>> OKAY.
WITH THIS, LET'S GET STARTED.
WELCOME, EVERYBODY.
I WOULD LIKE TO CALL TO ORDER
THE 86TH MEETING OF THE NATIONAL
ADVISORY COUNCIL FOR
COMPLEMENTARY AND INTEGRATIVE
HEALTH.
MY NAME IS MARTINA SCHMIDT, AND
I SERVE AS THE EXECUTIVE
SECRETARY FOR THE NCCIH NATIONAL
ADVISORY COUNCIL.
I NOTE FOR THE RECORD THAT THIS
MEETING IS BEING HELD AS A
VIRTUAL MEETING FOR EVERYBODY
ATTENDING, INCLUDING
COUNCILMEMBERS AND NCCIH STAFF.
THIS MEETING IS RECORDED AND
BROADCAST TO THE PUBLIC.
WE WILL ENDEAVOR TO FINISH THIS
AFTERNOON BY 4:00 P.M.
THE OPEN SESSION OF COUNCIL IS
OPEN TO THE GENERAL PUBLIC TO
ATTEND VIA LIVE NIH VIDEOCAST.
AND BEFORE I GO INTO MORE
ADMINISTRATIVE REMARKS AND TALK
A LITTLE BIT ABOUT THE AGENDA,
I'LL JUST HAND IT QUICKLY OVER
TO DR. LANGEVIN SO SHE CAN
WELCOME EVERYBODY WE HAVE AT THE
VIDEOCAST HERE.
>> THANK YOU VERY MUCH,
DR. SCHMIDT.
IT'S A GREAT PLEASURE TO WELCOME
YOU ALL, THOSE JOINING US ON
VIDEOCAST AS WELL AS THOSE OF US
ON ZOOM.
TO THIS MEETING OF THE NATIONAL
CENTER FOR COMPLEMENTARY AND
INTEGRATIVE HEALTH ADVISORY
COUNCIL.
WE HAVE AN EXCITING PROGRAM
TODAY, AND WE ARE LOOKING
FORWARD TO -- I LOOK FORWARD TO
MY DIRECTOR'S REPORT, AS WELL AS
SOME REALLY VERY, VERY EXCITING
PRESENTATIONS THAT WE ARE
LOOKING FORWARD TO.
SO I'M HANDING IT BACK OVER TO
DR. SCHMIDT.
>> THANK YOU.
SO THE COUNCIL MEETING IS
CONVENED AS REQUIRED BY TITLE 4T
GOVERN THE NIH IN GENERAL AND
NCCIH SPECIFICALLY AS LAID OUT
IN SECTION 287C-21.
AND IN ACCORDANCE WITH THE
FEDERAL ADVISORY COMMITTEE ACT.
I NOTE THAT THE CLOSED SESSION
OF THIS COUNCIL WAS HELD EARLIER
THIS MORNING AND WAS CLOSED TO
THE PUBLIC IN ACCORDANCE WITH
THE GOVERNMENT AND THE SUNSHINE
ACT.
THE OPEN SESSION TODAY WILL
INCLUDE THESE OPENING PROCEDURAL
REMARKS FOLLOWED BY A REVIEW AND
APPROVAL OF OUR COUNCIL
OPERATING PROCEDURES.
FOLLOWING THAT, DR. LANGEVIN
WILL PRESENT THE NCCIH
DIRECTOR'S REPORT TO COUNCIL.
WE DO HAVE A FEW COUNCILMEMBERS
ROTATING OFF COUNCIL, SO TODAY
IS THEIR LAST COUNCIL MEETING
WITH US AND DR. LANGEVIN WILL
TAKE THE OPPORTUNITY TO
RECOGNIZE THEIR SERVICE, AND
ALSO ALL THE INVALUABLE ADVICE
THEY HAVE EXTENDED TO NCCIH
DURING THEIR TENURE.
FOLLOWING A SHORT FIVE-MINUTE
BREAK, WE ARE THEN EXCITED TO
WELCOME DR. KARINA WOULD TERSE,F
THE TRIBAL RESEARCH OFFICE.
SHE WILL BE GIVING US AN UPDATE
ON THE FASCINATING WORK HER
OFFICE IS DOING ALIGNED WITH
NCCIH AND DISCUSS FUTURE
POSSIBILITIES FOR
COLLABORATIONS.
SHE WILL BE JOINED BY ONE OF OUR
OWN COUNCILMEMBERS, DR. DANIEL
DICKERSON, WHO WILL COMPLEMENT
DR. WALTERS' PRESENTATION WHO
WILL TALK ABOUT HIS WORK ABOUT
NATIVE AMERICAN TRADITIONAL
PRACTICES AND SPIRITUALITY.
WE WILL FINISH THE PRESENTATIONS
BY TALKING ABOUT THE COUNCIL
WORKING GROUP PROCESS AND HOW WE
CAN MAKE MORE EFFECTIVE USE OF
IT, AS IT RELATES TO PROVIDING
FEEDBACK AND ADVICE TO NCCIH.
SO OUR FIRST ORDER OF BUSINESS
WILL BE TO APPROVE THE SEPTEMBES
WHICH WAS PROVIDED TO ALL
COUNCILMEMBERS VIA THE
ELECTRONIC COUNCIL BOOK, AND I
THINK, YES, A COPY IS CURRENTLY
DISPLAYED ON THE SCREEN.
AT THIS TIME, I WOULD LIKE TO
FINALIZE THE MINUTES.
ARE THERE ANY CORRECTIONS TO THE
COUNCIL MEETING MINUTES?
IF YES, PLEASE RAISE YOUR HAND.
IF NOT, MAY I HAVE A MOTION TO
APPROVE THE MINUTES FOR THE
SEPTEMBER 2023 COUNCIL MEETING?
>> SO MOVED.
>> MM-HMM.
DO WE HAVE A SECOND?
>> SECOND.
>> OKAY.
ANY DISCUSSION?
ARE THERE ANY OTHER CONCERNS?
IF NO, THEN WE SHOULD HAVE A
VOTER SHEET SHOWING UP ON YOUR
SCREEN.
HERE IT IS.
SO ALL IN FAVOR, PLEASE VOTE TO
APPROVE THE MINUTES.
OKAY.
THANK YOU.
THE MOTION HAS BEEN APPROVED
UNANIMOUSLY.
WITH THIS, LET'S MOVE ON, AND
THE NEXT THING WE HAVE TO DO IS
TO REVIEW OUR COUNCIL OPERATING
PROCEDURES.
AND PLEASE JUST ONE SECOND SO I
CAN PULL UP THE PRESENTATION.
OKAY.
CAN YOU SEE THE TITLE SLIDE?
>> YES, WE CAN.
>> PERFECT.
THANK YOU.
COUNCIL WILL REVIEW ITS
OPERATING PROCEDURES ONCE A YEAR
TO REVIEW IF THEY ARE STILL
SERVING NCCIH' NEEDS.
THIS IS WHY WE DO THIS ONCE A
YEAR.
COUNCIL IS REQUIRED TO ANNUALLY
REVIEW THESE AND TO DETERMINE
WHETHER THEY CONTINUE TO SERVE
THE NEEDS OF NCCIH.
ALL NIH AWARDING INSTITUTES ARE
REQUIRED BY POLICY TO ESTABLISH
STAN DAND OPERATING PROCEDURES
FOR INTERACTION BETWEEN ADVISORY
COUNCIL AND STAFF RESPONSIBLE
FOR THE DAY TO DAY MANAGEMENT OF
EXTRAMURAL PORTFOLIOS AS
DESCRIBED IN OUR COUNCIL
OPERATING PROCEDURES.
THE TOPICS YOU SEE LISTED HERE
ARE OUTLINED IN OUR OPERATING
PROCEDURES AND DESCRIBE NCCIH AS
COUNCIL'S RESPONSIBILITIES.
SO NCCIH INFORMS COUNCIL OF
CURRENT SCIENTIFIC, BUDGETARY,
AND/OR LEGISLATIVE ISSUES THAT
MAY HAVE AN IMPACT ON NCCIH, AS
WELL AS SIGNIFICANT CHANGES TO
NCCIH AND/OR NIH, INCLUDING
PERSONNEL CHANGES.
IN REGARD TO THE SECONDARY
REVIEW OF APPLICATIONS, BEFORE
EACH COUNCIL MEETING, AN AGENDA,
SUMMARY STATEMENTS, ASSIGNMENTS,
SPECIAL ACTION WORKSHEETS AND
OTHER MATERIALS ARE PROVIDED TO
COUNCILMEMBERS AND BOTH
COUNCILMEMBERS AND NCCIH STAFF
MAY IDENTIFY APPLICATIONS
NEEDING DISCUSSION OR SPECIAL
COUNCIL ACTION.
THE ACTIONS YOU SEE LISTED HERE
ARE AVAILABLE TO COUNCIL AND
NCCIH, SO LET'S HAVE A LITTLE
BIT OF A CLOSER LOOK AT THE ONES
THAT YOU SEE LISTED HERE.
SO APPLICATIONS WITH NO SPECIAL
CONCERNS WILL BE ELIGIBLE FOR
FUNDING AS SOON AS THE EXECUTIVE
SECRETARY OF COUNCIL CERTIFIES
THAT THE COUNCIL REVIEW IS
COMPLETE.
THESE APPLICATIONS GENERALLY ARE
APPROVED BY EN BLOC ACTIONS.
AND THESE ARE THE APPLICATIONS
THAT ARE RELEVANT TO THE NCCIH
MISSION.
THEY HAVE NO CONCERNS AS IT
RELATES TO HUMAN PARTICIPANTS,
ANIMALS, OR BIOHAZARDS.
THERE ARE NO ISSUES REGARDING
THE INCLUSION OF WOMEN,
CHILDREN, OR MINORITIES.
THESE ARE USUALLY DOMESTIC
APPLICATIONS, AND THESE ARE
APPLICATIONS THAT DON'T HAVE AN
APPEAL ASSOCIATED WITH THEM.
IN CLOSED SESSION, COUNCIL
REVIEWS GRANT APPLICATIONS
NEEDING SPECIAL CONSIDERATIONS.
AND THESE INCLUDE GRANT
APPLICATIONS THAT ARE EITHER
NOMINATED FOR HIGH OR LOW
PROGRAM PRIORITY.
THESE ARE APPLICATIONS THAT HAVE
CONCERNS RELATED TO HUMAN
SUBJECTS, ANIMALS, OR BIOHAZARDS
THAT HAVE ISSUES ASSOCIATED WITH
THE INCLUSION OF WOMEN,
CHILDREN, AND/OR MINORITIES.
THIS WOULD BE FOREIGN
APPLICATIONS, THIS WOULD BE AN
APPLICATION WHERE THE APPLICANT
HAS APPEALED THE REVIEW.
AND THIS THEN ALSO -- WE HAVE
THE SPECIAL COUNCIL REVIEW,
WHICH IS FOR APPLICATIONS WHERE
THE PI IS SUPPORTED WITH MORE
THAN $2 MILLION OF TOTAL COSTS.
FOR SPECIAL COUNCIL REVIEW,
EMPHASIS WILL BE PLACED ON HOW
THE PROPOSED WORK FORWARDS THE
NCCIH MISSION AND ITS HIGH
PRIORITY RESEARCH AREAS IS
OUTLINED IN THE STRATEGIC PLAN,
AND HOW INNOVATIVE AND DISTINCT
THE PROJECT IS FROM OTHER FUNDED
PROJECTS OF THE INVESTIGATOR.
OPTIONS THAT ARE AVAILABLE TO
COUNCIL IS, THE COUNCIL CAN
CONCUR WITH THE REVIEW OF THE
STUDY SECTION.
OR COUNCIL CAN NOMINATE AN
APPLICATION FOR HPP, WHICH
RAISES AN APPLICATION IN ORDER
FOR FUNDING CONSIDERATION OR THE
OPPOSITE, LPP, WHICH LOWERS THE
APPLICATION IN ORDER FOR FUNDING
CONSIDERATION.
THEN THERE'S A CATEGORY THAT WE
CALL OTHERS, WHICH INCLUDES ALL
UNUSUAL ACTIONS THAT CANNOT BE
IDENTIFIED AS EITHER
CONCURRENCE, HPP OR LPP.
ALSO COUNCIL CAN RECOMMEND TO
DEFER AN APPLICATION FOR
ADDITIONAL INFORMATION OR
CONSIDERATION BY COUNCIL AT A
LATER TIME.
COUNCIL CAN ALSO DEFER
APPLICATION FOR ADDITIONAL STUDY
SECTION INPUT FOR
RECONSIDERATION OF THE
SCIENTIFIC AND TECHNICAL MERIT
OF AN APPLICATION.
COUNCIL CAN RECOMMEND A CHANGE
IN SCOPE, BUDGET, AND DURATION
OF SUPPORT.
AND COUNCIL CAN ALSO RECOMMEND
AN ACTION WE CALL NOT
RECOMMENDED BY COUNCIL, WHICH
REMOVES THE APPLICATION FROM
CONSIDERATION FOR FUNDING.
THE NCCIH DIRECTOR MAY DELEGATE
TO GRANTS MANAGEMENT AND PROGRAM
STAFF THE AUTHORITY TO NEGOTIATE
ADJUSTMENTS IN DOLLARS OR THE
TERMS AND CONDITIONS OF GRANTS
AND COOPERATIVE AGREEMENTS
RECOMMENDED BY COUNCIL.
ALL ADJUSTMENTS MADE REFLECT THE
LATEST DETERMINATION OF ACTUAL
OR ESTIMATED NEEDS OF THE
PROJECT.
THE COUNCIL'S RECOMMENDATIONS,
PROGRAM RELEVANCE, THE CURRENT
NIH COST MANAGEMENT PLAN AND THE
AVAILABILITY OF NCCIH FUNDS TO
SUPPORT THE RESEARCH EFFORT.
THE FOLLOWING STAFF ACTIONS DO
NOT REQUIRE COUNCIL
RECOMMENDATIONS BUT MAY BE
PRESENTED TO THE COUNCIL FOR
INFORMATION PURPOSES.
SO FOR EXAMPLE, IF THERE WOULD
BE A CHANGE OF PRINCIPAL
INVESTIGATOR ON A GRANT, IF
THERE IS A CHANGE OF INSTITUTION
BY THE PI, IF APPLICATIONS ARE
DEFERRED FOR RE-REVIEW, AND
ADMINISTRATIVE SUPPLEMENTS.
THAT'S USUALLY NOT SOMETHING
THAT WOULD REQUIRE COUNCIL
RECOMMENDATION.
IN REGARD TO EXPEDITED EN BLOC
CONCURRENCE, AS PER NIH POLICY,
ICs MAY STREAMLINE THE EN BLOC
CONCURRENCE TO EXPEDITE FUNDING
ACTIONS.
APPLICATIONS ELIGIBLE FOR EEC
MUST MEET ALL OF THE FOLLOWING
CRITERIA: THEY MUST BE PEER
REVIEWED AND ASSESSED AS
SCIENTIFICALLY MERITORIOUS,
WHICH FOR US GENERALLY MEANS
WITHIN OUR FUNDING SOURCE.
THIS HAS TO BE A DOMESTIC
APPLICATION.
THERE CANNOT BE ANY UNRESOLVED
HUMAN, ANIMAL SUBJECTS,
BIOHAZARDS OR INCLUSION ISSUES.
THE APPLICATION HAS TO BE
RELEVANT TO NCCIH'S MISSION.
AND IT MAY ALSO INCLUDE
APPLICATIONS THAT REQUIRE THE
AVAILABILITY OF TIME LIMITED
UNIQUE RESOURCES.
EEC OCCURS GENERALLY 6 TO
7 WEEKS PRIOR TO THE REGULAR
MEETING OF COUNCIL.
ALL REGULAR MEMBERS OF COUNCIL
MAY VOTE.
APPLICATIONS MUST RECEIVE AT
LEAST TWO VOTES FOR AND NO VOTES
AGAINST CONCURRENCE.
APPLICATIONS CONCURRED WILL THEN
BE ELIGIBLE FOR FUNDING
DECISIONS BY THE DIRECTOR AND
SUBSEQUENT PROCESSING FOR
AWARDS.
EEC ACTIONS WILL BE COMMUNICATED
TO COUNCIL DURING THE REGULAR
MEETING.
IN EXCEPTIONAL SITUATIONS, THE
DIRECTOR HAS THE AUTHORITY TO
ACT UPON EXTENUATING
CIRCUMSTANCES.
THE DIRECTOR MAY CONSULT WITH A
SUBSET OF COUNCILMEMBERS.
AND THE ACTIONS WILL BE
DOCUMENTED AND REPORTED TO
COUNCIL.
IN REGARD TO CONCEPTS FOR
RESEARCH INITIATIVES, CONCEPTS
CAN ORIGINATE FROM STAFF, THE
SCIENTIFIC COMMUNITY,
CONSTITUENCY ORGANIZATIONS,
AND/OR CONGRESS.
NCCIH STAFF PREPARES CONCEPT
SUMMARIES FOR REVIEW BY COUNCIL
IN THE OPEN SESSION.
COUNCIL MAY RECOMMEND EITHER
APPROVAL, MODIFICATION,
DEFERRAL, OR DISAPPROVAL OF A
CONCEPT.
APPROVED CONCEPTS THEN MAY LEAD
TO ONE OR MORE FUNDING
OPPORTUNITY ANNOUNCEMENTS.
IN REGARD TO APPEALS, AN
APPLICANT MAY APPEAL THE
ASSESSMENT OF THE GRANT
APPLICATION BY A SCIENTIFIC
REVIEW GROUP AS ASSESSED THROUGH
THE SUMMARY STATEMENT.
NOW, CRITERIA THAT WOULD BE
RELEVANT FOR AN APPEAL ARE IF
THERE IS EVIDENCE THAT A FACTUAL
ERROR MIGHT HAVE SIGNIFICANTLY
CHANGED THE SCORE OF AN
APPLICATION.
IF THERE IS EVIDENCE FOR
REVIEWER BIAS, OR CONFLICT OF
INTEREST.
ALSO IF THERE IS LACK OF
SCIENTIFIC EXPERTISE ON THE
REVIEW PANEL.
REASONS THAT WOULD NOT LEAD TO
AN APPEAL OR WOULD NOT BE
CONSIDERED AS RELEVANT IS IF
THTHERE IS A DISCREPANCY -- IF
THERE'S EITHER DIFFERENCE IN
SCIENTIFIC OPINION OR IF THERE
ARE ERRORS OF OMISSION.
SO IF THE DISCREPANCY WOULD BE
CLASSIFIED AS THAT.
OKAY.
IN REGARD TO ELIGIBLE APPEALS,
IF PROGRAM AND REVIEW STAFF
AGREE THAT AN APPEAL IS JUSTI
JUSTIFIED, MEANING IT MEETS THE
RELEVANT CRITERIA THAT WE JUST
WENT OVER, THEN THE GRANT IS
DEFERRED FOR RE-REVIEW, AND THIS
HAPPENS BEFORE THE APPLICATION
WOULD EVEN BE BROUGHT TO
COUNCIL'S ATTENTION.
IF STAFF DISAGREES ABOUT AN
APPEAL, THEN THE CENTER'S APPEAL
OFFICER ADJUDICATES, AND FOR
NCCIH, THAT'S DR. EDWARDS.
IF THE APPEAL OFFICE SUPPORTS
THE APPEAL, THEN IT IS SENT TO
COUNCIL FOR RESOLUTION.
FOR INELIGIBLE APPEALS, MEANING
THOSE THAT ARE NOT ALIGNED WITH
THE GUIDELINES WE JUST WENT
OVER, MEANING IT IS NOT BASED ON
RELEVANT CRITERIA.
THEN THE APPLICANT'S APPEAL
LETTER IS PROVIDED TO
COUNCILMEMBERS VIA THE
ELECTRONIC COUNCIL BOOK AS AN
INFORMATION ITEM.
ONLY.
COUNCILMEMBERS SERVE AS A
RESOURCE TO DEVELOP, RECOMMEND,
AND SET POLICY AND RESEARCH
PRIORITIES.
ON OCCASION, SPECIAL WORKING
GROUPS MAY BE FORMED TO EXAMINE
AND ADDRESS CRITICAL SCIENTIFIC
OR POLICY ISSUES OF IMPORTANCE
TO NCCIH AND ITS CONSTITUENCIES.
AND WE WILL TALK A LITTLE BIT
MORE ABOUT WORKING GROUPS LATER
TODAY.
OKAY.
WITH THIS, DO WE HAVE ANY
QUESTIONS, COMMENTS, ON THE
COUNCIL OPERATING PROCEDURES?
IF NO, THEN MAY I HAVE A MOTION
TO APPROVE THE COUNCIL OPERATION
PROCEDURES?
>> MOTION TO APPROVE.
>> THANK YOU.
DO WE HAVE A SECOND?
>> SECOND.
>> THANK YOU.
SO NOW WE NEED A VOTER SHEET
AGAIN.
PERFECT.
THANK YOU.
OKAY.
COUNCIL OPERATING PROCEDURES
HAVE BEEN APPROVED.
THANK YOU!
AND WITH THIS, I'M HANDING THE
MEETING OVER TO DR. LANGEVIN.
>> THANK YOU SO MUCH.
IT LOOKS LIKE WE'RE A LITTLE BIT
AHEAD OF SCHEDULE BUT THAT'S
FINE.
SO I'M GOING TO UNSHARE THAT AND
I WILL SHARE MY SCREEN.
CAN YOU ALL SEE MY SLIDE?
>> YES.
>> GREAT.
OKAY.
SO IT'S MY GREAT PLEASURE TO
PRESENT MY DIRECTOR'S REPORT TO
COUNCIL.
AT THIS TIME.
AND I WILL START BY A VERY
IMPORTANT EVENT AT NIH, WHICH IS
THAT WE HAVE WELCOMED OUR NEW
DIRECTOR, NIH DIRECTOR,
DR. MONICA BERTAGNOLLI.
SHE WAS PREVIOUSLY DIRECTOR OF
THE NATIONAL CANCER INSTITUTE
FOR A YEAR AND WE ARE DELIGHTED
THAT NOW SHE HAS BEGUN HER
DUTIES AS NIH DIRECTOR.
AND ONE OF THE FIRST THINGS THAT
SHE DID AS NIH DIRECTOR IS TO BE
VERY CLEAR ABOUT FOUR VERY
IMPORTANT PRIORITIES THAT SHE
HAS.
ONE IS ENSURING DIVERSITY IN
CLINICAL TRIALS, EMBRACING
LEARNING-BASED ANALYTICAL TOOLS,
RESTORING TRUST IN SCIENCE, AND
STRENGTHENING COLLABORATIONS
ACROSS NIH.
AND THESE PRIORITIES ARE VERY
WELL ALIGNED WITH OUR PRIORITIES
AT NCCIH, SO WE'RE VERY EXCITED
TO BE WORKING UNDER HER
LEADERSHIP.
THE OTHER IMPORTANT EVENT IS
THAT DR. TARA SCHWETZ WAS
PREVIOUSLY PRINCIPAL DEPUTY
DIRECTOR, ACTING PRINCIPAL
DEPUTY DIRECTOR, BECAME THE
DIRECTOR OF THE DIVISION OF
PROGRAM COORDINATION, PLANNING,
AND STRATEGIC INITIATIVES AT
NIH.
THIS IS AN IMPORTANT OFFICE THAT
OVERSEES MANY OF THE DIFFERENT
OFFICES AT THE OFFICE OF THE
DIRECTOR, SUCH AS THE OFFICE OF
WOMEN'S HEALTH, PREVENTION,
BEHAVIORAL AND SOCIAL SCIENCES,
AS WELL AS THE TRIBAL HEALTH
OFFICE.
AND DR. KARINA WALTERS IS GOING
TO BE PRESENTING ON THIS THIS
AFTERNOON.
DR. SCHWETZ IS VERY IMPORTANT IN
COORDINATING THESE OFFICES.
WE ALSO ARE VERY, VERY PROUD
THAT PRESIDENT BIDEN HAS HONORED
DR. STEVEN ROSENBERG OF THE
NATIONAL CON SER INNATIONAL CANH
THE NATIONAL MEDAL OF TECHNOLOGY
AND INNOVATION, THE NATION'S
HIGHEST HONOR FOR TECHNOLOGICAL
ACHIEVEMENT.
DR. ROSENBERG'S PIONEERING WORK
DEVELOPED THE FIRST EFFECTIVE
IMMUNOTHERAPIES FOR PATIENTS
WITH ADVANCED CANCER, AND THIS
HAS JUST BEEN A REVOLUTIONARY
CHANGE IN OUR APPROACH TO CANCER
TREATMENT.
THIS SLIDES ARE NOT ADVANCING.
THERE WE GO.
ANOTHER IMPORTANT EVENT THAT HAS
HAPPENED IS THAT THE REVISION OF
THE GRANT REVIEW PROCESS THAT
WE'VE BEEN DISCUSSING NOW AT
SEVERAL DIFFERENT COUNCIL
MEETINGS, WE HAD A DISCUSSION OF
THIS IN DR. BYRNES' PRESENTATION
AT LAST COUNCIL, AND THIS HAS
NOW TAKEN -- WILL BE TAKING
EFFECT ON JANUARY 25TH, SO JUST
IN A FEW DAYS.
THIS REVIEW PROCESS, IT NOW
SIMPLIFIES THE REVIEW CRITERIA
THAT WENT FROM FIVE CRITERIA TO
NOW THREE.
AND THEN TWO OF THE FACTORS HAVE
BEEN KIND OF FOLDED INTO ONE,
AND SO WE THINK THAT THIS IS
GOING TO BE HELPING REALLY
FOCUSING ON SOME OF THE AREAS
THAT WE FEEL ARE THE MOST
IMPORTANT IN A WAY THAT
FACILITATES THE REVIEW OF THESE
AREAS WHILE ALSO STREAMLINING
SOME OF THE REVIEW PROCESS.
ANOTHER VERY IMPORTANT PROGRAM,
NIH-WIDE PROGRAM THAT WAS
LAUNCHED IS THE COMPASS PROGRAM.
AND THIS IS A PROGRAM THAT IS AN
NIH COMMON FUND PROGRAM ACROSS
NIH.
FIRST OF ITS KIND.
VERY IMPORTANT PROGRAM THAT IS
LED BY THE NATIONAL INSTITUTE OF
NURSING RESEARCH.
AND THIS IS ABOUT COMMUNITY-LED
RESEARCH TO STUDY WAYS TO
ADDRESS UNDERLYING STRUCTURAL
SYSTEMIC FACTORS WITHIN
COMMUNITIES THAT AFFECT HEALTH,
SUCH AS, FOR EXAMPLE, ACCESS TO
HEALTHY FOODS OR ACCESS TO SAFE
GREEN SPACES, EMPLOYMENT
OPPORTUNITIES, TRANSPORTATION.
SO THIS IS REALLY ADDRESSING
THESE PROBLEMS AT A SYSTEMIC
LEVEL, WHICH IS QUITE UNIQUE AND
NEW.
SO WE LOOK FORWARD -- THERE WERE
26 AWARDS THAT WERE MADE TO
COMMUNITY ORGANIZATIONS.
THIS IS VERY MUCH COMMUNITY-LED
RESEARCH, APPROXIMATELY
$171 MILLION OVER FIVE YEARS.
WE ALSO HAVE -- JUST WANT TO
DRAW ATTENTION TO THE
INTERNATIONAL CONGRESS ON
INTEGRATIVE MEDICINE AND HEALTH,
WHICH WILL TAKE PLACE IN APRIL
IN CLEVELAND.
THOSE OF YOU THAT HAVE NOT YET
REGISTERED, STRONGLY ENCOURAGE
YOU TO DO SO.
NCCIH HAS A VERY IMPORTANT
PRESENCE THERE.
WE DO A LOT OF DIFFERENT
WORKSHOPS AND THIS IS ONE OF OUR
MAIN AVENUES FOR CONNECTING WITH
RESEARCHERS, VERY EXCITING
EVENT.
I'M GOING TO BE TELLING YOU A
LITTLE BIT MORE LATER ON ABOUT
SOME OF THE SPECIFIC SESSIONS
THAT WE ARE GOING TO BE LEADING.
NOW FOR SOME STAFF UPDATES.
WE ARE VERY PROUD TO WELCOME OUR
SECOND TENURED INVESTIGATOR NOW,
DR. LAUREN ATLAS, WHO IS THE LAB
CHIEF IN THE SECTION ON
AFFECTIVE NEUROSCIENCE AND PAIN
IN THE INTRAMURAL RESEARCH
PROGRAM.
WE ALSO ARE VERY HAPPY TO
ANNOUNCE SOME NEW STAFF IN BOTH
THE OFFICE OF ADMINISTRATIVE
OPERATIONS, THE DIVISION OF
EXTRAMURAL ACTIVITIES, AND THE
OFFICE OF CLINICAL AND
REGULATORY AFFAIRS, AS WELL AS
SOME STAFF THAT HAVE LEFT US TO
PURSUE OTHER OPPORTUNITIES.
AND IN THE DIVISION OF BE
INTRAMURAL RESEARCH, WE HAVE
SEVERAL NEW VISITING FELLOWS AND
GRADUATE STUDENTS THAT HAVE
COME -- I'M SORRY -- THAT HAVE
BOTH ARRIVED AND DEPARTED.
NOW ABOUT THE BUDGET.
SO THERE'S REALLY ONLY VERY
LITTLE I CAN SAY ABOUT THE
BUDGET AT THE MOMENT BECAUSE WE
ARE IN A CONTINUING RESOLUTION
UNTIL MARCH 8TH.
SO WE HOPEFULLY WILL BE ABLE TO
PROVIDE MORE INFORMATION ABOUT
OUR BUDGET AT THE NEXT COUNCIL
MEETING WI.
WHAT CONTINUING RESOLUTION MEANS
IS THAT WE ARE CURRENTLY FUNDED
AT THE FY 23 FUNDING LEVELS.
SO THERE'S NO NEW UPDATES IN
THIS AREA.
AT THE MOMENT.
SO I JUST WANTED TO TAKE A
MINUTE TO HIGHLIGHT A COUPLE OF
STUDIES THAT ARE OF INTEREST AND
NOT THAT -- ALL OF THE RESEARCH
THAT NCCIH FUNDS IS OF INTEREST
TO US, BUT JUST IN PARTICULAR I
WANT TO HIGHLIGHT TWO STUDIES
THAT ARE A LITTLE BIT UNUSUAL.
ONE IS THIS VERY INTERESTING
STUDY OF CREATING A
COMPLEMENTARY AND INTEGRATIVE
HEALTH LEXICON TO BETTER
REPRESENT THE OFTEN
UNDERREPRESENTED COMPLEMENTARY
AND INTEGRATIVE HEALTH
APPROACHES IN STANDARD
TERMINOLOGIES, AND THEN APPLY
STATE OF THE ART NATURAL
LANGUAGE PROCESSING TECHNIQUES
TO HELP RECOGNIZE THEM IN THE
BIOMEDICAL LITERATURE.
