North Dakota State University CI Report – Interim

What has been most instrumental to your progress?

The Bush Community Innovative Administrative (BCIA) Team was reorganized as directed by President Lindquist. The team now consists of three members from Cankdeska Cikana Community College (CCCC) Next Steps Program and one individual from North Dakota State University School of Nursing (NDSU SON). This collaborative team continues to manage, implement, and evaluate the overall grant activities. Additionally, the Community Stakeholder Committee (CSC) was revised due to job movement and election of new personal into tribal council positions. Membership on the CSC includes: District Judge, Associate Judge, Juvenile Court, BIA police, lawyer, Tribal Health Council Chairperson and Council members, Tribal Health Director, high school principals and superintendents, high school counselors, Director of Student Success, Director of Employment and Training, public health nurse, CCCC President, CCCC Next Steps Director, CCCC Next Steps Assistant Director, CCCC Job Placement Specialist, CCCC GED Director, CCCC Board of Regents, CCCC faculty and staff. We are in the process of selecting students to join this committee.

At the start of each meeting, CSC members are provided with an overview of the Bush Community Innovation Grant, purpose, and proposed activities. CSC members developed and edited the Youth In School and Drop Out interview questions starting with the following words: Involvement, expectations, school engagement, bullying, culture, discrimination, isolation, academic achievement, belonging, feeling unsafe, homelessness, literacy, suspended or expelled, friends, peers, dating, school climate, drugs, alcohol, tired, abuse, violence, physical illness (student and/or family member), pregnancy, anger, mental illness, trauma, PTSD, poverty, transportation, teachers, counselors, parental support, alternative school models, and “other”. After reviewing the literature and high school study results, 28 questions were developed for each group. CSC members responded to the Survey Monkey questions and the results were tabulated and presented back to CSC members for discussion. CSC members finalized 2 sets of interview questions. The interview packet consisted of seven demographic questions, 30 questions for enrolled students and 31 questions for dropped out adults. NDSU IRB approval was granted.

Twenty interviews were completed (10 individuals who dropped) in January 2017 and (10 students who remain in high school) in February 2017. Two undergraduate students were hired to transcribe the data. Once the interviews were transcribed, Dr. Heuer completed a content analysis of the data. The following themes for In School Youth included: School Involvement, Study Skills, Support in School, Family Support, Dropping Out of High School, Challenges in School, and Future Plans. The overarching themes were presented to the BCIA Team. The team requested student quotes be added. Dr. Heuer broke each theme into subthemes and student quotes were analyzed and added to appropriate sections. Then the In School Report was sent to President Lindquist and Mr. Longie for their feedback along with questions on how we will: 1) present that data to the CSC, 2) pare the report down for the CSC and then 3) who will report the data to the CSC. Dr. Heuer is still working on the Drop Out Report but it should be completed within the week. She is cross checking the transcriptions, tapes, and field notes for accuracy.

Key lessons learned

First, when the CSC team developed the questions for the two groups, they were similar in structure and format except the topics were different, in school versus drop out. We had hoped to garner insight as to the factors that assisted students to remain in school as to those that prompted them to drop out. The high school principals were instrumental in assisting Dr. Heuer with the interview process of high school students. There was difficulty in recruiting the drop out participants and as a result, this group is older so we are unable to compare the results of the two groups. In reflection, we should have contacted the high school principals to check if they could provide us with the names and contact information of students who recently dropped out of high school. While the differing ages between the two groups is disappointing, I do not consider this a failure because we still obtained valuable information from the participants. Second when conducting the interviews, I noticed a difference in the responses between groups. Younger students and adults were more open in discussing their life situations whereas, some of the older participants were more guarded in their responses.

