed using thematic analysis to identify primary risk and protective factors. Results were used to modify the language and safety strategies in myPlan.

Results: Both survivors and practitioners focused on risk and protective factors at the social, structural, and institutional levels through the following themes. For risk factors, first, women were vulnerable due to a high threshold for ‘red flags,’ postponing recognizing signs until violence became lethal or near-lethal. This pattern was a result of high exposure to violence in their family of origin, neighborhood, and community.  Second, in addition to intergenerational patterns of violence, intricate family and extended family structures complicate how to address IPV. Third, for women living on reservation, rurality could increase survivors’ isolation due to a number of factors. Fourth, jurisdictional complexities in tribal territories and inconsistent or limited law enforcement. Fifth, given the small, tight-knit community, leaving the abuser often means leaving the homeland, and there is a challenge with a lack of confidentiality in DV services. Protective factors included family support, social connections with Native women, and support of grandparents and elders. Women described great resilience in the face of contemporary and historical trauma. Participants emphasized the importance of cultural connection, including participation in ceremony and spiritual practices. 

Conclusion and Implications: Based on these findings, the myPlan intervention was adapted into ourCircle, incorporating risk and protective strategies from the data. For example, culturally specific violence myths and truths were added. One of the most noteworthy changes is that a new category of protective strategies, “Connecting to Native Community,” was added. This project shows a promising cultural adaptation of an effective intervention.