Form 0920-20PJ Interview Discussion Guide

Formative Research on Community-Level Factors that Promote the Primary Prevention of Adverse Childhood Experiences (ACEs) and Opioid Misuse Among Children, Youth, and Families in Tribal American India

Attachment L_Interview_Discussion Guide for Community Leaders and Service Providers

Community Leaders or Service Providers

OMB: 0920-1351

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Attachment L. Interview Discussion Guide for Community Leaders and Service Providers


Form Approved

OMB No: 0920-xxxx
Exp. Date: xx-xx-xxxx


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BIRCH Interview Discussion Guide

For Community Leaders & Service Providers


Opening Blessing and Activity – as appropriate – (e.g., cultural activity, land acknowledgement) [Facilitated by community researcher; Will work with the facilitator to determine whether this should come before or after consent review and survey, and/or introductions]


Consent Review and Survey [For in-person Interviews only]

  • Thank you taking the time to speak with me today!

  • Before we get started, we would like you to review and sign the consent form for this study [provide consent form]. Would you like any support to go through this document? [if yes, read consent to participant].

  • We would like to review some key parts of the consent form together. [Briefly verbally review the key parts of the consent form including purpose and use of study data, confidentiality parameters and data security, and opportunity to decline at any time. Be sure to emphasize that information is kept confidential and personal information is stored separately from their responses today, helping to preserve anonymity. Note that the audio recording will be destroyed soon after a transcript is produced].

  • Do you have any questions? Please take your time and feel free to ask any questions you have as you read through it. After you have reviewed the consent form and the research team has adequately addressed any questions or concerns you have, please sign and return the form to [insert name]. The signed consent form will be stored separately from other information so your name will never appear with the information you provide.

  • [Once the consent form is signed, administer the survey.] Thank you! This is a brief survey to help us describe, as a whole, the people we speak with in this study. These data will be combined to describe participants as a group. You will not be identified personally. [Administer survey – either by having participant read and complete individually or if support for consent process was sought by participant, community researcher to read each item and responses aloud and assist participant to complete survey]. Please let me know if you have any questions about any of the survey questions or response options. You can choose to skip or not answer any question for any reason. You can also decide to not complete this survey and still participate in the discussion today.


[If meeting virtually or over the phone] – [If the participant hasn’t completed the survey, please ask them to do so immediately after the interview]


Permission to Record

As we indicated in the consent form and invitation we would like to (audio) record this discussion. The recording will be destroyed after we are able to prepare the transcript or notes from the discussion. Are there any questions about the recording? Ok, I will begin the recording now [Begin recording].


[If the participant refuses recording]. Ok, instead my study assistant [insert name] will take detailed notes [Begin note taking].


Introduction

Hello, [Name/Names]. Thank you for taking the time speak with me today! [Introduce all facilitators] My name is [Insert name]. I am/we are a researcher with [insert organization or institution and a very brief description of focus of research/experience]. This discussion is part of a study that is funded by the Centers for Disease Control and Prevention to understand how health and well-being are supported in urban and rural Native communities.


As part of this study, we are conducting interviews with leaders and service providers from [insert Tribe or urban Indian community name], such as yourself, and also hosting some focus groups with other community members here.

You have been invited here today because you have been identified as someone with knowledge about [insert Tribe or urban Indian community name] community strengths and qualities. We would like to hear your voice, perspective, and experience to understand what is helpful in your community in supporting children and families. We want to discuss the community supports and resources available to provide safe, stable, and nurturing relationships and environments for American Indian and Alaska Native children and families.

We will ask some questions to help start the conversation but will really have this space as an opportunity for us to learn from you. We will spend about 60-90 minutes together. The flow of the conversation will be as follows. We’ll pose some questions about positive childhood experiences in this community, then turn to community prevention of adverse childhood experiences and substance use, recovery and healing journeys from substance use, community collaborations in this area, and we will end with your ideas about opportunities to enhance prevention of trauma and substance use.

If you need to take a break at any time, for any reason, please feel free to do so.

We’ve done a lot of talking so far! Let’s go ahead and get started.




BACKGROUND


  1. I understand that you are a [community leader/provider] who works on efforts to prevent childhood trauma and/or opioid use in [insert Tribe or urban Indian community name]. Can you tell me about this work?

    • Follow up questions:

      • How long have you worked for this organization/in this community?

      • Briefly, what are your primary roles and responsibilities?

      • How does your organization or efforts serve the community?

  1. Do you currently live in [insert Tribe or urban Indian community name]?

  2. Did you grow up in [insert Tribe or urban Indian community name]?



COMMUNITY PROMOTION OF POSITIVE CHILDHOOD EXPERIENCES


Let’s begin by discussing how this community helps support community wellness and positive childhood experiences.


