Youth Capacity Building and Leadership Through CBPR and Conflict Transformation with the Montagnard Refugee-Origin Community

Community-based participatory research (CBPR) is an increasingly popular framework used for ethical health disparities research and social justice praxis with refugee communities (Ellis et al., 2007; Wallerstein & Duran, 2006). It is anchored by several main pillars, including recognition of the community context, indigenous knowledge, and practices; shared leadership and decision-making; capacity building; and empowerment and transformation for social change (Blumenthal, 2011; Minkler & Wallerstein, 2003; Wallerstein et al., 2005). When applied in real-life scenarios, CBPR fosters mindful and reciprocal relationships by deflating power imbalances and dismantling distrust between mainstream academic researchers (outsiders) and refugee community constituents (insiders) (Tobias et al., 2013).

Participatory Action Research (PAR), from which CBPR derives, has been described as a “decolonizing methodology” that counters social inequities through the emphasis on community members and researchers coproducing knowledge to promote social change (Kia-Keating & Juang, 2022). CBPR includes rigorous approaches to engage community members and reduce power differentials, including scrutiny of community members' and researchers' gains and potentials for harm from the research process, and the accountability of the latter to the former (Kia-Keating & Juang, 2022). Such approaches are key to transformative work with marginalized communities in a societal and institutional climate of structural racism.

In particular, youth from refugee-origin communities within the United States differ markedly from the dominant society in their ethno-history, identity, cultural beliefs, and world views (Reynolds & Bacon, 2018). These differences can heighten youth from refugee-origin communities' vulnerability to adverse mental health outcomes (Frounfelker et al., 2020). However, this also has implications for their potential to act as agents of community empowerment when they are supported through the education process (United Nations High Commissioner for Refugees (UNHCR), 2018). In the United States, there has been more emphasis on supporting refugee youth to adjust to the receiving society's educational expectations and settings (Reynolds & Bacon, 2018), and less on recognizing and developing their cultural and linguistic expertise to bridge mutual gaps with mainstream agencies, resources, and society to empower their communities.

This is where the CBPR pillars—equitable voice, recognizing indigenous knowledge, and community capacity building focus—can be agents of transformation and change. For example, Yoon et al. (2022) used the CBPR approach to engage and examine acculturation, cultural integration, and life satisfaction with South Sudanese refugee youth/young adults formerly known as “the Lost Boys” of Sudan. CBPR facilitated refugee youth storytelling as a way of building their history in the United States, and for affirming their existence and purpose in this new country setting. For Southeast Asian refugee youth engaged in CBPR, the benefits have included expanded skills to conduct youth-centered research, improved oral communication, and increased confidence and empowerment as leaders for social change (Patraporn, 2019).

Conflict transformation (CT) refers to a holistic approach to reconfiguring conflicts into opportunities for positive relationship building and social change (Lederach et al., 2007; Rupesinghe, 1995). It is characteristically defined by its application of nonviolent methods (e.g., dialog, negotiation, and mediation) in addressing and increasing understanding, equality, and respect within social relationships (Frazer & Ghettas, 2013). This makes CT particularly well suited for attending to the complex dimensions of social conflicts within tribal communities with a goal of developing practical and sustainable templates for targeted actions when future conflicts arise (Madden & McQuinn, 2014).

CT as an approach aligns well with CBPR as both focus on relationship building through dialog, negotiated agendas and spaces, and collaboration among its actors. Furthermore, CT (as does CBPR) recognizes and tries to address power imbalances and inequalities by focusing on changing social structures and relationship patterns that exclude community member voices (Lederach, 2003). Taken together, CBPR and CT are an effective conceptual framework and practical approach to addressing the concerns, challenges, and agency of marginalized refugee communities and their youth.

