NenŨnkUmbi/
Edahiyedo

We Are Here Now

Sexual and reproductive health interventions grounded in community and culture have the potential to improve wellbeing within individuals, families, communities and systems.

What's included in the We Are Here Now toolkit?

Part 1 Beginning the Journey: Where We Have Been
Part 2 Intervention Components and Materials
Part 3 Evaluation
Part 4 Dissemination Methods and Examples
Part 5 Cultural Relevance
Part 6 Preparing for a Randomized Controlled Trial (RCT) in a Tribal Community
Part 7 Supporting Materials

What is NenŨnkUmbi/ Edahiyedo/ We Are Here Now?

NenŨnkUmbi/Edahiyedo (We are Here Now or NE) is an evidence-based intervention designed to reduce sexual and reproductive health (SRH) disparities in American Indian youth ages 14 to 18 years old. This 9-month program includes the following four components:

Individual: Adapted Native STAND Curriculum
Family: Sexual Reproductive Health Guide for Parents
Community: Cultural Mentoring Program
Systems: Agency Coordination and Quarterly Meetings

Who Should Use the We Are Here Now toolkit?

We Are Here Now can be integrated and adapted in tribal communities, schools, clinics, and other community-based programs.The toolkit may be useful for communities interested in building their research capacity or implementing an evidence-based interventionto improve sexual and reproductive health outcomes.

View and download We Are Here Now Introduction.

View and Download Introduction

Beginning the Journey –

Where We Have Been

NE utilized a community-based participatory research (CBPR) approach to develop capacity within the Fort Peck tribal communities to address sexual and reproductive health disparities. CBPR requires full buy-in from the community to achieve capacity building, community engagement, collaboration, and infrastructure development.

The components of the intervention were tailored to address four main levels to reach individuals, families, communities, and systems. This multi-level approach aimed to address the complex characteristics that influence sexual reproductive health outcomes in a way that fits
the community and its culture.

View and download Part 1: Beginning the Journey – Where We Have Been.

View and Download Part 1

Community-Based Participatory Research Approach

Intervention Components & Materials

In this section, we provide an overview of the NE intervention and how it was implemented on the Fort Peck Reservation. This section also provides examples of the materials used.

The NE team adapted these materials to their culture, community, and needs. NE materials were developed to address sexual reproductive health on four main levels; individual, family, community, and systems. This section provides a summary of the materials used at each level.

View and download Part 2: Intervention Components & Materials.

View and Download Part 2

Intervention Overview

Dissemination Methods & Examples

For any intervention that occurs in a Tribal reservation or community, public awareness of the benefits for the intervention requires buy-in by the entirety of the community. The best way to disseminate information is to report in person to the key groups involved in the intervention. These key groups included Tribal leaders/government authorities, community/ parent groups, school staff members, but most
importantly students involved in the intervention.

View and download Part 4: Dissemination Methods

View and Download Part 4

Cultural Relevance

Designing the NE intervention was a collaborative process over 15 years between the Fort Peck Tribes and Montana State University. Using community-based participatory research methods and principles, adaptations of NE took 12 months to complete. There were many cultural aspects that were considered when developing and designing NE; they are detailed in this section.

View and download Part 5: Cultural Relevance

View and Download Part 5

Preparing for a Randomized Controlled Trial (RCT) in a Tribal Community

The NE intervention was structured as a Randomized Controlled Trial (RCT), allowing researchers and partners to compare outcomes between groups receiving the intervention. RCTs can be adapted and implemented in any community; preparation is key for successful implementation. Preparing for a RCT in a tribal community takes staffing and personnel,partnerships, and funding. This section outlines considerations for tribal communities as they prepare for a RCT.