SO JUST TO GIVE YOU SOME
EXAMPLES OF SOME OF THE
DEFINITIONS OF, FOR EXAMPLE,
MIND-BODY THERAPIES OR MANUAL
BODY-BASED THERAPIES, ENERGY
THERAPIES, ET CETERA.
THESE HAVE ALL BEEN ADDRESSED IN
THIS PAPER, AND I ENCOURAGE YOU
TO TAKE A LOOK.
IT'S AN INTERESTING APPROACH,
AND WE THINK THAT THIS IS GOING
TO HAVE IMPLICATIONS AS TO HOW
PEOPLE APPROACH THIS KIND OF
TOPIC IN THE FUTURE.
THIS IS A VERY INTERESTING STUDY
THAT I WANT TO POINT OUT THAT
REALLY TIES A LOT OF THINGS
TOGETHER.
IT LOOKS AT THE RELATIONSHIP
BETWEEN LEVELS OF C-REACTIVE
PROTEIN, THIS REFLECTS SYSTEMIC
INFLAMMATION IN THE BODY, AS
WELL AS THE RELATIONSHIP BETWEEN
RACIAL DISCRIMINATION AND
PERCEIVED THREAT IN THE NETWORK
OF PERCEIVING THREAT IN THE
BRAIN.
SO LOOKING AT ACTIVATION OF THE
VENTROMEDIAL PREFRONTAL CORTEX.
AND WHAT THE STUDY SHOWS IS THAT
THE LEVELS OF C-REACTIVE PROTEIN
IN THE BLOOD, SYSTEMICALLY IN
THE CIRCULATION, MODERATED THE
RESPONSE OF THE BRAIN TO THIS
PERCEIVED THREAT.
THIS IS SPECIFICALLY IN BLACK
AMERICAN WOMEN.
SO VERY INTERESTING STUDY.
I WANT TO JUST NOW HIGHLIGHT
SOME PROGRAM NEWS, AND I'M GOING
TO DO SOMETHING NEW THIS TIME
AROUND.
BECAUSE IN THE PAST, THE WAY
THAT I WAS ORGANIZING THESE
DIRECTOR'S REPORTS WAS BASICALLY
KIND OF FOCUSING MORE ON LIKE,
FOR EXAMPLE, PAST EVENTS, FUTURE
EVENTS AND FUNDING
OPPORTUNITIES, ET CETERA.
WE FELT IT WAS IMPORTANT TO NOW
TRY TO INTEGRATE THIS
INFORMATION BETTER SO THAT IT
MAKES MORE SENSE TO YOU ALL.
I WANTED TO USE MORE OF A
THEME-BASED APPROACH.
AND SO WITH PUTTING TOGETHER
THESE THEMES HERE THAT ARE
HIGHLIGHTED IN THIS SLIDE, AND
I'M GOING TO TALK YOU THROUGH
THIS TO SHOW YOU WHAT THESE
THEMES ARE ABOUT.
SO YOU CAN SEE HERE THAT ON THE
TOP, THERE ARE FIVE COLORED
THEMES THAT REPRESENT WHAT WE
SAY THE WHAT, THE TYPE OF
RESEARCH THAT WE ARE FUNDING.
THEN AT THE BOTTOM, THERE ARE
TWO THEMES, THE WHO AND THE HOW.
AND SO AS FAR AS IN THE TOP
CATEGORY, WE HAVE PAIN AND PAIN
MANAGEMENT, MIND AND BODY
CONNECTIONS, HEALTH RESTORATION,
NUTRITION CONTINUUM AND NATURAL
PRODUCTS, AND WHOLE PERSON
HEALTH.
I'M GOING TO TAKE YOU THROUGH
SOME OF THESE TO GIVE YOU A
SENSE OF WHAT THIS MEANS.
SO PAIN AND PAIN MANAGEMENT,
THAT'S PRETTY OBVIOUS.
A LOT OF WHAT NIH FUNDS
HISTORICALLY HAS BEEN ABOUT
PAIN, A LARGE PART OF OUR
PORTFOLIO, AND WHAT WE'RE REALLY
FOCUSING ON, WHAT I WANT TO SHOW
HERE IS WHAT WE'VE BEEN DOING
HISTORICALLY AND WHERE DO WE
WANT OUR PORTFOLIO TO GROW.
ONE OF THE AREAS WHERE WE REALLY
WANT OUR PORTFOLIO TO GROW IS IN
THE AREA OF PAIN MANAGEMENT, IN
TERMS OF MANAGING SYMPTOMS, BUT
ALSO GETTING TO UNDERSTAND
ENDOGENOUS PAIN RESOLUTION.
WHAT ARE THE MECHANISMS BY WHICH
PAIN CAN RESOLVE, AND HOW DO WE
SUPPORT THAT, AND HOW CAN WE
PREVENT PAIN?
HOW CAN WE PREVENT THE
TRANSITION FROM ACUTE TO CHRONIC
PAIN, AND INCORPORATE THAT INTO
PAIN MANAGEMENT.
SO THESE ARE SOME OF THE THEMES
THAT WE ARE EXPLORING AND WE
WANT TO KEEP GROWING.
THE ORANGE CATEGORY, THE MIND
AND BODY CONNECTION, IS AN
INTERESTING ONE AS WELL.
SO IT WOULD INCLUDE, FOR
EXAMPLE, THINGS LIKE MIND AND
BODY THERAPIES, WHICH IS A LOT
OF WHAT THE RESEARCH THAT WE'RE
ALREADY DOING, BUT WE ALSO IN
THIS CATEGORY INCLUDE STRESS,
FOR EXAMPLE, AND STRESS
MANAGEMENT, AS WELL AS SLEEP,
AND INTEROCEPTION, WHICH IS A
TOPIC THAT WE'VE BEEN
INCREASINGLY INTERESTED IN.
SO THAT ALL FALLS IN THAT ORIGIN
CATEGORY.
THE LIGHT BLUE, HEALTH
RESTORATION CATEGORY, IS A VERY
INTERESTING ONE.
SO IT INCLUDES, AS I MENTIONED
FOR PAIN, BUT MORE GENERALLY,
THE RETURN TO HEALTH AFTER AN
ILLNESS OR AN INJURY, A CONCEPT
THAT WE ALSO CAN SOMETIMES CALL
SALUTOGENESIS, THE ABILITY TO
RESIST, RECOVER, ADAPT, AND GROW
FROM A CHALLENGE, ESPECIALLY
STRESSORS.
SO THIS IS ALSO A CATEGORY WHERE
WE WANT TO REALLY GROW OUR
PORTFOLIO.
THE GREEN CATEGORY IS THE
CATEGORY OF NUTRITION CONTINUUM
AND NATURAL PRODUCTS.
SO THIS INCLUDES, ORVETION THE
TYPES OF NATURAL PRODUCTS LIKE
PHYTOCHEMICALS, FOR EXAMPLE,
MICROBIOME, PROBIOTICS,
CANNABINOIDS FOR EXAMPLE THAT
WE'RE FUNDING, BUT WE'RE ALSO
EXPENDING THIS CATEGORY INTO
WHAT WE CALL A NUTRITION
CONTINUUM, WHICH IS OUR INTEREST
IN KIND OF OVERALL SPECTRUM OF
NUTRITION INCLUDING BIOLOGICAL
AS WELL AS BEHAVIORAL, SOCIAL,
AND ENVIRONMENTAL ASPECTS OF
NUTRITION, WHICH IS IN KEEPING
WITH OUR WHOLE PERSON HEALTH
FRAMEWORK.
NOW THE CATEGORY IN THE CENTER,
THE WHOLE PERSON HEALTH, IS, OF
COURSE, THE VERY SORT OF CENTRAL
THEME OF OUR EXISTING STRATEGIC
PLAN, AND IT HAS TO DO WITH
UNDERSTANDING THE SCIENCE OF
INTERRELATED SYSTEMS, AS WELL AS
MULTICOMPONENT INTERVENTIONS
INCLUDING WHOLE HEALTH SYSTEMS
AND LOOKING AT THE EFFECT OF
THESE INTERVENTIONS ON
MULTISYSTEM OUTCOMES.
SO NOW IF WE GO BELOW THE LINE
INTO THE WHO AND THE HOW, FIRST
OF ALL, THE WHO.
SO WHO MEANS WHO IS DOING THE
RESEARCH, THE RESEARCH
WORKFORCE, BUT ALSO RESEARCH
PARTICIPANTS.
AND INCREASINGLY, WE WANT TO
INCLUDE, RIGHT, RESEARCH
PARTICIPANTS IN THE FORM OF
ENGAGEMENT IN THE DESIGN OF
RESEARCH STUDIES, COMMUNITY
ENGAGEMENT, FOR EXAMPLE, SO
THESE TWO CATEGORIES YOU SEE ARE
VERY WELL LINKED.
WE ALSO INCLUDE SPECIAL
POPULATIONS, FOR EXAMPLE, ACTIVE
MILITARY AND VETERANS
POPULATIONS, HEALTH DISPARITIES,
AND AS WELL AS ALL THE VARIOUS
DIFFERENT CATEGORIES OF
POPULATIONS THAT MAY BE
EXPERIENCING THESE HEALTH
DISPARITIES.
AND FINALLY, THE HOW.
SO BY THE HOW, WE INCLUDE
METHODS SUCH AS, FOR EXAMPLE,
PRAGMATIC AND IMPLEMENTATION
RESEARCH, WHICH IS SOMETHING
THAT WE PAY A LOT OF ATTENTION
TO IN DEVELOPING THE RIGOROUS
METHODS TO PERFORM PRAGMATIC
TRIALS, FOR EXAMPLE, AS WELL AS
IMPLEMENTATION SCIENCE AND
DISSEMINATION.
THEN DATA SCIENCE, WHICH IS AN
AREA WHERE WE ARE REALLY
INCREASINGLY PAYING A LOT OF
EFFORT INTO DEVELOPING THAT AND
INCORPORATING THE MOST RECENT
AND UP TO DATE OF METHODS TO
BOTH COLLECT AS WELL AS ANALYZE
DATA, INCLUDING MULTI-SCALE
MODELING, ARTIFICIAL
INTELLIGENCE, ET CETERA.
SO I'M GOING TO GO THROUGH THE
REST OF THE REPORT IS GOING TO
BE ORGANIZED AS YOU SEE -- YOU
WILL SEE ALONG THESE THINGS.
,
JUST TO ORIENT YOU, THE FIRST
CATEGORY WILL BE PAIN AND PAIN
MANAGEMENT.
SO IN THE UPPER RIGHT CORNER OF
THE SLIDE HERE, YOU'LL SEE THE
RED DOT, THAT KIND OF ORIENTS
YOU AS TO WHICH CATEGORY THIS
EVENT OR WHATEVER IS.
AND THEN ON THE UPPER LEFT, THIS
LITTLE TRIANGLE HERE, WILL LET
YOU KNOW WHAT KIND OF THING I'M
TALKING ABOUT, WHETHER IT'S A
PAST EVENT OR A FUTURE EVENT OR
FUNDING OPPORTUNITY.
SO HOPEFULLY THIS KIND OF WILL
HELP YOU GET A SENSE OF HOW
NCCIH ORGANIZES ITS ACTIVITIES.
SO THE FIRST THING I WANT TO
POINT OUT IN TERMS OF PAIN AND
PAIN MANAGEMENT HAS TO DO WITH
OUR COLLABORATION, VERY
IMPORTANT COLLABORATION WITH THE
HEAL INITIATIVE.
SO THE HEAL INITIATIVE STANDS
FOR HEALTH AND ADDICTION LONG
TERM.
IT'S A TRANS-NIH PROGRAM WHICH
NCCIH IS ONE OF THE CO-LEADS,
AND ONE OF THE IMPORTANT
INITIATIVES THAT WAS LAUNCHED IS
THE -- LAST YEAR IS THE HEAL
PURPOSE NETWORK.
AND WHAT THIS IS, IS TO
REALLY -- IT'S AN EFFORT TO
CONNECT PAIN RESEARCHERS ACROSS
THE CONTINUUM OF PAIN RESEARCH
FOR ALL DISCIPLINES AND ALL
CAREER STAGES.
WE HAD A MEETING OF THE PURPOSE
NETWORK BACK IN NOVEMBER, AND AT
THIS MEETING, DR. LANAY MUDD AND
INNA BELFER HIGHLIGHTED NCCIH
STRATEGIC PRIORITIES AND FUNDING
OPPORTUNITIES FOR PAIN RESEARCH.
AND THE PURPOSE NETWORK ALSO HAS
A WONDERFUL DIGITAL PLATFORM FOR
RESEARCH TRAINEES AND
RESEARCHERS ACROSS THE CONTINUUM
OF BASIC TRANSLATIONAL AND
CLINICAL RESEARCH, I REALLY
ENCOURAGE YOU TO GO AND CECH IT
OUT.
CHECK IT
OUT.
ANOTHER UPCOMING EVENT RELATED
TO THE HEAL INITIATIVE, THIS IS
THE FIFTH ANNUAL HEAL INITIATIVE
INVESTIGATOR MEETING.
THIS WILL TAKE PLACE ON FEBRUAR.
IT IS A VIRTUAL HYBRID AND
IN-PERSON EVENT.
REGISTRATION IS OPEN.
IT'S VERY IMPORTANT FOR ALL THE
HEAL INVESTIGATORS TO GET
TOGETHER AND SHARE ACROSS THE
HEAL ECOSYSTEM.
NOW AGAIN RELATED TO PAIN AND
HEAL, BUT THIS TIME A NOFO.
THIS IS A NOTICE OF FUNDING
OPPORTUNITY.
THIS IS OUR NEW ACRONYM FOR WHAT
WE USED TO CALL RFAs.
SO -- WELL, WE STILL CALL THEM
RFAs, IN THE NUMBER OF THE
RFA, BUT WE CALL THEM NOFOs
NOW.
JUST ONE MORE THING.
SO THIS PARTICULAR ONE IS
FOCUSED ON PREVENTION.
THE IMPLEMENTATION OF SUBSTANCE
USE PREVENTIVE SERVICES.
SO THERE'S MANY, MANY, MANY
DIFFERENT RFAs IN THE HEAL
INITIATIVE THAT WE ARE
PARTICIPATING IN.
I'M NOT GOING TO HIGHLIGHT THEM
ALL, BUT THIS PARTICULAR ONE, I
WANTED TO HIGHLIGHT IT BECAUSE
THIS PARTICULAR ONE, THE LEAD
INSTITUTE IS THE NATIONAL
INSTITUTE ON DRUG ABUSE.
WE PARTICIPATE IN THIS AS WELL,
AND WE'RE VERY INTERESTED
ESPECIALLY WA BECAUSE OF THIS
PREVENTIVE FOCUS.
HERE'S ANOTHER ONE, ANOTHER
NOFO.
THIS TIME ON NON-ADDICTIVE
ANALGESIC THERAPEUTICS
DEVELOPMENT.
THIS ONE WE ARE INTERESTED IN
BECAUSE IT HAS RELEVANCE TO OUR
NATURAL PRODUCTS PORTFOLIO.
IT FOCUSES ON SMALL MOLECULES,
BIOLOGICS TO TREAT PAIN.
SO AGAIN, THIS IS -- THE
APPLICATION DEADLINE IS VERY
SOON.
NOW WE'RE GOING TO TRANSITION
OVER TO THE SECOND CATEGORY,
WHICH IS THE MIND AND BODY
CONNECTION.
SO FIRST WE START WITH A PAST
EVENT.
THIS ONE WAS THE INTEROCEPTION
INVESTIGATOR MEETING.
THIS WAS THE SECOND MEETING OF
THE INTEROCEPTION INITIATIVE,
WHICH IS THE NIH NEUROSCIENCE
BLUEPRINT INITIATIVE.
THIS WAS ON NOVEMBER 11TH.
EXTREMELY SUCCESSFUL MEETING, WE
HAD OVER A THOUSAND ATTENDEES,
AND IT WAS JUST REALLY A
PHENOMENAL MEETING.
I REALLY ENCOURAGE YOU TO CECH
IT OUT OCHECKIT OUT ON THE VIDE.
IT WAS ALL VIDEOTAPED AND A
REALLY OUTSTANDING MEETING.
ANOTHER OUTSTANDING MEETING
OCCURRED ON DECEMBER 14 AND 15,
IT WAS THE MUSIC AS MEDICINE:
THE SCIENCE AND CLINICAL
PRACTICE.
THIS WAS LED BY NCCIH.
IT'S SUPPORTED BY A NUMBER OF
INSTITUTES, CENTERS AND OFFICES
AS WELL AS THE NATIONAL
ENDOWMENT FOR THE ARTS.
AGAIN, MUSIC AND MEDICINE WAS A
MEETING WITH VIDEOCAST AND THE
OUTSTANDING THING ABOUT THIS
MEETING WAS THAT IT WAS A REALLY
TRULY CROSS DISCIPLINARY MEETING
BECAUSE THERE WERE SCIENTISTS AS
WELL AS MUSICIANS THAT
PARTICIPATED IN THIS, AS WELL AS
DEMONSTRATED THE MUSIC AS WE
INTERSPERSED WITH THE SCIENTIFIC
PRESENTATIONS.
TRULY FASCINATING.
ANOTHER PAST EVENT WAS THE
SOCIETY FOR NEUROSCIENCE MEETING
ON NOVEMBER 13TH, A SYMPOSIUM ON
MECHANISMS AND MODULATIONS OF
THE BRAIN LYMPHATICS SYSTEM.
THIS WAS CHAIRED BY DR. HELENE
BENVENISTE, ONE OF OUR
COUNCILMEMBERS, AS WELL AS
CO-CHAIRED BY DR. INNA BELFER.
AN UPCOMING MEETING NOW, AGAIN
IN THE MIND AND BODY CONNECTION
THEME.
AT THE INTERNATIONAL CONGRESS OF
INTEGRATIVE MEDICINE & HEALTH IN
APRIL, WE'RE GOING TO BE HAVING
A SESSION ON ADVANCING THE
SCIENCE OF EMOTIONAL WELL-BEING
AND HOW WE CAN IMPROVE WHOLE
PERSON HEALTH.
THIS IS GOING TO BE ORGANIZED BY
DR. ERIN QUINLAN, WHO'S THE
CONTACT PERSON ON THIS.
MOVING ON TO THE HEALTH
RESTORATION THEME, WE WERE VERY
FORTUNATE TO HAVE AS OUR STRAUS
LECTURE, OUR FLAGSHIP LECTURE
EVERY YEAR TO HONOR THE MEMORY
OF DR. STEPHEN STRAUS, A LECTURE
BY DR. AHMED TAWAKOL OF NATIONAL
HOSPITAL ON NOVEL INSIGHTS INTO
HEART BRAIN INTERACTIONS AND
NEUROLOGICAL RESILIENCE.
IT WAS AN OUTSTANDING LECTURE,
IT WAS, AGAIN, VIDEOTAPED.
I HIGHLY ENCOURAGE YOU TO CHECK
IT OUT ON OUR WEBSITE.
I'M NOW GOING TO MOVE ON TO THE
WHOLE PERSON HEALTH THEME.
SO I WAS ACTUALLY VERY FORTUNATE
TO HAVE THE OPPORTUNITY TO GIVE
TWO LECTURES ON WHOLE PERSON
HEALTH.
ONE WAS ON THE FUTURE OF
HEALTHCARE UNCOVERING THE WHO
WHOLE -- THE THIRD INTERNATIONAL
SYMPOSIUM IN VIENNA.
THIS WAS A REALLY WONDERFUL
MEETING THAT BROUGHT TOGETHER
MANY INVESTIGATORS LOOKING AT
IMAGING SUCH AS TOTAL BODY PET
BUT ALSO COMPLEXITY SCIENCE,
NETWORK MEDICINE.
IT WAS TRULY FASCINATING.
THEN RIGHT BEFORE THAT, IN ROME,
AT THE SECOND WORLD CONGRESS ON
INTEGRATIVE MEDICINE AND HEL, I
GAVE A TALK ON ADVANCING
INTEGRATIVE MEDICINE TOWARDS
EVIDENCE-BASED AND
PATIENT-CENTERED COMPREHENSIVE
CARE WHERE I REALLY FOCUSED ON
THE CHALLENGES AND POTENTIAL
REWARDS OF MOVING BEYOND SILOS
OR REALLY DOING INTEGRATIVE
RESEARCH.
A FUTURE UPCOMING MEETING NOW AT
THE INTERNATIONAL CONGRESS ON
INTEGRATIVE MEDICINE & HEALTH IN
CLEVELAND IS GOING TO BE A
WORKSHOP ON NEW STRATEGIES AND
METHODOLOGIES FOR WHOLE PERSON
RESEARCH.
THIS IS REALLY KIND OF MOVING
FORWARD WITH A LOT OF THE THEMES
THAT WERE DISCUSSED AT OUR WHOLE
PERSON RESEARCH WORKSHOP THAT WE
HAD IN 2021, BUT REALLY KIND OF
REALLY TAKING IT A STEP FORWARD
AND REALLY BUILDING ON THAT.
SO WE'RE GOING TO HAVE A VERY
NICE GROUP OF VERY -- VERY
EXCITED WE'RE PARTICIPATING IN
THIS ALONG WITH DR. JEFF DUSEK,
DR. PATRICIA HERMAN, DR. EMRIN
HORGUSLUOGLU, AND DR. AARON LEE,
SO REALLY ENCOURAGE YOU WHO
ATTEND THE MEETING TO ATTEND
THIS WORKSHOP.
SO ANOTHER UPCOMING SESSION AT
THE INTERNATIONAL CONGRESS OF
ICMH MEETING IS GOING TO BE A
SESSION ON OPEN ACCESS
REPOSITORIES, HOW THEY CAN BE
LEVERAGED TO ADVANCE WHOLE
PERSON HEALTH RESEARCH.
AND THIS WILL BE HELD BY
DR. QUINLAN.
MOVING ON TO THE NUTRITION AND
NATURAL PRODUCTS CATEGORY.
I WAS ALSO VERY FORTUNATE TO
PARTICIPATE IN A WONDERFUL
CONFERENCE CALLED THE CLIMATE
UNDERGROUND WHICH WAS WITH
FORMER VICE PRESIDENT AL GORE
AND DR. DENNIS DERRYK ON AN
IMPORTANT THEME WHICH IS THE
THEME OF THE LINK BETWEEN HUMAN
HEALTH AND PLANETARY HEALTH.
THIS IS REALLY BECOMING A VERY,
VERY IMPORTANT ASPECT OF HEALTH.
THE IDEA THAT HUMAN HEALTH AND
PLANETARY HEALTH ARE NOT
SEPARATE, THAT THEY ARE REALLY
LINKED.
THE ONE AREA THAT WAS DISCUSSED
AT LENGTH THERE IS THE IDEA OF
REGENERATIVE AGRICULTURE, HOW
DOING AGRICULTURE IN A WAY
THAT'S GOOD FOR THE SOIL IS ALSO
GOOD FOR HUMANS.
BECAUSE IT YIELDS MORE HEALTHY
PRODUCTS OF THIS AGRICULTURE IN
FORMS OF PLANTS THAT HAVE THE
BENEFIT OF BEING GROWN IN AN
ENVIRONMENT THAT INCLUDES
MICROBIOME IN ADDITION TO
ORGANIC MATTER, SO THIS WAS A
VERY INTERESTING DISCUSSION.
ANOTHER VERY IMPORTANT NOTICE OF
FUNDING OPPORTUNITY HERE THIS
TIME IN THE AREA OF NUTRITION
CONTINUUM AND NATURAL PRODUCTS
IS OUR RESOURCE CENTER FOR
CANNABIS AND K CANNABINOID
RESEARCH.
THIS IS AN EFFORT TO REALLY
PROVIDE RESOURCES TO
INVESTIGATORS TO OVERCOME SOME
OF THE CHALLENGES OF DOING
RESEARCH IN THIS SPACE.
THERE WILL BE A TECHNICAL
ASSISTANCE WEBINAR IN THIS AREA
ON JANUARY 25TH, AND THE AN R
CONTACT OFFICER IS DR. PATRICK
STILL.
I HAVE A STLIED MISSI SLIDE MIS.
IN ADDITION TO THIS, THERE'S A
SAVE THE DATE FOR A WORKSHOP
THAT WE'RE GOING TO BE HOLDING
ON ENDOCRINE DISRUPTORS.
THE SAVE THE DATE I BELIEVE IS
GOING TO BE JUNE 10TH AND 11TH.
AND JUST LOOK AT OUR WEBSITE FOR
THAT.
THIS IS A WORKSHOP THAT WE'RE
GOING TO BE ORGANIZING TOGETHER
WITH THE NATIONAL INSTITUTE ON
ENVIRONMENTAL HEALTH SCIENCES.
NOW I'M GOING TO MOVE TOWARDS
THE NEXT CATEGORY, WHICH IS THE
WHO OR WORKFORCE DEVELOPMENT AND
SPECIAL POPULATIONS.
THIS IS A HAVE IMPORTANT EVENT,
WHICH WAS THE LAUNCHING OF THE
RAND REACH CENTER, WHICH IS A
VIRTUAL CENTER FOR COLLABORATIVE
RESEARCH IN COMPLEMENTARY AND
INTEGRATIVE HEALTH TO PROVIDE
RESOURCES TO EMPOWER SCHOOLS OF
COMPLEMENTARY AND INTEGRATIVE
HEALTH INSTITUTIONS FOR
IMPROVING THEIR RESEARCH
CAPACITY AS WELL AS THEIR
COMPETITIVENESS IN SUBMITTING
GRANT APPLICATIONS.
SO THE RAND, WE TALKED ABOUT
THIS CENTER AT THE LAST COUNCIL,
BUT IT WAS FINALLY LAUNCHED ON
NOVEMBER 2ND AND WE'RE VERY
EXCITED ABOUT THAT.
AGAIN ANOTHER UPCOMING WORK SHON
AT THE INTERNATIONAL CONGRESS ON
INTEGRATIVE MEDICINE AND HEALTH
IS GOING TO BE A POST CONFERENCE
WORKSHOP ON NAVIGATING EARLY
STAGE CAREER TRANSITIONS AND
FINDING FUNDING FOR CAREER
DEVELOPMENT IN COMPLEMENTARY AND
INTEGRATIVE HEALTH RESEARCH.
IT'S GOING TO BE LED BY
DR. LANAY MUDD AND INNA IS THE
BELLFER.
NOW I WANT TO POINT OUT WHAT WE
CALL NOSIs, NOTICE OF SPECIAL
INTEREST.
THESE ARE NOT FUNDING
ANNOUNCEMENTS BUT SIMPLY POINT
TO OTHER FUNDING ANNOUNCEMENTS.
IF YOU GO TO THE WEBSITE AND
SEE, ALL THESE NOSIs ARE NOT
LED BY NCCIH BUT WE HAVE AN
INTEREST IN THEM, ESPECIALLY IN
THE AREA OF DIVERSITY, EQUITY
AND INCLUSION AND ACCESSIBILITY.
SO THIS PARTICULAR ONE IS A
SPECIFIC NOSI FOR ADMINISTRATIVE
SUPPLEMENTS TO ENCOURAGE
MENTORSHIP IN THIS AREA.
THIS IS LED BY THE OFFICE OF THE
DIRECTOR OF THE NIH.
HERE'S ANOTHER ONE.
THIS TIME BY THE BRAIN
INITIATIVE, AS WELL AS THE
NATIONAL INSTITUTE ON ALCOHOL
ABUSE AND ALCOHOLISM.
AGAIN, RESEARCH TO PROMOTE --
THESE ARE SUPPLEMENTS TO PROMOTE
DIVERSITY, AGAIN, FOR MENTORING.
ANOTHER NOSY, T NOSI, THIS TIMEE
NIH OFFICE OF DISEASE
PREVENTION, TO PROMOTE MENTAL
HEALTH WEALTH BEING IN
POPULATIONS WITH HEALTH
DISSPAIRTS.
ONE MORE ON THIS TIME
MULTI-SECTORAL PREVENTIVE
INTERVENTIONS.
THIS IS AN INTERESTING ONE.
WHAT MULTI-SECTORAL
INTERVENTIONS ARE, ARE
INTERVENTIONS INVOLVING TWO OR
MORE SERVICE CENTERS, SUCH AS
PUBLIC HEALTH, EDUCATION,
HOUSING, SOCIAL SERVICES, CHILDD
WELFARE, ET CETERA.
AND SO THIS IS LED BY ALSO THE
OFFICE OF DISEASE PREVENTION.
HERE IS AN EVENT, AN UPCOMING
EVENT, PREAPPLICATION SEMINAR
FOR THE MULTI-SECTORAL
INTERVENTION THAT I JUST
MENTIONED.
SO IF YOU'RE INTERESTED IN THIS
FUNDING OPPORTUNITY, YOU SHOULD
CHECK OUT THIS WEBINAR ON
FEBRUARY 9TH.
AND FINALLY, THIS ONE IS A
FUNDING OPPORTUNITY BY THE
NATIONAL INSTITUTE ON MINORITY
HEALTH AND HEALTH DISPARITIES ON
HEALTHCARE DISPARITIES AMONG
PEOPLE LIVING WITH DISABILITIES.
WHICH HAS BEEN NOW FOLDED IN TO
THE CATEGORIES OF HEALTH
DISPARITIES.
NOW, FINALLY, THE METHODS AND
DATA SCIENCE CATEGORY, WHICH IS
THE HOW.
AGAIN, A VERY IMPORTANT CATEG
CATEGORY.
THE PAST EVENT WAS A PANEL AT
THE ACADEMY HEALTH MEETING ON
THE SCIENCE OF DISSEMINATION AND
IMPLEMENTATION IN HEALTH.
AND THIS PANEL WAS LED BY
DR. BEDA JEAN-FRANCOIS OF NCCIH.
IT'S REALLY TO DISCUSS VERY MUCH
THE IMPORTANCE AND THE METHODS
THAT ARE NEEDED IN ORDER TO DO
THIS RESEARCH WELL.
AND THEN ALSO THERE WAS A
SESSION ON IMPLEMENTATION
STRATEGIES INTO LARGE SCALE
MULTI-SITE PRAGMATIC CLINICAL
TRIALS, AS WELL AS EXPANDING
SUPPORT FOR IMPLEMENTATION
SCIENCE ACROSS THE NIH.
AND THIS REALLY BUILT ON THE
STRENGTH THROUGH THE NIH --
EXCUSE ME, I'M BLANKING -- PMC.
PAIN MANAGEMENT COLLABORATORY.
SORRY.
WE HAVE SO MANY COLLABORATORIES,
WE GET THEM MIXED UP SOMETIMES.