The Montagnards, an indigenous people from the Highlands of Central Vietnam, are not ethnically Vietnamese, but comprise different tribes with multiple cultures and languages. Their name belies the unity it implies since it was a French colonial term (“highlanders”) that referred to where tribes lived (Central Highlands) (Andresen, 1988). The term “Montagnard” describes several individual tribes who lived in proximity to one another at a greater or lesser distance, with varying degrees of interaction. They fought alongside U.S. special forces troops during the Vietnam War and suffered from violence and deprivation. Their villages experienced high levels of retributive persecution and ethnic violence after the war ended.

In 1986, the first small group (200) of Montagnard refugees arrived in the Piedmont Triad (cities of Greensboro, High Point, and Winston-Salem) North Carolina (NC) (Bailey, 2002; Raper, 2009). There are now five major Montagnard tribes in NC (Jarai, Rhade, Bunong, Koho, and Bahnar), each speaking a distinct language. The continued use of the umbrella term “Montagnard” by the U.S. military followed these refugees to America. Their connection with the military yielded sponsorship and support for U.S. resettlement from veterans in NC. This, coupled with efforts of local faith-based organizations and resettlement agencies during the 1990s and 2000s, contributed to the NC establishment of the largest single community of Montagnards (>10,000 individuals) outside of Southeast Asia. Most of this population is concentrated in Greensboro, a city in Guilford County, NC, with a long history of civil rights activism (Bailey, 2002; Corby, 2010).

First-generation Montagnard refugees came from rural and subsistence farming backgrounds (Andresen, 1988). Many had a third grade or lower literacy level (Bailey, 2002), which made the pathway to learning English quite challenging, particularly for preliterate elders (those accustomed to primarily oral communication in tribal languages). This difference in language and culture has resulted in isolation from English-speaking neighbors, limited knowledge of American law, local rules and customs, poor health literacy, limited access to health care, and curtailed employment opportunities for those economically responsible for households (Bailey, 2002). While the reported median family income for Guilford County Asian American families is $63,587 (Cone Health, 2022), this hardly reflects the state of many Montagnard families. There are extreme differences that exist across Asian American subgroup incomes, especially among Southeast Asians of refugee origin who occupy the lowest national Asian American income quintile, $17,743 (Austin, 2022).

The Piedmont Triad boasts about its well-known teaching and academic research institutions, home to social-justice-focused Quaker and United Methodist colleges, two celebrated historically black colleges and universities with significant civil rights history, a minority serving institution, and a community college. Of its three cities, Greensboro has the largest concentration of Montagnards. It has the highest rates of high school graduates (about 90%) and college graduates (about 40%) (U.S. Census, 2017–2021). Despite this, Montagnard youth remain underrepresented and even invisible to most American educators and institutions of higher education in the region because they do not track their ethnic identity, tribal affiliation, or refugee origin. They are also sometimes mistaken for other Asian American subgroups or assumed to be the stereotypical “model minority” quiet high achievers.

Disaggregated enrollment data that show numbers and trends for Montagnard college students do not exist currently. Community leaders indicate that individual Montagnard families, especially a few educated elites, have pushed their children to obtain a college education. However, for these college-going youth, the educational journey is quite often an exceptional and lonely experience, given the difficulty of “fitting in” and explaining to peers who they are. Individual resilience and emotional support from families might see them through navigating the degree-seeking process and graduation. For the rest, the challenges of social integration described above remain. This often results in economic pressures to go straight into low paying jobs rather than seeking higher education or specialized training.

Since 2008, our team has included faculty researchers/mentors and students from area universities and local community researchers/advocates. We have worked extensively with the Montagnard community, where the specific aims are to facilitate community empowerment and agency, highlight their unique history, promote family and community health and wellness, and create awareness about and recognition of community members as experts in their culture, its preservation, language, history, and everyday life. These aims supersede many relationships previously built on resettlement agency goals such as self-sufficiency, acculturation, English language proficiency, and quick employment.