  1. From your experience here in [insert Tribe or urban Indian community name], what is great about growing up here? I’m going to write down what I hear from you about positive childhood experiences, so I can reference this later in our discussion. [list positive childhood experiences]


    • Clarifying question:

            • What are examples of ways the community helps children to grow up happy and healthy in [insert Tribe or urban Indian Community name]? Some ways communities may support children could be, for example, through activities for families, early care settings or schools, community programs or institutions, or cultural practices that help to keep children healthy and strong.


    • Follow-up questions:

            • How else does [insert Tribe or urban Indian community name] support health and well-being for children, families, and young adults? Some ways communities may support health and well-being could include, for example, providing a lot of opportunities for community members to gather, hosting traditional events, or connecting community members to resources to have a safe home environment. [continue to add any health and well-being promotion efforts to the list]

            • How do these positive experiences for children, families, and young adults affect health and well-being in this community?


    • Probes:

    • Examples - when needed to more fully understand the concept

            • Tell me more about [resource or support].

            • Could you describe a specific example of [resource or support]?

    • Cultural practices: - defer to community researcher about appropriateness

            • In what ways might cultural activities or practices contribute to children’s positive experiences in [insert Tribe or urban Indian community name]?

            • How does [insert Tribe or urban Indian community name] support children’s and youths’ participation in cultural practices?


  1. I’ve been writing down the positive experiences and resources you’ve talked about, and ways they support health and well-being. [Briefly review some or all components of the list]. How are these resources and supports promoted within [insert Tribe or urban Indian community name]? For example, how do young people and families learn about or get connected to these resources?


  • Follow-up questions:

    • Is access more difficult for some or does everyone have equal access?

    • What challenges or barriers gets in the way of communities making these positive experiences available and accessible to all children, families and young adults?

    • How might [insert Tribe or urban Indian community name] go about trying to overcome the challenges and barriers?



COMMUNITY PREVENTION OF ACEs AND SUBSTANCE USE


Now, we would like to talk about efforts that are focused on helping people and communities prevent adverse childhood experiences and substance use – to keep them from happening or reduce how often they happen. In our discussion today, when we refer to adverse childhood experiences or adversity, we mean experiences that can cause trauma such as physical or emotional harm, neglect, family conflict, historical trauma, and racism.


  1. From your perspective, what are some of the more common adverse events and trauma that children, families, and young adults in [insert Tribe or urban Indian community name] experience or may have experienced in the past? [defer to community researcher on whether to provide a list of ACEs to respond to]


  1. How does [insert Tribe or urban Indian community name] help prevent children, families, and young adults from experiencing adverse childhood experiences and trauma? I would like to write down what I hear from you about prevention resources or strategies. [list prevention strategies and resources]


    • Clarifying question:

      • For example, one way could be having a particular characteristic or quality of the community, such as a foundation of multi-generational households. Or, another could be a specific thing that community members do or have access to, such as parenting resources, or governmental commitments to addressing poverty. What does [insert Tribe or urban Indian community name] do or provide to protect [children and families / youth and young adults] from having negative or harmful experiences?


    • Follow up questions:

      • How might these resources and strategies that you have talked about today also work to prevent or reduce substance use? [note which listed prevention resources or positive childhood experiences are also discussed as strategies for substance use – e.g., with an asterisk]

      • What additional ways does [insert Tribe or urban Indian community name] work to prevent or reduce substance use among [children and families / youth and young adults]? [list additional efforts and resources that are mentioned for substance use]


    • Probes:

      • Examples - when needed to more fully understand the concept

        • Tell me more about [resource or support].

        • Could you describe a specific example of [resource or support]?

      • Cultural practices: - defer to community researcher about appropriateness

        • In what ways might cultural activities or practices in [insert Tribe or urban Indian community name] contribute to the prevention of adverse childhood experiences and substance use?

        • How does [insert Tribe or urban Indian community name] support [children and families’ / youth and young adults’] participation in these cultural practices?

      • Mechanisms:

        • How do you think [resource/program/service] is beneficial to preventing substance use and adverse childhood experiences/trauma?


  1. You’ve come up with a helpful list(s) of the ways that [insert Tribe or urban Indian community name] prevents or reduces negative childhood experiences and substance use. For example, you’ve mentioned [briefly review some or all components of the list]. How are these resources and supports promoted within [insert Tribe or urban Indian community name]? For example, how do young people and families learn about or get connected to prevention efforts or resources?


  • Follow-up questions:

    • Is access more difficult for some or does everyone have equal access?

    • What challenges or barriers gets in the way of communities making these prevention resources available and accessible to all children, families and young adults?

