Research Capacity Strengthening in American Samoa: Fa'avaeina le Fa'atelega o le Tomai Sa'ili'ili i Amerika Samoa

Va'atausili Tofaeono, Lana Sue I Ka'opua, Angela Sy, Tyran Terada, Rachelann Taliloa-Vai Purcell, Salote Aoelua-Fanene, Katherine Tong, Victor Tofaeono, Tofoipupu Unutoa-Mageo, Luana Scanlan, Kevin Cassel, Adelaida Rosario, Va'atausili Tofaeono, Lana Sue I Ka'opua, Angela Sy, Tyran Terada, Rachelann Taliloa-Vai Purcell, Salote Aoelua-Fanene, Katherine Tong, Victor Tofaeono, Tofoipupu Unutoa-Mageo, Luana Scanlan, Kevin Cassel, Adelaida Rosario

Abstract

Capacity-building partnerships are central to the sustainable development goals (SDGs), the UN's blueprint for achieving global health equity. The UN Permanent Forum on Indigenous Issues endorses the SDG and underscores the need for global partnerships that respect local leadership and culture. Innovations that weave or integrate Indigenous and Western knowledges are emphasised. These recommendations guided the INdigenous Samoan Partnership to Initiate Research Excellence (INSPIRE). INSPIRE is led by investigators from American Samoa and supported by US co-investigators. In project year one, INSPIRE queried: What weaving approaches are feasible for promoting community access to INSPIRE's research hub and for training Indigenous researchers? Weaving procedures involved interlacing Samoan and Western knowledges. Cultural tailoring strategies were used to customise communications. Formative evaluation suggests the feasibility of INSPIRE's efforts. Evidential tailoring provided information on American Samoa (A.S.) social determinants of health; trainees indicated increased research commitment. Linguistic and sociocultural relevance tailoring were positively received; trainees reported increased interest in research praxis and initiated an A.S. research capacity-strengthening model. Social work assured knowledge parity in development/delivery of the training curriculum and culturally safe discussions on social determinants of health, territorial status and Samoan survivance. Findings are context-specific yet offer considerations for capacity-strengthening partnerships seeking to advance health equity.

Keywords: American Samoa; US territories; culture; health disparities; research capacity; social determinants of health.

© The Author(s) 2019. Published by Oxford University Press on behalf of The British Association of Social Workers.

Figures

Figure 1
Figure 1
INSPIRE Logo: decided by the research cohort, the logo represents the collaboration between the partnering agencies: American Samoa Community Cancer Coalition, University of Hawaii, and Vanguard University (American Samoa Community Cancer Coalition, 2016).
Figure 2
Figure 2
Le Fale o So’ofa’atasiga: Le fa’avae (foundation) is built on values of tomai saili’ili (knowledge-seeking, research), service leadership to aiga potopoto (community) and fa’asamoa (Samoan culture). As a collectivist culture, values of felagoglagoma’i (cooperation) and fa’asoa (sharing) are emphasised. Pou (pillars) of the house represent learning strategies, including va’ai (observing), fa’aloga (listening), talanoaina (discussing), fa’aali (using/applying knowledge). Le taualuga (roof) symbolises ola fa’aleagaga (life according to the Spirit, faith). Spirituality covers the place where Indigenous Samoan research is advanced. It ensures the cultural safety necessary for weaving all ways of knowing. Advances in culturally relevant health innovations thus are potentiated.

