Leaders of longtime Messengers for Health program receive national award

BOZEMAN — The leaders of a longtime collaborative partnership between Montana State University and members of the Apsáalooke (Crow) Nation of rural southeastern Montana have been recognized nationally for their work to promote health equity and social justice.

Messengers for Health co-directors Suzanne Held and Alma McCormick recently received the Robert Wood Johnson Foundation Award for Health Equity Presented by Community-Campus Partnerships for Health. McCormick is a member of the Apsáalooke Nation and Held is a community health professor in the MSU College of Education, Health and Human Development. Messengers for Health – which is also called Messengers – originally focused on culturally appropriate ways to increase cancer screening rates among Apsáalooke women. The partnership has since expanded to multiple topic areas including women’s health, men’s health, healthcare provider cultural competency, healthy relationships and chronic illness self-management.

“We are honored to receive this award as it showcases the power of a true partnership, where all members contribute, and of using the strengths of the community to effect positive change and see significant results,” Held said.

“It has been most rewarding to see the health of my people improved during the time of our partnership and through the work of Messengers for Health,” McCormick said.

Held and McCormick accepted the award Nov. 11 at the annual American Public Health Association meeting in San Diego. It will also be presented to them in Princeton, New Jersey, at the Robert Wood Johnson Foundation's Awards for Health Equity Recognition and Learning event, set for Dec. 11 and 12.

The award highlights the power and potential of community-campus partnerships successfully using systems and policy change needed to overcome the root causes of health, social, environmental and economic inequalities, according to the foundation. It recognizes two key leaders or key individuals – one from the community and one academic partner – who spearhead the success in the area of exemplary partnerships between communities and academic institutions that are striving to achieve health equity and social justice.

Held and McCormick started working together in 1996 on ways to help Crow women get screened for breast and cervical cancer and formed Messengers for Health, a project that was supported by a research grant from the American Cancer Society. To develop their current program, Báa nnilah, McCormick led Messengers for Health community meetings and interviewed community members with chronic illness to listen to their stories and better understand, from within, what makes it easier and what makes it more difficult to manage their conditions. Báa nnilah means the cultural practice of sharing advice with others, often through stories.

The Báa nnilah Project arose from what community members shared in the interviews and involves mentors (Aakbaabaaniilea, the ones who give advice) from within the community who are, themselves, successfully managing chronic illness. Trained and armed with information and culturally based strategies, those mentors lead meetings with other illness sufferers to talk through ways to cope with illness, forge better relationships with health care providers, remain physically active, get adequate nutrition and generally solve problems. The Báa nnilah Project is a collaboration between MSU and Messengers for Health and is currently funded by an approximately $2 million, five-year grant from the National Institutes of Health.

According to Held and McCormick, the Messengers for Health program believes that for health equity to occur, it is necessary to address the root causes of disparities and to locate power in the Apsáalooke people as the arbiters of their own health and their own future.

“This is a systems change approach that has proven to be highly effective,” McCormick said.

“There are extreme differences in health equity in Montana between whites and American Indians, in both general life expectancy and length of survival with chronic illness,” Held added.

Messengers for Health strives to place indigenous voices, epistemologies, outlook, priorities and goals at the center of its research process, McCormick said, and is led by the Apsáalooke Community Advisory Board. The research approach questions Western research assumptions, resulting in innovative new methods that are consonant with Apsáalooke culture, she added. For example, Messengers for Health has developed a method for analyzing qualitative health stories that retains whole stories versus breaking them into pieces.

“Suzanne and I are proud of this research, which is reciprocal, respectful and relevant,” McCormick said.

“Messengers for Health is a great model for future long-term community-based participatory research partnerships, and an example of scholarship that is really making a difference in culturally relevant ways,” said Alison Harmon, dean of the College of Education, Health and Human Development. “I am delighted that the project has gotten national recognition.”

In addition to the Apsáalooke Nation and MSU, Messengers for Health collaborators include many other clinical, academic, governmental and tribal institutions throughout the region, Held said. More information is available at messengersforhealth.org/.

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