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Meghani A, Sharma M, Singh T, Dastidar SG, Dhawan V, Kanagat N, Gupta A, Bhatnagar A, Singh K, Shearer JC, Soni GK. Enhancing COVID-19 Vaccine Uptake among Tribal Communities: A Case Study on Program Implementation Experiences from Jharkhand and Chhattisgarh States, India. Vaccines (Basel) 2024; 12:463. [PMID: 38793714 PMCID: PMC11125841 DOI: 10.3390/vaccines12050463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/13/2024] [Accepted: 04/19/2024] [Indexed: 05/26/2024] Open
Abstract
Tribal populations in India have health care challenges marked by limited access due to geographical distance, historical isolation, cultural differences, and low social stratification, and that result in weaker health indicators compared to the general population. During the pandemic, Tribal districts consistently reported lower COVID-19 vaccination coverage than non-Tribal districts. We assessed the MOMENTUM Routine Immunization Transformation and Equity (the project) strategy, which aimed to increase access to and uptake of COVID-19 vaccines among Tribal populations in Chhattisgarh and Jharkhand using the reach, effectiveness, adoption, implementation, and maintenance framework. We designed a qualitative explanatory case study and conducted 90 focus group discussions and in-depth interviews with Tribal populations, community-based nongovernmental organizations that worked with district health authorities to implement the interventions, and other stakeholders such as government and community groups. The active involvement of community leaders, targeted counseling, community gatherings, and door-to-door visits appeared to increase vaccine awareness and assuage concerns about its safety and efficacy. Key adaptations such as conducting evening vaccine awareness activities, holding vaccine sessions at flexible times and sites, and modifying messaging for booster doses appeared to encourage vaccine uptake among Tribal populations. While we used project resources to mitigate financial and supply constraints where they arose, sustaining long-term uptake of project interventions appears dependent on continued funding and ongoing political support.
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Affiliation(s)
| | - Manjula Sharma
- John Snow India Pvt. Ltd., Delhi 110070, India; (M.S.); (T.S.); (S.G.D.); (A.G.); (A.B.); (G.K.S.)
| | - Tanya Singh
- John Snow India Pvt. Ltd., Delhi 110070, India; (M.S.); (T.S.); (S.G.D.); (A.G.); (A.B.); (G.K.S.)
| | - Sourav Ghosh Dastidar
- John Snow India Pvt. Ltd., Delhi 110070, India; (M.S.); (T.S.); (S.G.D.); (A.G.); (A.B.); (G.K.S.)
| | - Veena Dhawan
- Ministry of Health & Family Welfare, Government of India, New Delhi 110011, India;
| | | | - Anil Gupta
- John Snow India Pvt. Ltd., Delhi 110070, India; (M.S.); (T.S.); (S.G.D.); (A.G.); (A.B.); (G.K.S.)
| | - Anumegha Bhatnagar
- John Snow India Pvt. Ltd., Delhi 110070, India; (M.S.); (T.S.); (S.G.D.); (A.G.); (A.B.); (G.K.S.)
| | - Kapil Singh
- World Health Organization, New Delhi 110011, India;
| | | | - Gopal Krishna Soni
- John Snow India Pvt. Ltd., Delhi 110070, India; (M.S.); (T.S.); (S.G.D.); (A.G.); (A.B.); (G.K.S.)
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2
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Bartkowski JP, Klee K, Xu X. Youth Suicide Prevention Programming among the Mississippi Band of Choctaw Indians: Effects of the Lifelines Student Curriculum. CHILDREN (BASEL, SWITZERLAND) 2024; 11:488. [PMID: 38671705 PMCID: PMC11049181 DOI: 10.3390/children11040488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Abstract
Suicide continues to be a leading cause of mortality for young people. Given persistent intersecting forms of disadvantage, Native American adolescents are especially vulnerable to mental health adversities and other suicide risk factors. The Mississippi Band of Choctaw Indians (MBCI) implemented the Choctaw Youth Resilience Initiative (CYRI), a five-year SAMHSA-funded project that began in 2019. This study uses Choctaw student pre-test/post-test survey data to examine the effectiveness of the Hazelden Lifelines Suicide Prevention Training curriculum for youth. A lagged post-test design was used, whereby post-surveys were administered at least one month after program completion. Several intriguing results were observed. First, the lagged post-test model was subject to some pre-to-post attrition, although such attrition was comparable to a standard pre/post design. Second, analyses of completed surveys using means indicated various beneficial effects associated with the Lifelines curriculum implementation. The greatest benefit of the program was a significant change in student perceptions concerning school readiness in response to a suicidal event. Some opportunities for program improvement were also observed. Our study sheds new light on suicide prevention training programs that can be adapted according to Native American youth culture. Program implementation and evaluation implications are discussed in light of these findings.
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Affiliation(s)
- John P. Bartkowski
- Department of Sociology and Demography, University of Texas at San Antonio, San Antonio, TX 78249, USA;
| | - Katherine Klee
- Bartkowski & Associates Research Team, San Antonio, TX 78258, USA;
| | - Xiaohe Xu
- Department of Sociology and Demography, University of Texas at San Antonio, San Antonio, TX 78249, USA;
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3
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Bartkowski JP, Klee K, Xu X. Expanding the Question-Persuade-Refer (QPR) Evidence Base: Youth Suicide Prevention among the Mississippi Band of Choctaw Indians. Healthcare (Basel) 2024; 12:834. [PMID: 38667595 PMCID: PMC11050565 DOI: 10.3390/healthcare12080834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/28/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Youth suicide risks have been on the rise or persistently elevated for decades, and Native American communities are especially vulnerable. This study provides a promising framework for suicide prevention among underserved populations in the U.S., especially Native American communities in states lacking strong suicide prevention supports. Our investigation reports the evaluation results of the Question-Persuade-Refer (QPR) gatekeeper training program, a key component of the SAMHSA-funded Choctaw Youth Resilience Initiative (CYRI) implemented by the Mississippi Band of Choctaw Indians (MBCI). QPR trains adult gatekeepers to identify youth at risk of suicide and refer them to certified mental health service providers. Standardized QPR pre-test and post-test training surveys were administered at in-person trainings delivered to youth-serving MBCI organization leaders and staff. Statistical analyses of all survey items indicate that QPR gatekeeper trainings significantly enhanced the knowledge of prevention practices and risk identification skills for the MBCI trainees. The robust evidence of positive changes revealed in this study suggests that QPR can be an effective suicide prevention program for underserved minority communities, especially Native American populations in rural states where suicide is a persistent and leading cause of mortality.
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Affiliation(s)
- John P. Bartkowski
- Department of Sociology and Demography, University of Texas at San Antonio, San Antonio, TX 78249, USA; (J.P.B.); (X.X.)
| | - Katherine Klee
- Bartkowski & Associates Research Team, San Antonio, TX 78258, USA
| | - Xiaohe Xu
- Department of Sociology and Demography, University of Texas at San Antonio, San Antonio, TX 78249, USA; (J.P.B.); (X.X.)
