Case Study of the Replication of Family Group Decision Making: Adaptations of Evidence-Based Practices to Honor Indigenous Community Way of Life

Background/Purpose: Working with indigenous populations requires respect for and adherence to culturally relevant ways of life regardless of the evidence-base and research requirements. In the QIC-AG tribal site, non-native evaluators and research team members were challenged to bridge western evidence-based research methodologies, indigenous agency practices and a traditional Native community’s way of life. The tribe participating as a QIC-AG site, chose Family Group Decision Making (FGDM) as an intervention. The tribe identified children and youth who need permanent family units and a lack of licensed foster homes that reflect the tribe’s values. This presentation includes findings related to the process of applying implementation science to assess the tribe’s readiness for full implementation.

Method: Prior to full implementation of the FGDM, the tribe was asked to have one to five families complete the intervention and evaluation components as part of usability testing. A QIC-AG developed usability testing tool was administered to assess 10 items of screening, consent process, survey, conference preparation, FGDM conferences, participation, incentives, information transfer, fidelity measures, and tracking systems.

Results: Only two families completed usability testing, but insights assisted the evaluation team in making immediate adaptations to the intervention protocols. Adaptations were made in conceptual equivalents to ensure that the words/phrases in the survey and interviews associated with the child and family well-being would be meaningful and therefore are communicated in the tribe’s language.  Elders were consulted during each phase of the implementation and adaptation to make sure that the implementation of the intervention was culturally relevant. Adaptations were made to the survey to include measures on historical trauma to complement the ACES measure. An adaptation was made in the assessment tools such as the Ecomap to reflect the culturally relevant matrilineal kinship system in the Winnebago Tribe of Nebraska and an adaptation was made in the research design to reflect the Circular Logic Model used in Native American populations.

Conclusions/Implications: As a result of usability testing, the evaluation team made changes to protocols. The primary change was a shift in perspective related to sample size. It was recognized that the tribe would continue to face recruitment issues and that non-native evaluators would have to honor those struggles by adapting evaluation plans. Working with Native American populations requires culturally relevant evaluations and indigenous responsive interventions. This case study highlights the need for implementation science and intervention research to consider and find ways to adapt western interventions using culturally relevant evaluations.