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Logo with the words IndigenousSIPIN and a blue wave graphic
Logo for IndigenousSIPIN intervention, shared with author permission from Haozous, E., Yeary, K., Maybee, W., Porter, C., Zoellner, J., John, B., Henry, W. A. E., & Haring, R. C. (2024). Indigenous knowledge and sugar sweetened beverages: Qualitative adaptations towards chronic disease prevention and intervention. Explore (New York, N.Y.), 20(6), 103066. Advance online publication. https://doi.org/10.1016/j.explore.2024.103066

November is Native American Heritage Month. To observe it, The Rotation spoke with Dr. Emily A. Haozous, PhD, RN, FAAN (Chiricahua Fort Sill Apache). 

Dr. Haozous is a nurse and research scientist with the Pacific Institute for Research and Evaluation - Southwest Center, based in Albuquerque, New Mexico. Dr. Haozous conducts community-based and community-guided research and evaluation in collaboration with Native American partners, including urban tribal centers, reservation-based tribal organizations, and tribal governments. Her work is focused on issues of access to care, health equity, cancer and non-cancer pain management, cultural tailoring, and national trends in premature mortality. Dr. Haozous has a clinical background in oncology, hospice, and palliative care nursing. She is a breast cancer survivor and has co-facilitated a women’s cancer support group continuously since 2007. Dr. Haozous received her undergraduate degree in music from the University of California, Santa Cruz, and her MSN and PhD in nursing from Yale University. Most recently, she participated in the authorship of the National Academy of Medicine’s special publication, Systems’ Impact on Historically and Currently Marginalized Populations (expected publication date 2025).

Dr. Haozous is first author of the recent publication, “Indigenous knowledge and sugar sweetened beverages: Qualitative adaptations towards chronic disease prevention and intervention.” The focus of this publication is the adaptation for one Indigenous population of an evidence-based curriculum (SIPsmartER) to reduce consumption of sugar-sweetened beverages (SSB). The study reports on the successful adaptation of the curriculum resulting in a curriculum called IndigenousSIPIN, and also provides valuable insights into the practice of cultural tailoring

The Rotation: Thanks for taking time to talk with me today. I wanted to speak about your most recent publication, and discuss some concepts related to research and Native populations that it introduced me to. I noticed quite a few co-authors on this paper.

EH: It was a really big team. We had people from all over the country and different disciplines… The one thing we didn’t have were any MDs. That wasn’t a conscious decision, just how it worked out. People think about medical research, or health research, and they think about doctors. Here we have nutritionists, we have nurses, we have a social worker… We have people from all across the healthcare spectrum.

The Rotation: I was intrigued by the use of the concept of the Good Mind, a concept familiar to Indigenous people from the community that was addressed by this adaptation, in the modification of the SSB curriculum, which also introduced the metaphor of the Clean and Dirty River as a framework for the curriculum. These worked for the specific Indigenous group the intervention was tested on, who were male athletes in the Northeastern U.S. Would these metaphors be understood to all Indigenous people?

EH: What you’re asking me about is Native Science. That’s kind of the core of cultural tailoring. The old mainstream perspective on cultural tailoring of health literature is “Well, let’s just change the color scheme and maybe add some photos. If they speak a different language, we’ll change the language. Or maybe we’ll make the font size bigger.”

The Rotation: Sort of like when someone doesn’t understand English, so the other person just speaks louder?

EH: That’s a good way to think about it. Think about how that feels, if you’ve ever been to another country and people have done that to you… But when we’re talking about actual cultural tailoring, you really want to think about, Who are the people you’re trying to communicate with, How do they think? What’s important to them? What is their culture? And so, when you do that… it stops being about changing the color scheme – well, actually, maybe the color scheme is important. A lot of Native tribes – I’m not going to say all, because that would be disrespectful, [since] there are 574 recognized tribes in this country right now, and that number’s changing all the time, and we’re all different – color is important to us. When I go and spend time with my tribe, I can tell who’s Apache because of the colors they’re wearing. And I can tell who’s Comanche because of the colors they’re wearing. So color’s important.

