Interviews from the Field: Swinomish Indian Tribal Community

October 6, 2017

Name of your project: Swinomish Community Health Assessment and Code Development

Is your ANA funding for one, two or three years? 2 years.

How did your project come about – how was it determined?
For several years, we have talked internally about creating a Swinomish community health program, which would be similar to a County public health department but based on Swinomish health values and priorities. The purpose of the program is to better serve the needs of Swinomish community members by focusing activities on the health priorities of the Swinomish community. Even the name—“community health” instead of “public health” – represents how the focus of the program is meant to be Swinomish specific. Creating and enacting a community health assessment is one of the nationally recognized steps necessary in developing public health programming (along with a health improvement plan and a strategic plan). We also identified the need to update the Swinomish health codes to support these endeavors.

Who were instrumental in the development of the project?
This project has been developed by the Swinomish Community Environmental Health Program, led by Swinomish elder Larry Campbell and Dr. Jamie Donatuto. The Swinomish Health, Education and Social Services Committee and Swinomish Senate approved the project and provide oversight and guidance.

How did you address bringing together (synthesizing) ideas?
We have decades of ideas from multiple Swinomish departments and programs about how to move forward. Before we applied for the grant, we consulted with directors and staff of several Swinomish health-related departments and programs, as well as the commissioned IHS Environmental Health Officer, Northwest Portland Area Indian Health Board staff, and Washington State Department of Health staff. Questions included: current functions of the program/ department; strengths, weaknesses, challenges, and opportunities (SWOT analysis); how a community health program might aid current programs/ departments; and, what potential synergies exist. Based on interview data, Swinomish health statistics, and 15 years of discussions and interviews with community members, Mr. Campbell and Dr. Donatuto crafted this project.

Who are the key project staff members?
Swinomish elder Larry Campbell and Dr. Jamie Donatuto are the project leads. We have a great team at the Swinomish Community Environmental Health Program as well—including our project technician, Myk Heidt, and several interns who are part of the project from Northwest Indian College and the University of Washington’s School of Medicine.

Where is your project located, what Tribes/service are do you serve?
We serve the Swinomish Indian Tribal Community, located in the Salish Sea, Washington State.

What are your main project objectives/ goals of your project?

  • Objective 1: By the end of 12 months, a community health assessment survey on the current status of Swinomish community health will be created and enacted with a target participation of 100 community members.
  • Objective 2: By the end of 12 months, the nine existing Swinomish community health ordinances will be reviewed and updated if needed, a minimum of two additional chapters will be added, and they will be submitted to the Swinomish Senate for review and approval.
  • Objective 3: By the end of 24 months, the project will outreach to a target audience of 200 community members at 4 community gatherings and publish 8 articles in the monthly Swinomish newsletter to engage Swinomish community members increasing knowledge and understanding of community health issues.
  • Objective 4: By the end of 24 months, the data from the Swinomish Community Health Assessment will be analyzed and the results reported to a target 200 community members at a minimum 4 community gatherings, as well as in a minimum of 8 articles in the monthly Swinomish newsletter.

How has your project benefited the community overall (impact)?
We are in Year 1 of the project and are in the process of creating the health assessment. This process involves reviewing community health assessments as the local, state and federal level from tribal and nontribal sources, and determining how to develop an assessment that will best speak to Swinomish values, while remaining commensurate with non-Swinomish assessments for comparison purposes. The health code revisions are currently being updated and will be completed by the end of Year 1.

What are your future plans to continue your efforts?
Our next step is to enact the community health assessment this year. In the longer term, once this project is complete, the results will feed into the next step in developing a community health program—creating the community health improvement plan.

What advice would you offer to someone planning or implementing a project similar to yours?
We feel that the most effective community health programs are founded on the community’s health beliefs, values and priorities—“this is a bottom up approach”. This means that the planning phase is key—take the time to find out what community members think and want, the current structure of government programs, and the current status of health codes. From there, research which available health assessment templates would be the best fit for modifying to reflect the health values, priorities and needs of the community. This is an example of tailoring the tools to fit the community’s questions and not tailoring the questions to fit the available tools.