AND THIS SESSION WAS LED BY DR
DR. JENNIFER BAUMGARTNER.
NOW AN UPCOMING EVENT, AGAIN IN
THE METHODS AND DATA SCIENCE
CATEGORY AT THE INTERNATIONAL
CONGRESS ON INTEGRATIVE
MEDICINE & HEALTH.
THIS IS A POST CONFERENCE
WORKSHOP THIS TIME ON
DISSEMINATION AND IMPLEMENTATION
SCIENCE, AGAIN LED BY
DR. BAUMGARTNER.
THIS IS NOW A FUNDING
OPPORTUNITY, NOFO, BY THE BRAIN
INITIATIVE.
AND THIS IS A VERY INTERESTING
ONE ON BRAIN BEHAVIOR
QUANTIFICATION AND
SYNCHRONIZATION.
WE SOMETIMES CALL THESE IN-BRAIN
BARBECUES.
THIS IS TO QUANTIFY BOTH
BEHAVIORS AND COMBINE THEM WITH
SIMULTANEOUS RECORDING OF BRAIN
ACTIVITY IN HUMANS.
THIS IS REALLY GROUNDBREAKING.
BECAUSE IT COMBINES A LOT OF
WHAT THE VERY EXCITING SCIENCE
THAT IS BEING DEVELOPED AS PART
OF THE BRAIN INITIATIVE THAT WE
PARTICIPATE IN, BUT REALLY KIND
OF GOING THE NEXT STEP IS
LOOKING AT ALL THESE TOOLS THAT
WE HAVE TO LOOK AT THE ACTIVITY
OF THE BRAIN, BUT COMBINING THEM
WITH VERY SPECIFIC MEASUREMENTS
OF BEHAVIOR IN ANIMAL MODEL, AND
EVENTUALLY SOME OF THESE
TECHNIQUES CAN BE MOVED INTO
HUMANS.
ACTUALLY SOME OF THIS WILL BE
TRANSLATING TO HUMANS ALREADY.
SO THE NEXT NOFO THAT I WANT TO
POINT OUT IS A VERY EXCITING
COLLABORATIVE APPROACH ACROSS
MULTIPLE AGENCIES.
SO THIS INCLUDES THE
COLLABORATION BETWEEN THE
NATIONAL SCIENCE FOUNDATION,
NSF, THE DIRECTORATES AND
OFFICES, 10 PARTICIPATING
AGENCIES.
NIH, INSTITUTES, DEPARTM DEPARTF
ENERGY AND MANY OTHER AGENCIES
ACROSS GOVERNMENT IN
COLLABORATIVE RESEARCH IN
COMPUTATIONAL NEUROSCIENCE.
SO THIS IS REALLY EMPOWERED IN
THE FUTURE OF RESEARCH AND
REALLY BRINGING THE NEXT
GENERATION OF COMPUTATIONAL
TOOLS INTO RESEARCH.
AND WE ARE PARTICIPATING IN THIS
BECAUSE WE THINK IT'S VERY
IMPORTANT TO INCORPORATE ALL OF
THIS INTO THE STUDIES OF
COMPLEMENTARY AND INTEGRATIVE
HEALTH.
SO I HOPE THAT THIS NEW KIND OF
TRAVELOGUE THROUGH THESE VARIOUS
CAT IMCATEGORIES OF RESEARCH HAE
HELPED YOU TO UNDERSTAND OUR
STRATEGY TO KIND OF EVOLVE OUR
PRIORITIES AND OUR PORTFOLIO IS
ORGANIZED.
I THINK IN PREVIOUS COUNCIL
DISCUSSIONS, WE SORT OF HAD THE
FEEDBACK THAT THERE WAS A
PERCEPTION THAT WE WERE TRYING
TO DO A LOT OF THINGS, AND WE
ARE, AND IT'S TRUE.
BUT WE ARE NOT DOING A LOT OF
DISPARATE THINGS.
WE'RE DOING A LOT OF THINGS IN A
VERY DELIBERATE AND ORGANIZED
WAY THAT BUILDS UPON THE
STRENGTHS OF THE PREVIOUS KIND
OF, FOR EXAMPLE, 10 YEARS AGO OR
SO, FIVE, 10 YEARS AGO TO BEFORE
THIS CURRENT STRATEGIC PLAN,
THERE WAS A VERY CLEAR FOCUS ON
TWO SPECIFIC AREAS, THE MIND AND
BODY THERAPIES, AND THE NATURAL
PRODUCTS.
IN THIS CURRENT STRATEGIC PLAN,
WE HAVE -- AND THEN, OF COURSE,
PAIN HAS ALWAYS BEEN A FOCUS.
IN OUR CURRENT STRATEGIC PLAN,
WE HAVE EXPANDED THIS TO REALLY
LOOK AT THE WHOLE PERSON.
WE HAVE EXPANDED TO THE HEALTH
RESTORATION AS AN IMPORTANT
THEME.
WE HAVE, AS I EXPLAINED, KIND OF
EXPANDED OUR CONCEPTS OF THE
MIND AND BODY CONNECTION, AS
WELL AS THE NUTRITION CONTINUUM,
BUT AS YOU CAN SEE, ALL OF THIS
FITS VERY WELL WITHIN THE
SCIENCE THAT WE HAVE BEEN
FOCUSING ON FOR A LONG TIME.
AND THEN THE TWO CATEGORIES THAT
ARE THE CROSS-CUTTING CATEGORIES
OF THE WHO AND THE HOW, ARE SO
IMPORTANT BECAUSE IT REALLY
HELPS US TO INCUR ALL OF THIS
RESEARCH OF THE WHAT INTO VERY
SOLID METHODS, AS WELL AS
DEVELOPING THE VERY IMPORTANT
WORKFORCE AND THE UNDERSTANDING
HOW TO APPROACH ALL OF THE
POPULATIONS OF INDIVIDUALS WHERE
WE WANT THE RESEARCH TO IMPACT
IN AN EQUITABLE MANNER, TO MAKE
SURE THAT NOBODY GETS LEFT OUT.
SO WHAT WE'RE DOING NOW IS A BIT
OF AN EXERCISE, AND WE WANT TO
HAVE EVERYBODY'S FEEDBACK FOR
COUNCIL AS WELL AS FROM THE
COMMUNITY AT LARGE.
AS TO WHETHER THEY FIND THAT
THIS NEW ORGANIZING PRINCIPLE,
FIRST OF ALL, MAKES SENSE, AND
DOES IT HELP TO UNDERSTAND WHAT
WE'RE DOING, AND AS WE MOVE INTO
OUR NEXT STRATEGIC PLAN, WHICH
WE'RE GOING TO BE STARTING NEXT
YEAR, IS THIS A GOOD FRAMEWORK
FOR US TO BUILD ON.
AND THAT'S WHY WE WANTED TO DO
THE PRESENTATION TODAY, THIS W
WAY, TO REALLY KIND OF TEST
DRIVE A LITTLE BIT THIS FORMAT.
IT'S NOT SET IN STONE.
WE ARE CERTAINLY OPEN TO -- AND
THIS IS NOT ANY -- IT DOES NOT
MEAN -- THIS IS NOT GOING TO BE
THE NEXT STRATEGIC PLAN.
OUR NEXT STRATEGIC PLAN IS NOT
STARTED YET.
SO AS FAR AS THAT PROCESS IS
CONCERNED, WE'RE GOING TO BE
GOING OVER ALL THE STEPS
INCLUDING REQUEST FOR
INFORMATION, ET CETERA, MANY,
MANY DIFFERENT STEPS AS WE DID
WITH OUR PREVIOUS STRATEGIC
PLAN.
BUT WHAT THIS IS MORE --
REFLECTS IS MORE OF A REFLECTION
OF WHERE WE ARE NOW.
AND HOW DO WE BEST KIND OF
SYNTHESIZE THE MANY DIFFERENT
EXCITING OPPORTUNITIES THAT
WE'RE DEVELOPING INTO A
FRAMEWORK THAT HOPEFULLY MAKES
SENSE.
SO I AM GOING TO STOP SHARING
NOW, AND I REALLY LOOK FORWARD
TO HEARING EVERYBODY'S COMMENTS
AND REACTIONS TO THIS.
>> WE HAVE DR. BROLINSON WHO WAS
VERY PATIENT RAISING HIS HAND
FOR A WHILE, SO DR. BROLIN
SORNTION PLEAS.
>> JUST ONE LIN COMMENT, HELENE,
WHEN YOU MENTIONED THE CHANGE IN
THE REVIEW PROCESS, I THINK YOU
SAID IT STARTS IN A FEW DAYS.
IT ACTUALLY STARTS IN A YEAR.
I THINK IT'S 12 MONTHS FROM NOW.
NOT JUST IN A FEW DAYS.
IT WAS IN ONE OF YOUR VERY EARLY
SLIDES.
>> I'M SORRY, DID I SAY IN A FEW
DAYS?
MY APOLOGIES.
>> IT HAPPENS TO ALL OF US.
NO BIG DEAL.
>> 2025.
WE HAVE A LITTLE BIT MORE TIME
TO PREPARE, YEAH.
>> YEAH, MY BAD.
SORRY ABOUT THAT.
ANY OTHER COMMENTS?
ANY OTHER BLOOPERS?
>> HELENE, I HAVE A COMMENT.
THANK YOU SO MUCH FOR SHARING
ALL THIS, AND REALLY INTERESTING
PROGRESS AND EXCITING
INITIATIVES TO REPORT, AND THANK
YOU FOR REPRESENTING US ALL ON
BEHALF OF NCCIH AND THESE
IMPORTANT INITIATIVES.
I JUST WANTED TO ASK A LITTLE
BIT MORE ABOUT -- IT SEEMS LIKE
THERE'S A REALLY INTERESTING
THEME WITH THE NOSIs AROUND
THIS IDEA OF BUILDING MORE
INCLUSIVITY AND BOTH IN TERMS OF
WHO'S PARTICIPATING IN RESEARCH,
WHO'S PARTICIPATING IN CLINICAL
TRIALS, THE TYPES OF MENTORSHIP
THAT ARE HAPPENING, AND I
WONDERED WHETHER THERE'S SOME
SPECIFIC EFFORTS THAT ARE GOING
ON AT NCCIH TO TRY TO FACILITATE
THAT.
YOU TALKED A LITTLE BIT ABOUT
THOSE NOTICES OF SPECIAL
INTEREST, BUT I WAS JUST A
LITTLE CURIOUS ABOUT WHAT'S
GOING ON BEHIND THE SCENES TO
SUPPORT ALL THAT AND WHAT'S
DRIVING IT AND IF YOU COULD SAY
A LITTLE MORE ABOUT IT.
>> GOOD QUESTION.
SO BASICALLY WHAT'S DRIVING IT
IS ALL OF NIH IS DRIVING IT.
THIS IS SOMETHING THAT'S
HAPPENING THROUGHOUT NIH, AND
WE'RE VERY FORTUNATE THAT -- YOU
SAW ALL OF THE DIFFERENT
INITIATIVES STARTING FROM THE
OFFICE OF THE DIRECTOR, TO ALL
THE VARIOUS DIFFERENT INSTITUTES
ARE PROVIDING US WITH ALL OF
THESE MECHANISMS ALREADY.
WE DON'T HAVE TO REINVENT ALL OF
THESE OURSELVES.
AS A SMALL CENTER, IT'S REALLY
IMPORTANT FOR US TO TAKE
ADVANTAGE OF ALL OF THE
INITIATIVES THAT ARE ALREADY IN
PLACE WHERE WE FEEL THAT WE CAN
APPLY ALL OF THESE OPPORTUNITIES
TO OUR WORKFORCE, AND TO OUR
INVESTIGATORS, AND TO OUR TYPE
OF RESEARCH.
WHEN NECESSARY, WE WILL DEVELOP
OUR OWN.
SO FOR EXAMPLE, WE HAVE SOME
INITIATIVES THAT WE ARE
SPECIFICALLY TARGETING FOR, FOR
EXAMPLE, EMOTIONAL WELL-BEING IN
UNDERSERVED POPULATIONS.
ALL OF OUR EFFORTS AT THE V.A.
AND DEPARTMENT OF DEFENSE DEAL
WITH A VERY UNDERSERVED AND
VERY -- POPULATION THAT'S
IMPACTED -- I SHOULDN'T SAY
UNDERSERVED.
THEY'RE WELL SERVED BY THE VA
AND DOD BUT THEY'RE
DISPROPORTIONATELY IMPACTED BY
PAIN, FO FOR EXAMPLE.
AND SO THERE'S A LOT OF THESE
KINDS OF SPECIFIC EFFORTS THAT
WE ARE DOING BUT AT THE SAME
TIME, WE TRY TO TAKE ADVANTAGE
OF WHAT'S ALREADY THERE, AND SO
PERHAPS DR. JEAN-FRANCOIS WANTS
TO COMMENT OR DR. EDWARDS?
>> I'LL COMMENT.
NADJA, JUST TO ANSWER YOUR
QUESTION MORE SPECIFICALLY, WE
DO HAVE DIVERSITY AND HEALTH
DISPARITY WORKING GROUP WITHIN
THE DIVISION OF EXTRAMURAL
RESEARCH THAT MEETS MONTHLY TO
MONITOR THESE ACTIVITY, AND
WE'VE REALLY MADE SOME CHANGES
INTO THE NUMBER OF TIMES THAT WE
ENCOURAGE DIVERSITY SUPPLEMENTS
TO BE SUBMITTED TO NCCIH.
WE'VE HAD A NUMBER OF WEBINARS.
ONE OF THEM WAS ABOUT ENGAGING
DIFFERENT POPULATIONS, AND THEIR
PARTICIPATION INTO OUR CLINICAL
TRIALS.
SO YOU KNOW, THERE'S AN ACTIVE
GROUP WITHIN THE DIVISION THAT
ACTUALLY MONITORS THIS AND HELPS
US ACTUALLY TAKE ADVANTAGE OF
THESE OPPORTUNITIES THAT ELAINE
MENTIONED.
IN FACT, TODAY ONE OF THE K9
K99/R00 IS THE MOSAIC PROGRAM
FROM NIGMS, WHICH IS FOCUSED ON
DIVERSITY.
SO THIS IS AN EXAMPLE OF WHERE,
YOU KNOW, THE INITIATIVE CAME
FROM AT THE INSTITUTE, BUT WE
PARTICIPATED AND ALREADY
IDENTIFIED A GRANT THAT WILL BE
NCCIH THAT WE ARE CONSIDERING
FUNDING.
SO I THINK WE HAVE A LOT OF
ACTIVE PARTICIPATION ACROSS THE
BOARD.
AND LANAY HAS PUT IN THE WEB
PAGE THAT HIGHLIGHTS SOME OF
THOSE ACTIVITIES.
THANKS.
>> WONDERFUL.
THANK YOU SO MUCH FOR ALL OF
THAT!
IT REALLY DID COME THROUGH IN
THE PRESENTATION.
I THINK EVEN MORE SO THAN IT HAS
IN THE PAST, SO IT FEELS REALLY
EXCITING TO SEE THESE EFFORTS
STARTING TO BEAR FRUIT AND BE
COMING A PART OF THE CULTURE AND
THE ENVIRONMENT AT NCCIH AND AT
NIH IN GENERAL.
>> YES, YES, I WOULD SAY THIS IS
REALLY GATHERING STEAM IN A WAY
THAT'S VERY GOOD.
AND THANKS, EMILY, FOR
MENTEMMELINE, FORMENTIONING THE.
WE REALLY TRY TO TAKE ADVANTAGE
OF EVERYTHING THAT'S OUT THERE
AT OUR DISPOSAL.
ANY OTHER COMMENTS?
>> YES, I'D JUST LIKE TO SAY,
THIS IS AN AMAZING FIRST DRAFT,
IT APPEARS TO REALLY TRY TO
ENCAPSULATE ALL THAT THE CENTER
IS REALLY TRYING TO ADDRESS AND
ACCOMPLISH.
I WOULD IMAGINE THAT AS EMMELINE
WAS TALKING ABOUT, THAT THERE
MAY BE DIFFERENT VERSIONS FOR
DIFFERENT ETHNIC MINORITY OR
UNDERSERVED POPULATIONS, FOR
INSTANCE, PAIN, YOU KNOW, WE'RE
PREPARING A PAPER IN OUR GROUP,
ONE OF THE FIRST -- TO OUR
KNOWLEDGE ONE OF THE FIRST
PAPERS ON PAIN AND NATIVE
AMERICANS, AND KIND OF THE
CONNECTION OF CULTURAL
CHARACTERISTICS AND OTHER
HISTORY AND HOW THAT MAY TIE IN
WITH PAIN FOR THIS GROUP.
SO I WOULD IMAGINE, YOU COULD
PUT A WHOLE OTHER -- PAIN COULD
HAVE ITS OWN CIRCLE OF
DISCUSSION, SO I WAS CURIOUS IF
THERE WILL BE KIND OF LIKE
SUBGROUPINGS OF THE EFFORT IN
THIS WAY.
>> WELL, I SHOULD MENTION -- I
MEAN, SO ETHNIC AND RACIAL
MINORITIES, ALSO SEX AND GENDER
MINORITIES, ALSO PEOPLE WITH
DISABILITIES, YOU KNOW, THESE
ARE ALL KIND OF CONSIDERED TO
BE, YOU KNOW, DIFFERENT
CATEGORIES OF MINORITY AND
UNDERSERVED POPULATIONS, AND SO
WE DEFINITELY CAN AND WILL AND
HAVE BEEN, YOU KNOW, TARGETING
SOME SPECIFIC AREAS, FOR
EXAMPLE, AS YOU MENTIONED IN THE
AREA OF PAIN, CERTAIN OF THESE
CATEGORIES OF INDIVIDUALS WHO
ARE DISPROPORTIONATELY AFFECTED.
WOMEN ARE ALSO
DISPROPORTIONATELY AFFECTED BY
PAIN.
AND SO, YES, CERTAINLY IN
SPECIFIC AREAS OF RESEARCH,
THERE IS DEFINITELY -- IT'S
APPROPRIATE AND IMPORTANT, YOU
KNOW, TO TARGET SPECIFIC
POPULATIONS OF PEOPLE WHO ARE
DISPROPORTIONATELY AFFECTED, AND
ALSO, YOU KNOW, PEOPLE WHO HAVE
SOCIAL ECONOMIC DISPARITIES
ACROSS THE BOARD, AND SO THIS IS
WHERE WE'RE VERY EXCITED ABOUT
SOME OF THESE INITIATIVES, LIKE
THE COMPASS INITIATIVE THAT ARE
REALLY LOOKING AT THE SYSTEMIC
INITIATIVES -- I MEAN
INTERVENTIONS.
THIS IS PRETTY REVOLUTIONARY,
ACTUALLY, FOR NIH TO BE GOING
INTO.
SO WE'RE REALLY WATCHING THIS
VERY CAREFULLY, WE'RE
PARTICIPATING.
YOU KNOW, THE WHOLE AREA OF
SOCIAL DETERMINANTS OF HEALTH IS
SOMETHING THAT HAS BEEN REALLY
SO MUCH RISEN TO THE FRONT OF
AWARENESS.
BOTH FROM THE POINT OF VIEW OF
UNDERSTANDING THE FACTORS THAT
LEAD TO ILLNESSES AND HEALTH
PROBLEMS, BUT ALSO THE NEED TO
HAVE DEVELOPED INTERVENTIONS
THAT ARE SPECIFIC TO ADDRESS
THESE SOCIAL DETERMINANTS AND
SOME OF THEM CAN BE ADDRESSED AT
THE INDIVIDUAL LEVEL, YOU KNOW,
KIND OF IN TERMS OF INDIVIDUAL
INTERVENTIONS, FOR EXAMPLE,
MANAGING STRESS WOULD BE ONE.
BUT SOME OF THEM NEED TO BE AT
THE SYSTEMIC LEVEL, BECAUSE IF
SOMEBODY IS UNDER STRESS BECAUSE
THEY LIVE IN A VIOLENT, NOISY NY
NEIGHBORHOOD THAT HAS AIR
POLLUTION, THERE'S ONLY SO MUCH
OF MINDFULNESS, YOU KNOW,
MEDITATION IS NOT GOING TO FIX
THAT.
YOU KNOW, SO YOU REALLY NEED A
COMBINED APPROACH.
THIS IS WHERE WE'RE VERY EXCITED
ON OUR COLLABORATIONS WITH THE
NATIONAL INSTITUTE OF
ENVIRONMENTAL HEALTH SCIENCES,
THAT THERE REALLY HAVE BEEN
ADVOCATING UNDERSTANDING THE
CONCEPT OF THE EXPOSOME, WHICH
IS THE TOTALITY OF THE EXPOSURES
THAT SOMEBODY IS -- OVER THEIR
LIFETIME, INCLUDING
ENVIRONMENTAL EXPOSURES,
INCLUDING CHRONIC STRESS, AND
INCLUDING SORT OF MORE PHYSICAL
AND CHEMICAL EXPOSURES.
SO I THINK MORE TO COME HERE.
I THINK THIS IS AN AREA WHERE
WE'RE GOING TO BE VERY MUCH
BENEFITING FROM PARTNERSHIPS
WITH THE OTHER INSTITUTES AND
CENTERS AT NIH.
BECAUSE WE CAN'T DO EVERYTHING.
BUT WE HAVE TO BE -- BUT WE CAN
INFLUENCE WHAT PEOPLE DO, YOU
KNOW, BY THE KINDS OF QUESTIONS
THAT WE ASK.
AND I SHOULD ADD, ONE OF THE
AREAS WHERE NCCIH HAS HAD AN
IMPACT IS TO REALLY EMPHASIZE
THE POSITIVE ASPECTS OF WHAT WE
CAN DO TO MITIGATE SOME OF THE
ENVIRONMENTAL STRESSORS AND
PROMOTE RESOLUTION OF STRESS AS
WELL AS RESILIENCE.
SO, BEN.
>> YES.
HI, HELENE, THANK YOU.
AS USUAL I WANT TO THANK YOU FOR
TAKING NCCIH INTO THIS MORE
WHOLE PERSON SPACE WHERE YOU'RE
INCLUDING BOTH THE CONCEPT OF
WHOLE PERSON HEALTH AND THE
IMPACT OF SOCIAL DETERMINANTS OF
HEALTH.
AND WHAT I JUST WANTED TO SHARE
IS THAT -- FOR PEOPLE WHO DON'T
KNOW, I'M AT THE VETERANS HEALTH
ADMINISTRATION.
THERE'S REALLY A TREND ACROSS
GOVERNMENT WHICH I KNOW YOU'RE
AWARE OF BUT PERHAPS NOT
EVERYBODY IS TO START THINKING
ABOUT HEALTH AND OUR
RESPONSIBILITY FOR HEALTH AS
BIGGER THAN JUST THE WAY WE
TRADITIONALLY HAVE, WHETHER
THAT'S PHYSICAL HEALTH, MENTAL
HEALTH, BUT THINKING ABOUT IT IN
A MORE KIND OF GLOBAL COMMUNITY
KIND OF SOCIAL FRAMEWORK.
SO THERE'S A WORKING GROUP
THAT'S BEING LED BY HEALTHY
PEOPLE 2030 OR THAT'S KIND OF
LAUNCHING, WHICH IS PART OF HHS,
TO REALLY TALK THROUGH FURTHER
HOW OUR SYSTEMS FOR EXAMINING
THESE THINGS ACROSS THE
DIFFERENT FEDERAL AGENCIES,
WHETHER IT'S HHS, CDC, CMS,
WHEREVER IT MIGHT BE, V.A., HOW
WE CAN BE MORE COHERENT IN THE
WAY WE DESCRIBE THE END POINTS
AND THE SORT OF ASPECTS OF WHOLE
PERSON HEALTH THAT WE'RE LOOKING
FOR.
AND I THINK YOU'VE BEEN INVITED
AND IF YOU HAVEN'T, I'M HEREBY
INVITING YOU.
IT'S JUST KIND OF GETTING OFF
THE GROUND, BUT I THINK -- THE
REAP I WANTED TO SAY THAT IS I
THINK THE IMPACT THAT YOU'RE
HAVING IN THESE COLLABORATIONS
AT NIH, PARTICULARLY AROUND WHAT
KINDS OF APPROACHES CAN MITIGATE
SOME OF THESE DIFFICULT
DETERMINANTS OF HEALTH,
ULTIMATELY THAT CAN REALLY ECHO
OUT ACROSS SOME OTHER GOVERNMENT
AGENCIES THAT ARE RESPONSIBLE
FOR A LOT OF IMPLEMENTATION
AROUND HEALTHCARE, WHETHER IT'S
HRSA OR WHOEVER ELSE IT MIGHT
BE, AND SO IT'S VERY EXCITING TO
SEE THE RESEARCH MOVING FORWARD
KIND OF REALLY IN PARALLEL BUT
ALSO IN SUPPORT OF THIS WHAT I
REALLY SEE AS A BIGGER TREND IN
HOW WE'RE LOOKING AT HEALTH.
SO I JUST -- AS USUAL, I THINK I
HAVE TO THANK YOU FOR THIS EVERY
SINGLE COUNCIL SESSION, BUT I'M
EXCITED TO SEE WHAT THAT GROUP,
WHAT HHS AND HEALTHY PEOPLE,
WHAT WE CAN ALL LEARN FROM THIS
NEW STUFF THAT'S HAPPENING.
IT'S GREAT.
THANK YOU.
>> WELL, THANK YOU, BEN.
YOU KNOW, I'VE BEEN REFLECTING A
LOT ON ALL OF THIS, AND I KNOW
WHAT PARTICULARLY I'M EXCITED
ABOUT IS THAT A LOT OF THE WORLD
HEALTH IS BEING USED A LOT AND
HAS BEEN USED A LOT, BUT NOT
ALWAYS TO REALLY MEAN HEALTH.
AND I THINK INCREASINGLY, IT IS.
YOU KNOW, I ALWAYS JOKE THAT THE
NATIONAL INSTITUTES OF HEALTH IS
INCREASINGLY INTERESTED IN
HEALTH BUT, YOU KNOW, IT'S AN
EFFORT TO PULL AWAY FROM REALLY
LOOKING AT DISEASES.
NOT THAT DISEASES ARE NOT
IMPORTANT.
THEY ARE.
BUT WE NEED TO UNDERSTAND HEALTH
AS WELL.
AND WE NEED MORE EFFORTS TO DO
THAT, AND I THINK THAT A LOT OF
THESE, LIKE THE HEALTHY PEOPLE
INITIATIVE AND I THINK THAT A
LOT OF THESE INITIATIVES THAT
ARE ACROSS GOVERNMENT, THEY
REALLY TAKE HEALTH SERIOUSLY.
AND SO I THINK THIS IS A VERY
GOOD SIGN.
SO THANK YOU.
FOR MENTIONING THAT.
HELEN.
>> SORRY, I COULDN'T FIND THE
HAND BUT I HAVE --
>> THAT HAND WORKS TOO.
>> SO YOU KNOW, YES, I'M ALSO
EXCITED ABOUT THE WHOLE THING OF
WHOLE PERSON HEALTH, AND THIS
BECOMING A MOVEMENT THAT PEOPLE
FOLLOW, AND THE FACT THAT NCCIH
CAN LEAD IN THAT EFFORT.
I'M A PART OF THE WHOLE BRAIN
HEALTH MOVEMENT, AND IT'S A
SNOWBALL ROLLING, YOU KNOW, ALL
THE ORGANIZATIONS ARE SIGNING ON
THAT NEVER WANTED TO WORK WITH
EACH OTHER ACTUALLY.
AMERICAN ACADEMY OF NEUROLOGY,
AMERICAN HEART ASSOCIATION,
AARP, YOU KNOW, SO ALL OF A
SUDDEN, THERE'S THIS
OPPORTUNITY, AND WORLD HEALTH
ORGANIZATION ACTUALLY PROVIDES
THE KEY DOCUMENTS TO SUPPORT IT
ON BRAIN HEALTH AND GLOBAL
AGING, AND I THINK THE
GOVERNMENT ALSO, THROUGH MY WORK
THROUGH OTHER WORLD PSYCHIATRIC
ASSOCIATION, THERE'S A PUSH ON
ADVOCACY, AND PERCEIVING HEALTH
AS A HUMAN RIGHT.
AND SO WE'RE GOING TO BE -- WE
HAVE BEEN PUBLISHING AND WILL BE
PUBLISHING MORE DOCUMENTS AND
PAPERS AND WORKING WITH
LEGISLATURES AND GOVERNMENTS ON
HEALTH AS A HUMAN RIGHT.
THAT GETS A LOT OF TRACTION WITH
CONSUMER ORGANIZATIONS AND ALL
SORTS OF STAKEHOLDERS.
SO JUST TO --
>> I WOULD BE VERY -- WOULD LOVE
IF YOU COULD SEND THE
COORDINATORS FOR THIS WHOLE
BRAIN HEALTH.
CAN YOU SEND --
>> OH, YES, WE'VE HAD SEVERAL
SUMMITS.
THE AMERICAN ASSOCIATION OF
NEUROLOGY HAD TWO SUMMITS NOW
AND THEY'RE WORKING WITH TWO
CONGRESSMEN ON THIS, AND THEY
ACTUALLY LABELED SEPTEMBER 15TH
OF 2022 AS BRAIN HEALTH DAY.
AND WE JUST HAD -- I'M THE
PRESIDENT OF THE AMERICAN
ASSOCIATION FOR GERIATRIC
PSYCHIATRY, WE HAD A POSITION
PAPER WITH MULTIPLE
ORGANIZATIONS SIGNED ON
PUBLISHED, AND A BRAIN HEALTH
SUMMIT OF OUR OWN MAKING, BUT
THIS IS, AGAIN, IT'S A GLOBAL
INITIATIVE.
AND THE ALZHEIMER'S ASSOCIATION,
FOR INSTANCE, HAS THIS -- SO
IT'S A NOW KNOWN KNOWLEDGE IN
ORDER TO PREVENT ALZHEIMER'S
DISEASE, 40% OF ALZHEIMER'S
DISEASE IS DUE TO LIFESTYLE
FACTORS.
AND THAT'S A BIG TRAIN NOW
MOVING, YOU KNOW, WE'RE ALL
MOVING ON LIFESTYLE FACTORS.
DRUG COMPANIES NOW TALK BRAIN
HEALTH, WHICH IS UNHEARD.
AND THEY HAVE SUMMITS AND ALL
SORTS OF STAKEHOLDER MEETINGS ON
THIS ISSUE.
SO I THINK IT'S A MOMENTUM THAT
WE ALL HAVE TO WORK WITH, YOU
KNOW?
>> THAT'S GREAT.