The Rotation: That’s why I was wondering, when you are culturally tailoring an intervention or instrument, are there terms that transcend differences between the tribes? I’m asking whether the ways that you modified the tool are fundamentally, across the board, things that would be understood, regardless of tribe.

EH: I don’t think I could say that. I’d have to talk to each person and say, “Does this make sense to you?” Until I had talked to someone from every single tribe or community – and even within tribes there’s differences – I’d have to really do a scan to be able to confidently say yes or no. 

So getting back to [cultural tailoring] – we have to get to what is meaningful for people. So it’s not just about color and not just about pictures, but what is meaningful for those people.”

The Rotation: I look at many studies that aren’t designed like this. Is this research practice of culturally tailoring instruments or interventions something fairly new?

EH: Yes. The practice of really digging deep into a community and finding out what is meaningful to you. And it is not just using an algorithm, but going in and saying, “Is this color aesthetically pleasing to you? Are there colors that we shouldn’t be using? Are there pictures that we shouldn’t be using?” You know, in some communities you don’t include pictures of people who have passed on. Which is challenging, because – people die. And so you have to be very careful with that. And in other communities they really want that, to celebrate people who have been important to them.

In science, they want algorithms. In dissemination and implementation research, it’s all about, “What works here should be able to work everywhere else.” And that’s just not the case in Native communities. So, I can’t take the Clean and Dirty River model and use it in the Southwest. Because we just don’t have the same accessibility to water. So I can use the same practice of finding a meaningful metaphor and trying to transform it, but I can’t use Clean and Dirty River.

Chart showing five stages of tailoring the existing SIPsmartER intervention to the Indigenous-focused IndigenousSIPIN.
Figure 1 from Haozous, E., Yeary, K., Maybee, W., Porter, C., Zoellner, J., John, B., Henry, W. A. E., & Haring, R. C. (2024). Indigenous knowledge and sugar sweetened beverages: Qualitative adaptations towards chronic disease prevention and intervention. Explore (New York, N.Y.), 20(6), 103066. Advance online publication. https://doi.org/10.1016/j.explore.2024.103066. Shared with author permission.

The Rotation: I was curious about the graphic in the article, which depicts the stages of cultural tailoring of evidence-based interventions. 

EH: That was just me trying to make something that was usable. Part of it is, we have this whole curriculum for the program that we didn’t want to publish, because we didn’t want it to become mainstream.

The Rotation: You don’t want it to be used like a blunt instrument.

EH: Exactly.

The Rotation: Publication of these findings is intended to demonstrate cultural tailoring in practice, but it is not intended as a product to be posted online or whatever.

EH: If people want to contact my colleagues and see the materials they created, it’s up to them.

The Rotation: Were all the team members Indigenous?

EH: Some people were not. We spent some time with the non-Indigenous team members getting them to understand… Some people were saying, “You’ll never get them to drink water.” Because there’s no precedent in the literature where you could convince people who were basically addicted to drinking SSB to stop drinking sweet things. And so we had to do a lot of teaching within the team to say, Look, a lot of traditional beverages are sweet, they’re just not sugar-sweetened. They’re sweetened with berries, there are teas that you can sweeten. And natural stevia grows in the area where we did this research. And they were like, “They’ll never choose water.” And we were able to prove them wrong.

The Rotation: Part of the work being done here is to dismantle the assumptions people are making.

EH: For one of them, this person had been working in the field for a very long time, and her biggest success was getting people to drink diet sodas. And we were like, maybe we can aim for a different purpose.

The Rotation: How much of your published work has been related to Indigenous people?

EH: I always get called in as the expert on Indigenous research. I’m happy to do that. That’s my mission. I’ve published in a lot of different places, domains, whether it’s large data analysis or qualitative research looking at access to care in different places, whether that’s in Indian Health Service or pain management or telehealth.

The Rotation: Do you have recommendations for those who are new to reading research conducted in Indigenous populations?

