Agnes Attakai

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Scholarly Contributions

Journals/Publications

• Kahn, C. B., Reinschmidt, K., Teufel-Shone, N. I., Oré, C. E., Henson, M., & Attakai, A. (2016). American Indian Elders' resilience: Sources of strength for building a healthy future for youth. American Indian and Alaska native mental health research (Online), 23(3), 117-33.
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  This study examined American Indian (AI) elders' resilience to support an intervention to build resilience among AI urban youth. A literature review of peer-reviewed articles that address resilience in AI and other Indigenous elders yielded six studies that focused on intergenerational relationships, culture, and self-identity. In addition, a qualitative research project collected narratives with urban AI elders to document perceptions of resilience and resilience strategies. The combined outcomes of the literature search and research project revealed how resilience is exemplified in elders' lives and how resilience strategies are linked to cultural teachings and values, youth activities, and education.
• Reinschmidt, K. M., Attakai, A., Kahn, C. B., Whitewater, S., & Teufel-Shone, N. (2016). Shaping a Stories of Resilience Model from urban American Indian elders' narratives of historical trauma and resilience. American Indian and Alaska native mental health research (Online), 23(4), 63-85.
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  American Indians (AIs) have experienced traumatizing events but practice remarkable resilience to large-scale and long-term adversities. Qualitative, community-based participatory research served to collect urban AI elders' life narratives on historical trauma and resilience strategies. A consensus group of 15 elders helped finalize open-ended questions that guided 13 elders in telling their stories. Elders shared multifaceted personal stories that revealed the interconnectedness between historical trauma and resilience, and between traditional perceptions connecting past and present, and individuals, families, and communities. Based on the elders' narratives, and supported by the literature, an explanatory Stories of Resilience Model was developed.
• Whitewater, S., Reinschmidt, K. M., Kahn, C., Attakai, A., & Teufel-Shone, N. I. (2016). Flexible Roles for American Indian Elders in Community-Based Participatory Research. Preventing chronic disease, 13, E72.
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  Community-based participatory research builds partnerships between communities and academic researchers to engage in research design, decision making, data collection, and dissemination of health promotion initiatives. Community-based participatory projects often have formal agreements or defined roles for community and academic partners. Our project (November 2012-November 2014) was designed to document life narratives of urban American Indian elders as a foundation for developing a resilience-based health promotion curriculum for urban American Indian adolescents aged 12 to 18. We used a flexible method for engaging community partners that honored the individual strengths of elders, encouraged them to describe how they wanted to contribute to the project, and provided multiple ways for elders to engage with university partners. We invited elders to participate in one or more of the following roles: as members of consensus panels to develop interview questions, as members of a community advisory board, or as participants in individual qualitative interviews. The flexibility of roles gave elders the opportunity to serve as advisors, co-developers, interviewees, or reviewers during 2 years of curriculum development. Engaging American Indian elders in the research process acknowledged the multiple layers of expertise they had as traditional leaders in the community while promoting trust in and ownership of the project. This flexible technique can be used by other communities that may not be comfortable with structured processes of engagement.
• Coe, K., Martin, L., Nuvayestewa, L., Attakai, A., Papenfuss, M., De Zapien, J. G., Seymour, S. S., Hunter, J., & Giuliano, A. (2007). Predictors of Pap test use among women living on the Hopi reservation. Health care for women international, 28(9), 764-81.
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  Between July and December 1993, the Hopi Department of Health Services, in collaboration with the Arizona Cancer Center (AZCC), conducted a population-based study of cervical cancer risk factors, screening practices, and predictors of Pap test utilization among American Indian women age 18 years and older living on the Hopi reservation in northern Arizona. This survey, entitled the Healthy Hopi Women's Study, involved a stratified random sample of households from each of the 11 Hopi villages. The final study sample was 559 completed face-to-face interviews. This article reports on unpublished findings of the survey and discusses how the Hopi utilized the study's findings to develop a Centers for Disease Control and Prevention (CDC)-funded breast and cervical cancer program.
• Coe, K., Wilson, C., Eisenberg, M., Attakai, A., & Lobell, M. (2006). Creating the environment for a successful community partnership. Cancer, 107(8 Suppl), 1980-6.
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  This paper describes the development of the American Indian Oncology Program (AIOP) and presents the accomplishments of a participatory research approach that involved an integrated network for cancer care and research. AIOP used a participatory process to develop infrastructure, identify research questions, develop methodologies, write supplemental grants, and evaluate accomplishments based on community defined measures of success. Partnerships between University and Indian Health Service, private, and state institutions led to improved collaboration. Health services delivery improved by increasing provider involvement at multiple institutions via a Tumor Board. Community awareness improved through workshops addressing community-specific cancer concerns. Collectively, these resulted in an environment receptive to the development of research activities. The AIOP team, through a participatory process, developed infrastructure at each institution that facilitated interaction, community-based education, and improved patient care; identified new partners; raised community-level knowledge and awareness about cancer; encouraged a research-friendly environment and building research capacity; and increased the cultural competency of researchers wishing to work in American Indian communities and created a cadre of future American Indian cancer researchers. As evidenced by successful pilot project development and formation of ongoing research and funding applications, the authors created a research-receptive environment and promoted potentially sustainable research capacity in the community. Much of their success is the result of utilizing a participatory model for capacity building that included not only communities but institutions. Cancer 2006. Published 2006 by the American Cancer Society.
• Coe, K., Attakai, A., Papenfuss, M., Giuliano, A., Martin, L., & Nuvayestewa, L. (2004). Traditionalism and its relationship to disease risk and protective behaviors of women living on the Hopi reservation. Health care for women international, 25(5), 391-410.
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  The fundamental aim of this study was to identify factors crucial for the development of effective cancer prevention programs for American Indian (AI) populations. Toward that end, we developed an instrument to assess the influence of traditionalism on health risks such as smoking, consumption, and obesity. A population-based survey was conducted among 559 randomly selected women living on the Hopi reservation aged 18 years and older, from July through December 1993. To construct a traditionalism score, we conducted focus groups in the community. A multidimensional approach was adopted by assessing three dimensions of native culture: language usage; cultural participation, or participation in such activities as Hopi ceremonies; and percentage of life spent off-reservation. A mean score of the three dimensions was computed for each respondent. High levels of traditionalism were significantly associated with disease protective behaviors, such as practicing traditional Hopi activities to keep healthy (OR = 3.07), and significantly inversely associated with disease risk factors such as smoking (OR = 0.26) and obesity (OR = 0.60) independent of age, marital status, and education. As these data provide a strong rationale for the promotion of traditions in public health programs aimed at decreasing rates of chronic disease among AI women, we conclude this paper with a discussion of the importance of traditionalism and how it might be accurately assessed.

