Indigenous Peoples and research: self-determination in research governance

Community-engaged artificial intelligence: an upstream, participatory design, development, testing, validation, use and monitoring framework for artificial intelligence and machine learning models in the Alaska Tribal Health System

American Indian and Alaska Native (AI/AN) communities are at a critical juncture in health research, where combining participatory methods with advancements in artificial intelligence and machine learning (AI/ML) can promote equity. Community-based participatory research methods which emerged to help Alaska Native communities navigate the complicated legacy of historical research abuses provide a framework to allow emerging AI/ML technologies to align with their unique world views, community strengths, and healthcare goals. A consortium of researchers (including Alaska Native Tribal Health Consortium, the Center for Alaska Native Health Research at University of Alaska, Fairbanks, Stanford University, Southcentral Foundation, and Maniilaq Association) is using community-engaged AI/ML methods to address air medical ambulance (medevac) utilization in rural communities within the Alaska Tribal Health System (ATHS). This mixed-methods convergent triangulation study uses qualitative and quantitative analyses to develop AI/ML models tailored to community needs, provider concerns, and cultural contexts. Early successes have led to a second funded project to expand community perspectives, pilot models, and address issues of governance and ethics. Using the Ethical, Legal, and Social Implications of Research framework to address implementation of AI/ML in AI/AN communities, this second grant expands community engagement, technical capacity, and creates a body within the ATHS able to provide recommendations about AI/ML security, privacy, governance and policy. These two projects have the potential to provide equitable AI/ML implementation in Alaska Native healthcare and provide a roadmap for researchers and policy makers looking to effect similar change in other AI/AN and marginalized communities.

Trusted partners, community priorities, and data protections: requirements for precision medicine research with Alaska Native peoples

Precision medicine holds promise for improving health care by tailoring disease treatment and prevention efforts to the needs of individual patients. It also raises ethical questions related to equitable distribution of the benefits of precision medicine; data management, including the terms of data ownership, sharing, and security; and, the nature and extent of community engagement in and oversight of research. These questions are particularly salient for minoritized communities that have been harmed by unethical research practices and often deprived the full benefit of advances in medical science. Understanding the perspectives of these communities is essential to the design and conduct of ethical and effective precision medicine research. This study explored perspectives on the acceptability, feasibility, value, and benefits and harms of precision medicine research among Alaska Native and American Indian (ANAI) peoples. We conducted four focus groups with ANAI individuals who receive primary care from a Tribal health organization in Anchorage, Alaska. Participants were willing to engage in precision medicine research provided specific requirements were met. Research must be conducted by the Tribal health organization or another trusted partner, community health priorities must drive the research agenda, and researchers must employ robust data protections to guard against loss of data security and maintain control over data use and access. These requirements work collectively to ensure research benefits and respects Tribal sovereignty. These findings could help inform efforts to design and implement precision medicine research programs tailored to concerns of ANAI peoples.

Resilience Informatics in Public Health: Qualitative Analysis of Conference Proceedings

BACKGROUND

In recent years, public health has confronted 2 formidable challenges: the devastating COVID-19 pandemic and the enduring threat of climate change. The convergence of these crises underscores the urgent need for resilient solutions. Resilience informatics (RI), an emerging discipline at the intersection of informatics and public health, leverages real-time data integration from health systems, environmental monitoring, and technological tools to develop adaptive responses to multifaceted crises. It offers promising avenues for mitigating and adapting to these challenges by proactively identifying vulnerabilities and fostering adaptive capacity in public health systems. Addressing critical questions regarding target audiences, privacy concerns, and scalability is paramount to fostering resilience in the face of evolving health threats.

OBJECTIVE

The University of Arizona held a workshop, titled Resilience Informatics in Public Health, in November 2023 to serve as a pivotal forum for advancing these discussions and catalyzing collaborative efforts within the field. This paper aims to present a qualitative thematic analysis of the findings from this workshop.

METHODS

A purposive sampling strategy was used to invite 40 experts by email from diverse fields, including public health, medicine, weather services, informatics, environmental science, and resilience, to participate in the workshop. The event featured presentations from key experts, followed by group discussions facilitated by experts. The attendees engaged in collaborative reflection and discussion on predetermined questions. Discussions were systematically recorded by University of Arizona students, and qualitative analysis was conducted. A detailed thematic analysis was performed using an inductive approach, supported by MAXQDA software to manage and organize data. Two independent researchers coded the transcripts; discrepancies in coding were resolved through consensus, ensuring a rigorous synthesis of the findings.

RESULTS

The workshop hosted 27 experts at the University of Arizona, 21 (78%) of whom were from public health-related fields. Of these 27 experts, 8 (30%) were from the field of resilience. In addition, participants from governmental agencies, American Indian groups, weather services, and a mobile health organization attended. Qualitative analysis identified major themes, including the potential of RI tools, threats to resilience (eg, health care access, infrastructure, and climate change), challenges with RI tools (eg, usability, funding, and real-time response), and standards for RI tools (eg, technological, logistical, and sociological). The attendees emphasized the importance of equitable access, community engagement, and iterative development in RI projects.

CONCLUSIONS

The RI workshop emphasized the necessity for accessible, user-friendly tools bridging technical knowledge and community needs. The workshop's conclusions provide a road map for future public health resilience, highlighting the need for scalable, culturally sensitive, community-driven interventions. Future directions include focused discussions to yield concrete outputs such as implementation guidelines and tool designs, reshaping public health strategies in the face of emerging threats.