THEN WE HAVE TO CONNECT THE
BRAIN HEALTH WITH THE STOMACH
HEALTH AND THE FOOT HEALTH
AND --
>> O IT'S WHOLE PERSON HEALTH,
YES.
>> THANK YOU.
WOLF.
>> I JUST HAVE A TERMINOLOGY
QUESTION.
I HEAR BOTH, WHOLE HEALTH AND
WHOLE PERSON HEALTH.
>> OH.
>> ARE THEY THE SAME?
>> AH, YOU REALLY KIND OF ASKED
A MILLION DOLLAR QUESTION HERE.
SO WHOLE HEALTH, RIGHT, IS
ALREADY A TERM THAT HAS BEEN --
I DON'T WANT TO SAY THE WORD
BRANDED BUT IT'S USED A LOT AND
THE V.A. HAS BEEN USING THAT
TERM QUITE A BIT.
FOR THEIR
APPROACH TO HEALTHCARE.
AT THE NIH, WHEN WE STARTED
DOING OUR PREVIOUS STRATEGIC
PLAN, WE THOUGHT A LOT ABOUT
THIS FIVE YEARS AGO.
THE REASON WHY WE DECIDED TO PUT
THE WORD "PERSON" IN THERE IS IT
HAD TO DO WITH A FEW THINGS.
ONE IS THAT -- SO THE WHOLE
PERSON HEALTH HAS TWO
COMPONENTS.
IT HAS A WHOLE PERSON COMPONENT,
AND IT HAS THE HEALTH COMPONENT.
AND I SEE THEM AS ORTHOGONAL, SO
THE WHOLE PERSON COMPONENT MEANS
INTEGRATION ACROSS THE PERSON.
BECAUSE AT NIH, AND A LOT OF
PLACES IN SCIENCE, WHATEVER,
THERE'S A TENDENCY TO BREAK UP
THE PERSON INTO PARTS.
RIGHT?
SO YOU KNOW, ALL THE DIFFERENT
OORGANS, SYSTEMS AND PARTS OF TE
BODY.
SO THE WORD PERSON WAS IMPORTANT
THERE, BECAUSE IT MEANT THAT,
YOU KNOW, WE REALLY WANT TO MAKE
AN EFFORT TO INTEGRATE ACROSS
ALL OF THIS, AS WELL AS THE
BIOLOGICAL BEHAVIORAL SOCIAL AND
ENVIRONMENTAL ASPECTS OF THE
PERSON.
AND THEN THE HEALTH COMPONENT
HAS TO DO WITH THE BIDIRECTIONAL
HEALTH CONTINUUM GOING FROM
HEALTH TOWARDS AND BACK AND
HEALTH BETWEEN HEALTH AND LESS
HEALTH, RIGHT?
THIS IS HOW WE DEFINE IT.
THIS IS WHAT NCCIH DEFINES WHOLE
PERSON HEALTH THAT WAY.
IT'S NOT -- OTHER PEOPLE MIGHT
USE IT -- BUT FOR US THAT WAS
IMPORTANT.
WE RECOGNIZE, HOWEVER, THAT HOW
WE VIEW WHOLE PERSON HEALTH IS
ENTIRELY RELEVANT TO THE VA'S
DEFINITION OF WHOLE HEALTHCARE,
RIGHT?
SO WHOLE HEALTH, WHOLE PERSON
HEALTH, THERE'S NOT A HUGE
DIFFERENCE, BUT AS FAR AS FOR
RESEARCH, OUR RESEARCH
OPERATIONAL DEFINITION, WE
THOUGHT IT WAS IMPORTANT TO HAVE
A PERSON IN THERE.
>> THANKS FOR THE CLARIFICATION.
>> IT IS A TRICKY QUESTION, AND
WE'VE SPENT A LOT OF TIME
TALKING ABOUT THIS, DISCUSSING
IT, ET CETERA.
>> THANK YOU.
>> THANK YOU, HELEN, FOR PUTTING
THAT IN THE CHAT.
COOL.
ANY OTHER THOUGHT OR COMMENT?
I SPECIFICALLY WOULD LIKE TO ASK
COUNCILMEMBERS ABOUT FEEDBACK ON
THE DISPLAY, USING THE DIFFERENT
CATEGORIES AND HOW TO ORGANIZE.
WAS THAT HELPFUL?
>> IT SEEMED EFFECTIVE.
>> BETTER?
IT WASN'T QUITE SO BEWILDERING
TO SEE ALL THIS LITANY OF
FUNDING OPPORTUNITIES AND EVENTS
AND -- GOOD.
GOOD.
BECAUSE HERE'S WHAT HAPPENED,
RIGHT?
WE WERE KIND OF THE VICTIMS OF
OUR OWN SUCCESS, YOU KNOW?
OVER THE PAST FIVE YEARS, AS WE
WERE JUST -- WE'D KEEP DOING
MORE AND MORE THINGS, AND IN MY
DIRECTOR'S REPORTS, I KEPT
HAVING MORE AND MORE -- WE WERE
COLLECTING ALL OF THESE PAST
EVENTS AND FUTURE EVENTS AND
FUNDING OPPORTUNITIES, AND IT
WAS STARTING TO BECOME
OVERWHELMING.
AND I WAS ACTUALLY CONCERNED
THAT THERE WAS -- IT WAS NOT
SENDING RIGHT MESSAGE, THAT IN
FACT WE WERE SCATTERING
OURSELVES, AND NOT REALLY
FOCUSING, WHICH WAS NOT THE
CASE, REALLY, BUT IT LOOKED THAT
WAY.
SO I THINK THAT HOPEFULLY GOING
FORWARD, WE WILL BE ABLE TO USE
THIS FORMAT TO SHOW YOU THE
AREAS OF SCIENCE WHERE WE ARE
GROWING, AND, YOU KNOW, AREAS OF
SCIENCE THAT WE MAY WANT TO
CONSOLIDATE, AND MAYBE NEW AREAS
THAT WE WANT TO DEVELOP.
BUT WE THINK THAT -- SO
GENERALLY PEOPLE THOUGHT IT WAS
HELPFUL?
GOOD.
ALL RIGHT.
SO IF THERE ARE NO FURTHER
COMMENTS, WE'RE A FEW MINUTES
EARLY.
MARTINA?
>> LET'S JUST GO AHEAD.
I MEAN, IF WE END A LITTLE BIT
EARLIER WITH THE --
>> EXCEPT WE HAVE OUR GUEST
SPEAKER --
>> YES, AND WE ALREADY CONTACTED
HER.
SO SHE IS AWARE THAT WE'RE A
LITTLE BIT AHEAD OF SCHEDULE.
>> IS THAT GOING TO WORK?
>> BUT ACTUALLY WE ALSO HAVE
ONLY A 5-MINUTE BREAK SCHEDULED,
SO I THINK -- SO PEOPLE --
>> PERFECT.
>> PEOPLE WILL PROBABLY BE
HAPPY.
>> SO WE'LL START ON TIME THEN.
NICE.
OKAY.
THANK YOU, EVERYONE.
FOR YOUR FEEDBACK AND
EVERYTHING.
ALL RIGHT.
>> THE RECOGNITION SECTION
BEFORE --
[SPEAKER MUTED]
-- THE COUNCILMEMBERS --
>> THEN HAVE THE BREAK BEFORE WE
START WITH THE PRESENTATIONS.
>> I THINK A FEW PEOPLE MIGHT
HAVE LEFT.
DO YOU THINK SOME PEOPLE LEFT
ALREADY?
>> NO, I THINK EVERYBODY IS
COMING BACK ON.
WE ARE GOOD.
>> ARE YOU SURE?
>> YEP.
>> SOME PEOPLE MIGHT HAVE THEIR
CAMERAS OFF.
>> BUT WE HAVE 60 PEOPLE HERE.
I THINK WE ARE GOOD.
>> OKAY.
ALL RIGHT.
WELL, IT'S NOW THE SAD PART.
OF THE SESSION.
WE HAVE TO SAY GOODBYE TO FOUR
OUTSTANDING COUNCILMEMBERS.
I DON'T KNOW HOW WE'RE GOING TO
LIVE WITHOUT THEM.
THESE FOUR INDIVIDUALS LIVED
THROUGH US, THROUGH COVID,
THROUGH EVERYTHING, AND WE'RE SO
GRATEFUL TO HAVE HAD THEIR
SERVICE, BEGINNING WITH DR. TODD
BRAVER.
THANK YOU SO MUCH, TODD.
I MEAN, I CANNOT JUST -- THERE'S
NO WORDS TO EXPRESS HOW
WONDERFUL IT WAS TO HAVE YOU ON
COUNCIL AND WE ARE GOING TO MISS
YOU VERY, VERY MUCH.
THANK YOU.
DR. TONY DELITTO, AGAIN, YOU
KNOW, IS JUST -- YOUR EXPERTISE
AND EVERYTHING THAT YOU'VE
BROUGHT TO COUNCIL HAS BEEN JUST
PHENOMENAL AND, AGAIN, WE'RE
GOING TO MISS YOU.
BIG SHOES TO FILL.
DR. MEHLING.
YOU KNOW, IT'S SORT OF -- YOU
REALLY BROUGHT SO MUCH OUT OF
THE BOX, YOU KNOW, POINTS OF
VIEW THAT WERE ALWAYS SO WELL
RECEIVED AND SO THOUGHTFUL.
THANK YOU SO, SO MUCH.
AND FINALLY, DR. SHINTO, IS SHE
STILL THERE?
YES, LYNNE.
THANK YOU SO MUCH, LYNNE.
IT WAS A REAL PLEASURE HAVING
YOU, AND REALLY SORT OF
APPRECIATE HAVING ALL OF YOU
WITH ALL OF YOUR RESPECTIVE
EXPERTISE IN ALL OF THE DOMAINS
REALLY CAME TOGETHER TO THIS
COUNCIL TO ENRICH IT AND ALWAYS
SORT OF MADE OUR DISCUSSION SO
MUCH GREATER THAN THE SUM OF THE
PARTS, YOU KNOW, JUST HAVING
ALL -- EVERYBODY'S COMING FROM A
DIFFERENT DIRECTION, BUT REALLY
HELPING US TO MOVE TOWARDS A
COMMON GOAL.
AND I REALLY APPRECIATE I THINK
ALL OF YOU ACTUALLY CAME TO OUR
SOCIAL GATHERING AND I HOPE MANY
OF YOU WILL DO THAT IN THE
FUTURE.
THOSE OF YOU STILL ON COUNCIL.
SO THANK YOU AGAIN.
IT WAS LOVELY TO HAVE YOU, AND
WE'RE SO GRATEFUL FOR YOUR
SERVICE.
THANK YOU.
>> OKAY.
ANY COMMENTS, ANY ADDITIONAL
COMMENTS?
I SEE TEARY EYES,
>> THIS IS A SAD PART.
IT'S LIKE SAYING GOODBYE TO
FRIENDS, BUT WE'RE NOT SAYING
GOODBYE FOREVER, YOU KNOW?
WE'LL STILL SEE YOU.
BUT IT WAS SO NICE TO HAVE YOU
BE PART OF THE COUNCIL.
>> THOSE OF YOU, YOU THINK YOU
ARE RID OF US, GET RID OF US,
NO.
WE HAVE A TENDENCY TO CALL ON
OUR PREVIOUS COUNCILMEMBERS.
>> YES, YES, YES!
SO YOU'RE NOT OFF THE HOOK
COMPLETELY.
>> NOPE, NOT COMPLETELY.
OKAY.
WITH THIS, LET'S SEE, SO --
LET'S SEE.
DO WE HAVE DR. WALTERS ALREADY
HERE?
>> NOT YET.
AND WE ASKED HER TO COME IN
AT -- 2:15?
>> 2:15.
BUT I WILL CONTACT HER AGAIN
WHEN WE TAKE A BREAK.
>> OKAY.
>> ARE WE COMING BACK AT 2:15 OR
BEFORE THAT?
>> THAT'S WHAT I'M JUST TRYING
TO FIGURE OUT.
SO LET'S DO 2:15.
BECAUSE THAT'S --
>> WE'LL KEEP OUR ORIGINAL PLAN,
THAT WAY WE CAN HAVE A SLIGHTLY
LONGER BREAK, RIGHT?
>> EXACTLY.
THE BREAK IS NOW -- SO THIS
MEANS IT'S 1:56 FOR ME AT THE
MOMENT.
IF WE CONTINUE AT 2:15, WE HAVE
A 20-MINUTE BREAK.
GOOD. PERFECT.
THANK YOU, EVERYBODY. >> THANK YOU.
>> OKAY. I THINK WE ARE BACK ON
VIDEOCAST, SO WE CAN GET
STARTED.
DR. LANGEVIN, PLEASE.
>> WELL, IT'S MY GREAT PLEASURE
TO INTRODUCE A SESSION WHICH
WE'RE VERY EXCITED ABOUT AND HAS
RESULTED IN PART FROM SOME OF
THE DISCUSSIONS THAT WE HAD WITH
THIS COUNCIL AND SOME OF OUR
PREVIOUS COUNCIL MEETINGS.
SO I AM DELIGHTED TO INTRODUCE
DRS. KARINA WALTERS AND DAN
DICKERSON, WHO WILL EXPLORE HOW
NATIVE AMERICAN HEALTH PRACTICES
INCLUDING SPIRITUAL PRACTICES
FIT INTO THE WHOLE PERSON HEALTH
PARADIGM AND DISCUSS AREAS OF
SHARED INTEREST BETWEEN THE WORK
SUPPORTED BY THE TRIBAL HEALTH
RESEARCH OFFICE AND NCCIH.
SO FIRST IT'S MY GREAT PLEASURE
TO INTRODUCE DR. KARINA WALTERS.
DR. WALTERS WAS APPOINTED AS THE
DIRECTOR OF THE TRIBAL HEALTH
RESEARCH OFFICE AT THE NIH IN
APRIL OF 2023.
IN THIS ROLE, DR. WALTERS WORKS
TO ADVANCE INITIATIVES TO ENSURE
TRIBALLY INFORMED BIOMEDICAL AND
BEHAVIORAL RESEARCH, ENHANCE
NIH'S TRIBAL CONSULTATION AND
TRIBAL ENGAGEMENT EFFORTS, AND
COORDINATE AMERICAN INDIAN AND
ALASKA NATIVE RESEARCH ACROSS
NIH AND WITH OTHER FEDERAL
ENTITIES.
SHE'S DEEPLY COMMITTED TO
ENGAGING TRIBAL LEADERSHIP IN
HEALTH RESEARCH EFFORTS.
SHE'S A SOCIAL EP DE EP DEEP YOT
AND HEALTH PREVENTION SCHOLAR.
DR. WOULD DERS HAS MORE THAN 28
YEARS OF AMERICAN INDIAN AND
ALLAHALASKA NATIVE HEALTH RESEAH
EXPERIENCE ENCOMPASSING
FOUNDATIONAL SCIENCE, DISEASE
PREVENTION, HEALTH PROMOTION AND
INTERVENTION RESEARCH.
SHE'S CONDUCTED SOCIAL
EPIDEMIOLOGICAL RESEARCH ON THE
ENVIRONMENTAL, HISTORICAL,
SOARNL AND CULTURAL DETERMINANTS
OF HEALTH AND HEALTH EQUITY IN
AAAI COMMUNITIES AND AS WELL
DESIGNED IMPAIRD TESTED TRIBALLY
DERIVED CHRONIC DISEASE
PREVENTION INTERVENTIONS AND
MUCH OF HER EARLY SOCIAL
EPIDEMIOLOGICAL RESEARCH
INVOLVED LGBT, TWO SPIRIT AND
URBAN AI AND POPULATIONS ACROSS
THE UNITED STATES.
ADDITIONALLY -- PHYSICAL
ACTIVITY PROMOTION, DIABETES,
DEPRESSION, AND HIV PREVENTION.
SHE SERVED AS AN NIH PRINCIPAL
INVESTIGATOR OR COINVESTIGATOR
ON 35 NIH AWARDS.
PRIOR TO COMING TO NIH
DR. WALTERS WAS A TENURED FULL
PROFESSOR AND ALSO SERVED AS
ADJUNCT PROFESSOR IN THE
DEPARTMENT OF GLOBAL HEALTH AND
THE SCHOOL OF PUBLIC HEALTH AND
IS COFOUNDING DIRECTOR OF THE UW
INDIGENOUS WELLNESS RESEARCH
INSTITUTE.
FROM 2012 TO 2019, SHE WAS
ASSOCIATE DEAN FOR RESEARCH AT
THE UNIVERSITY OF WASHINGTON
SCHOOL OF SOCIAL WORK, AND SHE
IS THE FIRST AMERICAN INDIAN
FELLOW INDUCTED INTO THE
AMERICAN ACADEMY OF SOCIAL
WELFARE AND SOCIAL WORK.
SHE EARNED A BACHELOR'S DEGREE
IN SOCIOLOGY FROM THE UNIVERSITY
OF CALIFORNIA LOS ANGELES AND
MSW AND PH.D. IN SOCIAL WELFARE
ALSO FROM UCLA.
SO WE ARE SO DELIGHTED TO HAVE
YOU, AND THE FLOOR IS YOURS.
>> WELL, THANK YOU SO MUCH FOR
THAT INTRODUCTION.
[SPEAKING FOREIGN LANGUAGE]
NAVAJO NATION.
GOOD AFTERNOON, EVERYBODY.
MY NAME IS KARINA WALTERS.
I'M ENROLLED IN THE CHOCTAW
NATION OF OKLAHOMA, AND I AM
COMING TO YOU FROM THE NAVAJO
NATION TODAY.
SO I JUST PAID MY RESPECTS TO
THE LAND THAT I'M IN TODAY.
I'M GOING TO OPEN UP WITH A
COUPLE OF SLIDES, AND LET ME
MAKE SURE I'M SHARING.
APPROPRIATELY HERE, MAKE SURE
I'VE GOT THIS CORRECT HERE.
OKAY.
CAN PEOPLE SEE THAT?
>> YES.
>> OKAY, GREAT.
WELL, I JUST WANTED TO SHARE A
LITTLE BIT ABOUT THE TRIBAL
HEALTH RESEARCH OFFICE SINCE I'M
NEW HERE TO THE NIH AND HAVE
BEEN HERE FOR EIGHT MONTHS NOW,
AND I WANT TO SHARE A LITTLE BIT
ABOUT OUR VISION AND MISSION AND
SOME OF OUR PRIORITIES AND HOW
THAT ALIGNS WITH NCCIH, BUT I
ALSO WANT TO FIRST ACKNOWLEDGE
THAT IN COMING TO THIS, NOT JUST
IN TERMS OF -- YOU JUST HEARD MY
KIND OF WAY TOO LONG RESUME
THERE ON MY CV ABOUT MY ACADEMIC
ACCOLADES, BUT ACTUALLY I COME
TO THE INTERESTS OF NCCIH
PRIORITIES IN AREAS FOR AMERICAN
INDIA AND ALASKA NATIVE ISSUES
FROM A PERSONAL AND SPIRITUAL
POSITION AS WELL.
I'VE BEEN A SUNDANCER FOR ALMOST
25 YEARS IN THE AMERICAN INDIAN
COMMUNITY, I'M A TRADITIONAL
HEALTH PRACTITIONER AS WELL, I
USED TO RUN -- BACK IN SEATTLE I
USED TO RUN SWEAT LODGES FOR OUR
COMMUNITY THERE, SO I COME AT
THIS BOTH FROM A HANDS-ON LIVED
EXPERIENCE AS WELL AS RESEARCH
INTEREST IN SHARING SOME OF THE
DIFFERENT KINDS OF OPPORTUNITIES
FOR WORKING CLOSELY WITH OUR
INDIGENOUS KNOWLEDGES AND OUR
TRADITIONAL HEALTH PRACTICES AND
PROTOCOLS AS A WAY OF ACHIEVING
HEALTH AND HEALTH EQUITY FOR
INDIAN COUNTRY.
SO THIS IS BOTH PERSONALLY
IMPORTANT TO ME AS WELL AS
PROFESSIONALLY IMPORTANT TO ME,
AND TO OUR COMMUNITIES ACTUALLY.
SO I'M EXCITED TO SHARE WITH YOU
A LITTLE BIT HERE.
AND I'M HAPPY TO ANSWER
QUESTIONS AT THE END OF THIS
PRESENTATION OR AFTER DAN SPEAKS
TO TALK A LITTLE BIT MORE ABOUT
NATIVE HEALTH AND SPIRITUAL
PRACTICES, BUT YOU KNOW, WE GET
TO BE THE SYNERGISTIC HUB FOR
ALL AMERICAN INDIAN AND ALASKA
NATIVE ACTIVITIES AND
INITIATIVES AT THE NIH.
OUR POSITION BEING IN DE DPCPSIS
WELL AS WITH TRIBAL PARTNERS.
UNLIKE OTHER OFFICES, WE TEND TO
BE MUCH MORE FORWARD-FACING,
WORKING REALLY DIRECTLY WITH OUR
TRIBAL COMMUNITIES, TO GENERATE
NATIVE SCIENCE AND A RESEARCH
WORKFORCE THAT BUILDS HEALTHY
LIVES AND COMMUNITIES.
SO OUR ULTIMATE GOAL IS TO GROW
INDIGENOUS HEALTH AND HEALTH
EQUITY THROUGH CULTURALLY
CREDIBLE AND MEANINGFUL
INDIGENOUS DRIVEN SCIENCE AND
OUR THEME FOR THIS YEAR PRETTY
MUCH REFLECTS THAT WHICH IS
INDIGENOUS KNOWLEDGE -- THAT
ALLIANCE BEAUTIFULLY WITH NCCIH
AS WELL.
A LITTLE ABOUT WHO WE SERVE.
I'M GOING TO DO SOME CLARIFYING
THINGS HERE.
I APOLOGIZE FOR THOSE WHO
ALREADY ARE REALLY FAMILIAR WITH
AMERICAN INDIAN ALASKA NATIVE
RESEARCH, BUT FOR THOSE WHO
AREN'T, I THINK IT'S GOOD TO SET
SOME PARAMETERS HERE ABOUT WHO
WE SERVE.
SO WE SERVE 574 FEDERALLY
RECOGNIZED NATIONS.
277 OF THOSE ARE IN ALASKA.
AND AMERICAN INDIAN ALASKA
NATIVES, WE MAKE UP NEARLY 3% OF
THE POPULATION NOW, WE TEND TO
BE YOUNGER, AND ONE IN FOUR OF
US LIVE IN POVERTY OR EXPERIENCE
FOOD INSECURITY, AND ACTUALLY
THE HIGHEST OF ANY OTHER RACIAL
OR ETHNIC GROUP IN THE UNITED
STATES.
SO -- AND POVERTY RATE IS EVEN
HIGHER IN RESERVATION
ENVIRONMENTS.
WE ALSO ENGAGE NATIVE HAWAIIAN
AND OTHER INDIGENOUS POPULATIONS
OF THE U.S. TERRITORIES AS WELL
SO THERE IS A UNIQUE
RELATIONSHIP FOR THAT SIMILAR TO
AMERICAN INDIAN AND ALASKA
NATIVE TRIBAL GOVERNMENTS.
WE DO HAVE -- IT'S A GOVERNMENT
TO GOVERNMENT RELATIONSHIP THAT
WE HAVE WITH NIH AND TRIBAL
NATIONS.
HUNDREDS OF TREES AND TREE -- ,
LAWS AND SUPREME COURT DECISIONS
HAVE REINFORCED INHERENT POWERS
OF SELF GOVERNMENT AND RECOGNIZE
TRIBAL SOVEREIGNTY, AND THERE'S
ALSO A FEDERAL INDIAN TRUST
RESPONSIBILITY TO ENSURE AND
PROTECT TRIBAL RIGHTS, LANDS,
ASSETS AND RESOURCES AND THAT
INCLUDES HEALTH AND WELFARE, AND
A POLITICAL AND TRUST
RELATIONSHIP ACTUALLY ALSO
EXISTS AS WELL AS NATIVE
HAWAIIANS, EVEN THOUGH THERE'S
CURRENTLY NO FORMAL TRIBAL
GOVERNMENT THERE, BUT CONGRESS
DOES REQUIRE THAT FEDERAL
AGENCIES CONSULT WITH NATIVE
HAWAIIAN COMMUNITIES AS THE
INFORMAL REPRESENTATIVES OF --
FOR NATIVE HAWAIIAN COMMUNITIES.
SO THERE IS SOME RELATIONSHIP
THERE THAT WE ALSO HONOR.
BUT WE ARE LIVING A DREAM THAT
HONESTLY OUR ANCESTORS DID NOT
DREAM FOR US.
WE'RE LIVING A REALITY THAT'S
REALLY NOT HEALTHY.
CURRENTLY WE LIVE IN A SYSTEM
THAT'S CHRONICALLY UNDERFUNDED,
INACCESSIBLE AND INADEQUATE.
THE INDIAN HEALTH SERVICE FOR
EXAMPLE IS ABOUT 50% OF WHAT IT
SHOULD BE IN TERMS OF SPENDING
PER CAPITA ON NATIVE
POPULATIONS.
THE SPENDING ON FEDERAL
PRISONERS IS ACTUALLY MORE THAN
DOUBLE THAT PER CAPITA THAN IHS
SPENDING.
SO THAT JUST GIVES YOU AN IDEA
OF HOW LOW OUR SPENDING IS, AND
OF COURSE THE STRUCTURAL
DETERMINANTS OF HEALTH THAT I'VE
ACKNOWLEDGED WITH FOOD
INSECURITIES BUT ALSO
SUBSTANDARD, OVERCROWDED
HOUSING, DISPROPORTIONATE
EXPOSURE TO ENVIRONMENTAL TOXINS
AND OTHER STRUCTURAL ELEMENTS.
THESE AND OTHER STRUCTURAL
FACTORS HAVE LED TO INCREDIBLY
HIGH MULTIPLE CHRONIC DISEASE
BURDEN, OR RATHER WHAT WE WOULD
CALL SYNDEMICS WHERE WE HAVE
MULTIPLE SYNERGISTIC EPIDEMICS
HAPPENING SIMULTANEOUSLY IN
INDIAN COUNTRY.
SO IT'S NOT JUST DIABETES AND
IT'S NOT JUST HEART DISEASE.
IT'S LIVING WITH DIABETES AND
HEART DISEASE AND PTSD.
SO WHEN COVID HIT, IT REALLY
EXPLOITED THIS KIND OF
SYMPTOMATIC SITUATION THAT WE'RE
CURRENTLY LIVING IN.
SO OF COURSE THE IMPACT IS OUR
LIFE EXPECTANCY IS THE LOWEST
IT'S EVER BEEN.
NOW OUR LIFE EXPECTANCY IS TO
THE AGE OF 65.
I JUST MET WITH A COMMUNITY OUT
HERE IN THE SOUTHWEST THIS WEEK
AND THEIR LIFE EXPECTANCY IS 46
YEARS OLD.
46 YEARS OLD.
SO YOU KNOW, OVER A QUARTER OF
OUR POPULATION DIE BEFORE THE
AGE OF 45.
SO THESE STRUCTURAL DETERMINANTS
HAVE VERY REAL IMPACT ON OUR
WELL-BEING.
WE ALSO HAVE HIGHEST OPIOID
OVERDOSE RATES AND SUICIDE RATES
AND DEATH RATES AND SO ON.
SO WE'RE FACING MULTIPLE PUBLIC
HEALTH CRISES, BUT REALLY FEW
LISTEN AND WE TEND TO BE
INVISIBLE TO PUBLIC AWARENESS,
BECAUSE TBEGATHERING DATA ABOUTR
POPULATIONS IS FEW AND FAR
BETWEEN.
ONE OUT OF THREE OF OUR KIDS ARE
GOING TO BE DYING IN CHOCTAW
NATION BY 2050, ONE OUT OF THREE
WILL BE LIVING WITH TYPE~2
DIABETES.
AND THAT'S AGAIN NOT THE VISION
OF LOVE AND LIFE OUR ANCESTORS
HELD FOR US AS THEY WALKED THE
TRAIL OF TEARS.
MY TRIBE ACTUALLY ARE ALL THE
SURVIVORS, DESE DENT SURVIVORS
OF THOSE -- THEY WALKED THAT
TRAIL WITH THE VISION OF LOVE
AND LIFE AND HEALTH AND
WELL-BEING FOR US.
THEY DIDN'T IMAGINE THIS FOR US.
SO WE HAVE SOMETHING TO DO, WE
HAVE OBLIGATION TO DO SOMETHING
ABOUT THAT, AND HOW WE SEE IT IS
RECONNECTING TO THAT POWER AND
VISION AND LOVE NOW TO CHANGE
THE COURSE OF OUR HEALTH AND TO
HARNESS OUR COLLECTIVE
SCIENTIFIC AND INDIGENOUS WISDOM
TO ACHIEVE THAT COLLECTIVE
HEALTH.
AND THE IMPORTANCE OF ALSO
ACKNOWLEDGING AND BUILDING ON
THE RESILIENCE AND PEOPLE WHO
ARE DOING WELL, HOW CAN WE BUILD
FROM THAT HEALTH AND WELL-BEING
APPROACH.
AND AT THRO, SINCE I'VE ARRIVED,
WE'VE DEVELOPED CORE VALUES THAT
WE OPERATE BY THAT I THINK ALSO
ALIGNED WELL WITH NCCIH AND WE
USE THE ACRONYM CEDAR.
BASICALLY C STANDS FOR
CREATIVITY, REALLY MOVING BEYOND
CONVENTIONAL APPROACHES TO
SCIENCE, EMPLOYING AN INNOVATIVE
INDIGENOUS-CENTERED IDEAS AND
METHODS TO ENSURE SCIENCE
DERIVES SUSTAINABLE POPULATION
HEALTH CHANGE.
OF COURSE MAINTAINING HIGH
STANDARDS OF ETHICS IN THAT
PROCESS.
DETERMINATION IS REFLECTING ON
THAT SELF-DETERMINATION,
ENSURING THAT WE'RE HONORING
TRIBAL SOVEREIGNTY INCLUDING
DATA SOVEREIGNTY WITH OUR TRIBAL
PARTNERS.
AND THAT LEADS TO
ACCOUNTABILITY.
SO WE ARE HOLDING OURSELVES
ACCOUNTABLE FOR THE QUALITY AND
THE TIMELINESS AND LASTING
IMPACTS OF OUR WORK AND FOR THE
COMMITMENTS WE MAKE TO TRIBAL
COMMUNITIES, AND THAT
ACCOUNTABILITY ENGENDERS BETTER
TRUST AND RESPECT AND RESPECT IS
REALLY CRITICAL, WE RESPECT AND
VALUE ALL THE UNIQUE TALENTS
THAT OUR COMMUNITIES BRING TO
BEAR ON INDIGENOUS HEALTH AND
ACHIEVING INDIGENOUS HEALTH
EQUITY, BUT ALSO RESPECTING ALL
THE TALENTS AT NIH AND OTHER
COLLEAGUES WHO CAN HELP US GET
THERE.
