October Public Health Spotlight
Office of the Secretary of Health
Mission: The Public Health Spotlight promotes the work of community health leaders and researchers across the state of Washington.
This month we’re lucky to be spotlighting Dr. Kait Hirchak, Assistant Professor in the Department of Community and Behavioral Health in the Elson S. Floyd College of Medicine at Washington State University. Dr. Hirchak’s passion is culturally re-centering evidence-based treatments, and her research particularly focuses on community health and treatment in Tribal communities. Dr. Hirchak’s academic credentials have deep Washington roots; she holds a BA in Native American Studies from The Evergreen State College, and both an MHPA in Health Policy and Administration and PhD in Prevention Science from Washington State University. Before her current position, she was a postdoctoral fellow in the Center on Alcohol, Substance Use And Addictions (CASAA) at the University of New Mexico. Read on to learn more!
What got you interested in public health?
Living back home on the reservation led to a fundamental transformation in my beliefs. As a descendant of the Eastern Shoshone Tribe, I came to appreciate my ancestors’ and American Indian and Alaska Native (AI/AN) communities’ strengths and values. These include dignity and reverence for all living beings, with our lands at the center. Related, I realized that changes in policy to address AI/AN health inequities needed to consider the cultural and social values of the community to effectively revitalize health and well-living. It was when I worked for the Tribal health department, sitting in the sacred talking circle, listening to the struggle, empowerment, and hope of those in recovery from substance use disorders, that I became passionate about addressing the substance use-related health inequities within my community and among Indigenous communities more generally.
Can you tell me about your work?
For 15 years, I have partnered with AI/AN communities to support efforts related to health equity and well-being. I’m particularly interested in health policy, assessing alcohol and substance use disorder interventions among AI/AN communities, and culturally centering evidence-based interventions. I’m currently culturally and developmentally adapting contingency management (a treatment approach that provides incentives for abstinence from substances to encourage behavior change) among 18–29-year-olds in partnership with a rural reservation outpatient treatment center. We have also partnered with Tribal communities to examine the impacts of COVID-19 on delivery and access of medications for opioid use disorder among AI/AN providers and adults in the PNW and are really starting to analyze those qualitative data now. Highlights include the importance of telemedicine in access to care but also the challenges for some communities, including the impact on social connection and cultural engagement.
What’s one accomplishment of you or your organization you’re particularly proud of?
Contingency management has decades of evidence as a treatment for substance use disorders but until recently, has been very underutilized in real-world settings. Members of the PRISM Team have been involved in the policy efforts to broaden the availability of contingency management at the state and national level. Through our training, implementation and partnership efforts, WA and MT have included contingency management as a part of their 1115 demonstration waivers for Medicaid, making it a Medicaid covered service. We have also been a part of a federal committee and national technical assistance and training initiatives. These efforts have focused on addressing regulatory barriers and developing the infrastructure so that contingency management can be more accessible for AI/AN communities who are interested in this treatment option.
Please complete this sentence: Healthy communities…
… are value-centered, know their strengths and culture, and have the tools to thrive.
What’s one piece of advice you have for someone wanting to pursue a life in public health?
Relationship building and being a good relative is everything. Making connections with people and emphasizing reciprocity (I take care of you, you take care of me) to build trust is one of the many things that makes this work meaningful.
What’s your favorite place in Washington state?
The incredibly beautiful traditional mud bay fishing site of the Squaxin Island Tribe at the head of Eld Inlet watershed in the Mud Bay area. Translated from Squaxin it is called the “Gathering Place.” It has and will always be a harvesting and processing site of the Squaxin people.
Where can people find you or your organization?
https://www.prismcollab.org/circle-collab
@WSU_PRISMCollab