Governance of Indigenous data in open earth systems science

In the age of big data and open science, what processes are needed to follow open science protocols while upholding Indigenous Peoples' rights? The Earth Data Relations Working Group (EDRWG), convened to address this question and envision a research landscape that acknowledges the legacy of extractive practices and embraces new norms across Earth science institutions and open science research. Using the National Ecological Observatory Network (NEON) as an example, the EDRWG recommends actions, applicable across all phases of the data lifecycle, that recognize the sovereign rights of Indigenous Peoples and support better research across all Earth Sciences.

Measuring Wellness Through Indigenous Partnerships: A Scoping Review

Indigenous wellness has been defined in varying contexts by diverse Indigenous Peoples. The existing indicators used to measure wellness are often defined from a Western perspective. Despite the rich conceptualizations of Indigenous wellness, there exists a notable gap in how it can be measured in contemporary contexts through an Indigenous lens. A scoping review methodology with the aim of identifying measures of wellness developed through Indigenous partnerships was carried out. We completed a systematic search in the following electronic databases: PubMed, CINAHL, Psych Info Academic Search Complete, SocIndex, and the Native Health Database. We then carried out a two-stage article screening process to identify eighteen relevant papers. Content analysis was then used to identify (1) the major categories for the partnership contexts utilized in the process for measuring Indigenous wellness and (2) the kinds of measures developed. Five main categories were characterized, including the following: (1) building relationships that uphold Indigenous worldviews is important, (2) a call for co-development protocols that weave multiple worldviews, (3) the need to increase awareness of the limitations in measuring Indigenous wellness, (4) community-specific context is important, and (5) a call for strengths-based indicators. Governments, organizations, and research partners are called upon to support the co-development of meaningful engagement protocols that privilege and reflect Indigenous voices and perspectives when measuring Indigenous wellness.

Advancing microbiome research in Māori populations: insights from recent literature exploring the gut microbiomes of underrepresented and Indigenous peoples

The gut microbiome plays vital roles in human health, including mediating metabolism, immunity, and the gut-brain axis. Many ethnicities remain underrepresented in gut microbiome research, with significant variation between Indigenous and non-Indigenous peoples due to dietary, socioeconomic, health, and urbanization differences. Although research regarding the microbiomes of Indigenous peoples is increasing, Māori microbiome literature is lacking despite widespread inequities that Māori populations face. These inequities likely contribute to gut microbiome differences that exacerbate negative health outcomes. Characterizing the gut microbiomes of underrepresented populations is necessary to inform efforts to address health inequities. However, for microbiome research to be culturally responsible and meaningful, study design must improve to better protect the rights and interests of Indigenous peoples. Here, we discuss barriers to Indigenous participation in research and the role disparities may play in shaping the gut microbiomes of Indigenous peoples, with a particular focus on implications for Māori and areas for improvement.

Scientists and scientific journals should adhere to ethical standards for the use and reporting of data from Indigenous people

Internationally, governments and scientists are bound by legal and treaty rights when working with Indigenous nations. These rights include the right of Indigenous people to control the conduct of science with Indigenous nations. Unfortunately, in some cases, individual scientists and scientific teams working with biological and genetic data collected from Indigenous people have not respected these international rights. Here, we argue that the scientific community should understand and acknowledge the historical harms experienced by Indigenous people under the veil of scientific progress (truth) and implement existing standards for ethical conduct of research and sovereign control of data collected within Indigenous communities (reconciliation). Specifically, we outline the rationale for why scientists, scientific journals and research integrity and institutional review boards/ethics committees should adopt, and be held accountable for upholding, current international standards of Indigenous data sovereignty and ethical use of Indigenous biological samples.

Overcoming human exceptionalism: The role of ethical nature-culture relations in the developmental contexts of indigenous children

Indigenous populations, including American Indians, Alaska Natives, First Nations, and other first peoples worldwide, have been largely overlooked in child development research. This commentary examines how Indigenous relationality intersects with developmental science, advocating for a shift from human exceptionalism to an interconnected relationality among people, land, and more-than-human beings. Drawing from diverse Indigenous knowledge and practices, The Six Pillars to Advance Indigenous Relationality among Children provides frameworks for integrating Indigenous worldviews emphasizing interconnected responsibilities and sustainability. Embracing Indigenous relationality-grounded in respect and reciprocity-dismantles inequitable systems, enhances socioecological well-being, and supports healthy Indigenous child development, fostering responsible relationships with the land and ensuring a sustainable future for generations.

Genetic research with Indigenous Peoples: perspectives on governance and oversight in the US

Introduction

Indigenous Peoples are increasingly exerting governance and oversight over genomic research with citizens of their nations, raising questions about how best to enforce research regulation between American Indian, Alaska Native, and Native Hawaiian peoples and researchers.

Methods

Using a community-engaged research approach, we conducted 42 semi-structured interviews with Tribal leaders, clinicians, researchers, policy makers, and Tribal research review board members about their perspectives on ethical issues related to genetics research with Indigenous Peoples in the US.

Results

We report findings related to (1) considerations for Indigenous governance, (2) institutional relationships upholding sovereignty, (3) expectations for research approvals, and (4) agreements enacting Indigenous governance. Participants described concerns about different ways of exerting oversight, relationships and agreements between Indigenous Peoples and researchers, and gaps that need to be addressed to strengthen existing governance of genomic data.

Discussion

The results will ultimately guide policy-making and development of new strategies for Indigenous Peoples to enforce oversight in research to promote ethically and culturally appropriate research.