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4
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Toombs E, Lund J, Kushnier L, Stopa A, Wendt DC, Mushquash CJ. Addressing experiences of trauma within Indigenous-focused substance use residential treatment: a systematic review and environmental scan. J Ethn Subst Abuse 2023:1-53. [PMID: 38146766 DOI: 10.1080/15332640.2023.2293943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Indigenous individuals in Canada disproportionally experience higher rates of substance use concerns. This study examined clinical practices currently implemented with Indigenous-led residential treatment facilities to simultaneously address substance use and post-traumatic stress. A systematic review of relevant literature retrieved published approaches to address these concurrent disorders with Indigenous individuals. This review retrieved 35 sources related to trauma and substance use treatment among Indigenous individuals or communities. Among these sources, all leveraged cultural approaches as a dual treatment for trauma symptoms and substance use. Inconsistent results were reported among those sources (n = 3) who analyzed comparisons with wait-list controls or used randomized-controlled designs. Using culture-as-treatment was elaborated upon in the second goal of this study: an environmental scan of Indigenous-led treatment programs and qualitative interviews with 10 treatment center staff to understand how programs may address both substance use and traumatic symptoms among Indigenous-led substance use treatment centers across Canada. When we searched the websites of these centers, we found that approximately 38% (16 of 43) of treatment centers discussed implementing some form of treatment that addressed trauma symptoms in conjunction with primary substance use. Among the 10 staff participants, all discussed how trauma can impede client success in treatment, and ACE-specific programming is useful within their respective treatment programs. Results showed that when manualized treatments are used, they must be adapted to meet the specific needs of Indigenous communities, and culture-as-treatment is a popular approach among Indigenous-led treatment centers, particularly for addressing trauma symptoms.
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Affiliation(s)
- Elaine Toombs
- Department of Psychology, Lakehead University, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, ON, Canada
| | - Jessie Lund
- Department of Psychology, Lakehead University, ON, Canada
| | | | - Ana Stopa
- Department of Psychology, Lakehead University, ON, Canada
| | | | - Christopher J Mushquash
- Department of Psychology, Lakehead University, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, ON, Canada
- Thunder Bay Regional Health Sciences Centre, ON, Canada
- Thunder Bay Regional Health Research Institute, ON, Canada
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5
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Snyder CR, Mohammed SA. A Critical Race Theory Analysis of Mental Health Disparities Research. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01840-x. [PMID: 37884854 DOI: 10.1007/s40615-023-01840-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023]
Abstract
Health disparities and the impact of racism on the mental and physical health of people of color has been well-documented. However, health research has historically approached race as a genetic and biological attribute to explain differences in health outcomes. Although more recent policies and research have begun to move toward conceptualizing race as a socially constructed category that can be thought of as a proxy for racism, the ways in which race and racism are conceptualized in mental health disparities research needs deeper analysis. Using critical race theory (CRT) and content analysis, we investigate how mental health research has examined race, racism, and mental health in PubMed articles published between 2012 and 2022. Findings suggest a need for more complex conceptualizations of race, particularly related to essentialized, monoracial framings that rarely explore how race is defined and employed. Much of the research analyzed did not position racism, discrimination, or oppression as central to contextualizing racial mental health disparities. Additionally, the role of voice was often missing, limiting understandings of racialized experiences. Results of this analysis illuminate areas the need for more racism conscious approaches to understanding racial disparities in mental health and identifying opportunities to promote health equity.
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Affiliation(s)
- Cyndy R Snyder
- Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Selina A Mohammed
- School of Nursing and Health Studies, University of Washington, Bothell, WA, USA
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6
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Holder M. "I Believed in Myself More Than Anything." Indigenous Intimate Partner Violence Advocates Promote Resiliency Among Clients. Violence Against Women 2023:10778012231176200. [PMID: 37272035 DOI: 10.1177/10778012231176200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Indigenous intimate partner violence (IPV) advocates are essential for Indigenous women experiencing IPV who seek support amidst personal and historic trauma. IPV advocates work with and on behalf of clients to identify resources and promote resiliency. Indigenous advocates share their personal IPV experience. They provide individual ways they halted intergenerational trauma, moved toward becoming healthy, and made changes in their personal lives which affect services provided to their clients. This study fills a literature gap as it examines the intersection of Indigenous IPV advocates' personal journey of ending intergenerational trauma as a path to promoting resiliency among their clients.
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Affiliation(s)
- Melissa Holder
- School of Social Welfare, University of Kansas, Lawrence, KS 66045, USA
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Palley E, White C, Newransky C, Abram M. Interdisciplinary Children's Behavioral Health Workforce Development for Social Work and Nursing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085601. [PMID: 37107883 PMCID: PMC10139134 DOI: 10.3390/ijerph20085601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023]
Abstract
This paper will begin with a review of child health inequities globally, in the United States and in the State of New York. It will then describe a model training program that was designed to educate social workers and nurse practitioners to create a workforce able to address child behavioral health inequities in the United States (US), specifically New York State. Behavioral health care refers to prevention, care and treatment for mental health and substance abuse conditions as well as physical conditions caused by stress and life crises. This project uses an interdisciplinary training program for nurse practitioner and Master of Social Work students to address workforce shortages in underserved communities in New York State. It will present process evaluation findings to highlight the program's initial success and will conclude with a discussion of the data that are still needed and the challenges of obtaining this data.
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Affiliation(s)
- Elizabeth Palley
- School of Social Work, Adelphi University, Garden City, NY 11530, USA
- Correspondence:
| | - Chireau White
- School of Social Work, Adelphi University, Garden City, NY 11530, USA
| | | | - Marissa Abram
- College of Nursing and Public Health, Adelphi University, Garden City, NY 11530, USA
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8
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Wilson D, Werk A, Hemmer B. A Nursing School on Reservation Land. Am J Nurs 2022; 122:49-55. [PMID: 36384796 PMCID: PMC10311005 DOI: 10.1097/01.naj.0000904096.09348.6a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
ABSTRACT An associate degree in nursing program was established six years ago at the tribal college of the Fort Belknap Indian Reservation, home of the Aaniiih and Nakoda people. As this program continues to evolve and grow, it offers a successful example of how to increase diversity in nursing and potentially improve the health outcomes of Native Americans living on and nearby reservation communities.
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Affiliation(s)
- Deborah Wilson
- Deborah Wilson is a doctoral candidate at the Johns Hopkins University School of Nursing in Baltimore, MD, and a member of the teaching faculty at Aaniiih Nakoda College on the Fort Belknap Indian Reservation, MT. Alicia Werk is an enrolled member of the Aaniiih Tribe, an MSN student at the Johns Hopkins University School of Nursing, and a former nurse education instructor at Aaniiih Nakoda College, where Brigit Hemmer is the director of the Grow Our Own nursing program. Contact author: Deborah Wilson, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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9
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Handal AJ, Vasquez Guzman CE, Hernandez-Vallant A, Lemus A, Hess JM, Casas N, Galvis M, Medina D, Huyser K, Goodkind JR. Measuring Latinx/@ immigrant experiences and mental health: Adaptation of discrimination and historical loss scales. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2022; 93:27-40. [PMID: 36375031 PMCID: PMC10030193 DOI: 10.1037/ort0000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Migration processes encompass uncertainty, discrimination, racism, stigma, social isolation, lack of access to resources, fear of deportation, and family separation, having a critical impact on the health of Latinx/@ immigrants in the United States. It is essential to accurately measure the ways in which social, legal, economic, and political contexts impact mental health. This article discusses adaptation and use of discrimination and historical loss measures in a multilevel community-based advocacy, learning, and social support intervention (Immigrant Well-Being Project) with Latinx/@ immigrants in New Mexico, using participatory research approaches. Participants (n = 52) were recruited through community partner organizations and completed four qualitative and quantitative interviews over a 12-month period. The present analysis draws on the baseline quantitative data. Results show it is possible to adapt standardized measures of discrimination developed to assess the experiences of other racial/ethnic groups; however, the most common responses involved response options added by our research team. For the historical loss instrument, there was a high frequency of "never" answers for many items, suggesting that they were not relevant for participants or did not capture their experiences of loss. As with the discrimination measures, the items we added resonated the most with participants. The contexts of discrimination and loss for Latinx/@ immigrant populations are complex, thus the tools we use to measure these experiences and their impact on health must account for this complexity. This study contributes to these endeavors through involving community members in the conceptualization and measurement of discrimination and historical loss among Latinx/@ immigrants. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Alexis J. Handal
- Department of Epidemiology, University of Michigan School of Public Health
| | - Cirila Estela Vasquez Guzman
- Department of Family Medicine, Oregon Health Science University
- Department of Sociology, University of New Mexico
| | - Alexandra Hernandez-Vallant
- Department of Psychology, University of New Mexico
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico
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10
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Jinkerson-Brass S. Creating Oneness-Ceremonial Research. J Assoc Nurses AIDS Care 2022; 33:646-656. [PMID: 36094468 DOI: 10.1097/jnc.0000000000000359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022]
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11
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Rashid S, ElSalhy M. A cross-sectional study of dental students perception of dental faculty gender differences. PLoS One 2022; 17:e0271570. [PMID: 35905091 PMCID: PMC9337690 DOI: 10.1371/journal.pone.0271570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 07/04/2022] [Indexed: 11/19/2022] Open
Abstract
Objective
The objective of this study was to evaluate students’ perceptions of differences in learning from faculty of different gender.