The team's efforts have been less of a single program and more so a series of overlapping and flexible approaches to deliberately redefine our roles and relationships with political and religious leaders, elders, women, youth, and health professionals within the community. They also help to nurture and develop youth into confident, next-generation leaders. Montagnard youth aspirations are often underpromoted because they have few mentors or role models within their own tribal communities. Coming to a state with comparatively few Asians, first- or 1.5-generation Montagnard youth have been trailblazers with no maps, sometimes only partially aware of the insults and racial epithets cast at them, sometimes fully aware.

In 2011, a Montagnard community health leader in the Greensboro area approached area researchers and community advocates for technical assistance with addressing chronic disease prevalence in their community. Of particular concern was the perception of widespread hypertension in family members, even among young adults. The Montagnard Hypertension project evolved in response to this community prioritized concern. This inaugural CBPR project involved collaboration across diverse stakeholders: Montagnard medical professionals (who trained in Vietnam, but cannot practice in the United States), community health workers (mothers and grandmothers), the Women's Learning Group (women attending ESOL classes), tribal elders, church leaders, Montagnard community youth/college students, and non-Montagnard students and faculty researchers/mentors across disciplines in higher education campuses. For the purposes of our project, we operationalized CBPR into a process that could both meet this community where it was, and support the varied community interests, motivations, roles, and development of capacities. Additionally, we implemented strategies best suited for work across three main tribal language groups (Jarai, Rhade, and Bunong), as well as with preliterate and limited-English-proficient (LEP) members and households.

Our CBPR goals were to document much needed baseline data, uncover new information about factors driving the hypertension problem, create additional opportunities for building trust, and better mobilize community resources (i.e., the high school and college age youth who were “natural helpers” and represented highly knowledgeable language and cultural experts across tribal communities). With modest funding through multiple institutional mechanisms, we launched a four-phase interdisciplinary project between 2013 and 2015 which engaged more than 30 college youth. The phased project included (a) the “Hypertension Terminology” project for developing a “dictionary” of parallel Montagnard/English terminology for general health and hypertension; (b) a focus group discussion (FGD) phase to check specialized terminology and confirm community consensus about the problem; (c) the development, approval, and deployment of a culturally relevant and cognitively tested behavioral risk factor survey; and (d) the biological sample and behavioral data collection in households and community settings. Specific details of the research design and data collection process can be found in the original publication (Morrison et al., 2018), which includes Montagnard youth as coauthors.

Our project aimed to build the capacity of Montagnard youth as rising professionals and community leaders by empowering them to understand how research could benefit their community, learn to safeguard community interests and agendas in research partnerships, and how to engage their cultural and language expertise through all steps of the research process. During this project, our team (as described above) trained the student researcher group, which consisted of Montagnard and other college youth (African American, African, Asian, Latinx, mixed race, international, immigrant, refugee, and from low-income backgrounds) in human subjects' protection through institutional IRB certifications and provided instruction on conducting literature searches. We also trained the student researcher group in facilitation of FGDs, their transcription, translation, and analysis, and in survey development, which was guided by the results of literature reviews and the FGDs.

Montagnard youth identified more culturally relevant items and wording for measures of interest, and worked alongside the other students to assemble, assess, adjust, and administer the survey in multigenerational households, with a special concern for elders who were preliterate and/or LEP. For example, the Montagnard students created short videos with simply worded tribal language scripts for the informed consent process with such elders. We trained all students to collect anthropometric (height, weight, and waist circumference) and biological measures (blood pressure, saliva, and hair samples). Montagnard youth practiced collection and measurement activities, using each other as examples to ensure culturally sensitive and respectful data collection encounters with participants. They also trained the other students on the team to implement these sensitive and respectful practices. In many instances, we (the researchers/mentors) yielded to the wisdom of Montagnard youth, given their familiarity with tribal language, cultural customs, and taboos associated with touching the human body. They also coordinated teams for data collection and entry with faculty supervision to foster peer learning and accountability.

