Utilization of the Native American Talking Circle to Teach Incident Command System to Tribal Community Health Representatives

Abstract

The public health workforce is diverse and encompasses a wide range of professions. For tribal communities, the Community Health Representative (CHR) is a public health paraprofessional whose role as a community health educator and health advocate has expanded to become an integral part of the health delivery system of most tribes. CHRs possess a unique set of skills and cultural awareness that make them an essential first responder on tribal land. As a result of their distinctive qualities they have the capability of effectively mobilizing communities during times of crisis and can have a significant impact on the communities' response to a local incident. Although public health emergency preparedness training is a priority of federal, state, local and tribal public health agencies, much of the training currently available is not tailored to meet the unique traits of CHRs. Much of the emergency preparedness training is standardized, such as the Federal Emergency Management Agency (FEMA) Training Programs, and does not take into account the inherent cultural traditions of some of the intended target audience. This paper reports on the use of the Native American Talking Circle format as a culturally appropriate method to teach the Incident Command System (ICS). The results of the evaluation suggest the talking format circle is well received and can significantly improve the understanding of ICS roles. The limitations of the assessment instrument and the cultural adaptations at producing changes in the understanding of ICS history and concepts are discussed. Possible solutions to these limitations are provided.

TheUnitedStates' Experience with the Incident Command System: What We Think We Know and What We Need to Know More About

“…Yet, exposure is too abstract a notion by itself. The ICS research suggests that the individuals involved in response must understand ICS (Branum et al., ; Buck et al., ; Crichton, Lauche, & Flin, ; Granillo et al., ; Lutz & Lindell, ; Moynihan, 2009a, p. 904), have had significant training in the system (Branum et al., ; Buck et al., ; Crichton et al., ; Granillo et al., ; Lutz & Lindell, ; Moynihan, 2009a, p. 903), and significant experience with ICS through exercises and/or previous response efforts (Branum et al., ; Buck et al., ; Crichton et al., ; Granillo et al., ; Lutz & Lindell, ; Moynihan, 2009a, p. 903) for the system to be most useful.…”

“…For the organization to contribute positively to ICS usefulness, it appears that ICS must be accepted outside of administration and management of the organization – throughout the entire organization (Thomas, Hsu, Kim, Colli, Arana, & Green, ). Training of employees throughout the organization is also critical (Lutz & Lindell, ; Buck et al., ; Moynihan, 2009a; Thomas et al., ); and, the training must be culturally appropriate for the system to be adopted in a meaningful way (Granillo et al., ). Beyond training, the extent to which organizations have prepared a pre‐incident plan that incorporates ICS (Branum et al., ; Thomas et al., ), exercised that plan (Thomas et al., ), and evaluated its performance using ICS after exercises (Thomas et al., ) is important to understanding the ability of individual organizations to contribute to ICS usefulness in response.…”

“…Granillo et al. () have suggested that there must also be an emergency management orientation within the surrounding culture.…”

“…appears predicated, in part, on a value system that is clearly defined and almost completely accepted' (p. 1295). Regardless, the ICS research suggests it is critical that all participating individuals accept, or buy-into, use of the system (Bigley & Roberts, 2001;Buck et al, 2006;Granillo, Renger, Wakelee, & Burgess, 2010). Arnold, O'Brien, Walsh, Ersoy, and Rodoplu (2001) suggest that participating individuals must have been exposed to the system prior to participating in a response for the system to work.…”

“…In addition to the many pre-and per-response variables discussed to this point, variables related to the local area where ICS is being used may also be relevant. Granillo et al (2010) have suggested that there must also be an emergency management orientation within the surrounding culture.…”