Method
This cross-sectional study involved pre-doctoral dental students (years 2 to 4) who had a simulation and/or clinical experience working with dental faculty for at least one year. Students completed a self-administered questionnaire with three sections: demographic, difference between faculty related to their knowledge, skill, critical thinking, acceptance of cultural differences, and students’ preferences in working with faculty in specialty clinics.
Results
A total of 136 students completed the survey (75.4% response rate). Participants were 52.6% women, 62.2% self-identified as Caucasian/White. Students reported that female faculty are more understanding (p = 0.001) and accepting of cultural differences (p<0.001) compared to male faculty (p<0.05). Students reported perceiving female faculty more as being a role model than male faculty (p = 0.034). When comparing male and female students, male student’s perception of male faculty as a role model was significantly higher than female students (p<0.05). There was no significant difference in student’s perceptions between male and female faculty in their knowledge, skills, compassion, critical thinking, providing feedback, communication skills, and grading (p>0.05). Caucasian/White students perceived female faculty as more encouraging for discussions and male faculty as more rigid/inflexible (p<0.05).
Conclusions
Students perceived female faculty as more understanding and culturally competent compared to male faculty. There were no significant differences in student’s perceptions of male and female faculty in their knowledge, skills, compassion, critical thinking, feedback, communication skills, and grading. Students perceived female faculty as role models more than male faculty.
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Affiliation(s)
- Shaista Rashid
- A.T. Still University - Missouri School of Dentistry & Oral Health, St Louis, Missouri, United States of America
- * E-mail:
| | - Mohamed ElSalhy
- College of Dental Medicine, University of New England, Portland, Maine, United States of America
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12
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Alexander-Ruff JH, Hodgson CR. Engaging Members of a Northern Plains Indian Reservation to Promote Community Responsive Health Care. NASN Sch Nurse 2022; 37:325-329. [PMID: 35658569 DOI: 10.1177/1942602x221098350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes a project to engage community members and to determine how a school nurse-community partnership could improve healthcare equity within an American Indian community. The purpose of this community-building project was to establish a relationship among school nurse practitioners, children, and their community in a Northern Plains Indian reservation using a Community-Based Participatory Research (CBPR) model. CBPR requires a partnership between community members and school nurses in prioritizing community needs, developing an appropriate intervention, and engaging the community throughout the intervention project process. Partnering with teachers and the community, we engaged 78 students in a year-long project in which children depicted their perceptions of well-being and wellness through bimonthly art activities. This project laid the groundwork for a strong community partnership with school nurses in addressing the well-being of children and the further exploration of community needs.
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13
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Fanniff AM, Alexander AA. Improving Justice, Equity, Diversity, and Inclusion in Research on Sexual Abuse Perpetration. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2022; 34:10790632221091193. [PMID: 35548859 DOI: 10.1177/10790632221091193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Amanda M Fanniff
- Psychology Department, 31845Palo Alto University, Palo Alto, CA, USA
| | - Apryl A Alexander
- Graduate School of Professional Psychology, 2927University of Denver, Denver, Colorado, USA
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14
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Fortuna LR, Tobón AL, Anglero YL, Postlethwaite A, Porche MV, Rothe EM. Focusing on Racial, Historical and Intergenerational Trauma, and Resilience: A Paradigm to Better Serving Children and Families. Child Adolesc Psychiatr Clin N Am 2022; 31:237-250. [PMID: 35361362 DOI: 10.1016/j.chc.2021.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Research across populations demonstrates that intergenerational trauma can have lasting biological, psychological, and social consequences and affects groups of individuals in different ways. An appreciation of intergenerational trauma as experienced in diverse populations is important not only for understanding vulnerabilities and risk but also for cultivating opportunities for posttraumatic growth and healing. Understanding the contexts of trauma for children and families and the unveiling of structural inequities, both past and present, offers the opportunity to address these in using clinical and systems of care approaches in the public health spheres.
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Affiliation(s)
- Lisa R Fortuna
- University of California San Francisco, Zuckerberg San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Avenue 7M8, San Francisco, CA 94110, USA.
| | - Amalia Londoño Tobón
- National Institutes of Health, National Institute on Minority Health and Health Disparities, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Yohanis Leonor Anglero
- Boston Children's Hospital, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | | | - Michelle V Porche
- University of California San Francisco, Zuckerberg San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Avenue 7M8, San Francisco, CA 94110, USA
| | - Eugenio M Rothe
- Herbert Wertheim College of Medicine Florida International University, FIU Health Miami, 11200 Southwest 8th Street, Miami, FL 33199, USA
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15
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Pomerville A, Kawennison Fetter A, Gone JP. American Indian Behavioral Health Treatment Preferences as Perceived by Urban Indian Health Program Providers. QUALITATIVE HEALTH RESEARCH 2022; 32:465-478. [PMID: 34919004 DOI: 10.1177/10497323211057857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Behavioral health services specifically targeted for ethnoracial clients are typically tailored to the specific needs and preferences of these populations; however, little research has been done with American Indian clients specifically. To better understand how clinicians handle provision of treatment to this population, we interviewed 28 behavioral health staff at six Urban Indian Health Programs in the United States and conducted focus groups with 23 staff at five such programs. Thematic analysis of transcripts from these interviews and focus groups suggests that these staff attempt to blend and tailor empirically supported treatments with American Indian cultural values and practices where possible. Simultaneously, staff try to honor the client's specific preferences and needs and to encourage clients to seek cultural practices and connection outside of the therapy room. In so doing staff members were acutely aware of the limitations of the evidence base and the lack of research with American Indian clients.