As mentors we also provided opportunities for all the students' professional development through service learning, community engagement experiences, financial support for student scholarships, and travel to disseminate findings at local, state, and national conferences. We oversaw internships, independent studies, honors theses, and service-learning as capacity-building vehicles for student-led inquiry and community practice. We counseled youth about career opportunities, especially those that would better serve their community. We wrote letters of recommendation for scholarships, graduate and professional study, and jobs. We celebrated our collective hard work with recognition ceremonies for those graduating or advancing to the next level of professional training. This intense mentorship had direct influence on the young peoples' career and professional development, as well as community leadership trajectories. For example, Montagnard student team members gained achievements such as winning awards for research presentations, admission to graduate and professional programs (e.g., social work and public health), and emerged as senior leaders within local health departments and community nonprofit organizations.

As the project progressed, faculty mentor awareness and understanding of historical and community politics increased. The Montagnards' complex tribal dynamics that stem from identity politics and differences in leadership styles have been heavily shaped by Western and American influences, notably Christian missionaries and the U.S. military. This is not uncommon among refugee-origin communities as leadership is contingent upon the prevailing conditions before and after arrival in the United States. For example, Montagnard community leadership originally included government officials, doctors, teachers, and others who held these former titles while living in Vietnam. However, when they arrived in the United States, their leadership experience was often not formally recognized by the American system, nor did they propose how their experience could be applied in new ways in their new country to help themselves or their community. Thus, their former leadership roles were no longer recognized when they arrived in America.

Some obstacles were obvious for those who were leaders in their professions. For example, U.S. licensure and certification standards require advanced English language skills, strong familiarity with American professional practices and unwritten customs, and financial resources to pass recertification exams. Furthermore, U.S. resettlement policies prioritize employment for individuals almost immediately upon their arrival, coupled with limited and temporary financial support, with no pathway to recertification of credentials acquired overseas. This led to Montagnard doctors, who had been trained in Vietnam medical schools and held leadership positions, working in warehouses and nail shops. Finally, enduring system bias, corrosive mainstream American stereotypes about Asian Americans, and our region's long history of racism and discrimination (e.g., admission of black patients into our local hospital required a Supreme Court case, Simkins v Cone, 1963) remain entrenched obstacles. These, combined with the largely unchallenged social narrative of “Americans rescuing refugees,” have created “collective amnesia” about reasons for the global refugee stream. The history and experience of refugee communities, and the ongoing responsibilities of receiving societies to support and acculturate refugees in the longer term, have resulted in a “quiet neglect” of the needs of resettled refugees in the United States (Yamashita, 2021).

Pastorship and membership in quasi-military associations, especially for Montagnard men and some women who fought alongside U.S. special forces during the Vietnam War, represented two pathways of becoming respected leaders. In the United States, during the long wars in Iraq and Afghanistan, young men who joined the military were highly praised for following in their fathers' and grandfathers' footsteps. Historically, the unifying factor for older and younger Montagnard men's ideas of leadership is their partnership with Americans in the Vietnam War, an event that caused the destruction of almost all their villages, the loss of their ancestral lands, thousands of deaths, and finally, abandonment by the U.S. government as U.S. troops left. Those who were able to flee to the United States represented a tiny fraction of those who made up their villages' leadership. However, in the United States too, the generational divide in notions and goals of leadership persisted.

Next-generation Montagnard youth are often caught in the crossfire of these tensions. By their own indications, the elders and religious leaders in their tribal communities are skeptical of them. Elders hold high expectations of youth fidelity to traditional cultural and familial norms; thus, Montagnard college students must balance or negotiate these high expectations with their own academic, career, and leadership aspirations. Trapped between their elders' expectations and an unsupportive American environment, when given the chance, they candidly discussed these intergenerational disagreements and conflicts with researchers/mentors during the CBPR project debriefing sessions. Such talks were often spontaneous and informal and based on related topics they felt safe and free to expand upon. While they remained committed to participating in the CBPR project, they suggested that we prepare for potential disruptions due to obligation conflicts. For example, if we and the team needed to agree on a common time and meeting place, Montagnard students might explain why they could not meet, perhaps because they were needed back home to help with house cleaning, care of siblings or elders, church, or part-time jobs.