Presentations

• Attakai, A. (2014, September). Resilience Strategies: Facing Adversity. 7th ANNUAL TAKE CHARGE! Native American Youth Leadership Conference. Tucson, AZ: Southwest Institute for the Education of Native Americans.
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  Participants learn about prejudice, discrimination and how American Indians have faced adversity by listening to oral stories of adversity and resilience from American Indian elders (video) and participating in hands-on activities an discussions.
• Attakai, A., & Reinschmidt, K. M. (2014, October). American Indian Elders’ Stories of Resilience to Foster Health in Youth and their Families.. INIHKD & Manitoba NEAHR Conference 2014: Voices in Indigenous Health: From the Wisdom of the Elders to the Stories of the Youth.. Winnipeg, Manitoba, CAN.
• Attakai, A., Reinschmidt, K. M., Kahn-Thornbrugh, C., Whitewater, S., Chico, T., Jose, M., Mills, P., Neswood, N., Foster, K., & Teufel-Shone, N. I. (2014, June). Urban American Indian Elders Sharing Stories of Resilience.. Resiliency – The Science of Strength. 25th Annual Native Health Research Conference.. Phoenix, AZ.
• Attakai, A., Reinschmidt, K. M., Whitewater, S., Kahn-Thornbrugh, C., Chico, T., & Teufel-Shone, N. I. (2014, November). American Indian Elders’ Stories of Resilience to Foster Health in Youth and their Families.. 6th Biennial International Indigenous Development Research Conference 2014 (IIDRC 2014). Auckland, New Zealand.
• Kahn-Thornbrugh, C., Attakai, A., Reinschmidt, K. M., Whitewater, S., Chico, T., & Teufel-Shone, N. (2014, November). Resilience through the Worldview of Urban AmericanIndian Elders: Community to Individual Level Factors for Strengthening Family and Parenting Practices.. 6th Biennial International Indigenous Development Research Conference 2014 (IIDRC 2014). Auckland, NZ.
• Kahn-Thornbrugh, C., Reinschmidt, K. M., Attakai, A., Whitewater, S., & Chico, T. (2014, December). Urban American Indian Elder Stories of Resilience.. Transdisciplinary Collaborations: Evolving Dimensions of US and Global Health Equity, Minority Health and Health Disparities Grantees’ Conference.. National Harbor, Maryland.
• Reinschmidt, K. M., & Attakai, A. (2014, March). American Indian Stories of Resilience to Foster Wellbeing.. Society for Applied Anthropology 2014 Annual Meeting. Albuquerque, NM.
• Stroupe, N. R., Attakai, A. -., Reinschmidt, K. M., Teufel-Shone, N. I., Drummond, R. L., & Whitewater, S. (2013, April). Importance of Culture and Resilience in American Indian Community-Based Public Health. MEZCOPH 3rd Annual Social Justice Symposium.

Poster Presentations

• Bravo-Clouzet, R., Heckert, K. A., Ehiri, J. E., Rosales, C. B., Attakai, A. -., Guerrero, R., Andrade, R., & Taren, D. L. (2013, November). New frontiers in global health leadership: Building strong health systems to respond to non-communicable diseases – a versatile training toolkit for professionals and graduate students. American Public Health Association Annual Meeting. Boston MA: American Public Health Association.
• Stroupe, N. R., Reinschmidt, K. M., Teufel-Shone, N. I., Attakai, A. -., & Drummond, R. L. (2013, December). AMERICAN INDIAN STORIES OF RESILIENCE AND PATHS TO WELLBEING. 6th Annual Health Disparities Institute (Caribbean Exploratory Research Center, CERC). St. Thomas, U.S. Virgin Islands: Caribbean Exploratory Research Center.
• Stroupe, N. R., Reinschmidt, K. M., Teufel-Shone, N. I., Attakai, A. -., & Drummond, R. L. (2013, December). American Indian Stories of Resilience and Paths to Wellbeing. 6th Annual Health Disparities Institute (Caribbean Exploratory Research Center, CERC). St. Thomas, U.S. Virgin Islands: Caribbean Exploratory Research Center.