EH: The first thing I would suggest is that when people are reading an article, they find articles that are written by Indigenous authors. Usually there’s a disclosure statement if a person [on the team is] Native. You want a team that has Native people on the team. I’m starting to see articles coming from other countries where they’re just slurping up data from American sources, and they don’t have Native authors, and they’re terrible. The American Journal of Public Health is usually very careful about this. You want to make sure that [researchers have] followed data ownership guidelines from the tribes. That is usually included in the disclosure with the article. Usually the top tier journals will follow that, and the peer reviewers will keep track of that. It’s a very small circle, you start to see the same people publishing.

The Rotation: What was your experience working on this project?

EH: It was a great project. I like doing that kind of work, because it really makes me work my Indigenous mind, and I get to work with Native teams, which I really like to do.

The Rotation: How long did the project last, start to finish?

EH: It was a couple years, and it all happened during COVID. We had to do a lot of the interviews online, which was hard. But one of the best parts was talking to these men who really knew a lot about their culture, and a lot about how to encourage young men to drink water, and what was important to them.

The Rotation: I was struck by the quote in the article from a participant in the intervention who suggested that something that would make others in their community pay attention to reducing SSB consumption was the high cost of dental care, and the prospect of having dental problems, as being more persuasive than health issues which would appear farther down the road.

EH: There’s a lot going on there, like the fact that they don’t have access to good dental care. There’s so much more in there that we couldn’t add.

The Rotation: When we think about barriers to access to care, people are primarily thinking about, say, African American communities or urban versus rural communities. I think it is rare for people to perceive there are Native communities all around us confronting the same or similar issues. Thank you so much for taking the time to speak with me today.

For those interested in learning more about Native Science, Dr. Haozous recommends Gregory Cajete’s Native science : natural laws of interdependence (Clear Light Publishers, 2000.) This book is available to borrow from Georgetown University through Himmelfarb’s WRLC consortial borrowing program.

References

Haozous, E., Yeary, K., Maybee, W., Porter, C., Zoellner, J., John, B., Henry, W. A. E., & Haring, R. C. (2024). Indigenous knowledge and sugar sweetened beverages: Qualitative adaptations towards chronic disease prevention and intervention. Explore (New York, N.Y.), 20(6), 103066. Advance online publication. https://doi.org/10.1016/j.explore.2024.103066

 

Today is World Diabetes Day, with the theme of "Diabetes and Wellness." This year, learn with the Mayo Clinic how to help live your best life.

Today is World Diabetes Day, a day meant to support and raise awareness for the 537 million diabetics around the world. This year, the theme set by the International Diabetes Foundation is “Diabetes and wellness.” Healthy eating and exercise can make a profound impact on preventing and controlling diabetes. While many factors influence diabetes, their hope is to empower people to take agency over the disease or to encourage others to do the same. 

infographic from the Lexington-Fayette County Health Department

As the Mayo Clinic points out, the benefits of exercise extend to holistic improvement of health, both physically and mentally. For adults, they recommend “150 minutes a week of heart-pumping aerobic activity.” This might sound like a lot, but 2 and a half hours divided over seven days is about 21 minutes of activity a day. In other words, a total investment in health could be accomplished with a few jogs, walking to the metro, biking around, or – as the signs all around Ross Hall remind us – taking the stairs when possible. 

Personally, I am always an advocate for running, as it’s (nearly) free and can improve sleep, cardiovascular health, and mental health. And although research is still nascent, a connection between exercise and increased insulin sensitivity is beginning to emerge. Moreover, the amount of running necessary to improve health (20 minutes a day) is possible to fit into many different schedules, unlike other cardio exercises like swimming or kayaking. 

Of course, for diabetics, especially those suffering from hypoglycemia, extra precaution is necessary. The Mayo Clinic recommends checking blood sugar before exercise and gives guidance on when to avoid exercise. They recommend consulting with a doctor about activities before engaging with them. 