The other college youth who were part of the research team would join in to talk about their lives and generational pressures as a way of demonstrating empathy and solidarity with Montagnard youth. As faculty researchers/mentors, we at first saw these internal issues as threats to successful and reliable project implementation. However, we soon felt that we were not in a position to resolve or eliminate conflicts as outsiders. Therefore these “safe space” exchanges were permitted and even encouraged throughout the data collection process as we learned their value in building trust, team unity, commitment to purpose, and leadership. We also pivoted our attention to developing youth leadership competencies around the use of time-tested CT approaches (dialog, negotiation, and mediation) with their elders during the CBPR project.

For example, in partnership with faculty at other area colleges, and with guidance from more mature Montagnard young adults, we organized an intergenerational gathering in a large banquet room of a local restaurant that was frequented by Montagnard families. Each elder was seated with a small group of Montagnard and other college youth from the research team for more intimate dialog during the meal. Faculty mentors then facilitated an open dialog between Montagnard youth and key elders across tribal communities. Youth prepared and read short speeches that (a) emphasized respect and gratitude for elder contributions and sacrifices, (b) outlined CT strategies for intergenerational trust building and collaboration, and (c) expressed commitment to cultural preservation.

Within this negotiated mediation space, each elder candidly spoke about both their appreciation and concerns for youth. They primarily worried about youth inclination and capacity to continue in helping roles with situations impacting Montagnard elders and families. For example, families continued to see chronic medical bills significantly impact household stability and well-being. Elders needed help from their linguistically and technologically savvy youth with negotiating these costs and handling health payment systems. Non-Montagnard youth acted as observers and witnesses as is common in these processes. At the end of the CT dialog, we found ourselves championing youth leadership for the community education and outreach work that accompanied CBPR, impressing upon elders the continued need for their shared wisdom. As nonaligned outsiders, we offered advice and support that we hoped would reduce future intergenerational disputes and promote trust building for community action.

Although the Montagnard Hypertension project has since concluded, youth involvement and leadership in health-related CBPR and other collaborative health initiatives remain strong across our ongoing academic-refugee community partnerships and within our region. In fact, in 2015, Montagnard college students and working youth from different tribal backgrounds, and across local educational institutions in Guilford County NC, started the Montagnard American Organization (MAO) with the intention of (a) breaking away from the original community nonprofit, Montagnard Dega Association (MDA) that had been started by their elders in the 1980s and (b) unifying Montagnard youth across language, tribal, and church affiliation. MAO's inaugural leader (who came to the United States in her early teens) was instrumental in coordinating student research teams for survey data collection during our CBPR project. During her role as a student researcher, she was an important influencer to younger Montagnards just beginning their college studies and uncertain about their student status in the community. She graduated with a Bachelors in Social Work and joined the MDA main organization as a program coordinator. She later completed her Masters in Social Work, successfully obtained her Clinical Social Work licensure, and most recently became MDA's Executive Director (ED) when the original ED retired after 35 years of serving in that role.

The MAO has since transitioned to being the youth branch of the MDA, with emphasis on community involvement, cultural pride and preservation, job and career planning, training and education, college readiness and application assistance, and overall successful life skills. MAO youth leaders have now charted a way forward in times of crisis, as seen through more recent youth mobilization and deployment of resources to address COVID-19 challenges across tribal communities. As research mentors to more than 45+ college students, we recognize that community context, as well as family and intergenerational support, all contribute to successful and socially engaged youth. If Montagnard youth are to thrive, then we as researchers/mentors must continue to offer practical and feasible mechanisms such as CBPR and CT through which leadership and capacity for social action and change among refugee-origin communities can be enacted.