References

    1. American Samoa Community Cancer Coalition (2013) ‘American Samoa Comprehensive Cancer Control Plan 2007–2012’, available online at: (accessed January 23, 2018).
    1. American Samoa's Comprehensive Economic Development Strategy (2006) ‘Pago Pago, American Samoa’, Department of Commerce, American Samoa Government.
    1. American Samoa Department of Health (2013) ‘American Samoa behavioral risk factor surveillance system – fact sheet on colorectal cancer screening’, Pago Pago, American Samoa.
    1. American Samoa Government (2018) ‘Samoan culture and customs. Fa’a Samoa’, available online at: (accessed January 23, 2018).
    1. American Samoa Historic Preservation Office (2018) ‘Publications’, available online at: (accessed January 23, 2018).
    1. Aoelua-Fanene S. V. (2017) Cultural practices to reduce non-communicable diseases in American Samoa (doctoral Dissertation). Argosy University.
    1. Campbell P., Burnaby B. (2001) Participatory Practices in Adult Education, Mahwah, N.J, Lawrence Erlbaum Associates.
    1. Correia D. (2009) ‘ Making destiny manifest: United States territorial expansion and the dispossession of two Mexican property claims in New Mexico’, Journal of Historical Geography, 35(1), pp. 87–103.
    1. Cottle A. L. (1995) ‘ Silent citizens: United States territorial residents and the right to vote in presidential elections’, University of Chicago Legal Forum, 1995(11), pp. 315–38.
    1. Country Meters (2018) ‘Samoa Population’, available online at: (accessed January 23, 2018).
    1. Cultural Survival (2018) ‘What do the Sustainable Development Goals mean for indigenous peoples?’, available online at: -development-goals-mean-indigenous-peoples (assessed December 18, 2018).
    1. Essence on Health Research (2014) ‘Seven principles for strengthening research capacity in low- and middle-income countries’, available online at: (accessed January 23, 2018).
    1. Ford C. L., Airhihenbuwa C. O. (2010) ‘ The public health critical race methodology: praxis for anti-racism research’, Social Science & Medicine, 71, 1390–8.
    1. Friedman B. (2017) The Research Toolkit: Problem-Solving Processes for the Social Sciences, San Diego, Cognella Academic Publishing.
    1. Grattan F. (1985) An Introduction to Samoan Custom, Papakura, McMillan.
    1. Ife J. (2001) ‘ Local and global practice: Relocating social work as a human rights profession in the new global order’, European Journal of Social Work , 4(1), pp. 5–15.
    1. Jayasooria D. (2016) ‘ Sustainable Development Goals and social work: Opportunities and challenges for social work practice in Malaysia’, Journal of Human Rights and Social Work , 1(1), pp. 19–29.
    1. Ka‘opua L. S. I., Diaz T. P., Park S. H., Bowen T., Patrick K., Tamang S., Braun K. L. (2014) ‘ Colorectal cancer screening at the nexus of HIV, minority statuses, and cultural safety’, American Journal of Health Education, 45(1), pp. 42–51.
    1. Ka‘opua L. S., White S. F., Rochester P. F., Holden D. J. (2011a) ‘ Improving integration and coordination of funding, technical assistance, and reporting/data collection: Recommendations from CDC and USAPI stakeholders’, Pacific Health Dialog, 16(2), 30–40.
    1. Ka‘opua L. S., Park S. H., Ward M. E., Braun K. L. (2011b) ‘ Testing the feasibility of a culturally tailored breast cancer screening intervention with Native Hawaiian women in rural churches’, Health & Social Work, 36(1), pp. 55–68.
    1. Ka‘opua L. S., Tamang S., Dillard A., Kekauoha B. P. (2017) ‘ Decolonizing knowledge development in health research. Cultural safety through the lens of Hawaiian Homestead residents’, Journal of Indigenous Social Development, 5(2), pp. 20–42.
    1. Ka‘opua L. S., Tofaeono J. F., Park S. H., Scanlan L. M. Y., Ward M. E., Tofaeono V. W., Foifua S. J. (2010) ‘ Developing Tautai Lavea’i, a breast cancer patient navigation program in American Samoa’, Journal of Indigenous Voices in Social Work, 1(2), pp. 1–20.
    1. Lesa R. (1981) Learning Style of Samoan Students (Doctoral Dissertation), Provo, Utah, Brigham Young University.
    1. Milner G. B. (1993) Samoan Dictionary, Auckland, Pasifika Press.
    1. Morrison S. (2013) ‘ Foreign in a domestic sense: American Samoan and the last U.S. Nationals’, Hastings Constitutional Law Quarterly, 41(1), pp. 71–150.