Third, CSC approved 30-31 questions for the 1 to 11/2 hour interview. It was difficult to conduct in-depth interviews within the allotted timeframe. Next time, we need to decrease the number of questions or extend the amount of interview time to allow for the students to fully tell their story. I could not follow-up on some of their statements due to the time limitation. Fourth, there was extensive discussion about the race of the interviewer and concern about obtaining creditable data. Some CSC members believed it should be a Native person. After a 4 month delay, the BCIA team asked Dr. Heuer to conduct them. Even though the interview time was limited and the interviewer was Caucasian, the participants shared their life experiences which included violence, alcohol, drugs, fear, and abuse. As they were telling their stories, it became clear that the participants did not realize the chaos they were living with in their daily lives because it had become normalized for them. The extraordinary points that came through these interviews was the youths and young adults’ resiliency. Many of the In School students were able to cope because of the school structure and their friends.

Reflections on inclusive, collaborative or resourceful problem-solving

There are two elements that continue to be important to the success of this project. The first element is inclusive and is reflected by our invitation to 27 interdisciplinary community members. The knowledge and expertise of all these individuals are needed to address the issues surrounding high school drop on Spirit Lake Nation. All of these individuals are needed around the table in order to make the second element, collaboration successful. The CSC members who attend the meetings are engaged and the discussion has been extensive. They want to develop an intervention that that betters the community and prepares the students for the future. This group realizes that American Indian youth need to be mentored so they can continue their education and there can be succession planning for administrative roles.

Other key elements of Community Innovation

BCIA continues to bring in our knowledge, experience and resources from the Next Steps Program (Health Professions Occupations Grant) and the University, Community Partnership Health Professional Health Occupations Grant, and the HRSA Indigenous Wisdom in Nursing Program. For example, the Youth Education and Employment Survey results have been given back to each of the 12 schools along with how their school compared to their tribal nation or reservation and then All Schools. This data supports that many of the youth plan to attend a tribal, community, college or university. The main challenges identified in the survey were also supported by data collected during these interviews. Another thing I noticed as I was giving the survey to 11th & 12th grades, there were some students had difficulty reading. For example, this one young man was joking and acting out in class at the start of the survey. As other students settled down to compete the survey, I noticed behaviors that indicated he had difficulty with reading and copied his neighbor’s answers. Additionally, students asked about spelling words when completing the open-ended questions.

Understanding the problem

Additional clarity has been provided through the participant interviews and discussion at the CSC meetings. For example, a local superintendent shared a traumatic event that had taken place in a student’s life the night before but yet, she was in school the next day. There was a sharing of other examples and the discussion of how these behaviors have become normalized, yet it was agreed upon that high school students should not have to deal with these issues. This discussion also led to other community issues such as succession placement and who would replace the administrators as they retire. Regarding the potential intervention, it was agreed upon that the community needs to develop this project. The judge searched the web and found a potential model in California. He said that he would e-mail the agency and request information on their model and their success rate. He also stated that he planned to make a copy of the In School Report for all his juvenile staff. There was also discussion about the older participants not having a clear future direction for education or employment. The judge shared that our findings support what he has also found when they are released from prison.

If you could do it all over again…

I was not prepared for how emotionally draining it was to conduct these interviews, analyze the transcripts, field notes and listen to the recordings. From the CSC discussion, I did not think the participants would share their stories with me. But many told of their experiences with family or friend’s suicides or attempts, drug use, bullying, family issues, lack of trust and so forth. As they were telling their stories, I heard the emotion in their words but I also saw the hurt and anger in their faces. It was so difficult because as a nurse and a human, I wanted to do something to help them, to make it better for them so they could concentrate on school and future plans but there was nothing I could do at that time. I realize I am an outsider but we have enough qualitative and quantitative data that support the need for major changes. To be honest, if an intervention had not been associated with this project, I would have stopped the interviews after the first day of interviewing the high school students because they were sharing their life with me and all I could say was, “Thank you.” But these students shared their stories and I feel an obligation to complete this project.

One last thought

We will use formative and summative evaluation methods to evaluate the outcomes of the intervention. The outcomes will be written-up and distributed to the stakeholders and others throughout the state. There is a plan for presentations, development of a nonresearch based publication and maybe manuscripts