Ultimately, managing diabetes is a lifestyle change, one that requires support. The American Diabetes Association has many resources, as well as a local chapter in the DC Capital area. 

Pictures of Val Bowles (35 years) and Ian Roberts (5 years). Text: Congrats Val & Ian.

Himmelfarb Library congratulates staff members Valerie (Val) Bowles and Ian Roberts on their recent milestone work anniversaries at George Washington University! Val recently celebrated her 35th anniversary at GW, and Ian celebrated his 5th anniversary! To help celebrate these anniversaries, we interviewed Val and Ian to learn more about their careers at Himmelfarb.

When did you start working at GW? What was your first position here?

Val: September, 1989. My first position was the assistant to the since-retired Account Analyst Bozinca Baumuller.

Ian: October, 2019. I was (and remain) the Acquisitions and Resource Sharing Librarian.

What different positions have you held during your time at Himmelfarb?

Val: Executive Assistant to the Account Analyst for the library, Account Analyst for Educational Resources (Biomed, CASS, and Continuing Education) which is no longer, and now I’m the Account Analyst for Himmelfarb Library.

Tell us about your current position and what you do at Himmelfarb.

Val: I am the Account Analyst and am responsible for securing purchase orders, processing invoices, and managing the budget. I also have payroll and facilities responsibilities all with the library. Additionally, I provide accounting responsibilities for the Healing Clinic and the Office of Medical Education.

Ian: I buy books and help make decisions about buying and renewing platforms and databases. I also oversee resource sharing (both Interlibrary Loan and our Consortium Loan Service). In addition to my core title duties, I participate in the Practice of Medicine curriculum, communicate with vendors, manage collection development, run the annual Book Sale, and have helped lead library discussions and research related to artificial intelligence.

Can you tell us how Himmelfarb has changed over your career?

Val: Himmelfarb used to occupy the whole library but now there are at least 3 different departments housed in the library. And we used to have a staff lounge in the basement. Another big change is how I now process invoices. Back in the day (lol), I used to type them up on a payment request form and send them through interoffice envelopes. I also had to write them in a book for tracking purposes and then file them in our file cabinets by the vendor. We also used to be part of the Medical Center, different from now being part of the University.

Ian: I started five months before the pandemic began, so I saw the transition to full remote work and then eventually to the hybrid model we have now. Additionally (and partially informed by the hybrid work environment) I've seen a stark shift from the use of print resources to electronic resources.

What are some of the things you enjoy most about your job and working at Himmelfarb?

Val: I really enjoy working with numbers and ensuring that we stay under budget the most important part of my job. I really enjoy all of the many colleagues I have met and worked with over the years as well.

Ian: I appreciate that there's always room for growth and that I'm encouraged to try new things and find new trainings to take part in. The work is usually interesting because there's always a new project to tackle. And it's also a friendly, welcoming environment with excellent co-workers.

Can you share one or two of your favorite memories of working at Himmelfarb?

Val: The Holiday parties when staff would bring in homemade dishes/treats and some from their home countries, we had a great time.

Ian: The Misinformation project, which led to redesigning a class for first-year students about identifying and confronting misinformation as well as a book chapter that I co-wrote with colleagues. Also attending the Computers in Libraries Conference (which I've done twice now).

From all of us at Himmelfarb Library - congratulations to Val on your 35th anniversary and to Ian on your 5th anniversary at GW! We are so lucky to have you both as part of the Himmelfarb team!

Picture of Scrabble tiles laid out face down over a purple background with tiles that spell "Self Care" facing up.

It's been a stressful week. Take time to prioritize self-care today and throughout the week.

There isn’t a single definition of self-care, as self-care is different for everyone, but it generally refers to how we maintain, improve, and protect our health and well-being. Self-care boils down to doing things that preserve or improve your mental or physical health.

The GW Resiliency and Well-Being Center has great self-care resources focused on types of self-care, self-care strategies, and resources. Types of self-care listed here include breathing exercises, massage therapy, nutrition, meditation, exercise, journaling, yoga therapy, cognitive behavioral therapy, and gratitude practice.