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Affiliation(s)
- Andrew Pomerville
- Department of Psychology, 1259University of Michigan, Ann Arbor, MI, USA
| | - Anna Kawennison Fetter
- Department of Counseling Psychology, 5228University of Wisconsin-Madison, Madison, WI, USA
| | - Joseph P Gone
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Anthropology, 1812Harvard University, Cambridge, MA, USA
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16
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Cwik M, Doty SB, Hinton A, Goklish N, Ivanich J, Hill K, Lee A, Tingey L, Craig M. Community Perspectives on Social Influences on Suicide Within a Native American Reservation. QUALITATIVE HEALTH RESEARCH 2022; 32:16-30. [PMID: 34825619 PMCID: PMC10040248 DOI: 10.1177/10497323211045646] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Relative to the general population, Native Americans (NA) bear a disproportionate burden of suicide-related mortality rates. NA males and females aged 15 to 24 years experience suicide rates nearly 3 times than the U.S. all races rates in this age group. Although efforts have been made to understand and reduce suicide in tribal communities, a large portion has focused on individual characteristics with less attention given to social factors that may also inform suicide. This article aims to build on a local conceptual model of NA youth suicide by examining additional potential social factors through qualitative interviews. Findings from the thematic analysis resulted in the identification of seven perceived social influences: contagion, violence and abuse, discrimination and bullying, negative expectations, spirituality, social support, and cultural strengths. Public health approaches to reduce suicide should consider local social factors that resonate with tribal communities to build resilience.
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Affiliation(s)
- Mary Cwik
- Johns Hopkins University, Baltimore, MD, USA
| | | | | | | | | | - Kyle Hill
- Johns Hopkins University, Baltimore, MD, USA
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17
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Gonzalez MB, Sittner KJ, Saniguq Ullrich J, Walls ML. Spiritual connectedness through prayer as a mediator of the relationship between Indigenous language use and positive mental health. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2021; 27:746-757. [PMID: 34291975 PMCID: PMC8497410 DOI: 10.1037/cdp0000466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The objective of this study is to understand how Indigenous language and spirituality revitalization efforts may affect mental health within Indigenous communities. Although Indigenous communities experience disproportionate rates of mental health problems, research supporting language and spirituality's role in improving mental health is under-researched and poorly understood. METHOD Data for this study are from a Community-based Participatory Research Project involving five Anishinaabe tribes in Minnesota and Wisconsin. Participants were sampled from clinic records of adults with a diagnosis of type 2 diabetes, living on or near the reservation, and self-identifying as American Indian (mean age = 46.3; n = 191). RESULT Structural equation modeling illustrates that language use in the home is associated with positive mental health through spiritual connectedness. CONCLUSION Results support tribal community expressions of the positive effects of cultural involvement for Indigenous wellbeing, and improve what is known about the interconnectedness of language and spirituality. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Rieger KL, Bennett M, Martin D, Hack TF, Cook L, Hornan B. Digital Storytelling as a Patient Engagement and Research Approach With First Nations Women: How the Medicine Wheel Guided Our Debwewin Journey. QUALITATIVE HEALTH RESEARCH 2021; 31:2163-2175. [PMID: 34238067 PMCID: PMC8564217 DOI: 10.1177/10497323211027529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
When research is conducted from a Western paradigm alone, the findings and resultant policies often ignore Indigenous peoples' health practices and fail to align with their health care priorities. There is a need for decolonized approaches within qualitative health research to collaboratively identify intersecting reasons behind troubling health inequities and to integrate Indigenous knowledge into current health care services. We engaged with First Nations women to explore to what extent digital storytelling could be a feasible, acceptable, and meaningful research method to inform culturally safe health care services. This novel approach created a culturally safe and ethical space for authentic patient engagement. Our conversations were profound and provided deep insights into First Nations women's experiences with breast cancer and guidance for our future qualitative study. We found that the digital storytelling workshop facilitated a Debwewin journey, which is an ancient Anishinabe way of knowing that connects one's heart knowledge and mind knowledge.
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Affiliation(s)
- Kendra L. Rieger
- Trinity Western University, Langley, British
Columbia, Canada
- University of Manitoba, Winnipeg, Manitoba,
Canada
| | | | - Donna Martin
- University of Manitoba, Winnipeg, Manitoba,
Canada
| | | | | | - Bobbie Hornan
- Pimicikamāk Nīhithawī First Nation, Manitoba,
Canada
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19
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Deutsch AR, Lustfield R, Hanson JD. Where there's a will, there's a way? Strategies to reduce or abstain from alcohol use developed by Northern Plains American Indian women participating in a brief, alcohol-exposed pregnancy preconceptual intervention. Alcohol Clin Exp Res 2021; 45:2383-2395. [PMID: 34585745 DOI: 10.1111/acer.14721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Alcohol-exposed pregnancy (AEP) is an ongoing concern, especially within low-resource, high-risk areas such as rural American Indian/Alaska Native (AIAN) communities. Brief, preconceptual AEP-reduction interventions are popular in such areas but have a small impact on alcohol use. Developing a strategic alcohol change plan is a key program component; however, there is little research on strategy selection, especially within contexts that positively or negatively impact selection (e.g., cultural strengths, trauma, collective efficacy within AIAN communities). This study qualitatively analyzed strategies chosen to reduce alcohol use by AIAN women participating in a culturally tailored, brief, preconceptual AEP-reduction intervention. METHODS One hundred-sixty Northern Plains AIAN women who were participating in a brief AEP-reduction program developed a plan to accomplish an alcohol reduction/abstention goal at the first and last program sessions. The plan included choosing 1 or more strategies to (1) achieve the goal, (2) mitigate barriers, and (3) use cultural strengths. Qualitative analysis of the data involved thematic open and structured coding of all 3 strategies separately. We also examined how many different themes (different individual strategies) participants reported for each strategy component. RESULTS Most participants reported only 1 strategy (theme) for each of the 3 components. Common goal-achieving and barrier-mitigation strategies included positive social supports and avoiding negative or alcohol-involved social environments. Other strategies involved circular logic (e.g., the strategy to reduce drinking was to drink less). Both traditional and western cultural strengths were reported as important resources, although many participants had no cultural resource strategy. CONCLUSION Programs aimed at reducing AEPs may need to provide participants more support to develop strong strategies to reduce alcohol use when implemented within areas with high levels of trauma and contextual barriers that can impact strategy selection. Such support could include ways to improve health on both interpersonal and community levels.
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Affiliation(s)
- Arielle R Deutsch
- Avera Research Institute, Sioux Falls, South Dakota, USA.,School of Medicine, University of South Dakota, Vermillion, South Dakota, USA
| | - Rebecca Lustfield
- Avera Research Institute, Sioux Falls, South Dakota, USA.,School of Medicine, University of South Dakota, Vermillion, South Dakota, USA
| | - Jessica D Hanson
- Department of Applied Human Sciences, University of Minnesota Duluth, Duluth, Minnesota, USA
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20
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Gall A, Anderson K, Howard K, Diaz A, King A, Willing E, Connolly M, Lindsay D, Garvey G. Wellbeing of Indigenous Peoples in Canada, Aotearoa (New Zealand) and the United States: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115832. [PMID: 34071636 PMCID: PMC8198891 DOI: 10.3390/ijerph18115832] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022]
Abstract
Despite the health improvements afforded to non-Indigenous peoples in Canada, Aotearoa (New Zealand) and the United States, the Indigenous peoples in these countries continue to endure disproportionately high rates of mortality and morbidity. Indigenous peoples' concepts and understanding of health and wellbeing are holistic; however, due to their diverse social, political, cultural, environmental and economic contexts within and across countries, wellbeing is not experienced uniformly across all Indigenous populations. We aim to identify aspects of wellbeing important to the Indigenous people in Canada, Aotearoa and the United States. We searched CINAHL, Embase, PsycINFO and PubMed databases for papers that included key Indigenous and wellbeing search terms from database inception to April 2020. Papers that included a focus on Indigenous adults residing in Canada, Aotearoa and the United States, and that included empirical qualitative data that described at least one aspect of wellbeing were eligible. Data were analysed using the stages of thematic development recommended by Thomas and Harden for thematic synthesis of qualitative research. Our search resulted in 2669 papers being screened for eligibility. Following full-text screening, 100 papers were deemed eligible for inclusion (Aotearoa (New Zealand) n = 16, Canada n = 43, United States n = 41). Themes varied across countries; however, identity, connection, balance and self-determination were common aspects of wellbeing. Having this broader understanding of wellbeing across these cultures can inform decisions made about public health actions and resources.