    • How might [insert Tribe or urban Indian community name] go about trying to overcome the challenges and barriers?



SUBSTANCE USE RECOVERY


There are various ways people overcome trauma and substance use. Some language that is used to describe this process is ‘recovery’ and ‘healing journey.’


  1. For individuals in [insert Tribe or urban Indian community name] who have worked to overcome trauma or substance use on a healing journey, what resources or supports helped them heal?


    • Clarifying question:

      • What does [insert Tribe or urban Indian community name] do to help community members recover from traumatic experiences and substance use?


    • Follow up question:

      • How are resources or supports for healing journeys different for children, families, young adults?

        • What resources/supports exist for families with young children recovering from trauma and substance use?

        • What about older children and teenagers, and young adults?

        • What about for parents, including teen/young adult parents?


    • Probes:

      • Examples - when needed to more fully understand the concept

        • Tell me more about [resource or support].

        • Could you describe a specific example of [resource or support]?

      • Response to both trauma and substance use – if respondents only speak to one of these, ask about the other

        • What resources and supports help a person heal from [trauma / substance use]?

      • Cultural practices: - defer to community researcher about appropriateness

        • In what ways might cultural activities or practices in [insert Tribe or urban Indian community name] contribute to a person’s healing journey?

        • How does [insert Tribe or urban Indian community name] support [children and families’ / youth and young adults’] participation in these cultural practices?

      • Mechanisms:

        • How do you think [resource/program/service] is beneficial in helping individuals recover from substance use and ACEs/trauma?


  1. How are these resources and supports that help community members through their healing journeys promoted within [insert Tribe or urban Indian community name]? For example, how do young people and families learn about or get connected to these resources?


  • Follow-up questions:

    • Is access more difficult for some or does everyone have equal access?

    • What [other] challenges or barriers gets in the way of a person’s or family’s healing journey?

    • How might [insert Tribe or urban Indian community name] go about trying to overcome the challenges and barriers?


COMMUNITY COLLABORATIONS

We would like to talk with you about how individuals, programs, organizations, or others in [insert Tribe or urban Indian community name] may be working together either locally or regionally to prevent adversity in childhood and substance use.


  1. What, if any, formal or informal collaborations or partnerships are occurring in [insert Tribe or urban Indian community name] focused on preventing adverse childhood experiences and trauma? This could include coalitions, committees, initiatives, policy workgroups, cross-agency programs or funding streams, etc.

  • Probes:

  • More details if collaboration is mentioned:

    • Please tell me more about this partnership. Who are the partners in this collaboration?

  • Mechanisms:

    • What are they seeking to do?

    • What are their intended impacts on trauma and ACEs?

    • What is their theory of change, from what you know?

  • Impacts:

    • What have the partners accomplished to date?

  • If no collaboration is mentioned:

    • What community collaborations or partnerships should there be or what could be helpful from your perspective?


  1. What collaborations or partnerships, if any, are occurring that are focused on preventing or addressing opioid use and support healing journeys? These may be the same or different efforts than what you may have described above.


  • Probes:

    • More details if collaboration is mentioned:

      • Please tell me more about this partnership. Who are the partners in this collaboration?

    • Mechanisms:

      • What are they seeking to do?

      • What are their intended impacts on trauma and ACEs?

      • What is their theory of change, from what you know?

    • Impacts:

      • What have the partners accomplished to date?

    • If no collaboration is mentioned:

      • What community collaborations or partnerships should there be or what could be helpful from your perspective?



OPPORTUNITIES TO ENHANCE PREVENTION EFFORTS


  1. If anything was possible, what more would you have [insert Tribe or urban Indian community name] do to support well-being and healing journeys?


    • Clarifying question:

      • If resources were unlimited, what supports, resources, services or other factors might be needed or helpful in [insert Tribe or urban Indian community name] in breaking the cycle of both childhood trauma/adversity and substance use?




Thank you for taking the time to share with me today. Those are all the questions I have for you.


Is there anything else that we need to understand that we didn’t touch on today about how [insert Tribe or urban Indian community name] support individuals, children and families to be healthy?

Is there anything else you’d like to add to our discussion before we end?


Ok, thank you. I’m going to [end our recording/stop taking notes] now [End recording and note-taking].


And finally, after we are done hearing from members of [insert Tribe or urban Indian community name] and have a chance to begin summarizing the information, we may circle back with you to make sure our understandings of what you shared today are correct. This may be over email or a quick phone call. Are you willing to be contacted later? [If yes, check that we have their phone number and email address; if we do not, please ask for it]


[Share any additional information about dissemination protocols identified through the Data Sharing Agreement with the community]



Closing activity – as appropriate – (e.g., blessing, cultural activity) [facilitated by community researcher]



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