Self-care is also about the little things, like making sure you've eaten, drank some water, and gotten some sleep. If you're feeling up for it, physical activity can be great for self-care. Just going for a short walk and getting some fresh air can help ease anxiety and clear your head. Self-care can be taking time to rest, taking a break from social media or the news, and acknowledging and sitting with whatever feelings you are experiencing.

Doing little things that you enjoy can be a big boost to your self-care. Make time for your hobbies that bring you joy and satisfaction. Do things that help you feel refreshed and recharged. And make time to connect with friends, family, or loved ones. Feeling connected to other people can be a great way to promote your self-care and that of those around you. It's more important than ever to support one another, so please be kind and respectful to each other and yourself.

Note: Much of the text of this post was originally posted on July 24, 2024, in a post titled Happy International Self-Care Day!

Picture of black hands folded around a rainbow ribbon.
Photo by Anete Lusina

Himmelfarb Library’s Diversity, Equity, and Inclusion Committee (DEI Committee) is proud to announce the release of the new LGBTQ+ Health Research Guide! The guide features resources that address LBGTQ+ healthcare in clinical and research settings and explores sexual orientation and gender identity barriers to accessing healthcare. You’ll also find general resources including links to LGBTQ+ health organizations at GW and in the DC, Maryland, and Virginia area. Relevant books, e-books, and journals from Himmelfarb’s collection, educational resources about pronouns and preferred terminology, and podcasts to help you learn about LGBTQ+ healthcare are showcased in the guide. 

Featured books from Himmelfarb’s Diversity and Disparities in Health Care Collection include:

Highlighted journals on LGBTQ+ health include:

Please note that some resources, such as e-books and journal collections, may require GW credentials to access.

The Researchers tab of the guide provides insight into useful MeSH search terms, links to helpful research-related guides, and information about conducting research. This tab also features published works related to LGBTQ+ health by GW authors in Himmelfarb’s Health Sciences Research Commons (HSRC).

The DEI Committee wants this guide to be a high-quality resource relevant to our community, and we encourage our users to share relevant resources for inclusion in the LGBTQ+ Health Guide through our Resource Suggestion Form. If you are a member of a GW organization and would like your organization to be featured in this guide, or if you’re interested in partnering with the DEI Committee, please contact the current committee chair, Brittany Smith, at bsmith91@gwu.edu

Decorative image - November 2024 Study Break Guide

Eckington Flea
Date:
Saturdays, Now - May 24, 2025.
Time: 10:00 am – 2:00 pm
Location: Eckington Hall, 1160 Eckington Pl., NE
Cost: Free

Eckington Flea is a marketplace featuring an eclectic roster of vendors selling vintage clothing, household products (soaps, candles), books, art, collectibles, and more.  It will also feature artisanal foods like honey, and baked items along with fresh produce.  Vendors present will represent makers from Washington, D.C., along with the entirety of MD and VA.

UnFinished Objects (UFO) Craft Circle
Date:
Saturdays, Now- December 28, 2024
Time:
3:00 pm - 4:30 pm
Location:
DAR Museum, 176 D St., NW Washington DC 20006
Cost:
Free

Join us for the UnFinished Objects (UFO) Craft Circle at the DAR Museum! Bring your half-done projects, abandoned crafts, and unfinished masterpieces, and spend a cozy afternoon with fellow craft enthusiasts. Whether it's knitting, crocheting, painting, or any other craft, this event is a perfect opportunity to get inspired, share ideas, and finally complete those lingering projects. The UFO Craft Circle is an in-person event, so come prepared with your supplies and a positive attitude.

Let's turn those unfinished objects into beautiful creations together!

Registration is requested but not required.