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Affiliation(s)
- Alana Gall
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia; (K.A.); (A.D.); (D.L.); (G.G.)
- Correspondence:
| | - Kate Anderson
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia; (K.A.); (A.D.); (D.L.); (G.G.)
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia;
| | - Abbey Diaz
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia; (K.A.); (A.D.); (D.L.); (G.G.)
| | - Alexandra King
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada;
| | - Esther Willing
- Kōhatu–Centre for Hauora Māori, University of Otago, Dunedin 9054, New Zealand;
| | - Michele Connolly
- International Group for Indigenous Health Measurement, Columbia, MD 21045, USA;
| | - Daniel Lindsay
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia; (K.A.); (A.D.); (D.L.); (G.G.)
| | - Gail Garvey
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia; (K.A.); (A.D.); (D.L.); (G.G.)
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21
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"The Land Nurtures Our Spirit": Understanding the Role of the Land in Labrador Innu Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105102. [PMID: 34065830 PMCID: PMC8151664 DOI: 10.3390/ijerph18105102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022]
Abstract
We examined Indigenous views of wellbeing, aiming to understand how the Labrador Innu view influence of land on their health. The Innu live in two First Nation communities (Sheshatshiu and Natuashish) in the subarctic portion of the province of Newfoundland and Labrador, Canada. Their views on land and wellbeing are context specific and have not been studied; our research addresses this significant gap in literature. Findings highlight that the experience of being on the land with family and community, learning cultural knowledge, and gaining a sense of identity play a major role in enhancing wellbeing. Externally imposed policies and programs conceiving Indigenous land as a physical place only fail to understand that land sustains wellbeing by emplacing knowledge systems and cultural identity.
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22
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Triguero-Mas M, Anguelovski I, García-Lamarca M, Argüelles L, Perez-Del-Pulgar C, Shokry G, Connolly JJT, Cole HVS. Natural outdoor environments' health effects in gentrifying neighborhoods: Disruptive green landscapes for underprivileged neighborhood residents. Soc Sci Med 2021; 279:113964. [PMID: 34020160 DOI: 10.1016/j.socscimed.2021.113964] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/29/2021] [Accepted: 04/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cities are restoring existing natural outdoor environments (NOE) or creating new ones to address diverse socio-environmental and health challenges. The idea that NOE provide health benefits is supported by the therapeutic landscapes concept. However, several scholars suggest that NOE interventions may not equitably serve all urban residents and may be affected by processes such as gentrification. Applying the therapeutic landscapes concept, this study assesses the impacts of gentrification processes on the associations between NOE and the health of underprivileged, often long-term, neighborhood residents. METHODS We examined five neighborhoods in five cities in Canada, the United States and Western Europe. Our case studies were neighborhoods experiencing gentrification processes and NOE interventions. In each city, we conducted semi-structured qualitative interviews on NOE interventions, equity/justice, gentrification and health (n = 117) with case study neighborhood residents, community-based organizations, neighborhood resident leaders and other stakeholders such as public agencies staff. RESULTS Respondents highlighted a variety of interconnected and overlapping factors: the insufficient benefits of NOE to counterbalance other factors detrimental to health, the use of NOE for city branding and housing marketing despite pollution, unwelcomeness, increase of conflicts, threats to physical displacement for themselves and their social networks, unattractiveness, deficient routes, inadequate NOE maintenance and lack of safety in NOE. CONCLUSIONS Our study demonstrated that underprivileged neighborhood residents were perceived to experience new or improved NOE as what we call "disruptive green landscapes" (i.e. non-therapeutic landscapes with which they were not physically or emotionally engaged) instead of as therapeutic landscapes.
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Affiliation(s)
- Margarita Triguero-Mas
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain.
| | - Isabelle Anguelovski
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain; ICREA, Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Melissa García-Lamarca
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - Lucía Argüelles
- Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain; Internet Interdisciplinary Institute (IN3), Open University of Catalonia (UOC), Barcelona, Spain; Estudis d'Economia i Empresa (EEE), Open University of Catalonia (UOC), Barcelona, Spain
| | - Carmen Perez-Del-Pulgar
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - Galia Shokry
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - James J T Connolly
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain; School of Community and Regional Planning (SCARP), University of British Columbia, Vancouver, Canada
| | - Helen V S Cole
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
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23
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A process of healing for the Labrador Innu: Improving health and wellbeing in the context of historical and contemporary colonialism. Soc Sci Med 2021; 279:113973. [PMID: 33991790 DOI: 10.1016/j.socscimed.2021.113973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/11/2021] [Accepted: 04/23/2021] [Indexed: 02/03/2023]
Abstract
In light of the negative effects of historical and contemporary colonialism on the Labrador Innu, healing initiatives grounded in self-determination, renewal of cultural practices, and non-reliance on Western bio-medicine, are known, taught and widely practiced among the Innu. The value of Indigenous healing practices in the treatment of Indigenous people is well-recognized in Indigenous wellness literature, yet non-Indigenous health practitioners know little about healing processes. Moreover, to our knowledge, no studies have examined any contemporary Labrador Innu healing process. The main aim of this paper is to describe the process of healing among the Innu. Although there may be multiple processes of healing, we shed light on a major process that emerged from interviews and focus groups with 39 participants. Five stages of healing were described: being "under the blanket"; finding spiritual strength; extending hands out; finding strength and power; and helping others. Findings highlighted enablement of healing through spiritualities, support from Elders, return to culture, and resistance to negative stereotypes. We provide health professionals with valuable information for considering Innu healing as a model that expands their views for the benefit of Innu seeking mental health services. Implications for non-Innu health and social service providers are about broadening their understanding of the significant role of self-determination among Innu, learning Innu ways-of-knowing and being, recognizing one's own biases, and acknowledging the power imbalances between themselves and Innu people.
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24
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Aulandez KMW, Walls ML, Weiss NM, Sittner KJ, Gillson SL, Tennessen EN, Maudrie TL, Leppi AM, Rothwell EJ, Bolton-Steiner AR, Gonzalez MB. Cultural Sources of Strength and Resilience: A Case Study of Holistic Wellness Boxes for COVID-19 Response in Indigenous Communities. FRONTIERS IN SOCIOLOGY 2021; 6:612637. [PMID: 33869563 PMCID: PMC8022692 DOI: 10.3389/fsoc.2021.612637] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic has had disproportionately severe impacts on Indigenous peoples in the United States compared to non-Indigenous populations. In addition to the threat of viral infection, COVID-19 poses increased risk for psychosocial stress that may widen already existing physical, mental, and behavioral health inequities experienced by Indigenous communities. In recognition of the impact of COVID-19 related psychosocial stressors on our tribal community partners, the Johns Hopkins Center for American Indian Health Great Lakes Hub began sending holistic wellness boxes to our community partners in 11 tribal communities in the Midwestern United States and Canada in summer of 2020. Designed specifically to draw on culturally relevant sources of strength and resilience, these boxes contained a variety of items to support mental, emotional, cultural, and physical wellbeing. Feedback from recipients suggest that these wellness boxes provided a unique form of COVID-19 relief. Additional Johns Hopkins Center for American Indian Health offices have begun to adapt wellness boxes for the cultural context of their regions. This case study describes the conceptualization, creation, and contents of these wellness boxes and orients this intervention within a reflection on foundations of community-based participatory research, holistic relief, and drawing on cultural strengths in responding to COVID-19.