SO OUR STORY THEN AT THRO IS
ABOUT HARNESSING OUR POWER TO
HEAL THROUGH SCIENCE.
AND WE HOPE TO DO THIS BY
TURNING CULTURALLY INFORMED
DISCOVERY INTO HEALTH EQUITY
THROUGH FOUR MEANS.
BUILDING ON -- AND I'M GOING TO
BUILD O ON THE FOUNDATIONAL
ELEMENTS, I'M GOING TO USE EARTH
AND AIR AND WIND AND FIRE AS
KIND OF OUR FOUNDATION ELEMENTS.
SO TAKING AIR IS THE FIRST ONE,
EASY ACRONYM.
THE EASY THING TO REMEMBER IS
ADVANCING INDIGENIST RESEARCH,
AIR.
SO WE HOPE TO BE ADVANCING
CULTURALLY DERIVED, COMMUNITY
INFORMED BIOMEDICAL, SOCIAL AND
BEHAVIORAL NATIVE RESEARCH, AND
THIS REALLY DOES ENTAIL
UPLIFTING AND HARNESSING OUR
NATIVE INDIGI-NUITY, INDIGENOUS
KNOWLEDGES AND TECHNOLOGIES AS
CULTURALLY APPROPRIATE ACROSS
THE HEALTH SCIENCES, CULTURALLY
DERIVED INTERVENTIONS AND
CENTERING CULTURAL KNOWLEDGES
THROUGHOUT ALL PHASES OF THE
RESEARCH.
AND THIS INCLUDES GROWING
NATIVE-SPECIFIC INITIATIVES THAT
ALIGN WITH NATIVE COMMUNITY
PRIORITIES.
THIS IS WHERE I SEE OUR
OPPORTUNITY WITH NCCIH REALLY A
GREAT OPPORTUNITY TO HARNESS
BOTH THE PRIORITIES OF NCCIH
WITH ALIGNING VERY WELL WITH
NATIVE INTERESTS IN HARNESSING
AND LOOKING AT THE ROLE OF
TRADITIONAL HEALTH AND HEALING
PRACTICES AND BEING VERY
IMPORTANT KEY TO OUR HEALTH AND
WELL-BEING.
THE OTHER PIECES WE WANTED TO
IDENTIFY RESEARCH GAPS, AND
BUILD COLLABORATIVE AND CREATIVE
INITIATIVES, NOT ONLY WITHIN THE
NIH, BUT ALSO IN PARTNERSHIP
WITH HHS OPERATING DIVISIONS.
AND WHY IS BUILDING THIS
CULTURALLY CREDIBLE RESEARCH SO
IMPORTANT?
IT'S BECAUSE IT ACTUALLY DRIVES
TRIBAL DECISION-MAKING AND
POLICY-MAKING AND DIRECT
PRACTICE ON THE GROUND AND WILL
ULTIMATELY IMPACT NATIVE HEALTH.
IF WE HAVE CULTURALLY CREDIBLE
SCIENCE, WE'LL HAVE CULTURALLY
CREDIBLE OPPORTUNITIES FOR
PROGRAMS AND PRACTICES THAT WILL
THEN IMPACT OUR HEALTH AND
WELL-BEING.
SO OUR RESEARCH DRIVES THE
SOLUTIONS, AND SOLUTIONS
ULTIMATELY DRIVE THAT HEALTH
IMPACT.
ALSO, THIS WORK BUILDS ON
PRESIDENT BIDEN'S MANDATE TO
FEDERAL AGENCIES TO INCORPORATE
INDIGENOUS KNOWLEDGES IN ALL
FEDERAL AGENCIES, AND SO WE'LL
BE DOING THAT AS WELL THIS YEAR
AT THRO.
SO THAT INDIGENOUS KNOWLEDGE
MANDATE IN MY MIND MAKES A GREAT
HOME POTENTIALLY IN NCCIH AS
WELL.
THE SECOND AREA THAT WE WORK ON
IS OUR EARTH ELEMENT, AND THAT
IS ABOUT CULTIVATING CAPACITY,
AND THAT CULTIVATING CAPACITY
INCLUDES BUILDING A CULTURALLY
INFORMED INTERNAL NIH WORKFORCE,
AS WELL AS GROWING A CULTURALLY
REPRESENTATIVE EXTERNAL NATIVE
RESEARCH WORKFORCE.
AND THIS INCLUDES ON THE
INTERNAL SIDE, WE DO WORK ON
TECHNICAL ADVISING, COORDINATING
ACTIVITIES, TROUBLESHOOTING,
DOING EDUCATIONAL OUTREACH, AND
ON THE EXTERNAL SIDE, WE'RE
HOPING TO REALLY BUILD MORE
NATIVE RESEARCHERS AT THE
COMMUNITY LEVEL, NOT JUST THE
UNIVERSITY LEVEL.
AND WHY IS IT IMPORTANT TO
CULTIVATE A NATIVE RESEARCH
WORKFORCE?
BECAUSE IF YOU TOOK A 1,000
PH.D.s RIGHT NOW AND PUT THEM
IN THE ROOM, 735 WOULD BE WHITE,
65 WOULD BE HISPANIC, 63 WOULD
BE AFRICAN AMERICAN/BLACK, BUT
HOW MANY WOULD BE NATIVE?
3.
ONLY 3.
SO RIGHT NOW NATIVE RESEARCHERS
MAKE UP -- NOT EVEN RESEARCHERS,
JUST PH.D.s, MAKE UP ABOUT A
THIRD OF 1% OF ALL PH.D.
HOLDERS.
SO VERY SMALL PROPORTION.
AND WE NEED NATIVE RESEARCHERS
AT THE TABLE BECAUSE BRINGING IN
THAT CULTURAL EXPERIENCE AND
CULTURALLY BASED RELEVANT
QUESTIONS, AGAIN IN THAT
COMMUNITY HANDS-ON KNOWLEDGE,
ALLOWS US TO BUILD BETTER
SCIENCE, BETTER SOLUTIONS, AND
BETTER INTERVENTIONS.
THE THIRD ELEMENT IS WHAT WE
CALL WATER FOR THE WATER
ELEMENT, WATERING THE SEEDS OF
ENGAGEMENT.
WE SPEND A LOT OF TIME DOING
TRIBAL CONSULTATION ACTIVITIES,
AND TRIBAL ENGAGEMENT, THIS IS A
FORWARD-FACING ASPECTS OF OUR
WORK AT THRO.
AND WHAT WE HOPE IS THAT BY
BUILDING TRIBAL ENGAGEMENT AND
KOCONSULTATION, WE WANT TO ENSUE
THAT IT'S AUTHENTIC, CREDIBLE
AND RESPONSIVE TO THE NEEDS OF
TRIBAL NATIONS, AND WE WANT
COMMUNITIES TO REALLY KNOW WHAT
NIH OFFERS AND WHAT TOOLS AND
TECHNOLOGIES ARE AVAILABLE TO
THEM TO SOLVE THEIR MOST
PRESSING HEALTH CHALLENGES.
AND ALSO IT WARRANTS
STREAMLINING, AND I COULD TALK
ABOUT THAT LATER IF PEOPLE HAVE
INTEREST IN THAT, BUT WE DON'T
WANT TO OVERBURDEN OUR
COMMUNITIES AT THE SAME TIME,
AND I THINK THERE'S SOME
OPPORTUNITIES FOR STREAMLINING.
AGAIN, PARTNERSHIP -- BUILDING
PARTNERSHIPS SUCH AS THESE
ALLOWS FOR SUSTAINABLE SOLUTIONS
TO BE HAD AT THE COMMUNITY LEVEL
AS WELL.
THE FOURTH ELEMENT, FIRE, IS
BLAZING NEW TRAILS, NEW PATHS
FOR STRATEGIC INITIATIVES,
POLICIES AND COLLABORATIONS, AND
THIS REALLY DOES NECESSITATE
BUILDING COALITIONS BECAUSE WE
ARE NOT A FUNDING OFFICE.
WE'RE NOT A GRANT LN MAKING-MAKE
SO WE HAVE TO RELY ON THE
GOODWILL OF OTHERS TO PULL
TOGETHER AND SOLICITING INSIGHTS
AND STIMULATING COORDINATION AND
COLLABORATION ACROSS THE NIH,
HHS AND OTHER FEDERAL AGENCIES
AS APPROPRIATE.
AND WE HOPE TO DO THIS BY
BUILDING ON NATIVE ASSETS, OUR
NATIVE BRILLIANCE AND GREAT
MINDS WHILE BUILDING BRIDGES
ACROSS HISTORICAL SILOS.
THESE COALITIONS WILL HELP US
BUILD AND MAXIMIZE COMMUNITY
INTEREST AND HAVE REALLY BETTER
IMPACT IN OUR COMMUNITY.
SOME OF THE THINGS THAT WE'RE
FOCUSING ON AT THRO RIGHT NOW
ARE FOUR MAIN AREAS.
THE FIRST AND FOREMOST IS
DEVELOPING A TRIBAL DATA
SOVEREIGNTY POLICY AT THE NIH.
WE HAVE 27 INSTITUTES THAT KIND
OF HAVE THEIR OWN VERSION OF
WHAT THAT MEANS IN TERMS OF
WORKING WITH COMMUNITIES AND
ALTHOUGH WE DEVELOPED A DATA
SHARING GUIDANCE A FEW YEARS
AGO, WHICH WAS A GREAT START,
GUIDANCE DOESN'T QUITE HAVE THE
INFORMATION ABOUT HOW TO HONOR
TRIBAL SOVEREIGNTY, HOW TO
HONOR -- ENSURE THAT WE'RE --
THAT WE ARE FOLLOWING TRIBAL
ORDINANCES AND CODES, TRY TO
BECOME INCREDIBLY SOPHISTICATED
IN THE LAST DECADE AND HAVE
DEVELOPED ORDINANCES AND CODES
WITH RESPECT TO DATA THAT WE
HAVE TO BE ABLE TO ABIDE BY AND
WORK WITH.
SO WE'RE WORKING ON STREAMLINING
THAT ACROSS THE NIH THIS YEAR
AND WE'LL LOOK FORWARD TO THE
NIH'S INPUT IN THAT PROCESS.
WE'RE ALSO DEVELOPING A NEW
STRATEGIC PLAN, ANOTHER
OPPORTUNITY FOR US TO THINK DOWN
THE LINE HOW WE COULD
POTENTIALLY WORK TOGETHER, AS
WELL AS DEVELOPING THOSE
INDIGENOUS KNOWLEDGE GUIDELINES.
THE AREA WHERE I SEE WE HAVE
MOST POTENTIAL PROMISE WITH YOU
ALL IS DEVELOPING SOME OF THE
CROSS-CUTTING INITIATIVES THAT
WE HOPE TO HAVE AT THE NIH BUT
ALSO OUTSIDE OF THE NIH, IN
PARTNERSHIP WITH HHS OPERATIVES.
ONE OF THE ONES THAT WE ALREADY
HAVE A WORK GROUP STARTED JUST
RECENTLY IS A BOARDING SCHOOL
HEALING RESEARCH INITIATIVE
FOCUSING ON LOOKING AT THE
IMPACT OF INTERGENERATIONAL
TRAUMA ON INDIGENOUS WELL-BEING
AND IDENTIFYING SOLUTIONS FOR
ADDRESSING THE VERY INNOVATIVE
SOLUTIONS FOR RECOVERING HEALTH
AND WELL-BEING IN OUR INDIGENOUS
COMMUNITIES IMPACTED BY EVENT
SUCH AS BOARDING SCHOOL TRAUMA.
AND THIS IS IN PART INSPIRED BY
DEB HOLLAND'S WORK IN INDIAN
COUNTRY RIGHT NOW, WHERE SHE'S
GOING OUT TO COMMUNITIES AND
HOLDING LISTENING SESSIONS TO
FIND OUT ABOUT THE IMPACT OF
BOARDING SCHOOLS ON NATIVE
COMMUNITIES AND THEIR WELL-BEING
AND SHE'S ACTUALLY CREATING AN
ARCHIVE FOR THAT, AND WE FILTH
LIKE, HEY, WE SHOULD BE AT THE
TABLE TO BE ABLE TO DEVELOP SOME
INTERVENTIONS TO HELP
INTERGENERATIONAL TRAUMA AS IT'S
IMPACTED FAMILIES, MOVE THROUGH
THAT AND OF COURSE BUILDING ON
INDIGENOUS KNOWLEDGE TO DO THAT.
A GOOD EXAMPLE OF THAT IS FOR
EXAMPLE, BOARDING SCHOOLS
TARGETED ERADICATING LANGUAGE,
NATIVE LANGUAGES AND GETTING RID
OF THEM.
YOU KNOW, AND WE DO KNOW FROM
RESEARCH ALREADY THAT IF YOU --
SOME OF THE INTERVENTIONS THAT
INCORPORATE AND BUILD NATIVE
LANGUAGES IN YOUTH ACTUALLY
DECREASE YOUTH SUICIDE RATES
AMONG THE AMERICAN INDIANS AND
ALASKA NATIVES.
SO THAT'S AN EXAMPLE OF KIND OF
THE TYPE OF INTERVENTION THAT
COULD POTENTIALLY BE TESTED
COMING OUT OF AN INITIATIVE LIKE
THIS.
WORKING AROUND CLIMATE ACTION
AND SOME OF THE ISSUES THAT ARE
HAPPENING IN OUR COMMUNITIES ARE
DISPROPORTIONATELY HAVING TO
MOVE FROM TRIBAL LANDS, FOR
EXAMPLE, BECAUSE OF RISING
WATERS AND THAT'S IMPACTING
WHOLE COMMUNITIES WHEN YOU LEAVE
YOUR TRADITIONAL LANDS, THERE'S
ALL KINDS OF MEANING FOR THAT
FOR COMMUNITIES.
SO WE'RE REALLY LOOKING TO THINK
ABOUT HOW DO WE DO SOME
ANTICIPATORY GRIEF AND WORK
THROUGH SOME OF THESE ISSUES
ABOUT MOVEMENT AND HOW DO WE
INCORPORATE HOLISTIC WAYS OF
ADDRESSING WELL-BEING AS CLIMATE
CHANGE IS DISPROPORTIONATELY
IMPACTING OUR COMMUNITIES.
ANOTHER AREAS, MISSING, MURDERED
INDIGENOUS PEOPLE.
AGAIN DEB HOLLAND IS LEADING A
TASK FORCE ON THAT IN NATIVE
COMMUNITIES, PARTICULARLY WOMEN,
BUT ALSO MEN HAVE BEEN TARGETED
FOR SEX TRAFFICKING AND
KIDNAPPING AND MURDER.
AND SO WE'RE HOPING TO REDUCE
SOME OF THOSE RATES, OFFICE OF
RESEARCH ON WOMEN'S HEALTH HAS
ACTUALLY EXPRESSED AN INTEREST
IN POTENTIALLY PARTNERING WITH
US ON THAT.
AND ANYWAY, SO THOSE ARE JUST
SOME OF THE EXAMPLES.
IF I THINK ABOUT NCCIH, I'M JUST
GOING TO CLOSE WITH THAT, TO
SOME THINGS TO THINK ABOUT I A
LITTLE BIT, IS THAT THERE'S
REALLY GREAT OPPORTUNITY TO LOOK
AT THE ROLE OF NATIVE KNOWLEDGES
AND PRACTICES AS REALLY
POTENTIALLY LEADING SOME OF THE
ISSUES THAT YOU'RE ALREADY
EXPLORING.
SO FOR EXAMPLE, NEURAL ARTS AND
THE IMPACT OF NEUROARTS AND THE
IMPACT ON WELL-BEING.
THE ROLE OF SONGS, THE ROLE OF
DRUMS, RATTLES, TRADITIONAL TOOL
MAKING, TRADITIONAL ARTS THAT
COULD BE ANYTHING FROM BASKETRY,
WEAVING, TATTOOING, THINGS THAT
GO ON IN OUR COMMUNITIES, SOME
OF THE RESEARCH ON STROKE AND
SONGS IN INDIAN COUNTRY HAS
ALREADY BEEN DONE.
DAN IS PROBABLY GOING TO TALK TO
SOME OF HIS WORK HE'S DONE WITH
DRUMMING AND SUBSTANCE ABUSE
PREVENTION, SO THRA THERE'S REAN
OPPORTUNITY TO WORK IN
PARTNERSHIP TO IDENTIFY SOME OF
THESE TRADITIONAL PRACTICES AND
HOW THAT CAN IMPACT IN
TRADITIONAL ARTS AND HOW THAT
CAN IMPACT COMMUNITY HEALTH AND
WELL-BEING.
I KNOW TATTOOING IS BECOMING
SOMETHING THAT -- A BIG MOVEMENT
AMONG OUR YOUNG PEOPLE TO BRING
BACK TRADITIONAL TATTOOING IS
PART OF RITES OF PASSAGE AND
ACKNOWLEDGING COMMITMENT TO
COMMUNITY AND IT WILL BE
INTERESTING TO SEE HOW THAT, FOR
EXAMPLE, MAY HAVE AN IMPACT ON
PEOPLE'S OVERALL WELL-BEING AND
SENSE OF CONNECTEDNESS
BETWEEN -- IMPACTS WELL-BEING IN
A GOOD WAY.
ONE OF THE THINGS, THOUGH, WE
HAVE TO DISTINGUISH, AND I DON'T
SEE THAT YOU DO THIS WELL IN THE
LITERATURE IS DISTINGUISHING
BETWEEN TRADITIONAL HEALING AND
TRADITIONAL HEALTH PRACTICES.
TRADITIONAL HEALING PRACTICES
ARE THOSE PRACTICES THAT ARE
DONE TO CORRECT SOMETHING THAT'S
OUT OF BALANCE, WHEN THERE'S
THAT OUT OF BALANCE OR SOMETHING
NEEDS TO BE PUT BACK INTO
BALANCE, VERSUS TRADITIONAL
HEALTH PRACTICES, ARE THOSE
EVERYDAY PRACTICES TO KEEP
OURSELVES WELL.
SO WE'RE KEEPING OURSELVES IN
BALANCE.
AND OF COURSE THERE'S CEREMONIAL
CYCLES THAT ALSO NEED TO BE
ACKNOWLEDGED IN OUR COMMUNITIES
THAT WE HAVE LAND-BASED AND
EARTH-BASED AND SKY-BASED
CEREMONIAL CYCLES THAT IS PART
OF KEEPING OUR WELL-BEING, NOT
JUST AS AN INDIVIDUAL BUT AS A
COMMUNITY.
AND THOSE CYCLES ALSO INVOLVE
QUITE OFTEN OPPORTUNITIES FOR
HEALING PRACTICES THAT HAPPEN
DURING THOSE IMPORTANT
TRANSITION OR ENVIRONMENTAL
CYCLE EVENTS.
THAT'S THINGS LIKE SWEAT LODGE
AND OTHER PURIFICATION OR
HEALING RITES, BUT SOME OF THESE
CAN BE USED BOTH FOR DIAGNOSTIC
PURPOSES OR FOR ONGOING
PURIFICATION AND KEEPING
OURSELVES HEALTHY PURPOSES, BUT
IT COULD ALSO BE USED FOR
HEALING PURPOSES TO CORRECT THAT
ILLNESS.
AND THEN THE ROLE OF TRADITIONAL
MEDICINES AND PLANTS, OUR
INDIGENOUS COMMUNITIES HAVE
ALREADY CONTRIBUTED GREATLY,
QUITE OFTEN IT GOES
UNACKNOWLEDGED.
A GOOD EXAMPLE IS PRO STATIN IS
THE DRUG USED FOR HIV
MEDICATIONS, COMES OUT OF THE
MAMALABARK TRADITIONAL HEALERS
IN SMOA YA.
SAMOA.
ABOUT 1300 DIFFERENT TYPES OF
INDIGENOUS MEDICINES HAVE BEEN
INTEGRATED INTO OUR FARM COPE YA
THAT WE USE IN WESTERN SCIENCE
MODELS.
WILLOW AND ASPIRIN, THE
PROPERTIES ARE VERY SIMILAR.
BUT THERE ARE TRADITIONAL
MEDICINES THAT STILL CONTINUE TO
BE USED AND AT TIMES OF CRISIS
LIKE THE COVID CRISIS, ALMOST
EVERYBODY WENT TO TRADITIONAL
MEDICINES WHEN THEY COULDN'T GET
ACCESS TO HEALTHCARE SYSTEMS AND
THERE WAS A LOT OF SHARING
DURING THIS PERIOD AND A LOT OF
ACTUALLY HEALTH AND RECOVERY,
INFORMALLY SOME SERIOUS
DISCUSSIONS AMONG DIFFERENT
HEALERS AND COMMUNITIES THAT
SOME OF THE TRADITIONAL
MEDICINES THAT WERE USED HELPED
TO RECOVER -- HELP PEOPLE
RECOVER VERY QUICKLY FROM COVID.
SO THERE'S ALSO OTHER
OPPORTUNITIES FOR EXAMPLE.
I KNOW NIDA HAS EXPRESSED SOME
INTEREST IN PSYCHEDELICS AND THE
ROLE OF THINGS, HOW DOES THAT
PLAY A ROLE POTENTIALLY FOR
NATIVE COMMUNITIES.
I KNOW FOR MY COMMUNITY ALSO IN
TERMS OF THE TRADITIONAL ARTS,
IT'S NOT JUST ABOUT HARVESTING
CLAY, IT'S NOT A TRANSACTIONAL
NATURE LIKE THAT.
WHEN YOU D GO DO THIS THING, WHN
YOU HARVEST SOMETHING, PICK THAT
PLANT, HARVEST -- TO MAKE YOUR
BASKETS, YOU'RE PUTTING PRAYER
INTO THAT, YOU'RE ASKING
PERMISSION FOR THAT, YOU'RE
APPROACHING THAT PLANT WITH
REVERENCE, FOR LACK OF A BETTER
WORD, BUT THERE'S A RELATIONSHIP
THAT'S THERE SO IT'S ABOUT
RESTORING RELATIONAL WAYS OF
BEING IN OUR WORLD, SO A LOT OF
INTERVENTIONS IN INDIAN
COUNTRIES ARE ABOUT THAT, ABOUT
RESTORING RELATIONAL WAYS OF
BEING, WHETHER IT'S TO THE
SPIRIT WORLD OR THE PLANT WORLD
ELEMENTS, THE ANCESTORS OR YOUR
OWN BODY, THE COMMUNITY, IT'S
ALWAYS THAT RELATIONAL WAY OF
BEING -- IS REALLY CRITICAL TO
THOUGHT.
QUITE OFTEN A LOT OF THE
INTERVENTIONS IN INDIAN COUNTRY
BUILD ON ORIGINAL INSTRUCTIONS
OR INDIGENOUS KNOWLEDGES, OUR
STORIES, OUR TEACHINGS, BUT ALSO
RESTORING RELATIONAL WAYS OF
BEING IN THE WORLD AND ALL OF
THAT LEADS TO TRANSFORMING HOW
WE TALK AND THINK ABOUT
OURSELVES, THAT NARRATIVE
TRANSFORMATION.
SO THOSE THREE ELEMENTS, QUITE
OFTEN, ARE INCORPORATED IN
PREVENTION SCIENCE AND HEALTH
PROMOTION SCIENCE COMING OUT OF
INDIAN COUNTRY AND NATIVE
HAWAIIAN COMMUNITIES AS WELL.
THERE'S AN UPCOMING TRADITIONAL
MEDICINE SUMMIT THAT YOU ALL
MIGHT LIKE TO BE A PART OF AND
CONNECTED TO THE WHITE HOUSE IS
HELPING TO PUT ON.
THRO HAS BEEN INVOLVED IN
LEADING IN THE PAST BUT WILL BE
CONTRIBUTING TO IT COMING UP IN
PROBABLY SPRING.
THEY'RE LOOKING TO WORK ON
GETTING REIMBURSTMENT WITH CMS
ALSO FOR TRADITIONAL HEALTH
PRACTICES AND PROVIDERS AND
THAT'S PART OF THE WORK THERE.
SO I'M GOING TO CLOSE ON THAT
AND JUST SAY THANK YOU FOR
ALLOWING ME TO HAVE THIS TIME TO
SHARE A LITTLE BIT ABOUT WHAT
WE'RE DOING AT THRO AND TURN IT
OVER TO MY COLLEAGUE DANDY KER
SON.
HI, DAN.
>> HI!
GREAT TO SEE YOU.
>> WELL, THANK YOU SO MUCH THIS
WAS JUST SO OUTSTANDING AND I
CAN'T WAIT UNTIL THE DISCUSSION,
BUT BEFORE WE MOVE OVER TO DAN
AND BEFORE -- DID WE SAY WE WERE
GOING TO HAVE Q & A BETWEEN OR
SHOULD WE JUST GO STRAIGHT TO
DAN'S TALK AND THEN AFTERWARDS?
>> I THINK THE PLAN WAS TO GO
STRAIGHT THROUGH AND THEN HAVE A
DISCUSSION AFTER THAT.
>> SO LET ME INTRODUCE THEN
DR. DICKERSON.
DR. DANIEL DICKERSON IS
ASSOCIATE RESEARCH -- HIS
RESEARCH FOCUSES ON THE
DEVELOPMENT OF SUBSTANCE USE
TREATMENT AND PREVENTION
PROGRAMS FOR AMERICAN INDIAN AND
ALASKA NATIVE YOUTHS AND ADULTS.
HE IS CURRENTLY COPRINCIPAL
INVESTIGATOR ON NIH FUNDED STUDY
OF MOTIVATIONAL INTERVIEWING AND
CULTURE FOR URBAN NATIVE
AMERICAN YOUTH.
AND ALCOHOL AND DRUG USE
PREVENTION RESEARCH PROGRAM
TARGETING UR B URBAN NATIVE AMEN
YOUTH.
HE'S ALSO PRINCIPAL INVESTIGATOR
IN A STUDY INVESTIGATING THE
POTENTIAL BENEFITS OF SUBSTANCE
USE INTERVENTION USING DRUMMING
FOR NATIVE AMERICANS, CALLED
DRUM ASSISTED RECOVERY THERAPY
FOR NATIVE AMERICANS.
AND ALSO, CO-PI ON NATIVE
AMERICAN YOUTH SLEEP, HEALTH AND
WELLNESS, A STUDY ANALYZING
HEALTH AND SLEEP AMONG URBAN
NATIVE AMERICAN YOUTH.
DR. DICKERSON EARNED A DOCTOR OF
OSTEOPATHY AT THE WESTERN
UNIVERSITY OF HEALTH SCIENCES.
HE ALSO COMPLETED A GENERAL
PSYCHIATRY RESIDENCY AT LOMA
LINDA UNIVERSITY MEDICAL CENTER,
AN ADDICTION PSYCHIATRY
FELLOWSHIP AT YALE UNIVERSITY,
AS WELL AS A MASTER'S OF PUBLIC
HEALTH FROM THE AT STILL
UNIVERSITY IN CARES VILLE,
MISSOURI.
HE ALSO HAVE A VERY WONDERFUL
NCCIH ADVISORY COUNCILMEMBER, SO
THANK YOU SO MUCH, DAN, FOR
GIVING US A PRESENTATION AND
THEN AFTER THAT, WE'LL HAVE A
JOINT Q & A FOR BOTH OF OUR
SPEAKERS.
>> YES, THANK YOU SO MUCH,
HELENE.
[SPEAKING FOREIGN LANGUAGE]
I'M DAN DICKERSON, FROM MY
MOTHER'S SIDE, VILLAGE OF
WAYNERIGHT.
I RESPECTFULLY ACKNOWLEDGE ALL
OF THE INDIGENOUS LANDS THAT WE
ARE ON, VARIOUS REGIONS IN THE
U.S., AND HERE IN L.A., AND YES,
HONOR -- THANK YOU SO MUCH FOR
THIS OPPORTUNITY TO PRESENT FOR
YOU.
THIS WILL BE VERY BRIEF.
REALLY FOCUSING ON SOME OF THE
ASPECTS OF WHAT DR. WALTERS
TOUCHED UPON AS RELATES TO
RESEARCH WITH NATIVE AMERICAN
POPULATIONS.
SO I'D FIRST LIKE TO ACKNOWLEDGE
NCCIH, NIAAA, MYCO-INVESTIGATOR
DR. LIZ TAMEKO FROM THE RAND
CORPORATION, DR. CARRIE JOHNSON,
ONE OF OUR COMMUNITY LEADERS
FROM SACRED PATH INDIGENOUS
WELLNESS CENTER, BLANCA
DOMINGUEZ, PROJECT DIRECTOR,
DARTNA COMMUNITY ADVISORY BOARD,
GEORGE FUNMAKER, BEN HALE,
CARRIE JOHNSON.
SO BASICALLY I'LL BE TALKING
ABOUT IN ALL OF 15 MINUTES TWO
RESEARCH-FUNDED STUDIES THROUGH
NCCIH AND NIAAA.
AND THE ROLE -- AND HOW IT
RELATES TO WHOLE PERSON HEALTH,
AND SOME OF THE ASPECTS OF
SPIRITUALITY AND TRADITIONAL
PRACTICES WITH NATIVE AMERICANS
IN THEIR DEVELOPMENT AND THE
STUDY OF A SUBSTANCE USE
TREATMENT INTERVENTION FOR THIS
POPULATION.
SO AS RELATES TO NATIVE
AMERICANS, WE OFTEN TOUCH UPON
THE EFFECTS OF HISTORICAL-BASED
TRAUMA.
AND ITS EFFECTS ON NATIVE
AMERICAN SPIRITUALITY AND OUR
SOUL, SO TO SPEAK, THERE'S
AMAZINGLY GREAT BOOK BY EDUARDO
DURAN, HEALING THE AMERICAN
INDIAN SOUL WOUND, VERY, VERY
CRITICAL BOOK THAT'S MADE FO --E
REALLY TALKS ABOUT THE IMPACT OF
HISTORICAL TRAUMA ON NATIVE
PEOPLE AND HOW IT'S IMPACTED OUR
SPIRITUAL WELL-BEING AND OUR
SOULS, WITH THE SPIRIT OF
ALCOHOL HE REFERS TO, AND OF
COURSE THE EFFECTS OF RELOCATION
FROM NATIVE LANDS, RELOCATION
THAT'S RESULTED IN FRAGMENTED
COMMUNITIES, A DISRUPTION OF
CULTURAL COLLECTIVE IDENTITY AND
PERSONAL IDENTITY AND KIND OF A
SUDDEN DISCONNECTION FROM OUR
CULTURE THAT'S REALLY
PERPETUATED INTERGENERATIONALLY
SINCE THE 1400s.