African Diaspora Collection at the Mansion Galleries This Fall
Date:
Daily, Now - Nov 07, 2024. 10:00 a.m.
Time: 10:00 am
Location: 10701 Rockville Pike
Rockville, MD 20852
Cost: Free

From the Art Collections of Margo Thomas, Yonette Thomas, and Deborah Smith 
Curator: Zoma Wallace

This fall, the Mansion Galleries will feature art, artifacts, and ephemera of the African Diaspora. The work comes from the collections of Dr. Yonette Thomas, Dr. Margo Thomas, and Dr. Deborah Smith. Calling themselves the Three Sisters, the three collectors have been professionally and personally connected for almost 25 years.

With Zoma Wallace as curator, they have chosen works from their individual collections, which represent their personal interests. These works will be juxtaposed throughout the exhibition with music, dance, and other artistic expressions.

Mvskoke Etvlwv: The Muscogee People Festival
Date:
November 2nd
Time: 10:00 am – 5:30 pm
Location: National Museum of the American Indian, 4th St SW, Washington, DC 20560
Cost: Free

The Muscogee (Creek) Nation celebrates its tribal history, heritage, and culture with music, performances, a fashion show, and other cultural demonstrations. The festival includes Stomp dancing, veterans’ presentations, and hands-on activities for children and families, along with a showcase of jewelry, traditional recipes, and more.

Meditation with a Monk
Date: November 8th, 5:00 pm - 6:30 pm
Date: November 19th, 6:30 am - 8:00 am
Location: Lerner Health & Wellness Center
2301 G Street, NW, Washington, DC
Cost: Sessions are free to students and Lerner Health and Wellness Center members)

2024 Zoo Lights
Date:
Friday, November 22, 2024 – January 4, 2025
Time: 5:00 pm – 9:00 pm (Thursdays, Fridays, Saturdays and Mondays)
           5:00 pm – 8:00 pm (Sundays)
Cost: $6 (Each attendee, including children over the age of 2, will need a ticket.)

The Smithsonian's National Zoo is transforming into an enchanting winter wonderland with ZooLights this holiday season!

Now in its 16th year, this annual holiday light spectacular welcomes visitors to walk down festive pathways and explore immersive displays throughout the Zoo. Marvel at glowing lantern animals in their dazzling habitats, watch live nightly musical performances, take a spin on the Conservation Carousel, sample sweet and savory seasonal treats, and check gifts off your holiday shopping lists at our Asia Trail, Panda Plaza, and Great Cats stores.

ZooLights tickets are $6 per person. 

Notes: If you plan to drive and park at the Zoo, you must purchase a ZooLights - Parking Pass online before your visit. Passes are available for purchase immediately on the following page. Spaces are extremely limited.

Madison McFerrin
Date:
Saturday, November 15
Time: 6:00 pm
Location: Kennedy Center, Millenium Stage, 2700F St., NW, Washington, D.C. 20566
Cost: Free

Madison McFerrin’s distinct vocal and meticulously layered stylings of a capella and self-harmonizing culminate in work that blends the genres of R&B, pop, soul, and jazz, all with a sense of softness. Her genre-bending work has led to Questlove dubbing her early sound “soul-appella,” AdHoc to describe her work as “an oasis of serenity,” and The FADER noting how Madison’s “warm harmonies feel effortless.”

2024 Downtown DC Holiday Market
Date:
November 22, 2024 – December 23, 2024
Time: Daily, 12:00noon – 8:00 pm (Closed Thanksgiving Day)
Location: F Street NW, (Between 7th and 9th Streets NW)
Cost: Free

It’s that time again to experience the joys of holidays. The Downtown DC Holiday Market is an experience in tastes, sounds, colors, and textures. So come and grab a hot drink and snack while strolling through the many colorful stalls and shop until you drop.

Thanksgiving on the Vern
Date:
Tuesday, November 26, 2024
Location: GW MVC Post Hall, Mt. Vernon Campus
Cost: Free

Staying on campus during Thanksgiving break? Come out to Thanksgiving on the Vern on Tuesday, November 21 from 12:00-3:00pm for delicious food and fun! Enjoy turkey, pie, and more. Plus, take some to-go for later. RSVP is required by November 17!

Enjoy a Thanksgiving feast and fellowship on the Vern!