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Affiliation(s)
- Kevalin M. W. Aulandez
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, United States
| | - Melissa L. Walls
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, United States
| | - Nicole M. Weiss
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, United States
| | - Kelley J. Sittner
- Department of Sociology, Oklahoma State University, Stillwater, OK, United States
| | - Stefanie L. Gillson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Elizabeth N. Tennessen
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, United States
| | - Tara L. Maudrie
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, United States
| | - Ailee M. Leppi
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, United States
| | - Emma J. Rothwell
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, United States
| | - Athena R. Bolton-Steiner
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, United States
| | - Miigis B. Gonzalez
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, United States
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25
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O'Keefe VM, Cwik MF, Haroz EE, Barlow A. Increasing culturally responsive care and mental health equity with indigenous community mental health workers. Psychol Serv 2021; 18:84-92. [PMID: 31045405 PMCID: PMC6824928 DOI: 10.1037/ser0000358] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
There are 600 diverse American Indian/Alaska Native communities that represent strong and resilient nations throughout Indian Country. However, a history of genocidal practices, cultural assaults, and continuing oppression contribute to high rates of mental health and substance use disorders. Underresourced mental health care and numerous barriers to services maintain these disparities. Indigenous community mental health workers hold local understandings of history, culture, and traditional views of health and wellness and may reduce barriers to care while promoting tribal health and economic self-determination and sovereignty. The combination of Native community mental health workers alongside a growing workforce of Indigenous mental health professionals may create an ideal system in which tribal communities are empowered to restore balance and overall wellness, aligning with Native worldviews and healing traditions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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26
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Pool NM, Stauber LS. Tangled pasts, healthier futures: Nursing strategies to improve American Indian/Alaska Native health equity. Nurs Inq 2020; 27:e12367. [PMID: 32548947 DOI: 10.1111/nin.12367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 11/30/2022]
Abstract
American Indian/Alaska Native (AI/AN) populations in the United States continue to experience overall health inequity, despite significant improvement in health status for nearly all other racial-ethnic groups over the past 30 years. Nurses comprise the bulk of healthcare providers in the U.S. and are in an optimal position to improve AI/AN health by transforming both nursing education and practice. This potential is dependent, however, on nurses' ability to recognize the distinct historical and political conditions through which AI/AN health inequities have been produced and sustained. Nurse providers, educators, and leaders must in turn recognize how the sustained conditions of marginalization and expropriation that underpin current AI/AN health inequities continue to shape contemporary AI/AN health outcomes. This manuscript builds upon the extant literature of AI/AN historical health policy and utilizes decolonial theorizations of nursing and a cultural safety framework to propose a series of immediately actionable steps for nursing intervention into AI/AN health inequity. Ultimately, we suggest that it is crucial for nurses to collaborate with AI/AN individuals and communities across educational and clinical settings to further refine these approaches in alignment with the disciplinary obligation of promoting social justice within healthcare.
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Affiliation(s)
- Natalie M Pool
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Leah S Stauber
- Department of Mexican American Studies, Institute for LGBT Studies, College of Nursing, University of Arizona, Tucson, AZ, USA
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Trinidad SB, Shaw JL, Dirks LG, Ludman EJ, Burke W, Dillard DA. Perceptions of alcohol misuse among Alaska native health care system stakeholders: A qualitative exploration. J Ethn Subst Abuse 2020; 19:635-658. [PMID: 30714494 DOI: 10.1080/15332640.2018.1556766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although alcohol misuse is a priority for health care systems serving Alaska Native and American Indian (ANAI) people, stakeholders' perceptions of misuse are understudied. Patients (n = 34), providers (n = 20), and leaders (n = 16) at a Tribally owned and operated health care system reported that alcohol misuse results from the interaction of factors, including colonization, structural factors, social alienation, social norms about overdrinking introduced at the time of colonizing contact, coping with emotions, and beliefs about ANAI people and alcohol. Childhood exposure to alcohol misuse leads some ANAI people to avoid alcohol altogether, shedding light on the high levels of abstinence observed in ANAI communities.
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Affiliation(s)
| | | | | | - Evette J Ludman
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Wylie Burke
- University of Washington, Seattle, Washington
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28
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Cole AB, Hébert ET, Reitzel LR, Carroll DM, Businelle MS. Health Risk Factors in American Indian and Non-Hispanic White Homeless Adults. Am J Health Behav 2020; 44:631-641. [PMID: 33121581 DOI: 10.5993/ajhb.44.5.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: American Indians (AIs) are over-represented among homeless populations, but are understudied regarding their unique risk and resilience factors relative to non-Hispanic white (NHW) adults experiencing homelessness. In the current study, we aimed to address this gap. Methods: We recruited participants (108 AIs and 307 NHWs) from 6 homeless serving agencies in Oklahoma City, OK. Participants completed standard assessments of health, health behaviors, including alcohol and drug use, readiness to change endorsed health behaviors (eg, unsafe sex, fruit and vegetable intake, happiness with weight, physical activity), sleep location and quality, personal victimization, and discrimination. Results: Compared to NHWs, AIs endorsed greater alcohol use problems and were more likely to report having been arrested/booked for disorderly conduct or public drunkenness; however, AIs were less likely to report smoking cigarettes and reported greater readiness to change unsafe/unprotected sexual behaviors. Furthermore, compared to NHWs, AIs reported experiencing greater discrimination and were more likely to report sleeping outside or on the streets, versus in shelters; however, AIs reported fewer days of inadequate sleep. Conclusions: Findings suggest AI-specific risk and resilience factors for homelessness. This information can aid in treatment, service, and housing planning for this under-studied group who experiences some of the greatest health disparities.
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Affiliation(s)
- Ashley B. Cole
- Department of Psychology, Oklahoma State University, Stillwater, OK;,
| | - Emily T. Hébert
- Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Lorraine R. Reitzel
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX
| | - Dana M. Carroll
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Michael S. Businelle
- Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
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29
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Ornelas IJ, Osterbauer K, Woo L, Bishop SK, Deschenie D, Beresford SAA, Lombard K. Gardening for Health: Patterns of Gardening and Fruit and Vegetable Consumption Among the Navajo. J Community Health 2019; 43:1053-1060. [PMID: 29779075 DOI: 10.1007/s10900-018-0521-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
American Indians, including Navajo, are disproportionately affected by obesity and diabetes, in part due to diet-related health behaviors. The purpose of this study was to assess the patterns of gardening and fruit and vegetable (FV) consumption among residents in two communities on the Navajo Nation in order to inform a community gardening intervention. We analyzed survey data collected from participants in the Yéego Gardening study conducted in two communities in the Navajo Nation (N = 169). We found that 51% of the sample gardened, and on average participants gardened 8.9 times per month. Lack of time (53%) and financial barriers, such as gas for transportation or irrigation (51 and 49%, respectively), were reported as barriers to gardening. Most participants reported low levels of self-efficacy (80%) and behavioral capability (82%) related to gardening. Those with higher levels of gardening self-efficacy and behavioral capability reported more frequent gardening. Average daily FV consumption was 2.5 servings. Most participants reported high levels of self-efficacy to eat FV daily (64%) and high behavioral capability to prepare FV (66%). There was a positive association between FV consumption and gardening, with those gardening more than 4 times per month eating about 1 more serving of FV per day than those gardening 4 or fewer times per month. Further research is needed to better understand how gardening can increase fruit and vegetable availability and consumption among residents of the Navajo Nation.
