RESUMEN
Tribal Nations experience substance misuse at high rates often attributed to historical and contemporary traumas. In response, several Tribal Nations are addressing these issues through efforts to promote recovery and prevention to substance misuse. Study objectives were to partner with a Tribal Nation to develop a study to explore factors that contribute to the wellbeing of families to children with prenatal substance exposure and disseminate findings that can be translated back into the community. We applied Community-based participatory research (CBPR), strengths-based, and community-driven approaches during this two-year study development phase. We experienced challenges and identified solutions to partnering with one Tribal Nation on an epidemiological mixed-methods study centered on families with children that have prenatal substance exposure. Key inputs were becoming familiarizing with the community setting, structural supports for CBPR research, incorporating Indigenous CBPR principles, and developing a Community Advisory Team. We successfully collaborated with the Confederated Salish Kootenai Tribes Early Childhood Services program to develop a robust study design and a dissemination plan to ensure translation of study findings to the community. The robust study design consisted of common themes specific to a highly stigmatized study population, substance-abusing pregnant women, to protect participant confidentiality. Research alignment with community goals, allotting meaningful time to develop a research partnership, and incorporating culturally sensitive and community-relevant measures contributed to the successful development of an effective and rigorous study to better serve the Tribal Nation on addressing substance misuse.
RESUMEN
BACKGROUND: Asthma is an increasingly common chronic disease among children, and data point toward a complex mechanism involving genetic, environmental and epigenetic factors. Epigenetic modifications such as DNA hypo- or hyper-methylation have been shown to occur in response to environmental exposures including dietary nutrients. METHODS: Within the context of the asthma randomized trial of indoor wood smoke (ARTIS) study, we investigated relationships between diet, asthma health measures, and DNA methylation. Asthma health measures included a quality of life instrument, diurnal peak flow variability (dPFV) and forced expiratory volume in the first second (FEV1). Dietary intake was assessed with a food frequency questionnaire. Methylation levels of LINE-1 repetitive element and two promoter CpG sites for interferon gamma (IFNγ, -186 and -54) from buccal cell DNA were measured using pyrosequencing assays. RESULTS: Data were collected on 32 children with asthma living in western Montana who were recruited to the ARTIS study. Selenium and several methyl donor dietary nutrients were positively associated with the asthma quality of life measure. Intake of methyl donating nutrients including folate was positively associated LINE-1 methylation and negatively associated with IFNγ CpG-186. Higher levels of LINE-1 methylation were associated with greater dPFV. CONCLUSION: We identified several nutrients that were associated with improved quality of life measures among children with asthma. The IFNγ promoter CpG site -186 but not -54 was associated with the intake of selected dietary nutrients. However, in this small population of children with asthma, the IFNγ promoter CpG sites were not associated with respiratory health measures so it remains unclear through which epigenetic mechanism these nutrients are impacting the quality of life measure. These findings add to the evidence that dietary nutrients, particularly foods containing methyl donors, may be important for epigenetic regulation as it pertains to the control of asthma. Trial registration ClincialTrials.gov NCT00807183. Registered 10 December 2008.