    1. Mulitalo-Lauta P. (2000) Faasamoa and Social Work Within the New Zealand Context, Palmerston North, Dunmore Press.
    1. Office of Disease Prevention and Health Promotion (2016) ‘Cancer, Healthy People 2020’, available online at: (accessed January 23, 2018).
    1. One Samoana (2018) ‘Samoan culture’, available online at: (accessed January 23, 2018).
    1. Osman W. (2012) ‘Economic structure of American Samoa, Commonwealth of Northern Mariana Islands, United States Department of the Interior (DOI) Assistant Secretary, Insular Areas Office of Insular Affairs (OIA)’, available online at: (accessed January 23, 2018).
    1. Palafox N. A., Hixon A. L. (2011) ‘ Health consequences of disparity: The US affiliated Pacific Islands’, Australasian Psychiatry, 19(1_suppl), pp. S84–S89.
    1. Polynesian Voyaging Society and Kawaharada D. (2010), ‘The Settlement of Polynesia, Part I’, available online at: (accessed January 23, 2018).
    1. Pulotu-Endemann F. K. (2001) ‘Fonofale Model of Health’, available online at: (accessed January 23, 2018).
    1. Rodriguez-Vila O., Nuti S., Krumholz H. (2014) ‘ Healthcare disparities affecting Americans in the US territories: A century-old dilemma’, The American Journal of Medicine, 130(2), pp. 39–42.
    1. Schuftan C. (2015) ‘Denouncing foreign aid using the west lectures the rest dynamic’, available online at: (accessed December 18, 2018).
    1. Seiuli B. M. S. (2012) ‘ Uputaua: A therapeutic approach to researching Samoan communities’, The Australian Psychological Society, 24(1), pp. 24–37.
    1. Sitthi-amorn C., Somrongthong R. (2000) ‘ Strengthening health research capacity in developing countries: a critical element for achieving health equity’, BMJ, 321(7264), pp. 813–7.
    1. Stayman A. P. (2009) ‘U.S. territorial policy trends and current challenges’, Pacific Islands Policy, Honolulu, East-West Center.
    1. Tamasese K., Peteru C., Waldegrave C., Bush A. (2005) ‘ Ole taeao afua, the new morning: a qualitative investigation into Samoan perspectives on mental health and culturally appropriate services’, Australian & New Zealand Journal of Psychiatry, 39(4), pp. 300–9.
    1. Truell R., Jones D. R. (2012) ‘ The global agenda for social work and social development: a place to link together and be effective in a globalized world’, International Social Work, 55(4), pp. 454–72.
    1. Tulafono T, Interior, Insular Affairs, Inter-Agency (2012) ‘Statement of Governor Togiola T.A. Tulafono to the Department of Council’, available online at: (accessed January 23, 2018).
    1. United Nations Department of Economic and Social Affairs (2014) Partnership Briefs for Small Island States, New York, NY: United Nations.
    1. United Nations Department of Economic and Social Affairs (2018) available online at: (accessed December 18, 2018).
    1. United Nations Division for Sustainable Development (2018) Transforming Our World: The 2030 Agenda for Sustainable Development, New York, NY: United Nations.
    1. U.S. Census Bureau Citizens’ report: FY (2010) Summary of Performance and Financial Results, Washington, DC: U.S. Census; 2010.
    1. U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services (CMS) (2016) ‘National health expenditures 2016 highlights’, available online at: (accessed January 23, 2018).
    1. U.S. Department of Health and Human Services, U.S. Preventative Services Task Force (2015) ‘Final update summary: colorectal cancer screening’, available online at: (accessed January 23, 2018).
    1. U.S. Department of the Interior (DOI), Office of Insular Affairs (OIA) (2008) ‘Census issues in the territories’, available online at: (accessed January 23, 2018).
    1. U.S. Department of the Interior (DOI), Office of Insular Affairs (OIA) (2018) ‘American Samoa’, available at: (accessed January 23, 2018).
    1. Health and Human Services, U.S. Preventative Services Task Force (2015) ‘Final update summary: colorectal cancer screening’, available online at: (accessed January 23, 2018).
    1. Vizenor G. (2008) Survivance: Narratives of Native Presence, Lincoln, NE, University of Nebraska Press.
    1. World Health Organization (WHO) (2018) ‘Poverty and social determinants’, available online at: (accessed January 23, 2018).

Source: PubMed

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