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Affiliation(s)
- India J Ornelas
- Health Services, University of Washington, Box 359455, Seattle, WA, 98195, USA. .,Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, USA.
| | - Katie Osterbauer
- Nutritional Sciences, School of Public Health, University of Washington, Seattle, USA
| | - Lisa Woo
- Nutritional Sciences, School of Public Health, University of Washington, Seattle, USA
| | - Sonia K Bishop
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Desiree Deschenie
- New Mexico State University Agricultural Science Center, Farmington, USA
| | - Shirley A A Beresford
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, USA.,Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Kevin Lombard
- New Mexico State University Agricultural Science Center, Farmington, USA.,Plant and Environmental Sciences, New Mexico State University, Las Cruces, USA
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30
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Kading ML, Gonzalez MB, Herman KA, Gonzalez J, Walls ML. Living a Good Way of Life: Perspectives from American Indian and First Nation Young Adults. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:21-33. [PMID: 31486101 PMCID: PMC6800209 DOI: 10.1002/ajcp.12372] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In this study, we respond to calls for strengths-based Indigenous research by highlighting American Indian and First Nations (Anishinaabe) perspectives on wellness. We engaged with Anishinaabe community members by using an iterative, collaborative Group Concept Mapping methodology to define strengths from a within-culture lens. Participants (n = 13) shared what it means to live a good way of life/have wellness for Anishinaabe young adults, ranked/sorted their ideas, and shared their understanding of the map. Results were represented by nine clusters of wellness, which addressed aspects of self-care, self-determination, actualization, community connectedness, traditional knowledge, responsibility to family, compassionate respect toward others, enculturation, and connectedness with earth/ancestors. The clusters were interrelated, primarily in the relationship between self-care and focus on others. The results are interpreted by the authors and Anishinaabe community members though the use of the Seven Grandfather Teachings, which provide a framework for understanding Anishinaabe wellness. The Seven Grandfather Teachings include Honesty (Gwayakwaadiziwin), Respect (Manaadendamowin), Humility (Dabaadendiziwin), Love (Zaagi'idiwin), Wisdom (Nibwaakaawin), Bravery/Courage (Aakode'ewin), and Truth (Debwewin).
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Affiliation(s)
- Margarette L. Kading
- The College of St. Scholastica, Physician Assistant Studies, 940 Woodland Ave, Duluth, MN 55812
| | - Miigis B. Gonzalez
- Johns Hopkins Center for American Indian Health, 1915 South Street, Duluth, MN 55812
| | - Kaley A. Herman
- Johns Hopkins Center for American Indian Health, 1915 South Street, Duluth, MN 55812
| | - John Gonzalez
- Bemidji State University, 1500 Birchmont Drive NE, Bemidji, MN, 56601
| | - Melissa L. Walls
- Johns Hopkins Center for American Indian Health, 1915 South Street, Duluth, MN 55812
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Fuentes M, Lent K. Culture, Health, Function, and Participation Among American Indian and Alaska Native Children and Youth With Disabilities: An Exploratory Qualitative Analysis. Arch Phys Med Rehabil 2019; 100:1688-1694. [PMID: 30578776 PMCID: PMC6584540 DOI: 10.1016/j.apmr.2018.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/22/2018] [Accepted: 11/09/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the influence of traditional culture on health, disability, and health care services among American Indian and Alaska Native (AI/AN) children and youth with disabilities. DESIGN Exploratory descriptive qualitative analysis. SETTING Tertiary children's hospital. PARTICIPANTS A purposively sampled group (N=17) of AI/AN youth (n=4) with disability lasting at least 6 months age 8-24 years old and parents (n=13) of AI/AN children with disability lasting at least 6 months age 6 months to 17 years old. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participant responses to semistructured interview questions regarding health beliefs, daily activities, participation in cultural activities, and experiences receiving or having their child receive health care and rehabilitation services. RESULTS Three themes were identified: (1) participation in cultural activities is important for health as an AI/AN person; (2) experiences participating in cultural activities with functional differences; and (3) lack of recognition of the culturally related functional needs of AI/AN children with disabilities by rehabilitation providers. Children participated in cultural activities primarily through attendance at community-wide events. Barriers to participation in cultural activities included environmental barriers and adaptive mobility devices ill-suited to rough terrain. Participants perceived addressing functional needs related to culture, and cultural activities was not an expected part of rehabilitation services. CONCLUSIONS AI/AN children with disabilities experience barriers to participation in cultural activities, making it hard for them to achieve their definition of ideal health. Rehabilitation services have not identified or addressed these unmet culturally related functional needs.
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Affiliation(s)
- Molly Fuentes
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA; Seattle Children's Hospital Center for Child Health, Behavior, and Development, Seattle, WA.
| | - Kathryn Lent
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
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Woodbury RB, Ketchum S, Hiratsuka VY, Spicer P. Health-Related Participatory Research in American Indian and Alaska Native Communities: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2969. [PMID: 31426579 PMCID: PMC6719130 DOI: 10.3390/ijerph16162969] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/15/2019] [Accepted: 08/15/2019] [Indexed: 12/15/2022]
Abstract
A scoping review was conducted to assess the state of the literature on health-related participatory research involving American Indian and Alaska Native communities. Online databases were searched for relevant articles published between 1/1/2000 and 5/31/2017. 10,000+ data points relevant to community-level engagement in and regulation of research, community research capacity and cultural adaptation were extracted from 178 articles. Community engagement varied across study components: 136 (76%) articles reported community participation in research-related meetings and other events and 49 (27%) articles reported community involvement in initiation of research. 156 (88%) articles reported use of community-level tools to guide or regulate research. 93 (52%) articles reported that community members received research-related training. 147 (82%) articles described some type of cultural adaptation. Across all articles, data points on community engagement were not reported in 3061 (40%) out of 7740 cases. Findings suggest a need for increased community engagement in early stages of the research process and for reporting guidelines for participatory research involving American Indian and Alaska Native communities. There is also need to further existing research on the impact of different components of participatory research on process and outcome measures and to develop funding mechanisms that account for the time and resource intensive nature of participatory research.
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Affiliation(s)
- R Brian Woodbury
- Southcentral Foundation Research Department, 4085 Tudor Centre Dr., Anchorage, AK 99508, USA.