SO AS A RESULT, UNFORTUNATELY
THERE'S MANY HEALTH DISPARITIES
IN GREAT PART THAT ARE KIND OF
UNDER THE FOUNDATION OF
HISTORICAL TRAUMA.
BUT MORE AND MORE, WE'RE LOOKING
AT, OKAY, WE KNOW ALL THE STATS,
WE KNOW THESE KIND OF FACTS, BUT
WHERE DO WE GO FROM HERE?
SO THERE'S MORE OF AN EMPHASIS
ON OUR POSITIVE ASPECTS OF OUR
CULTURE, OUR RESILIENCY AND
INHERENT STRENGTHS, AND HOW DO
WE GET BACK TO THAT.
SO THERE'S MORE OF A -- WE KNOW
WHAT SOME OF THE STATS ARE SO
WHERE DO WE GO FROM HERE, HOW DO
WE CAPITALIZE ON STRENGTHS, AND
OVER AND OVER AGAIN COMMUNITIES
EMPHASIZE THE NEED FOR
INTEGRATING TRADITIONAL
PRACTICES AND TO INTERVENTIONS
OF VARIOUS HEALTH CONDITIONS.
BUT THERE'S A VERY LIMITED --
VERY LIMITED RESEARCH THAT HAVE
BEEN CONDUCTED, ANALYZED IN
TRADITIONAL PRACTICES AND PART
OF THAT REASON IS THAT WE ARE
WORKING AND DEALING WITH THE
SACRED PARTS OF THE CULTURE, I
HAVE TO BE REALLY CAREFUL AND
MINDFUL ON THAT PART OF THE
REALITY OF OUR SPIRITUAL KIND OF
BELIEFS.
SO ONE OF THE TRADITIONAL
PRACTICES THAT'S HIGHLY VISIBLE
IS THE USE OF DRUMMING WITH
NATIVE PEOPLE.
DRUMMING IS USED BY MOST ALL --
ALL PEOPLE IN THE WORLD.
AND WITH NATIVE AMERICANS,
THERE'S A SIGNIFICANT SPIRITUAL
MEANING.
IT'S A SACRED INSTRUMENT.
IT'S CARRIES SONGS, TRADITIONS,
SOMETHING IS UPDATING ON MY
SCREEN HERE.
SORRY ABOUT THAT.
SO WITH DRUMMING, IT'S REALLY A
CRITICAL PART OF OUR CULTURE,
AND THAT CARRIES TRADITIONS,
SONGS, STORIES, AND IT'S ALSO
BEEN KNOWN OF HAVING A POSITIVE
EFFECT OF BRINGING COMMUNITIES
TOGETHER AND HEALING OUR
POPULATIONS.
SO WE DEVELOPED -- AFTER I MET
WITH SOME COMMUNITY LEADERS AND
ELDERS AN INTERVENTION TO
INCORPORATE DRUMMING IN A
SUBSTANCE USE INTERVENTION
TREATMENT, AND WE NAMED IT
DARTNA, WHICH INCORPORATES
CULTURAL EDUCATION, TEACHINGS,
KIND OF A NATIVE AMERICAN VIEW
OF THE 12 STEPS, THE WHITE BISON
ORGANIZATION.
IT'S REALLY IMPORTANT TO KIND OF
HAVE THAT EDUCATION DUE TO THE
SACRED MEANINGS OF DRUMMING, AND
THEN ACTUAL DRUMMING AND THE
INTERVENTION, AND KIND OF A
PROCESSING, GROUP PROCESSING
GROUP OR TALKING CIRCLE.
AS PART OF THE WORKSHOP.
SO WE HAVE VARIOUS -- WE'RE
STILL STUDYING DIFFERENT
VERSIONS IN TERMS OF HOW MANY
WORKSHOPS IS OPTIMAL AND
FEASIBLE, SO WE HAVE IT RANGING
FROM 6 AND ORIGINALLY WE HAD 24
SESSIONS, SO WE'RE STILL REALLY
LOOKING AT WHAT COULD BE A
BENEFIT.
AND AS RELATES TO WHOLE PERSON
HEALTH, YOU KNOW, WE USE THIS
DIAGRAM OR THIS INTERVENTION
THAT REALLY LOOKS ON THE MENTAL,
PHYSICAL, SPIRITUAL AND
EMOTIONAL ASPECTS OF WELL-BEING.
THIS IS KIND OF A USE --
REFERRING TO NATIVE AMERICAN
MEDICINE WHEEL, SOG WE'VE BEEN N
USING WHOLE PERSON HEALTH FOR
CENTURIES, AND RECOGNIZE THE
INTERRELATEDNESS OF THESE
VARIOUS ASPECTS OF HEALTH AND
WELL-BEING.
SO IT'S REALLY EXCITING, YOU
KNOW, THRO, TO REALLY BE A PARTF
NCCIH'S KIND OF NEW EMPHASIS OR
ONGOING EMPHASIS IN THIS AREA.
SO WE FOLLOWED THE NIH STAGE
MODEL BY HAVING OUR INITIAL
TREATMENT PROGRAM.
WE DISCUSSED IT AT LENGTH WITH
COMMUNITIES.
THEY PROVIDED US FEEDBACK.
WE FINALIZED A TREATMENT MANUAL.
SO WE REALLY FOLLOWED THE
ASPECTS OF COMMUNITY-BASED
PARTICIPATORY RESEARCH.
THE IDEAS COME FROM THE
COMMUNITY.
THEY'RE CRITICALLY INVOLVED IN
THE DEVELOPMENTAL PROCESS, AND
WITH THE SUBSEQUENT ANALYSIS OF
THE INTERVENTION AND STUDIES.
SO WITH OUR FOCUS GROUPS,
INITIAL FOCUS GROUPS, SOME OF
THE TAKE-HOME POINTS WERE --
THAT WERE FOUND WAS THAT
DRUMMING CAN BE OF BENEFIT FOR
NATIVE PEOPLE, BUT YOU NEED TO
REALLY UTILIZE A CULTURAL BASED
FOCUS RATHER THAN A,
QUOTE-UNQUOTE, NEW AGE OR
NON-NATIVE APPROACH FOR NATIVE
PEOPLE.
IT'S GOT TO FOLLOW FOUNDATION OF
NATIVE CULTURE AND APPROPRIATE
ATTENTION TO GENDER ROLES.
SO THEN WE PRE-TESTED THIS
INITIAL VERSION OF DARTNA WITH
10 INDIVIDUALS, JUST TO GET
THEIR FEEDBACK FINALIZED, MAKE
FINAL POINTS TO OUR MAN UNITED
MANUAL.WE FOUND THERE WERE SOME
PROMISING AREAS OF IMPROVEMENT
WITH MEDICAL STATUS, PSYCHIATRIC
STATUS, SPIRITUALITY, AND
PHYSICAL AND FUNCTIONING LEVELS.
SO WE PURPOSELY LOOK AT THESE
OTHER AREAS IN ADDITION TO
SUBSTANCE USE, WE REALLY WANT TO
ALSO UNDERSTAND IF AND HOW WE
CAN IMPROVE MEDICAL STATUS,
MENTAL HEALTH AND SPIRITUAL
ASPECTS OF WELL-BEING AS WELL.
SO THERE ARE SOME PROMISING
BENEFITS AND SOME OF THE
FEEDBACK KIND OF HIGHLIGHTED.
I THINK MY COMPUTER HOPEFULLY
DID NOT FREEZE.
SORRY ABOUT THAT.
ONE OF OUR PARTICIPANTS REALLY
REFERRED TO THE SPIRITUAL
ASPECTS OF THEIR EXPERIENCE WITH
DRUMMING ACTIVITIES, SPIRITUAL
CONNECTION, AND FELT THAT THIS
WAS IMPORTANT IN THEIR RECOVERY.
WE THEN CONDUCTED A FEASIBILITY
CLINICAL TRIAL.
THIS HELPED US IN GETTING A
GRANT THROUGH NIAAA, WHERE WE
RECRUITED 63 INDIVIDUALS, COMING
FROM A WIDE VARIETY OF SUBSTANCE
USE TREATMENT.
MANY WERE INPATIENT, AND MANY
WERE ALREADY PARTICIPATING IN
SOME LEVEL OF TRADITIONAL
PRACTICES, AND THIS WAS REALLY
TO TRY TO GET FURTHER
INFORMATION ON HOW WE CAN
RECRUIT FROM THIS POPULATION, IN
AN URBAN AREA, AND INFORMATION
AND TRYING TO OBTAIN ADDITIONAL
INFORMATION ON THE POTENTIAL
BENEFITS OF DARTNA.
WE LOOKED AT -- I HAVE TO ADMIT,
ONE OF THE AREAS I THINK -- I
LIKE TO EMPHASIZE IS THERE'S A
HUGE NEED FOR THE FURTHER
DEVELOPMENT OF SPIRITUAL
MEASURES FOR -- PROBABLY FOR ALL
POPULATIONS AND IN OUR AREA,
NATIVE AMERICANS, THERE'S VERY
FEW THAT HAVE BEEN DEVELOPED
WITH COMMUNITIES.
SO WE USED STANDARD MEASURE FOR
GENERAL POPULATIONS IN THIS
STUDY, BUT THERE HAVE BEEN ONE
OR TWO I'VE COME ACROSS THAT I
PLAN TO USE ON MY NEXT STUDIES
THAT ARE MORE VETTED WITH NATIVE
COMMUNITIES.
SO WE CONDUCTED THE STUDY WITH
DARTNA VERSUS USUAL CARE, AND WE
FOUND AT THE END OF TREATMENT
THAT THOSE WHO ARE PARTICIPATED
IN DARTNA HAD SIGNIFICANTLY
IMPROVED CONCENTRATION AND
COGNITION, LOWER COUNTS OF
PHYSICAL AILMENTS, AND THERE
WERE PROMISING BENEFITS WITH THE
DARTNA, THOSE RANDOMIZED TO
DARTNA WITH BETTER PHYSICAL
HEALTH, FEWER DRINKS PER DAY,
AND LESS CANNABIS USE.
HOWEVER, IN THREE MONTHS, THERE
WERE SOME -- THERE WERE
DECREASES IN BENEFITS, AND EVEN
TO THE POINT WHERE THOSE IN
DARTNA REPORTED MORE CIGARETTE
USE AND DRINKS.
SO WE DISCUSSED THIS WITH OUR
COMMUNITY BOARD, OUR ELDER BOARD
AND THEY BELIEVE THAT WHAT MAY
BE HAPPENING IS THAT AFTER THIS
INTERVENTION, DRUMMING IN URBAN
AREAS FOR NATIVE PEOPLE, IT'S
VERY, VERY HARD TO FIND THOSE
OPPORTUNITIES IN THE BIG CITIES.
IT'S HARD, YOU'RE NOT GOING TO
LOOK ON YELP OR GOOGLE AND FIND
THESE KIND OF GROUPS.
YOU REALLY, REALLY HAVE TO HAVE
SOME CONNECTIONS AND SOME
REFERRAL -- SOME ASSISTANCE WITH
ELDERS AND OTHER NATIVE PEOPLE
TO REALLY FIND OPPORTUNITIES.
SO THEY REALLY FEEL THAT THERE'S
A NEED FOR REALLY DEVELOPING
KIND OF A CONTINUITY PLAN, A
REVENGS APPROACH SO BENEFITS
FROM INTERVENTIONS CAN BE
SUSTAINED FOLLOWING TREATMENT.
I THINK THAT PROBABLY TOUCHES
UPON A BIGGER ISSUE WITH
SUBSTANCE USE AND RELAPSE IN
THAT MANY, MANY INDIVIDUALS
UNFORTUNATELY END UP RELAPSING
AFTER TREATMENT.
SO I THINK IN THE BROADER FIELD,
THERE'S A NEED FOR FURTHER WORK
IN RELAPSE PREVENTION AND HOW
CAN WE HELP THOSE SUSTAIN AND
ACHIEVE RECOVERY IN THE LONG
TERM.
SO THOSE ARE MY MAIN POINTS.
I LIKE TO JUST EMPHASIZE THAT
NATIVE AMERICAN TRADITIONS
REALLY MIRRORS A LOT OF THE
WHOLE PERSON AGENDA ITEMS THAT
HELENE MENTIONED, JUST
PARALLELLED NICELY, AND THAT I
THINK FURTHER WORK IS NEEDED
WITH HOW DO WE STUDY AND ANALYZE
SPIRITUALITY.
THANK YOU SO MUCH.
>> THANK YOU SO MUCH.
THIS IS SO MUCH WHAT WE WERE
HOPING FOR FROM BOTH OF YOU.
AND I SEE A LOT OF HANDS UP, SO
DELIGHTED, SO LET'S START THE
CONVERSATION, HELEN.
>> YES, I HAVE A QUESTION TO
KARINA WALTERS.
IT MAY BE VERY NAIVE, BUT THE
EPIDEMIOLOGY THAT YOU'RE
DESCRIBING IS SO HORRIBLE TO
HEAR THAT, YOU KNOW, LONGEVITY
AND ESPECIALLY ON THE -- YOU
KNOW, ON DIABETES AND
CO-MORBIDITY IN GENERAL.
IS THIS LIKE RELATED TO AXIS OF
HEALTHCARE, GIVEN WHERE THEY
LIVE AND THE FEDERAL REGULATION
AND IF SO, IS THIS -- DO THEY -O
CHANGE THAT?
CAN YOU ADDRESS THAT?
I DON'T KNOW.
>> YES, I THINK A LOT IS -- A
LOT OF HEALTH ISSUES ARE
PROBABLY VERY MUCH JUST
STRUCTURAL DETERMINANTS, AND
ACTUALLY STRUCTURAL INEQUITIES
THAT YOU'RE KIND OF
HIGHLIGHTING.
SO ACCESS TO CARE, INADEQUATE
CARE, WHEN WE GET ACCESS TO
CARE, IT'S GETTING A LITTLE BIT
BETTER.
IHS IS, FOR EXAMPLE, WITH THE
POTENTIAL CONTINUING RESOLUTIONS
NOT HAPPENING FOR FUNDING, IHS
FOR THE FIRST TIME WAS NOT GOING
TO BE TOUCHED, THEY WOULD STILL
BE ABLE TO MAINTAIN SERVICES AND
FUNDING.
IN THE PAST, THAT WOULD NOT HAVE
BEEN THE CASE, BUT IT'S A
COMBINATION OF FACTORS.
THERE'S A WHOLE HISTORY TO BE
MOVED TO RESERVATION
ENVIRONMENTS, BUT URBAN INDIANS
ALSO ARE STRUGGLING, AND DAN --
APPRECIATE DAN'S RESEARCH.
I WAS BORN AND RAISED IN LA, SO
I'M FAMILIAR WITH LA URBAN
INDIAN ENVIRONMENT AND WE STILL
SEE SOME OF THE HIGHEST POVERTY
RATES IN URBAN AREAS, LACK OF
ACCESS TO HEALTH INSURANCE AND
ADEQUATE CARE WITH RESPECT TO
THAT.
THE SUBSTANDARD HOUSING IS A
MAJOR FACTOR IN SOME OF OUR
COMMUNITIES, NOT GOOD ACCESS TO
HEALTHY FOODS AND A LOT OF FOOD
INSECURITY.
SO IT'S A COMBINATION OF A LOT
OF THOSE FACTORS.
BUT IT'S NOT JUST THOSE FACTORS
TOO, SO I JUST WANT TO HIGHLIGHT
THAT, YOU KNOW, THERE'S BEEN A
SYSTEMATIC ARM TO INDIAN COUNTRY
AND COMMUNITIES FOR GENERATIONS.
I ALLUDED TO ONE EXAMPLE, JUST A
BOARDING SCHOOL, YOU KNOW,
BOARDING SCHOOLS WERE DESIGNED
TO KILL THE INDIAN TO SAVE THE
MAN.
THAT WAS THE QUOTE FOR THE
SCHOOLS, WHERE THEY WERE NOT --
WHERE NATIVE FAMILIES WERE
NOT -- INDIVIDUALS -- CHILDREN
WERE REMOVED FROM THEIR FAMILIES
AND PLACED HUNDREDS OF MILES
AWAY FROM HOME IN THESE BOARDING
SCHOOLS, FORBIDDEN TO SPEAK
THEIR LANGUAGE, FORCED
CHRISTIANITY ON TO THEM, AND YOU
KNOW, THAT HAD DEVASTATING
CONSEQUENCES FOR HEALTH AND
WELL-BEING FOR FUTURE
GENERATIONS, RIGHT?
YOU'VE LOST LANGUAGE, YOU'VE HAD
IMPACT ON SPIRITUAL PRACTICE
WHERE -- THOSE PRACTICES WERE
OUTLAWED UNTIL 1978.
IN 1980 -- IF YOU WERE CAUGHT
DANCING, DOING CULTURAL
CEREMONIES OR ENGAGING IN ANY
CULTURAL PRACTICES, YOU COULD BE
JAILED OR FINED OR FOOD RATIONS
FOR YOUR COMMUNITIES.
THESE KINDS OF EVENTS HAVE AN
IMPACT ON PEOPLE'S ELK, BOTH
MENTALLY, PHYSICALLY,
SPIRITUALLY, THE WHOLE 9 YARDS.
AND I THINK HOW COMMUNITIES HAVE
DONE WELL HAS ACTUALLY BEEN
HOLDING ON TO SOME OF THESE
THINGS AND REALLY -- SO STILL
MANAGING TO THRIVE DESPITE
ATTEMPTS AT -- EVERYTHING FROM
GENOCIDE TO FORMS OF GENOCIDE
WOULD BE LIKE THE SYSTEMATIC
DESTRUCTION OF LIFE WAYS,
CULTURAL WAYS AND ATTEMPTS TO
SYSTEMATICALLY DESTROY WORLD
VIEWS IN WAYS OF UNDERSTANDING
THE WORLD.
AND THAT'S BEEN -- HAD A
TREMENDOUS IMPACT ON OUR
COMMUNITIES.
HAVING SAID THAT, OUR
COMMUNITIES ALSO LIKE DAN SAID
DON'T WANT US TO ALWAYS
EMPHASIZE ON THE PATHOLOGY PART
OF IT, I KNOW NIH, WE WANT TO
SAY HEY, LET'S GET RID OF THE
WORST OF THE DISEASES, WE TEND
TO BE VERY DISEASE-FOCUSED, BUT
PART OF THE NEED THAT
COMMUNITIES ARE SAYING THAT WE
NEED TO PUT AT THE FOREFRONT IS
WHAT ARE WE DOING WELL AND HOW
CAN WE BUILD ON THE HEALTH AND
WELL-BEING OF OUR COMMUNITIES,
DESPITE ALL OF THIS, AND WHAT
CAN WE DO TO RECOVER OR RESTORE
OR CONTINUE TO GROW INDIGENOUS
WAYS OF KNOWING AND BEING THAT
HAS PERSISTENCE FOR FLEN YA THAA
THAT HAS HELPED US DO WELL.
WE HAVE STORIES, EVEN OUR
CHILDREN'S STORIES HOLD
KNOWLEDGE ON GOOD HEALTHFUL
PRACTICES.
I'LL GIVE YOU A BRIEF EXAMPLE.
WE HAVE A STORY ABOUT THE MOON
AND THE SUN, THEY USED TO LIVE
IN THE SKY TOGETHER, THE SUN WAS
MALE AND THE MOON WAS FEMALE,
THEY SHARED THE DAY SKY
TOGETHER, AND SHE WARNED HIM
BECAUSE THE SUN WOULD FLARE UP
ONCE IN A WHILE, IF ANY OF HIS
SUN FLARES HIT HER, SHE WOULD
GATHER ALL HER STAR CHILDREN AND
MOVE TO THE OTHER SIDE OF THE
WORLD AND ONE DAY, OF COURSE,
THAT HAPPENS, SUN GOT UPSET, ONE
OF THE HIS FLARES HIT HER AND
SHE GRABBED ALL OF HER STAR
CHILDREN AND MOVED TO THE OTHER
SIDE OF THE WORLD AND THAT'S WHY
WE HAVE NIGHT SKY AND DAYLIGHT
AND DARKNESS.
AND THAT MIGHT SOUND LIKE A KIND
OF SIMPLE STORY AND HE BEGGED
HER TO COME HOME AND SHE SAID
NO, BUT ONCE A MONTH THEY SHARE
TIME INTO THE SKY -- MORNING
TIME TOGETHER TO HAVE A
CONVERSATION BECAUSE THEY STILL
LOVED EACH OTHER.
AND THEY WOULD STILL TALK.
THAT'S TRADITIONAL STORIES ABOUT
TALKING ABOUT DOMESTIC VIOLENCE
PREVENTION RIGHT THERE, EMBEDDED
IN OUR STORIES.
SO WE HAVE OPPORTUNITIES TO PULL
OUT FROM THESE WAYS OF
KNOWING -- BEING TO CREATE
PREVENTION OPPORTUNITIES AND
OPPORTUNITIES FOR RECOVERING
HEALTH PRACTICES THAT HELP OUR
COMMUNITIES.
SO THAT'S JUST AN EXAMPLE OF
MOVING FORWARD IN A MORE
HEALTHFUL WAY.
>> WHAT A BEAUTIFUL STORY.
THANK YOU.
BEN?
>> WELL, FIRST OF ALL, JUST
THANK BOTH OF YOU FOR
PRESENTING.
BEN KLIGLER, I WORK FOR THE V.A.
I JUST HAD A COUPLE QUICK
COMMENTS I WANTED TO MAKE ABOUT
THIS IDEA OF HOW DO YOU KNOW,
HOW DO WE KNOW, WHAT IS SUCCESS
AND HOW DO WE DEFINE SUCCESS AND
WHO DEFINES SUCCESS?
WHATEVER WE'RE TRYING TO DO FOR
ANY GIVEN POPULATION.
AND IT KIND OF REALLY GOES TO
THAT STORY YOU JUST TOLD ABOUT
DIFFERENT WAYS OF KNOWING, AND
YOU KNOW, I'M SURE A LOT OF
PEOPLE HAVE READ THE BOOK
GRADING SWEET GRASS, YOU CAN
HAVE A QUOTE-UNQUOTE MODERN
SCIENTIFIC WAY OF KNOWING AND A
TRADITIONAL MORE HOLISTIC WAY OF
KNOWING AND THAT BOTH OF THESE
THINGS CAN REVEAL TRUTH TO US
THAT NEITHER ONE CAN REVEAL
NECESSARILY ALONE OR THEY EACH
HAVE A DIFFERENT KIND OF TRUTH
THAT THEY CAN REVEAL TO US.
SO FIRST OF ALL I JUST REALLY
APPLAUD YOU FOR HOLDING THAT
SPACE, KARINA, AT NIH, BECAUSE
THAT MUST BE QUITE A BATTLE.
I MEAN, I KNOW DR. LANGEVIN IS
TRYING TO HOLD THE SPACE FOR
WHOLE PERSON HEALTH, BUT HOLDING
THE SPACE FOR ENTIRELY DIFFERENT
WAYS OF KNOWING IS PROBABLY
PRETTY CHALLENGING.
SO BUT WHAT I WANTED TO SAY
SPECIFICALLY WAS GOING TO THIS
QUESTION OF HOW DO WE MEASURE,
HOW DO WE KNOW WE'RE ACHIEVING
WHAT WE HOPE TO BE ACHIEVING,
AND I THINK IT GOES TO DAN'S
STUDIES AS WELL.
AND I GUESS -- SO I HAVE TWO
QUESTIONS.
ONE IS HAVE WE DONE ANY WORK
WITH ELDERS IN THE TRIBES ASKING
THEM TO HELP US DEFINE SUCCESS.
IN OTHER WORDS, WHAT OUTCOME
SHOULD WE BE LOOKING AT?
WE KNOW WE WANT TO LOOK AT
ADHERENCE TO 12 STEP TREATMENT
OR TO LOWERING THE NUMBER OF
DRINKS A PERSON HAS IN A GIVEN
DAY, BUT THERE ARE OTHER WAYS TO
LOOK AT OUTCOMES, SO IN
PARTICULAR, IN V.A., WE'RE DOING
A LOT OF WORK AROUND THIS
QUESTION OF MEANING AND PURPOSE
IN LIFE, AND THAT
RE-ESTABLISHING CONNECTION WITH
THE THINGS THAT GIVE MEANING AND
PURPOSE IN LIFE MAY BE IN AND OF
ITSELF A REALLY IMPORTANT OUT
COME REGARDLESS OF WHETHER
PHYSICAL HEALTH HAS IMPROVED,
MENTAL HEALTH THE WAY WE THINK
OF IT HAS IMPROVED.
AND THAT THIS IS IN AND OF
ITSELF SOMETHING THAT -- WHETHER
OR NOT IT PROLONGS LIFE, IT
CHANGES THE NATURE OF LIFE IN A
WAY THAT MAY BE WHAT WE'RE
REALLY LOOKING FOR.
AND SO I GUESS I'M REALLY
INTERESTED IN CONTINUING TO
ENGAGE IN THIS, WE'RE TALKING
ABOUT THIS A LOT AT V.A. BECAUSE
AS YOU KNOW, WE SERVE REALLY
EVERYBODY IN THE COUNTRY,
INCLUDING A DECENT POPULATION OF
TRIBAL MEMBERS.
SO THIS QUESTION OF NOT IMPOSING
OUR DEFINITION OF SUCCESSFUL
OUTCOME ON A GIVEN POPULATION
THAT MAY REALLY HAVE ITS OWN
DEFINITION, AND HOW DO WE WORK
WITH THE KNOWLEDGE OF THAT
TRADITIONAL POPULATION AND THINK
ABOUT HOW ARE WE GOING TO DEFINE
SUCCESS IN A GIVEN STUDY.
AND I KNOW THAT GOES INTO
ANOTHER DOMAIN OF CONVINCING
REVIEWERS ON A GRANT APPLICATION
THAT THAT'S A LEGITIMATE WAY TO
DEFINE SUCCESS.
BUT I THINK THAT REALLY FITS IN
WITH NCCIH'S AGENDA AROUND THIS
QUESTION OF WHAT IS WHOLE PERSON
HEALTH.
AND WHOLE PERSON HEALTH IS
REALLY GOING TO BE DEFINED
DIFFERENTLY IN DIFFERENT
CULTURAL GROUPS, SO I JUST
REALLY APPRECIATE THE
CONVERSATION AND I'D LOVE TO --
IF I CAN BE HELPFUL OR IF OUR
WORK AT V.A. CAN BE HELPFUL, I'D
REALLY LOVE TO HAVE MORE
CONVERSATION ABOUT IT.
THANK YOU.
>> DAN, CAN I JUMP IN REAL QUICK
AND THEN PASS THIS TO YOU?
>> OF COURSE.
>> I DON'T WANT TO LOSE MY
THOUGHT.
I THINK WHAT YOU'RE IDENTIFYING
IS, I THINK ALL OF OUR
COMMUNITIES WOULD SAY, HEY, WE
WANT TO REDUCE OPIOID USE, WE
WANT TO IMPROVE HEALTH.
THOSE I THINK ARE CONSISTENT
WITH WHAT ELDERS WOULD SAY THEY
WANT TO SEE HAPPEN, BUT THE
ISSUE IS THAT THERE'S OTHER KIND
OF -- WHAT ARE THOSE MECHANISMS
OF CHANGE AND THAT'S WHERE WE
MIEPT HAVE DIVERGENT
UNDERSTANDINGS BETWEEN WESTERN
AND INDIGENOUS APPROACHES IN
SCIENCE.
SO THE MECHANISM -- IT'S GETTING
TO THIS CULTURALLY GROUNDED
MECHANISMS OF CHANGE.
I'LL GIVE YOU A BRIEF EXAMPLE IN
MY TRIBE, I DID A PROJECT
WITH -- IT WAS A SUBSTANCE ABUSE
AND OBESITY PREVENTION STUDY,
ACTUALLY FUNDED BY NIDA, AND WE
REALLY WORKED ON REALLY DEEPLY
BUILDING FROM OUR ORIGINAL
TEACHINGS AND INSTRUCTIONS AND
RELATIONAL WAYS OF BEING AND
RESTORING RELATIONAL WAYS OF
BEING AS BEING A HUGE MECHANISM
OF CHANGE, AND LOOKING AT
RELATIONAL WAYS OF BEING AS
DIFFERENT KINDS OF OUTCOMES AND
THAT INVOLVES CREATING NEW
MEASURES AND USING EXISTING
MEASURES, BUT THOSE -- WE SAW
THAT PEOPLE'S BEHAVIOR DOESN'T
CHANGE JUST BECAUSE YOU GIVE
THEM INFORMATION.
THE KIND OF INFORMATION THAT IS
ROOTED IN CULTURE AND GROUNDED
IN CULTURE THAT MAKES A HUGE
DIFFERENCE.
ONE OF THE THINGS WE FOCUSED ON
WAS WHAT KIND OF ANCESTOR -- DID
MY ANCESTORS DREAM ME TO BE?
WHAT KIND OF ANCESTORS DO I
DREAM THE FUTURE TO BE THROUGH
MY ACTIONS TODAY?
WHAT KIND OF ANCESTORS DO I WANT
TO BE?
AND JUST SHIFTING TO THINKING TO
THAT ANCESTRAL RELATIONAL WAY OF
THINKING WAS A HUGE FACTOR IN
MOTIVATING WOMEN TO PARTICIPATE
IAND REALLY BEGIN TO GET EXCITED
ABOUT DOING SOME OF THE WORK
AROUND SHIFTING BEHAVIORAL
CHANGE.
SO IT'S THOSE MECHANISMS OF
CHANGE I THINK WE NEED TO REALLY
KIND OF TALK ABOUT AND REALLY
ARTICULATE.
AND ANOTHER THING IS, THESE
SYSTEMS CAN WORK SIMULTANEOUSLY,
RIGHT?
SO ON THE ONE HAND, YOU KNOW, A
TRADITIONAL PRACTITIONER MIGHT
BE ADDRESSING ETIOLOGY
UNDERLYING SPIRITUAL IDEOLOGY OF
SOMETHING WHERE IT'S NOT
CONTRARY IN COMMUNITY FOR PEOPLE
THAT SEE THE WESTERN DOCTOR TO
ADDRESS SYMPTOMS.
RECOGNIZING THAT THEY MAY NOT
GET TO THE SPIRITUAL IDEOLOGY OF
WHAT DRIVES THE DISEASE
MANIFESTATION.
SO IT DOESN'T MEAN THAT THESE
TWO HAVE TO COUNTERACT EACH
OTHER, BUT THEY CAN WALK
TOGETHER WHEN DONE SKILLFULLY.
SO I'M SORRY, GO AHEAD, DAN.
I'M TALKING TOO MUCH.
>> THANK YOU SO MUCH, BEN,
THAT'S AN AMAZINGLY GREAT
QUESTION.
