Developing future Diné public health leaders starts with early, culturally significant exposure
Successfully guiding Diné youth toward health and public health professions begins with two important ideas—start students in a program in high school and cultivate in them a love and understanding of their own cultural, strength-based assets.
Researchers from Diné College and Northern Arizona University explored these findings and other lessons in their recently released publication, “Engaging Native American High School Students in Public Health Career Preparation Through the Indigenous Summer Enhancement Program.”
The publication examines the Indigenous Summer Enhancement Program (ISEP), a one-week summer training program, that exposes Native American high school students to public health careers and mentorship in Tsaile, Arizona.
Researchers include: Heather Dreifuss, director, High School Outreach, Research and Education Training with Navajo NARCH Partnership; Kalvina Belin, coordinator and ISEP instructor; Jamie Wilson, ISEP instructor; Shawndeena George, NAU Master of Public Health, Indigenous Health student; Amber-Rose Begay, project coordinator, public health program, Diné College; Carmella Kahn, assistant professor, School of Science, Technology, Engineering and Math, Diné College; Mark Bauer, professor, School of Science, Technology, Engineering and Math, Diné College; and Nicolette Teufel-Shone, associate director, Center for Health Equity Research (CHER) and professor in NAU’s Department of Health Sciences.
Diné College and NAU’s CHER: working together to make a different for students
In 2016, Diné College partnered with Northern Arizona University to develop the Navajo Native American Research Center for Health (NARCH) Partnership funded by the National Institutes of Health.
Since then, the Navajo NARCH Partnership has established three high school programs: ISEP, academic year internships, and a dual credit program for students interested in public health from local high schools to earn credit at Diné College. They also started a Bachelor of Science in Public Health Program for students entering Diné College with an associate’s degree, and they offer a 10-week Summer Research Enhancement Program (SREP)—a program that began 15 years ago prior to the Navajo NARCH Partnership with NAU.
“The Navajo NARCH Partnership team has been creative and innovative in ways to engage students at the high school and college levels to understand the scope, role and impact of public health,” Teufel-Shone said. “Through these programs, students with an interest in biological or social sciences can find a fit in public health. That’s the goal of NARCH—to build the Navajo Nation public health workforce and it starts with sparking an interest in a career unfamiliar to most students.”
Focusing on culture makes all the difference in ISEP success
Exploring six years of data-driven results from the ISEP, the team discovered that more than half of the students who attended ISEP attended college in public health fields.
They found that ISEP students felt that they learned how to advocate for the health of their community, and they gained more cultural insights into their communities. Students also said they learned resilience, and that the program instilled in them a knowledge that they could overcome difficult obstacles.
“The first day [of the ISEP program], we open up with the blessing and then we talk about resilience—individual resilience and community resilience—and how that looks,” Begay said.
On that first day, the ISEP students meet in a hogan, a Navajo sacred dwelling, with a medicine man for prayers and blessings. Begay said that for the students, being in the center point of the Navajo Nation, where they are within the protection of the four Sacred Mountains, creates a balance within them.
“Whether they are living on Navajo land or not, we are bringing them back to this place in the environment of Tsaile, Arizona,” Begay said. “It is a place where I can breathe and learn and think and connect with people in person.”
Examining ISEP’s successful model
Belin said that in addition to integrative teamwork between ISEP and SREP staff, other aspects that make the program successful for students are: assistance from peer mentors; exposure to guest speakers who are public health leaders in the community; opportunity to create a digital storytelling project that is shown at the end as well as a mini service learning research project; and experiences with a curriculum and agenda that are culturally specific and relevant to the local community.
The ISEP team introduces the Hózhó Resilience model consisting of three main elements: harmony in relationships, respect, and spirituality to design their public health prevention strategies.
“Just like Diné College, we incorporate the Diné Educational Philosophy (DEP), a Navajo conceptual framework, into the curriculum content,” Belin said. “Not only does DEP represent the Diné traditional living system, but it also serves as a guide for students when they’re working on their research project and career mapping.”
Belin said that they choose public health guest speakers who are actively working to promote health within Native communities to work with the students.
“Most of the speakers are from the tribal community as well, so they understand the unique challenges that community members face and the barriers they experience when navigating Western, academic institutions as a student,” she said.
As a result of the initial success, they recruit past ISEP participants to serve as peer mentors for the next year. Peer mentors help students through all aspects of the ISEP program.
George said that mental health was something that everyone was struggling with last year during the pandemic, so the team introduced meditation and provided resources to students to help them maintain balance.
“We make sure that we are there for each other and let each other know that it is a safe space and a safe environment to ask questions and reach out,” George said.
For their data, the researchers used an online Qualtrics evaluation questionnaire to collect students’ perception of the program.
In their survey responses, students wrote that they appreciated the program staff, fellow students, peer mentors and culturally relevant learning experiences in both virtual and in-person environments. Their recommendations included: expanding the length of ISEP and continuing hands-on activities and the Public Health Leadership series. When they moved to a virtual ISEP week last year due to COVID-19, they added a mental health component to address wholeness and healing.
Closing ceremony is just the beginning for ISEP students
At the end of the ISEP week, the group concludes with a closing prayer.
“We send them off with good blessing and protection and wish them well in their futures,” Begay said. Dreifuss said that before the final farewell, they give the students a chance to reflect on their experience together. She said that many of them have bonded closely during the course of the week.
“One thing that was very important that we did with students—before we did a formal ceremony, we did an informal one,” Dreifuss said. “The night before [the closing ceremony], we ask them to draw a picture of how ISEP has impacted their future direction.”
After the closing ceremony, George said that the most enlightening part of the program for her is when the guardians of participants have an opportunity to view their digital stories.
“The really got to see what their children were doing the past week—what they learned,” George said. “They [digital stories] are very personal and they really show the kind of information that ISEP was able to show them.”
George said that the team had several parents reach out after the program and thank they for their work.
“I think the [guardians’] email was more so them coming to the realization of how passionate their child was about public health after the program, and they could really see that they did learn a lot,” George said.