Assessment of Indigenous Historical Trauma

American Indian/Alaska Native (AI/AN) populations experience some of the most extensive health disparities in the U.S. for any demographic group. Increasing evidence shows that indigenous historical trauma (IHT) is a likely causal factor for AI/AN health disparities. However, recent research has only begun the process of defining and operationalizing IHT as a construct that could be measured and assessed as a health determinant, and the instruments now available focus primarily on historical loss experience and associated symptoms, though the experience and effects of IHT are likely to be more extensive. Progress is needed to develop validated assessment tools that capture broader and cross-generational aspects of the phenomenon. To address this specific gap in the literature and contribute to the reduction of health disparities among AI/ANs, we propose community-based research that brings together complementary strengths of the Department of Prevention and Community Health (DPCH) at the George Washington University Milken Institute School of Public Health (GWSPH), and Native American Lifelines, Inc. (NAL), a federally funded Urban Indian Health Center with locations in Baltimore, MD and Boston, MA. 

This partnership will: 

1. Use systematic qualitative methods (based on cultural domain analysis) and a community participatory approach to identify characteristics and manifestations of IHT as experienced and transmitted across generations, conceptualizing IHT as a shared interpretive framework or cultural model;
2. Use scale development procedures to develop an expanded IHT instrument that integrates these broader factors;
3. Test the instrument by administering it to a sample of 400 Urban Indian participants; and
4. Based on the results, assess associations between IHT and behavioral risks/outcomes and priority health conditions prioritized by NAL, including substance abuse and related issues, violence and abuse, diabetes, stress and depression. Results will be disseminated to NAL, to the field, and to practitioners.