I THINK WITH JUST SOME HELPFUL
COMMENTS THAT COME TO MIND, I
THINK RESEARCH IS A PROCESS IN A
WAY, YOU KNOW, I THINK
OFTENTIMES IN WESTERN-BASED
RESEARCH, WE DON'T HAVE THAT P
LESS THAN .05, WE KIND OF --
THROW IT IN THE TRASH AND WE
THINK OF A NEW IDEA.
AND I THINK WITH NATIVE
AMERICANS AND RESEARCH, WE'VE
ONLY BEEN DOING THIS FOR A
COUPLE FEW DECADES, AND I THINK
COMMUNITIES REALLY NEED TO HAVE
MORE OF A SAY IN INTERPRETING
THE RESULTS, AND EVEN HAVING
THAT EXTRA PERCEPTION OF WHAT'S
REALLY GOING ON WITH THOSE WHO
ARE IB VOFLE INVOLVED IN THE STD
WHAT'S REALLY WORKING.
THERE ARE COMMUNITY MEMBERS WHO
REALLY SAY IF IT'S NOT WORKING,
WHAT CAN WE -- WHAT DO WE HAVE
TO DO TO MAKE IT WORK, OR TO GET
WHERE WE'RE -- WHERE THE
COMMUNITY FEELS WE NEED TO GO.
I THINK THERE'S PROBABLY A HUGE
NEED FOR STATISTICAL APPROACHES
THAT ARE CULTURALLY FOCUSED A
BIT MORE WITH THE COMMUNITY AND
WITH RESEARCHERS, SO THAT -- AND
I'M NOT -- I WISH I WAS MORE OF
A STATISTICIAN-MINDED RESEARCHER
BUT I THINK IN IS A NEED TO TRY
TO REALLY FIGURE ON SOME
ANALYTIC APPROACHES, I COULD GET
AT WHAT'S HAPPENING WITH
INTERVENTIONS AND SOME PARTS OF
INTERVENTIONS ARE WITH
SPIRITUALITY AND NATIVE AMERICAN
TRADITION, FIRST OF ALL, HOW DO
WE GO ABOUT ANALYZING THAT, AND
HOW DO WE -- ARE WE DOING IT
CORRECTLY, ARE THERE WAYS THAT
WE CAN ANALYZE THESE ASPECTS OF
CULTURE MORE SUCCINCTLY?
SO THOSE ARE JUST SOME --
>> IF I CAN MAKE A QUICK COMMENT
ABOUT THAT, THIS IS SUCH A FUND
MENTAL QUESTION S, RIGHT?
WHEN WE LOOK AT THE EFFECT OF A
DRUG OR PILL, WE SAY DOES THE
DRUG WORK.
BUT WHEN WE'RE LOOKING AT
DIFFERENT KINDS OF INTERVENTIONS
THAT INVOLVE A PERSON'S BODY,
MIND, SPIRIT, IS THAT THE -- WE
TEND TO ASK THE SAME QUESTION,
DOES THE INTERVENTION WORK.
BUT ANOTHER WAY TO THINK ABOUT
IT, IT'S THE PERSON THAT'S
RECEIVING THE TREATMENT THAT'S
DOING THE WORK.
AND THE TREATMENT IS
FACILITATING OR HELPING, SO I
THINK ASKING THE QUESTION A
DIFFERENT WAY CAN BE HEL FUP, H,
BUT IT'S HARD WHEN YOU DO
RESEARCH BECAUSE WE TEND TO WANT
TO GET BACK DOWN TO THE DRUG
MODEL.
SO THIS IS ONE THING WE'RE
WORKING ON AT NCCIH, IS TRYING
TO FIGURE OUT BETTER WAYS TO ASK
THAT QUESTION.
>> LET ME JUST SAY TO THAT,
THAT'S PART OF THE DECOLONIZING
WORK OR INDIJ NIEZING WORK THAT
OUR COMMUNITIES ARE TALKING
ABOUT.
SO IT'S NOT -- IT'S NOT JUST DID
THE PILL WORK.
IT WOULD BE WHAT IS YOUR
RELATIONSHIP TO THAT PILL.
>> RIGHT.
>> AND DID YOU PRAY WITH IT, DID
YOU TALK TO IT, DID YOU TALK TO
THAT MEDICINE.
BECAUSE IN OUR INDIGENOUS WAYS
OF KNOWING IN GENERAL, THIS IS
KIND OF A GROSS GENERAL
STATEMENT BUT IT MANIFESTS
DIFFERENTLY FOR EACH TRIBE, BUT
THE GENERAL PROCESS IS, YOU
KNOW, PART OF COLONIZATION AND
THE IMPACT OF COLONIZATION ON
OUR COMMUNITIES IS TO BE GOOD
SUBJECTS, OR TO BE GOOD
PATIENTS.
AND THAT PASSIVITY IN THAT
PROCESS, YOU RECEIVE A TREATMENT
OR YOU RECEIVE SOMETHING, THAT'S
NOT HEALTHY FROM AN INDIGENOUS
POINT OF VIEW.
BECAUSE YOU HAVE A RELATIONSHIP
TO THIS, ONE ELDER SAID TO ME
BEAUTIFULLY, HE SAID, YOU HAVE
TO MEET THE MEDICINE HALFWAY FOR
THAT MEDICINE TO BE ACTIVATED.
SO YOU DON'T -- YOU'RE NEVER A
PASSIVE -- INDIGENOUS WAY OF
DOING THINGS IS NEVER A PASSIVE
WAY OF DOING IT, IT'S ALWAYS
ABOUT MEETING THAT MEDICINE
HALFWAY TO HAVE THAT MEDICINE'S
POWER REALLY BE ABLE TO HELP UP.
THAT'S A RELATIONAL WAY OF
THINKING.
SO I THINK THAT'S WHERE IT GETS
REALLY CREATIVE IN THINKING
ABOUT, YOU KNOW, HOW DO WE
IMPACT THAT, HOW DO WE LOOK THE
A THAT, BOTH IN INTERVENTION
DEVELOPMENT, HEALTH PROMOTION
MODELS, HOW DOES THAT EVEN
TRANSLATE INTO POTENTIAL
MEASURES IF POSSIBLE, YOU KNOW,
THOSE ARE THE KINDS OF THINGS TO
START TO IMPACT, BUT IT'S THAT
RELATIONAL WAY OF THINKING.
WE MAY BE LOOKING AT THE EXACT
SAME THING, BUT OUR APPROACHES
ARE DIFFERENT.
WE MAY BE TAKING A PILL, BUT YOU
KNOW, IT'S REALLY OUR
RELATIONSHIP TO THAT PILL THAT
REALLY MATTERS THAT WE WOULD SAY
FROM A MORE -- FROM THAT
INDIGENOUS MORE TRADITIONAL
POINT OF VIEW ON THAT.
>> I THINK THAT'S PROFOUND, AND
IT HAS -- SOME OF THESE
CONVERSATIONS WE HAVE AROUND
NONSPECIFIC EFFECTS OF TREATMENT
THAT A LOT OF THIS COULD BE
THAT, THE RELATIONSHIP TO THE
TREATMENT.
>> ABSOLUTELY.
>> RIGHT.
OH, THAT'S GREAT.
WELL, I DON'T WANT TO STEAL
OTHER PEOPLE DES -- SO GUNNAR.
>> THANKS SO MUCH, BEN.
THAT REALLY WAS A GREAT
QUESTION, AND IT'S BEEN A REALLY
GREAT DISCUSSION.
AND ONE OF MY FAVORITE FORREST
GUMPISMS IS MY MAMA ALWAYS SAID
MOST PEOPLE DON'T LOOK DOWN
UNTIL THEY START TALKING.
SO I'M IN A VERY HIGH RISK
SITUATION RIGHT NOW, BUT I'VE
GOT A COUPLE OF THOUGHTS AND
QUESTIONS, START WITH A REAL
BASIC ONE FOR DAN.
I'M A LITTLE CURIOUS ABOUT
THE -- SORT OF WHAT'S THE DOSE
OF DRUMMING.
IS IT YOU'RE DOING DRUMMING BY
YOURSELF OR YOU'RE DRUMMING IN A
GROUP, HOW MANY TIMES A WEEK,
AND DO YOU DRUM JUST WITH OTHER
NATIVE AMERICANS OR KIND OF HOW
THAT ALL ROLLED OUT AND THEN
IT'S KIND OF LIKE MUSIC THERAPY
BUT I WOULD IMAGINE THAT
POUNDING THE SKINS IS A LITTLE
DIFFERENT, FOR EXAMPLE, THAN
PLAYING A SAXOPHONE.
SO JUST YOUR THOUGHTS ON THAT.
>> YES, YES, THANKS FOR THE
QUESTION.
WITH THE DOSE OF DRUMMING IN OUR
LAST INTERVENTION, WE HAD TWO
HOURS A SESSION, SIX SESSIONS.
WE KIND OF MADE A SHORTER
VERSION.
AND IT IS GROUP DRUMMING, AND IR
STUDY, BECAUSE WE ASKED THE
ELDERS AND COMMUNITY MEMBERS
WHAT STYLE -- DRUMMING
TRADITIONS CAN DIFFER IN
DIFFERENT REGIONS, DIFFERENT
AREAS, BUT IN THE URBAN AREA,
CALIFORNIA HERE, POW-WOW-STYLE
DRUMMING OR LARGE DRUM WITH
ABOUT SIX OR SO INDIVIDUALS IS
MORE TYPICAL, SO THAT'S THE
STYLE OF DRUMMING THAT'S MORE OF
A GROUP DRUMMING AROUND A LARGER
POW-WOW DRUM, ONE DRUM FOR SIX
OR SO INDIVIDUALS.
AND TH PARTICIPANTS WILL SIT ARD
THE DRUM WITH AN ELDER PROVIDING
TEACHINGS FOR ABOUT AN HOUR OR
SO, AND THEN DRUMMING FOR AN
HOUR OR SO, AND THEN PROCESSING
GROUP FOR ABOUT A HALF-HOUR,
GIVE OR TAKE, AND THERE IS
RESEARCH FROM BARRY BITMAN, HE
MAY BE RETIRED NOW, NEW NEUROLOT
AT WASHINGTON STATE, AND HE'S
DONE A LOT OF RESEARCH WITH
DRUMMING, WITH GENERAL
POPULATIONS, AND HAS FOUND SOME
POTENTIAL NEUROLOGICAL-BASED
BENEFITS FROM DRUMMING.
AND THAT IT MAY HELP -- IT MAY
HELP WITH FOCUS AND
CONCENTRATION, SO IT'S
INTERESTING THAT WE'VE FOUND
SOME INITIAL SIGNIFICANT
FINDINGS OF IMPROVED COGNITION,
HOW -- I HAVE TO ADMIT, THAT'S
AN AREA I KIND OF WANT TO LOOK
MORE CLOSELY AT, AND THE
NEUROCOGNITIVE BENEFITS OF
POTENTIALLY THAT MAY BE
HAPPENING WITH DRUMMING.
AND THAT WOULD BE REALLY
IMPORTANT TO KNOW.
BUT -- YEAH, THAT'S ABOUT HOW
WE'RE DELIVERING THE
INTERVENTION AT THIS POINT.
>> THAT'S REALLY INTERESTING.
KARINA, I'M A PROFESSOR OF
FAMILY MEDICINE AND SPORTS
MEDICINE IN BLACKSBURG,
VIRGINIA.
AND ONE OF THE THINGS THAT I'M
SURE YOU'RE PROBABLY WELL AWARE
OF IS THAT THERE IS AN
OSTEOPATHIC SCHOOL AT OKLAHOMA
STATE THAT HAS A VERY LARGE
INVOLVEMENT WITH INDIGENOUS
TRIBES THERE IN THAT REGION, AND
I THINK IT'S A TRE M TREMENDOUSL
FOR EXPOSING MEDICAL STUDENTS TO
THE DELIVERY OF CULTURALLY
COMPETENT CARE IN THOSE TYPES OF
ENVIRONMENTS.
SO I THINK THAT'S REALLY
EXCITING, AND I DON'T KNOW IF
YOU'VE HAD ANY INTERACTIONS WITH
THOSE FOLKS AT OKLAHOMA STATE.
>> I HAVE HAD INTERACTIONS BUT
I'M VERY EXCITED ABOUT THAT
ACTUALLY.
I KNOW CHEROKEE NATION HAS PUT A
LOT OF EFFORT INTO SOME OF THIS,
AND I KNOW MY OWN TRIBE IS
LOOKING TO DEVELOP SOME MORE --
MORE HEALTHCARE MODELS.
I WOULD LOVE TO SEE A NATIVE
MEDICAL SCHOOL, THAT'S REALLY
COOL, SO --
>> YEAH, I THINK THAT SCHOOL
THERE HAS MORE NATIVE AMERICANS
MATRICULATING THERE THAN ANY
OTHER MEDICAL SCHOOL IN THE
COUNTRY.
>> YES.
>> SO REALLY, REALLY IMPORTANT,
YOU MADE SOME GREAT POINTS ABOUT
DEVELOPING THE CULTURALLY
REPRESENTATIVE NEYTIVE AMERICAN
WORKFORCE, RESEARCH WORKFORCE,
EXTREMELY IMPORTANT TO DO THAT
ON THE CLINICAL SIDE AS WELL,
AND THEN CONNECT THE DOTS.
GET THE CLINICIANS WORKING WITH
THE SCIENTISTS TO HELP IN A
MULTIDISCIPLINARY KIND OF WAY
SOLVE THESE BIG PROBLEMS.
ONE OF OUR CAMPUSES IS IN
SPARTANBURG, SOUTH CAROLINA,
WHICH IS VERY CLOSE TO CHEROKEE,
NORTH CAROLINA, SO WE'VE GOT A
GREAT WORKING RELATIONSHIP WITH
THE EASTERN BAND OF THE
CHEROKEES THERE, AND THEY'VE GOT
REALLY AWESOME MEDICAL CARE
DELIVERY SYSTEM.
I REMEMBER WHEN I FIRST WENT
THERE, WE WERE GOING TO TOUR
AROUND AND I'M THINKING WE'VE
GOT TO THINK ABOUT HOW WE CAN
HELP, AND AFTER I TOURED THEIR
HEALTHCARE FACILITY, I'M TOLD
CHIEF OF THE TRIBE, I SAID WE
CAN'T HELP YOU.
YOU CAN REALLY HELP US BY
PROVIDING OPPORTUNITIES FOR OUR
STUDENTS TO ROTATE IN THIS
ENVIRONMENT AND BE EXPOSED TO
THE DELIVERY OF THIS CARE,
BECAUSE IT TRULY WAS AN AWESOME
CARE DELIVERY MODEL THERE AND I
THINK GREAT OPPORTUNITIES FOR
RESEARCH THERE AS WELL.
>> THERE ARE SOME TRIBES THAT
ARE DOING REALLY WELL,
ESPECIALLY THE 638 TRIBES WHO
CREATED THEIR OWN FACILITIES AND
ARE RUNNING SOME THINGS.
THERE'S STILL A WORKFORCE
SHORTAGE ACROSS THE BOARD WHICH
IS STILL IMPACTING EVERYBODY,
BUT IT'S EXCITING THAT THEY'RE
DEVELOPING AN OPPORTUNITY WHERE
THERE'S SOME CULTURE SHARING AND
OPPORTUNITY FOR INTERNSHIPS AND
OTHER KINDS OF THINGS FOR
MEDICAL STUDENTS TO COME OVER
THERE, THAT WOULD BE GREAT.
I JUST WANTED TO ACKNOWLEDGE
SOMETHING ABOUT THE DRUMMING
PART.
THE ONE THING IS THE STORIES
THAT GO WITH THE DRUMS, THAT'S
PART OF THAT, I KNOW DAN ALLUDED
TO THAT AND I JUST WANTED TO
KIND OF -- AGAIN YOUR
RELATIONSHIP TO THE DRUM ITSELF
AND WHAT IT MEANS IS REALLY
POWERFUL IN INDIAN COUNTRY, EVEN
A POW-WOW DRUM MATTERS BUT THERE
ARE ALSO DIFFERENT -- THERE'S
HAND DRUMS, WATER DRUMS, THEY'RE
USED IN DIFFERENT POTENTIAL
CEREMONIES VERSUS POW-WOW WHICH
IS MORE OF A SOCIAL GATHERING,
EVEN THOUGH IT HAS A SPIRITUAL
ELEMENT, IT'S REALLY MORE
SOCIAL.
AND SO I THINK IT WOULD BE
REALLY INTERESTING TO SEE EVEN
THE TONAL DIFFERENCES AND THE
TONAL ASPECTS OF THE SONGS AS
WELL AS THE DRUMMING AND HOW
THAT HAS AN IMPACT ON
EVERYTHING.
NEURODEVELOPMENT, 'NOTHER OWE
ASPECTS NOT JUST FROM LIKE
STROKE RECOVERY OR OTHER THINGS
LIKE THAT, GENERAL SENSE OF
WELL-BEING THAT PEOPLE FEEL WHEN
THEY WALK AWAY FROM BEING
TOGETHER.
ESPECIALLY SINK FLIEZED DRUMMING
SYNCHRONIZED DRUMMINGBECAUSE YOR
AND ON BEAT TOGETHER AND KIND OF
FOCUSED IN ONE WAIVERS US
INDIVIDUAL DRUMMING AND IT
JUST -- IT WOULD BE INTERESTING
TO SEE ALSO KIND OF LEARNING
SONGS THAT ARE TIED TO CEREMONY
VERSUS SONGS THAT ARE TIED TO
MORE SOCIAL ASPECTS.
I'M WONDERING IF THERE WOULD BE
ANOTHER ELEMENT THERE THAT WOULD
GENERATE EVEN MORE KIND OF
FACILITATE SOME WELLNESS STUFF
FOR FOLKS' OUTCOMES, BUT ON THE
HEALING SIDE OF THINGS, WHEN YOU
DRUM, WHEN YOU SING, OR THAT
SONG HAS POWER IN IT, IT'S NOT
JUST THE DRUMMING ACTIVITY
ITSELF OR THE SINGING ITSELF.
BUT THERE'S A SPIRIT ASSOCIATED
WITH THAT SONG, THAT IS HELPING.
AND SO THE HEALER USUALLY WORKS
WITH A PERSON WHO'S RECEIVING OR
HEARING THAT SONG TO UNDERSTAND
THAT THERE'S A SPIRIT WORKING
THROUGH THAT SONG.
SO THAT SONG ISN'T EMPTY.
IT'S NOT JUST SOMETHING THAT YOU
CAN PICK UP AND YOU CAN GO SING
AFTERWARDS.
IT HAS TONAL QUALITIES AND THAT
CONNECT USUALLY TO EARTH
ELEMENTS, WATER, ROCKS OR --
IT'S -- SO IT'S VERY DIFFERENT
THAN OTHER KINDS OF SINGING AND
THEY ALL HAVE BENEFITS.
IT WOULD JUST BE INTERESTING TO
SEE THE DIFFERENT BENEFITS
ACROSS THEM.
SO ANYWAY, I WAS JUST THINKING
ABOUT THAT.
>> THESE ARE ALL GREAT RESEARCH
QUESTIONS, MY GOODNESS.
GOOD THING WE'RE RECORDING THIS.
LYNNE.
>> HI.
KARINA AND DAN, I'M LYNNE.
I'M A NATUROPATHIC PHYSICIAN IN
OREGON.
I SOG LOVE YOUR PERSPECTIVES ON
HEALTH AND HEALING.
DAN, I LOVE YOUR DRUMMING STUDY.
REALLY RESONATES, I MEAN,
DRUMMING REALLY RESONATES WITH
ME.
MY OWN CULTURE HAS PICO DRUMMING
SO I GREW UP IN AN IMMIGRANT
N█EIGHBORHOOD AND WE HAD TYCO
DRUMMING AND TRADITIONAL
JAPANESE DANCE, SO IT REALLY
KIND OF STRUCK A RESONANT CHORD
WITH ME.
KARINA, I REALLY LOVED YOUR
COMMENT ABOUT THE RELATIONSHIP
TO THE MEDICINE.
I JUST -- I THINK THAT IS REALLY
THE TRUE LENS HE TO A LOT OF
LOOKING AT TRADITIONAL
MEDICINES.
SO I JUST WANT TO SAY I ALSO
REALLY LOVE THAT LENS, AND I
THINK THAT LENS IS OFTEN
OVERLOOKED.
DAN, I WAS ACTUALLY -- HAD A
COUPLE QUESTIONS ABOUT YOUR
STUDY.
ONE, I WAS WONDERING IF YOU DID
ANY INTERVIEWING OF THE
PARTICIPANTS AFTER THE TREATMENT
TO SEE WHAT THEY WOULD LIKE AS
FOLLOW-UP, WAS MY FIRST
QUESTION.
>> YES.
THANKS FOR THE QUESTION AND
COMMENTS.
WE DID NOT UNFORTUNATELY, BUT IT
JUST MAKES ME THINK THAT WE DID
HAVE LIKE A SATISFACTION
QUESTIONNAIRE OF WHICH THEY WERE
VERY, VERY SATISFIED IN GENERAL
WITH THE INTERVENTION, WITH OUR
EXPERIENCES.
I THINK 92% OR SO OF THE
PARTICIPANTS HAD VERY HIGH KIND
OF CHOICES ON THE QUESTIONNAIRE
BEING SATISFIED.
BUT YES, WE HAD ACTU ACTUALLY A
MEETING WITH OUR ELDER ADVISORY
BOARD, OUR COMMUNITY ADVISORY
BOARD, AND THEY DID NOT HAVE
SPECIFIC RECOMMENDATIONS BUT
THEY DID FEEL THAT THERE NEEDS
TO BE MORE THOUGHT AND
APPROACHES TO HELPING PEOPLE TO
KIND OF CONNECT WITH THEIR
CULTURE IN THE URBAN AREAS, AND
IT KIND OF BRINGS UP A BIGGER
QUESTION WITH A LOT OF OUR
HEALTH PROGRAMS IN URBAN AREAS
AND HOW DO WE CONNECT OUR --
WE'RE ALWAYS TRYING TO WORK ON
THIS.
I ALSO WORK CLINICALLY AT A
CLINIC AS A PSYCHIATRIST IN L.A.
COUNTY, AND WE'RE CONSTANTLY
TRYING TO CREATE THOSE
OPPORTUNITIES.
AND PEOPLE ARE WANTING THESE
OPPORTUNITIES, THE NATIVE PEOPLE
ARE WANTING THESE.
SO WE'RE HOPING TO LEARN MORE AS
WE GO FORWARD.
>> YEAH, IT'S DEFINITELY A
LEARNING PROCESS.
I DID A STUDY ABOUT SIX YEARS
AGO WHERE WE WORKED WITH YOUTH
WHO HAD FIRST EPISODE
PSYCHOCIRCLES AND WE PSYCHOSISAE
INTERVENTION, A MULTICOMPONENT,
AND THE PHYSICAL ACTIVITY
COMPONENT, ACTUALLY ONE OF THE
THINGS WAS TYCO DRUM AND IT WAS
VERY, VERY POPULAR INTERVENTION
AS THIS MULTICOMPONENT.
WE DID -- WHEN WE INTERVIEWED
THE PARTICIPANTS AND THEIR
FAMILIES AFTER THE INTERVENTION,
ALMOST ALL OF THEM SAID THEY
WANTED BOOSTER SESSIONS.
SOMETHING LIKE THE INTERVENTION,
YOU KNOW, MAYBE SHORTER BUT A
BOOSTER BUT IT WAS DEFINITELY
CLEAR THAT THEY WANTED SOME
CONTINUATION, SO I JUST FELT
THAT WAS REALLY INTERESTING.
AND MY OTHER QUESTION WAS, WHEN
I THINK ABOUT DRUMMING, I THINK
ABOUT COMMUNICATION, AND AS
KARINA WAS SAYING, IT'S A
RELATIONSHIP TO THE MUSIC BUT
IT'S ALSO THE COMMUNITY HAS A
RELATIONSHIP OR THOSE DRUMMERS
HAVE A RELATIONSHIP WITH EACH
OTHER TO THAT DRUM, AND ACTUALLY
EVEN BROADER OUT TO THE
COMMUNITY BECAUSE A LOT OF TIMES
DRUMS ARE USED FOR COMMUNICATION
BETWEEN COMMUNITIES IN
TRADITIONAL USE OF DRUMS.
SO ONE OF THE THINGS THAT
SURPRISED US IN THE YOUNG PEOPLE
WITH PSYCHOSIS STUDY WAS THE
SOCIAL ASPECT OF GETTING
TOGETHER AND DOING A GROUP DRUM
OR GROUP INTERVENTION WAS HIGHLY
POSITIVE, THAT CONNECTION TO
OTHER PEOPLE WAS ACTUALLY AN
INTERVENTION WE DIDN'T EVEN
THINK ABOUT.
SO I WAS JUST -- WANTED TO
MENTION THAT I THINK SOMETIMES
WE FORGET ABOUT LOOKING AT
CONNECTIONS AND, YOU KNOW,
MEASURING CONNECTIONS BECAUSE
PEOPLE JUST FORGET ABOUT THAT.
AND I DON'T HAVE ANY GREAT IDEAS
OF WHAT A GOOD MEASURE WOULD BE,
BUT I LIKE THIS IDEA OF KIND OF
COMING OUTSIDE OF THE PERSON AND
THINKING ABOUT MEDICINE AS
SOMETHING YOU TAKE, BUT LOOKING
AT THIS BROADER KIND OF HOW ARE
WE ALL RECONNECTING.
>> I HAVE A COUPLE QUICK
COMMENTS, REALLY GREAT QUESTION
IN THAT I THINK A LOT OF -- OR
SOME INTERVENTION I'VE BEEN A
PART OF AT LEAST WITH
TRADITIONAL PRACTICES IS THEY'RE
KIND OF AN OPPORTUNITY TO ENGAGE
AND LEARN ABOUT THE TRADITIONAL
ACTIVITY, BUT I THINK THE DREAM
IS PRETTY MUCH -- THESE
INTERVENTIONS I'VE BEEN A PART
OF ARE KIND OF AN OPPORTUNITY,
QUOTE-UNQUOTE, TO LEARN AND
ENGAGE WITH YOUR CULTURE.
BUT THE DREAM IS TO KIND OF DO
THINGS THAT YOU'RE ALLUDING TO
AS BEING OUT IN THE COMMUNITY.
THIS IS PRETTY MUCH WE FEEL --
MOST PEOPLE COME IN TO OUR
INTERVENTION AT LEAST NOT HAVING
DRUM BEFORE OR CONNECTED, SO OUR
HOPE IS THAT AFTER THIS
INTERVENTION, THAT THEY CAN
CONTINUE FORWARD WITH THEIR REAL
LIFE, SO TO SPEAK, NOT JUST
THESE SIX WEEKS IN OUR
INTERVENTION AND YOU'RE ALL DONE
AND NOTHING ELSE TO DO.
NO, IT'S AFTER THAT, YOU KNOW,
THAT WE NEED TO REALLY KIND OF
START LOOKING AT HOW DO WE
FACILITATE THESE KIND OF SOCIAL
CONNECTIONS, AND THERE ARE SO
MANY OPPORTUNITIES OF
INTERESTING DRUMMING, ALL KINDS
OF DRUMMING GROUPS ONE COULD GET
INTO AND GET INVOLVED WITH
TRAVELING POW-WOWS, ALL KINDS OF
CONNECTIONS.
IN ANOTHER STUDY WE ARE USING,
WE ARE ANALYZING SOCIAL
CONNECTIONS AND USING SOCIAL
CONNECTION DIAGRAMS, MAYBE
APPROACHES LIKE THAT COULD HELP
FACILITATE DISCUSSIONS AS WELL.
>> THERE NEEDS TO BE -- IT'S NOT
JUST ONE INTERVENTION SHORT TERM
AND THEN SEND PEOPLE ON THEIR
WAY, RIGHT?
THERE NEEDS TO BE SOMETHING THAT
FOLLOWS UP.
ERICA, YOU HAD YOUR HAND UP A
WHILE AGO AND THEN -- MAYBE
ERICA SHOULD BE FIRST AND THEN
MARGARET?
>> THANK YOU.
WONDERFUL TO TALK ABOUT THIS AND
TO HEAR ABOUT THIS GREAT WORK.
IT JUST REALLY MAKES ME THINK
ABOUT THE IMPORTANCE OF OUR
ABILITY TO INCLUDE QUALITATIVE
INTERVIEW/STORY GATHERING
METHODOLOGIES IN THIS WORK THAT
WE'RE NOT QUITE -- THAT IS
EVOLVING IN TERMS OF WHAT THE
OUTCOMES PEOPLE ARE INTERESTED
IN, AND I HAVE TO SAY WHEN I'VE
HAD QUESTIONS THAT I'VE BEEN
UNCLEAR ABOUT, LIKE HOW WOULD
PEOPLE RECEIVE INTERVENTIONS OR
HOW MIGHT THEY THINK IT BENEFITS
THEM OR DOESN'T, WE GET SUCH
RICH AND NUANCED INFORMATION
WHEN WE APPLY HIGH LEVEL
RIGOROUS QUALITATIVE
METHODOLOGY, AND OF COURSE IT
NEEDS TO BE CULTURALLY
APPROPRIATE SO THE INTERVIEWERS
NEED TO HAVE A NUANCED
UNDERSTANDING OF WHAT A
PARTICIPANT MIGHT MEAN WHEN THEY
RESPOND IN A CERTAIN WAY, SAY,
ABOUT THE RELATIONSHIP WITH THE
PILL.
AND THAT THE INTERVIEWER GETS
THAT THAT'S A REAL THING.
THAT'S NOT A -- YOU KNOW, THAT
THAT IS A RICH AREA TO BE
EXPLORED, SO I WOULD JUST
ENCOURAGE THAT, AND I THINK
THERE WOULD BE SUCH NOT ONLY
RECEPTIVITY IN THE PARTICIPANTS,
BUT IT WOULD -- IT'S SO HELPFUL
IN GROUNDING THE NEXT QUESTIONS
AND THE NEXT -- TO THIS KIND OF
WORK IN GENERAL AND PARTICULARLY
IN THIS CULTURE WHERE STORIES --
THE BEAUTIFUL STORIES THAT
YOU'VE BEEN SHARING, KARINA.
JUST SORT OF IS SUCH A GOOD
REMINDER THAT HOW PEOPLE
UNDERSTAND WHAT THEY'RE OFFERED
AND WHAT THEY ACCEPT IS REALLY
IMPORTANT IN WHAT IMPACTS THEM,
WHAT THEY HOLD ON TO, HOW THEY
HOLD ON TO IT, AND THEN WHAT
THAT MEANS FOR THEM GOING
FORWARD.
I JUST LOVE THIS WORK AND I'M SO
EXCITED THAT WE GET TO TALK
ABOUT IT AND PAY ATTENTION.
>> 100% AGREE, QUALITATIVE IS
HUGE, AND ABSOLUTELY IS A
CRITICAL COMPONENT AND DESERVES
ITS OWN, YOU KNOW, OWN RESEARCH
GRANTS AND THINGS LIKE THAT,
BECAUSE I THINK THAT'S WHERE YOU
GET DEEP INFORMATION ABOUT SOME
OF THESE, AND EXAMPLES.
SOMETIMES WE'RE NEEDING
EXAMPLES.
WHEN I DID THE NATIONAL LGBT
HEALTH STUDY, WE DID INTERVIEWS
WITH 75 PEOPLE AND THIS WAS A
CRITICAL FACTOR.
SPIRITUALITY CAME UP CONSTANTLY
IN OUR INTERVIE INTERVIEWS ORGAY
WITH GREAT EXAMPLES OF THE ROLE
OF SPIRITUALITY IN PROMOTING
HEALTH FOR PEOPLE.
DIVINE INTERVENTIONS SOMETIMES,
WHERE LITERALLY THEY WOULD GET
EXAMPLES OF, YOU KNOW, ONE
EXAMPLE OF A WOMAN WAS ABOUT TO
KILL HERSELF AT DAWN, AND ALL OF
A SUDDEN SHE HEARD ALL THESE
WOMEN SINGING.
AND SURROUNDING HER.
AND IT CHANGED HER LIFE AND SHE
LITERALLY -- IT SAVED HER LIFE.
AND SO YOU GET ALL KINDS OF
AMAZING EXAMPLES THAT PEOPLE
WOULD BE WILLING TO SHARE, BUT
WE ALSO HAD NATIVE INTERVIEWERS
WHO WERE REALLY WELL TRAINED TO
CREATE AN ENVIRONMENT WHERE
WHATEVER YOUR SPIRITUAL OR YOUR
FAITH OR WHATEVER YOUR TRADITION
OR EXPERIENCES WAS A SAFE PLACE
TO TALK ABOUT THAT.
SO THAT MATTERS TOO.
GOOD TRAINING.
>> LET'S GO TO MARGARET AND THEN
BOB.
>> I HAD A REAL QUICK QUESTION.
THIS IS SO FASCINATING TO ME, I
KNOW VERY LITTLE ABOUT THE
TOPIC, BUT DAN, YOU MENTIONED
GENDER.
I WAS JUST CURIOUS, HOW DO YOU
INCORPORATE GENDER IN DESIGNING
THESE STUDIES?
>> GREAT QUESTION.
WITH DRUMMING, IT BECOMES QUITE
A DISCUSSION.
BECAUSE MANY TIMES MALE
TYPICALLY DRUM AND WOMEN DRUM
AND TRADITIONALLY, AND VARIOUS
TRIBES, SO IT BECOMES A
CONVERSATION, AND MANY TYPICAL
KIND OF DRUMMING GROUP YOU MAY
HAVE MALE DRUMMERS AND FEMALES
DANCING AND SINGING MORE SO THAN
DRUMMING.
ITHE ACTS OF DRUMMING COULD
DIFFER.
I'M HALF -- INUET BASICALLY,
NORTHERN ESKIMO, WE DRUM IN
STRAIGHT LINES, MEN DRUM --
TYPICALLY MEN DRUM THEIRS WITH
INDIVIDUAL DRUMS AND WOMEN
TYPICALLY DANCING IN FRONT.
THEN A MAN MAY PUT DOWN HIS
DRUM, COME OUT AND DANCE, THEN
GO BACK AND DRUM.
SO I DON'T KNOW IF I HAVE A
CLEAR ANSWER, SO BUT TO
WHAT DEGREE MEN AND WOMEN
BENEFIT AND IN WHAT WAYS, I
DON'T THINK THERE'S BEEN ANY
STUDIES.
KARINA, IF YOU KNOW OF ANY
NATIVE PEOPLE --
>> I THINK IT VARIES BUT I THINK
YOU HIT THE NAIL ON THE HEAD, IT
VARIES FROM REGION TO REGION AND
FROM TRIBE TO TRIBE.
THE BIG DRUM ACTUALLY THERE ARE
STORIES THAT CAME FROM WOMEN AND
PASSED TO THE MEN, SO THERE'S
ALL THESE DIFFERENT STORIES, BUT
THERE ARE WOMEN DRUMMERS WHO
DRUM AROUND THE BIG DRUM IN
CERTAIN REGIONS OF THE COUNTRY,
AND THAT'S BECOMING ACTUALLY
MORE SO NOW, AND THERE IS
EXCEPTION TO GENDER ROLES QUITE
OFTEN IN OUR COMMUNITIES AT
TIMES, WHEN IT'S CULTURALLY
APPROPRIATE.
AND WE DON'T ALWAYS HAVE BINARY
GENDERS EITHER.
SO IT GETS MORE COMPLEX WHEN YOU
START TALKING ABOUT GENDER IN
INDIAN COUNTRY AND THE ALASKA
NATIVE COMMUNITY.
>> CAN A DRUM APPROACH BE USED
THEM COMPARABLY FOR MEN AND
WOMEN OR DO YOU HAVE TO BE --
>> IT DEPENDS ON THEIR TRIBE AND
THE REGION.
I THINK THERE IS A DRUMMING
APPROACH THAT COULD BE
ACCOMMODATED, DEPENDING ON THE
DIFFERENT REGION.
>> BOB.
>> THANKS.
REALLY INTERESTING STUFF.
ONE OF THE THINGS THAT DAN WAS
MENTIONING WAS THE SOCIAL
ELEMENT, AND A STUDY THAT POPPED
UP FROM THE TRUMSO STUDY IN
NORWAY ON PAIN WAS SHOWING THAT
KIDS WHO SHARED THE SAME SOCIAL
NETWORKS HAD SIMILAR DEGREES OF
PAIN TOLERANCE.
SO YOU HAD LIKE HIGHLY TOLERANT
SOCIAL GROUPS AND RATHER
SENSITIVE SOCIAL GROUPS.
AND I'M WONDERING IF THERE'S A
WAY OF INCORPORATING THE SOCIAL
NETWORKS INTO THIS WHOLE -- INTO
THE WHOLE EXPERIMENTAL DESIGN
WITH THE RECOVERY AND BONDING
ESPECIALLY DURING THE DRUMMING
WHICH SOUNDS LIKE IT'S A VERY
SOCIAL ACTIVITY, AND THEN THE
RELAPSE MIGHT BE RESULTING IN A
WAY OF A BREAKUP OF THAT SOCIAL
CONNECTION.
>> THAT'S AN EXCELLENT IDEA.
>> THAT'S WHAT I THINK, THAT'S A
GOOD IDEA.
>> NO, BUT, YEAH, I THINK THERE
ARE -- YOU KNOW, SOMETIMES IT'S
NOT -- I THINK WE NEED TO LOOK
AT THAT AND STUDY THAT AND PUT
OUT DESIGNS, RESEARCH DESIGNS IN
THIS WAY.
THEN SOMETIMES IT'S NOT A
PERFECT WORLD.
I MEAN, WE ALL THINK IF YOU
ENGAGE IN THIS ACTIVITY OR THAT
ACTIVITY, YOU'LL HAVE A PERFECT
LIFE AND YOU'RE GOING TO DO
THINGS PERFECTLY AND BE 100%
HEALTHY, BUT NOT ALL THE TIME.
I MEAN, FOR INSTANCE, THERE ARE
SOME PEOPLE -- AND WE ALWAYS
REALLY EMPHASIZE THE HEALTHY
NOTIONS OF TRADITIONAL
PRACTICES, BUT SOME STILL DO
DRUGS AND ALCOHOL.
AND THEY'RE BEATING OR DRUMMING.
SO, YEAH, I THINK WE NEED MORE
STUDIES TO KIND OF LOOK AT
WHAT'S GOING ON IN SOCIAL
NETWORKS.
>> KARINA, I'M GETTING A
MESSAGE, YOUR TIME IS UP, AND
WE -- BECAUSE YOU HAVE TO GO,
AND I JUST WANT TO SAY HOW
GRATEFUL WE ARE THAT YOU WERE
ABLE TO SHARE ALL OF THIS WITH
US, THAT WE WERE ABLE TO COMBINE
YOUR TALK WITH DAN'S EXPERTISE.
WHAT A RICH DISCUSSION.
SO HAPPY.
AND AS I SAID, THIS IS REALLY
WHAT WE WERE HOPING WAS GOING TO
HAPPEN AND MORE.
SO WE HAVE MADE COPIOUS NOTES
AND WE WILL BE REVIEWING ALL THE
LOVELY IDEAS THAT WERE PUT
FORWARD AND LET'S GET TOGETHER
AND TALK.
>> I LOOK FORWARD TO THAT.
I HOPE THIS IS NOT JUST A
ONE-TIME OPPORTUNITY, BUT WE
LOOK FORWARD TO TALKING SOME
MORE ABOUT HOW WE COULD
POTENTIALLY PARTNER ON SOME
THINGS.
>> ABSOLUTELY.
NO QUESTION.
>> DAN, GREAT SEEING YOU.
>> GREAT SEEING YOU, YES.
>> YES, YES YES, ALL THE BEST.
THANK YOU SO MUCH.
>> THANK YOU.
>> SO, YEAH, WELL, WHAT AN
AMAZING DISCUSSION THIS WAS.
AND IT'S VERY INTERESTING HOW
REALLY THIS -- THE IDEA FOR
DOING -- FOR HAVING THIS
DISCUSSION TODAY REALLY CAME OUT
OF OUR PREVIOUS DISCUSSION AS I
SAID EARLIER ABOUT THE
IMPORTANCE OF REALLY EMBRACING
SPIRITUAL HEALTH AS BEING A PART
OF WHOLE PERSON HEALTH, WHICH
IS, YOU KNOW, A BIG AND
IMPORTANT TOPIC AND OF COURSE
WHAT WE TALKED ABOUT JUST NOW IS
NOT UNIQUELY SPIRITUAL HEALTH
BUT THERE'S A BIG COMPONENT OF
IT AS WAS ELOQUENTLY
ILLUSTRATED.
SO WONDERING, DAN, IF YOU HAVE
ANY CLOSING THOUGHTS.
>> I DON'T THINK I HAVE ANY
ADDITIONAL THOUGHT, BUT AS
KARINA MENTIONED, I LOOK FORWARD
TO FURTHER DISCUSSION ON THIS
TOPIC OF SPIRITUALITY AND WHOLE
PERSON HEALTH FOR DIVERSE
POPULATIONS, AND I'M CURIOUS TO
LEARN ABOUT OTHER POPULATIONS AS
WELL IN THE U.S. AND HOW THIS
CONVERSATION CAN CONTINUE.
>> YES, ABSOLUTELY.
AND IF I MAY, THERE'S ONE THING
THAT REALLY STRUCK ME.
WE HAVE ANOTHER FIVE MINUTES,
RIGHT, MARTINA?
>> 2:45.
GO AHEAD, PLEASE.
>> 2:45?
3:45.
OKAY.
SO WE'RE BASICALLY AT TIME.
>> WE'RE AT TIME, EXACTLY.
>> OKAY.
SO WE WILL MOVE ON BECAUSE I
DON'T WANT US TO BE LATE.
SO THANK YOU, AND LET'S GO OUT
TO THE NEXT STAGE.
WHATEVER THE NEXT TOPIC IS.
>> THE NEXT TOPIC IS COUNCIL
WORKING GROUP PROCESS, AND I
JUST WOULD LIKE TO SHARE, I HAVE
A FEW SLIDE, ONLY FOUR OR FIVE,
THAT I WANTED TO USE TO SET THE
STAGE HERE.
OKAY.
CAN YOU SEE MY SLIDE?
OKAY, GOOD.
SO I WOULD JUST LIKE TO TAKE
JUST A FEW MINUTES TO TALK A BIT
MORE ABOUT COUNCIL WORKING GROUP
PROCESS.
SO WHAT PROMPTED THE DISCUSSION
ABOUT COUNCIL WORKING GROUPS FOR
US WAS ACTUALLY LISTENING TO
SEVERAL MORE OR LESS IMPROMPTU
OCCURRING DISCUSSIONS DURING
SOME OF OUR MORE RECENT COUNCIL
MEETINGS, AND THAT MADE US HERE
AT NCCIH ASK THE QUESTIONS, YOU
AS COUNCILMEMBERS HAVE SUCH
EXTENSIVE AND RELEVANT EXPERTISE
AS IT RELATES TO THE MISSION OF
NCCIH.
I MEAN, IN THE END, THIS IS THE
REASON WHY WE HAD ASKED YOU IF
YOU WOULD BE WILLING TO SERVE ON
COUNCIL IN THE FIRST PLACE.
BUT WE WERE WONDERING, DO WE
REALLY MAKE OPTIMAL USE OF ALL
THE EXPERTISE THAT YOU BRING TO
THE TABLE WHILE YOU SERVE AS A
COUNCILMEMBER?
AND COINCIDENTALLY AT THE SAME
TIME, WHILE WE HERE AT NCCIH
WERE DISCUSSING THIS QUESTION,
WE WERE ALSO CONTACTED BY SOME
OF YOU ASKING US HOW YOU CAN
BE -- CAN MORE PRODUCTIVELY
CONTRIBUTE TO NCCIH'S MISSION
WHILE YOU SERVE ON COUNCIL.
SO IT IS -- WHERE DOES THIS
LEAVE US?
OKAY.
IF YOU LOOK AT OUR CHARTER, IT
STATES THE FOLLOWING: COUNCIL
WILL ADVICE, ASSIST AND CONSULT
NCCIH ON MATTERS RELATING TO
ACTIVITIES CARRIED OUT BY AND
THROUGH THE CENTER.
THIS IS THEN MORE SPECIFICALLY
STATED AND DESCRIBED IN OUR
COUNCIL OPERATING PROCEDURES.
HERE IT SAYS THAT COUNCIL SERVES
AS A NATIONAL RESOURCE IN
DEVELOPING AND SETTING OF NCCIH
POLICIES AND RESEARCH PRIORI
PRIORITIES, AND ON OCCASION,
SPECIAL WORKING GROUPS MAY BE
FORMED TO ADDRESS CRITICAL
SCIENTIFIC OR POLICY ISSUES THAT
ARE IMPORTANT TO NCCIH AND ITS
CONSTITUENTS.
YOU MIGHT REMEMBER THIS
PARAGRAPH FROM MY PREVIOUS
PRESENTATION AS WE JUST
APPROACHED OUR COUNCIL OPERATING
PROCEDURES A LITTLE WHILE AGO
LOOKING AT THE SECTION, WE
NOTICED THAT RECENTLY, WE
HAVEN'T REALLY MADE USE OF
WORKING GROUPS AS MUCH AND AS
EFFECTIVELY AS WE COULD HAVE,
AND AS WE HAVE DONE SO IN THE
PAST.
I THINK ONE RECENT EXAMPLE WAS A
WORKING GROUP THAT THEN IN THE
END LED TO THE DEVELOPMENT OF
THE RESEARCH ACROSS
COMPLEMENTARY AND INTEGRATIVE
HEALTH INSTITUTIONS VIRTUAL
RESOURCE CENTER NOFO WHICH LOOKS
AT OUR PHYSICIAN SCIENTIST
WORKFORCE.
SO HOW ARE THESE WORKING GROUPS
DEFINED?
THEY SERVE AS FACT FINDING BOD
BODIES THAT GATHER INFORMATION,
AND FOR FINAL DELIBERATIONS BY
COUNCIL.
SO FOLLOWING THE DELIBERATIONS,
THOSE WORKING GROUPS DO REPORT
BACK TO THE FULL MEETING OF THE
COUNCIL, AND THIS WOULD HAPPEN
DURING THE OPEN SESSION OF
COUNCIL.
THESE WORKING GROUPS ARE USUALLY
TEMPORARY IN NATURE.
THEY CAN HAVE A FLEXIBLE NUMBER
OF MEETING TIMES, MAYBE THEY
MIGHT ONLY MEET ONE TIME OR THEY
MIGHT MEET A COUPLE OF TIMES.
PARTICIPANTS MAY BE SELECTED BY
COUNCIL AND A FEDERAL OFFICIAL.
THEY ARE SUPPOSED TO HAVE A
DIVERSE AND BALANCED
PRESENTATION.
THE MATERIAL THAT'S MADE
AVAILABLE AND DISCUSSED IN THESE
MEETINGS ARE STRICTLY
CONFIDENTIAL.
COIs, CONFLICT OF INTEREST
WILL HAVE TO BE ASSESSED.
RECORDS ABOUT THESE MEETINGS ARE
MAINTAINED BY NCCIH, AND
IMPORTANT, THEY DO NOT
PARTICIPATE IN FUNDING
DECISIONS.
SO PARTICIPANTS IN THESE WORKING
GROUPS SHOULD -- COULD BE A
SUBSET OF COUNCIL MEMO WE A COUD
INCLUDE ADDITIONAL EXPERTISE IN
THE FIELD.
SO AFTER SETTING A LITTLE BIT OF
THE GROUNDWORK OR THE FRAMEWORK
ABOUT THESE WORKING GROUPS, THE
QUESTIONS THAT WE WOULD LIKE TO
ASK YOU IS, WOULD YOU BE
INTERESTED IN A MORE ACTIVE USE
OF THESE COUNCIL WORKING GROUPS,
AND IF YES, WHAT TOPICS COULD BE
DISCUSSED OR WOULD YOU SEE AS
BENEFICIAL FOR THESE WORKING
GROUPS?
AND WITH THIS, I STOP SHARING SO
WE CAN ACTUALLY SEE EACH OTHER.
SO, THOUGHTS, IDEAS?
FIRST REACTIONS?
NADJA?
>> MARTINA, THANK YOU.
THIS IS INTERESTING INDEED AND I
LOVE THE IDEA OF BEING INVOLVED
WITH WORKING GROUPS.
AND ONE TOPIC THAT I HAVE -- I
GUESS I WAS SORT OF INSPIRED BY
ATTENDING PREVIOUS COUNCIL
MEETINGS WITH THE IDEA THAT SOME
CONVERSATIONS HAVE BEEN
HAPPENING WITH COUNCIL THAT HAVE
LED TO INITIATIVES DOWN THE LINE
IN VARIOUS CASES, AND I WAS
WONDERING IF THAT WAS SOMETHING
THAT COULD CONTINUE TO BE
HAPPENING.
SO GLAD TO HEAR THAT YOU'RE
THINKING ALONG THOSE LINES.
ONE THING THAT HAS COME TO MY
MIND REPEATEDLY IS THAT WE TALK
ABOUT NATURAL PRODUCT AND WE
HEARD SOME CONVERSATIONS EVEN IN
ONE OF THE LAST PRESENTATIONS
ABOUT PLANT MEDICINES BEING USED
BY INDIGENOUS POPULATIONS AND
INTEREST IN UNDERSTANDING
MECHANISMS OF ACTION IN THOSE
SORT OF THINGS.
THIS HAS OBVIOUSLY BEEN AN AREA
OF RESEARCH FOR NCI FOR A LONG
TIME IN THE RECENT PAST I THINK
IT'S BEEN DIFFICULT TO GET SOME
OF THOSE INNOVATIVE PROPOSALS
THAT ARE DEALING WITH ISSUES
WITH COMPLEX BOTANICALS THAT
MIGHT NOT FIT IN THE FA
PHARMACEUTICAL DEFINITION
THROUGH REVIEW, AND THIS IS A
TOPIC WE'VE TALKED ABOUT MANY
TIMES, PART OF THAT HAS TO DO
WITH THE NATURE OF STUDY
SECTIONS AT CSR, THERE'S A LOT
OF STUDY SECTIONS THAT ARE SET
UP INTERNALLY AT NCCIH AND IT
SEEMS TO WORK BETTER THAT WAY
BUT WE HAVEN'T REALLY HAD THOSE
FOR THESE TYPES OF PROPOSALS IN
THE RECENT PAST.
WE HAVEN'T HAD RFAs BEYOND THE
CANNABIS WORK FOR FOR BOTANICAL
MEDICINES, SO IF THERE WERE
OPPORTUNITY TO HAVE
CONVERSATIONS ABOUT HOW TO CROW
ATE BETTER OPPORTUNITIES THAT
INTERSECTS WITH WHOLE PERSON
HEALTH, COMPLEX BOTANICALS AND
ALSO NATURAL PRODUCTS IN THE
INTERESTS OF NCCIH, HOW TO
CREATE THOSE OPPORTUNITIES, HOW
TO MAKE SURE THAT THOSE THINGS
DO WELL IN REVIEW, I WOULD LOVE
TO BE INVOLVED IN THOSE
CONVERSATIONS.
>> PERFECT.
HELENE, WOULD YOU LIKE TO
COMMENT A LITTLE BIT MORE?
>> VERY QUICKLY, I JUST
WANTED -- BECAUSE I'M SURE THERE
MUST HAVE BEEN A WORKING GROUP
BUT I THINK IT CAME UP LAST TIME
WITH THE WORD SPIRITUALITY.
HAS THAT BEEN RESULTING IN A
FORMAL WORKING GROUP IN TERMS OF
BRINGING THAT INTO THE MISSION
STATEMENTS?
>> HELENE, ACTUALLY IT'S REALLY
EXACTLY THIS IS WHAT REALLY
PROMPTED TO A LARGE PART THE
ENTIRE DISCUSSION THAT WE ARE
HAVING HERE, AND YES, THIS IS
ONE EXAMPLE THAT WE WERE
THINKING ABOUT ON OUR END.
>> WELL, IN THAT CASE, I WOULD
REALLY LIKE TO BE --
>> GUNNAR.
>> THANKS.
I THINK THIS IS A REALLY GREAT
DISCUSSION, AND ONE OF THE
THINGS THAT JUST GOT ME THINKING
ABOUT THE WHOLE SPIRITUALITY
THING BECAUSE I WAS THINKING
THAT'S PROBABLY WHAT PROMPTED
IT, BUT I THINK THAT ARE WHEN TO
BACK AND LISTEN TO THIS
RECORDING AND START TO DEVELOP
MEETING MINUTES, I BET THERE
WILL BE SOME THINGS THAT NONE OF
US SORT OF REMEMBER FROM THIS
MEETING BUT DO COALESCE AROUND
SOMETHING THAT MIGHT BE A WORK
GROUP.
SO I THINK THAT WHOEVER SORT OF
CULLS THROUGH THIS AND THEN
LOOKS FOR THERE MAY BE A TOPIC
OR TWO THAT LOOKS TO BE
APPROPRIATE FOR A WORK GROUP.
SO JUST FROM AN APPROACH
PERSPECTIVE.
AND THEN LASTLY, ONE OF THE
THINGS OF COURSE IS NEAR AND
DEAR TO MY HEART ARE PHYSICIAN
SCIENTISTS, WHICH I THINK
EVERYBODY KNOWS IS KIND OF A
DYING BREED.
I CERTAINLY DIDN'T ANTICIPATE
THAT I WAS GOING TO END UP BEING
A PHYSICIAN SCIENTIST AS A FIRST
YEAR MEDICAL STUDENT, BUT IT
REALLY HAPPENED ORGANICALLY FOR
ME UNTIL I GOT DOWN TO V COME
AND VIRGINIA TECH SO I DID QUITE
A BIT OF EXERCISE IMMUNOLOGY,
SORT OF EX-PHYS TYPE STUFF AND
GOT DOWN TO VCOM AND DID A
FELLOWSHIP IN CLINICAL RESEARCH
WHICH REALLY KIND OF LAUNCHED
ME.
SO I GUESS WHAT I'M THINKING
ABOUT IS, YOU THINK OF THE
TRADITIONAL SORT OF MD/PH.D. OR
DO/PH.D. OR DO/MPH OR THOSE
KINDS OF THINGS BUT I THINK WE
NEED TO THINK OUT OF THE BOX IN
TERMS OF BEING ABLE TO GIVE THE
PHYSICIAN WORKFORCE MAYBE AN
EASIER PATHWAY OR SOME OTHER
TYPE OF PATHWAY TO BECOMING
CLINICIAN RESEARCHERS, AND THEN
REALLY LOOK TO -- BECAUSE AGAIN
IN MY WORLD, IT'S
MULTI-INSTITUTIONAL,
MULTIDISCIPLINARY TEAMS THAT
WIN, THAT DO REALLY GOOD STUFF
THAT MOVE THE NEEDLE.
SO I'D BE INTERESTED IN A WORK
GROUP THAT WOULD LOOK AT WAYS TO
DEVELOP PHYSICIAN SCIENTISTS
THAT AREN'T CURRENTLY BEING DONE
WHERE PEOPLE HAVE TO GO
SOMEWHERE AND DO SOMETHING AS
OPPOSED TO GO SOMEWHERE, DO
SOMETHING FOR A WEEKEND, BEEN BE
ABLE TO PARTICIPATE IN ONLINE
FORUMS LIKE THIS, SELF-DIRECTED
LEARNING OPPORTUNITIES, THOSE
KINDS OF THINGS AND I'M RATTLING
ON HERE BUT THAT WOULD BE
SOMETHING THAT I THINK IS GOING
TO BE IMPORTANT TO THE FUTURE
PHYSICIAN WORKFORCE AND FUTURE
BIOMEDICAL/CLINICAL RESEARCH.
>> OKAY.
THANK YOU.
ANY MORE IDEAS, THOUGHTS,
COMMENTS?
OKAY.
IF NOT, SHOULD WE MOVE ON TO THE
LAST AGENDA ITEM?
>> SURE.
>> OKAY, GOOD.
AS WE ARE COMING TO THE END OF
THE MEETING, I WOULD JUST
LIKE -- I WOULD LIKE TO ANNOUNCE
THAT OUR NEXT COUNCIL MEETING
WILL BE HELD ON MAY 17TH, AND
THIS MEETING WILL BE HELD IN
PERSON.
SO TODAY WE ARE VIRTUAL, NEXT
ONE WILL BE IN PERSON AGAIN.
THE LAST AGENDA ITEM FOR THE
OPEN SESSION IS GENERALLY THE
PUBLIC COMMENT SESSION.
SINCE EVERYBODY IS ATTENDING
VIRTUALLY, IT IS NOT POSSIBLE TO
MAKE IN-PERSON COMMENTS.
THEREFORE, AS FOR THE LAST TWO
ROUNDS, ANY MEMBER OF THE PUBLIC
WHO WISHES TO MAKE A PUBLIC
COMMENT MIGHT DO SO BY SENDING
ME YOUR WRITTEN COMMENTS.
IN THIS CASE, WE HAVE CHANGED
THIS SINCE THE LAST TWO ROUNDS,
WITHIN 15 DAYS BEFORE THE ACTUAL
COUNCIL MEETING.
SO THIS CAN BE DONE EITHER VIA
EMAIL OR HARD COPY LETTER.
YOUR WRITTEN COMMENTS SHOULD BE
LESS THAN 700 WORDS IN LENGTH,
WHICH IS CONSISTENT WITH AROUND
A FIVE-MINUTE ORAL PRESENTATION.
YOUR WRITTEN COMMENT WILL THEN
BE PROVIDED TO COUNCIL VIA THE
ELECTRONIC COUNCIL BOOK IN
ADVANCE OF THE COUNCIL MEETING
AND I WILL ACKNOWLEDGE THE
RECEIPT OF THE COMMENTS WE
RECEIVED FOR COUNCIL DURING THE
OPEN SESSION.
SO FOR THIS ROUND, WE DID NOT
RECEIVE ANY COMMENTS THIS TIME
AROUND.
AS WE'RE GETTING TO THE END OF
THIS JANUARY COUNCIL MEETING, I
WOULD LIKE TO THANK ALL
COUNCILMEMBERS FOR ATTENDING
TODAY.
NCCIH WOULD NOT BE ABLE TO
FULFILL ITS MISSION WITHOUT YOUR
EXPERTISE, YOUR FEEDBACK, AND
YOUR GUIDANCE.
THANK YOU SO MUCH FOR JOINING US
TODAY, AND OFFERING YOUR ADVICE.
ALSO, SPECIAL THANKS GOES TO OUR
COUNCILMEMBERS WHO ARE ROTATING
OFF.
AS WE HAVE MENTIONED BEFORE, WE
WILL BE MISSING YOU AND YOUR
ADVICE.
I WOULD ALSO LIKE TO OFFER MY
SINCEREST THANKS TO ALL OF NCCIH
STAFF.
WITHOUT ALL OF YOUR HELP AND
WILLINGNESS TO MAKE ALL OF THIS
WORK AND COME TOGETHER, WE WOULD
NOT HAVE BEEN ABLE TO HAVE THIS
MEETING HERE TODAY.
AND WITH THIS, I'M HANDING THE
MEETING OVER TO DR. LAPG LANGER
HER CONCLUDING REMARKS.
>> THANK YOU, MARTINA.
THE REASON I HAD MY HAND UP IS
BECAUSE I SAW WOLF MEHLING'S
COMMENT IN THE CHAT ABOUT
FORMER -- OR ADVISORY MEMBERS
MAYBE INTERESTED IN THESE
WORKING GROUPS AND I THINK THAT
IS A GREAT IDEA.
WE HAD ACTUALLY DISCUSSED THAT
BEFORE AND IT WOULD BE A GREAT
WAY TO STAY CONNECTED TO YOU
ALL.
SO, WE'VE REACHED THE END OF OUR
MEETING.
I HOPE YOU AGREE WITH ME THAT
THIS I HAS REALLY BEEN A WONDERL
MEETING.
WE REALLY THANK ALL OF YOU FOR
YOUR GREAT PARTICIPATION IN THE
DISCUSSIONS.
WE CERTAINLY DIDN'T RUN OUT OF
THINGS TO TALK ABOUT, AND I CAN
SEE THAT THE TOPIC WAS THE --
THE TOPICS WERE INSPIRING AND
THIS IS WHAT WE HOPE THESE
MEETINGS ARE.
SO THANK YOU ALL, HAVE A GOOD
REST OF THE DAY, AND I'M NOT
GOING TO SAY SAFE TRAVELS
BECAUSE, YOU KNOW, YOU'RE
HOPEFULLY CLOSE TO HOME.
SO THANK YOU AGAIN, AND WE WILL
SEE YOU IN MAY.
>> OKAY.
SO IF THERE ARE NO FURTHER
COMMENTS, WITH THIS, THE 86TH
MEETING OF THE NCCIH COUNCIL IS
ADJOURNED.
AND I'M REALLY MISSING MY LITTLE
HAMMER THAT I USUALLY HAVE.
SO NEXT TIME.
>> OH, YEAH!
>> THANK YOU ALL.
>> TAKE CARE.
BYE-BYE.
>> YOU WANT TO DO YOUR OWN
DRUMMING THERE, MARTINA.
>> THESE A GOOD IDEA.
>> GREAT MEETING.
THANKS.
>> THANK YOU.