| | - Scott Ketchum
- University of Oklahoma, 5 Partners Place, Stephenson Pkwy, Suite 4100, Norman, OK 73019, USA
| | - Vanessa Y Hiratsuka
- Southcentral Foundation Research Department, 4085 Tudor Centre Dr., Anchorage, AK 99508, USA
| | - Paul Spicer
- Department of Anthropology, University of Oklahoma, 5 Partners Place, 201 Stephenson Pkwy, Suite 4100, Norman, OK 73019, USA
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Harry ML, Waring SC. The measurement invariance of the Patient Health Questionnaire-9 for American Indian adults. J Affect Disord 2019; 254:59-68. [PMID: 31108281 PMCID: PMC6690433 DOI: 10.1016/j.jad.2019.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/06/2019] [Accepted: 05/10/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND American Indian people have high suicide rates. However, little epidemiological data is available on depression prevalence, a suicide risk factor, in this population. Some research suggests that depression scales may perform differently for American Indian people. However, the Patient Health Questionnnaire-9 (PHQ-9), a depression scale widely-used in clinical practice, had not been assessed for cross-cultural measurement invariance with American Indian people. METHODS In this retrospective study of existing electronic health record (EHR) data in an upper Midwestern healthcare system, we assessed the measurement invariance of the standard one-factor PHQ-9 and five previously identified two-factor models for 4443 American Indian and 4443 Caucasian American adults (age >= 18) with a PHQ-9 in the EHR from 12/1/2005 to 12/31/2017. We also conducted subgroup analyses with adults ages >= 65. RESULTS Models showed good fits (e.g., CFI > 0.99, RMSEA < 0.05) and internal consistency reliability (ordinal alpha > 0.80). All models displayed measurement invariance between racial groups. Factor correlation was high for two-factor models, providing support for the one-factor model. American Indian adults had significantly higher odds of PHQ-9 total scores >= 10 and >= 15 than Caucasian American adults. LIMITATIONS Data came from a single healthcare system. CONCLUSIONS The PHQ-9 exhibited cross-cultural measurement invariance between American Indian and Caucasian American adults, supporting the PHQ-9 as a depression screening tool in this clinical care population. American Indian adults also had higher levels of depression than Caucasian Americans. Future research could confirm the generalizability of our findings to other American Indian populations.
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Affiliation(s)
- Melissa L Harry
- Essentia Health, Essentia Institute of Rural Health, 502 East Second Street, Duluth, MN 55805, USA.
| | - Stephen C Waring
- Essentia Health, Essentia Institute of Rural Health, 502 East Second Street, Duluth, MN 55805, USA
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Carron R, Kooienga S, Gilman-Kehrer E, Alvero R. Cultural Experiences, Patterns, and Practices of American Indian Women With Polycystic Ovary Syndrome: An Ethnonursing Study. J Transcult Nurs 2019; 31:162-170. [PMID: 31204601 DOI: 10.1177/1043659619856670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Knowledge is needed about the cultural experiences, patterns, and practices of American Indian women with polycystic ovary syndrome (PCOS), so nurses can provide culturally congruent care. Method: A qualitative, ethnonursing study based on Leininger's theory of culture care diversity and universality. Data were collected from 13 key informants living on a reservation in the Western United States. Data were analyzed with Leininger's four phases of qualitative analysis. Results: Three universal themes were identified: (1) control of PCOS symptoms is important for the cultural well-being of tribal women, (2) culturally congruent PCOS education and health care are important with variations in approaches to treatment, and (3) tribal culture is important with variations in use of tribal practices. Discussion: Tribal culture affects the health care beliefs and practices of American Indian women with PCOS. The findings can be used to improve culturally congruent care for women with this chronic condition.
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Isaac G, Finn S, Joe JR, Hoover E, Gone JP, Lefthand-Begay C, Hill S. Native American Perspectives on Health and Traditional Ecological Knowledge. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:125002. [PMID: 30675814 PMCID: PMC6371761 DOI: 10.1289/ehp1944] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 09/18/2018] [Accepted: 10/10/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND Traditional ecological knowledge (TEK) is a conceptual framework that highlights Indigenous knowledge (IK) systems. Although scientific literature has noted the relevance of TEK for environmental research since the 1980s, little attention has been given to how Native American (NA) scholars engage with it to shape tribal-based research on health, nor how non-Native scholars can coordinate their approaches with TEK. This coordination is of particular importance for environmental health sciences (EHS) research exploring interdisciplinary approaches and the integration of environmental and human health. OBJECTIVE Our perspective on TEK arose from a series of Health and Culture Research Group (HCRG) workshops that identified gaps in existing EHS methodologies that are based on a reliance on Euro-American concepts for assessing environmental exposures in tribal communities. These prior methods neither take into account cultural behavior nor community responses to these. Our objective is to consider NA perspectives on TEK when analyzing relationships between health and the environment and to look at how these may be applied to address this gap. DISCUSSION The authors—the majority of whom are NA scholars—highlight two research areas that consider health from a TEK perspective: food systems and knowledge of medicinal plants. This research has yielded data, methods, and knowledge that have helped Indigenous communities better define and reduce health risks and protect local natural food resources, and this TEK approach may prove of value to EHS research. CONCLUSION NA perspectives on TEK resulting from the HCRG workshops provide an opportunity for developing more accurate Indigenous health indicators (IHI) reflecting the conceptualizations of health maintained in these communities. This approach has the potential to bridge the scientific study of exposure with methods addressing a tribal perspective on the sociocultural determinants of health, identifying potential new areas of inquiry in EHS that afford nuanced evaluations of exposures and outcomes in tribal communities. https://doi.org/10.1289/EHP1944.
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Affiliation(s)
- Gwyneira Isaac
- Department of Anthropology, National Museum of Natural History, Smithsonian Institution, Washington, DC, USA
| | - Symma Finn
- National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Jennie R. Joe
- Department of Family and Community Medicine in the College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Elizabeth Hoover
- Department of American Studies, Brown University, Providence, Rhode Island, USA
| | - Joseph P. Gone
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Stewart Hill
- Natural Resources Institute, University of Manitoba, Manitoba, Canada
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Tang C, Tian B, Zhang X, Zhang K, Xiao X, Simoni JM, Wang H. The influence of cultural competence of nurses on patient satisfaction and the mediating effect of patient trust. J Adv Nurs 2018; 75:749-759. [DOI: 10.1111/jan.13854] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/22/2018] [Accepted: 08/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Chulei Tang
- Xiangya School of Nursing Central South University ChangshaChina
| | | | - Xiaoxia Zhang
- Xiangya School of Nursing Central South University ChangshaChina
- Nursing Faculty Henan Medical College ZhengzhouChina
| | - Kaili Zhang
- Xiangya School of Nursing Central South University ChangshaChina
| | - Xueling Xiao
- Xiangya School of Nursing Central South University ChangshaChina
| | - Jane M. Simoni
- Department of Psychology University of Washington Seattle Washington
| | - Honghong Wang
- Xiangya School of Nursing Central South University ChangshaChina
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Houghtaling B, Byker Shanks C, Ahmed S, Rink E. Grandmother and health care professional breastfeeding perspectives provide opportunities for health promotion in an American Indian community. Soc Sci Med 2018; 208:80-88. [PMID: 29772397 PMCID: PMC6015548 DOI: 10.1016/j.socscimed.2018.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 04/25/2018] [Accepted: 05/05/2018] [Indexed: 11/17/2022]
Abstract
RATIONALE While breastfeeding is well recognized as beneficial, rates of breastfeeding among American Indian women are below average and contribute to health inequities. Culturally specific approaches to breastfeeding research are called for to inform appropriate interventions in American Indian communities. Specifically, a grandmother's role in breastfeeding promotion is of great import particularly in American Indian (AI) groups, although is an understudied topic to date. OBJECTIVE This research seeks to fill a prominent literature gap by utilizing a grounded theory and community-based research approach to inform breastfeeding practices from the voices of grandmothers and health care professionals in a rural AI community in the United States. METHODS A community-based approach guided the research process. Convenience and snowball sampling was used to recruit for semi-structured and follow up member checking interviews with AI grandmothers (n = 27) and health care professionals (n = 7). Qualitative data were transcribed, characterized into meaning units, and coded by a review panel. Data were reconciled for discrepancies among reviewers, organized thematically, and used to generate community-specific breastfeeding constructs. RESULTS Three major themes emerged, each with relevant subthemes: (1) importance of breastfeeding; (2) attachment, bonding, and passing on knowledge; and (3) overburdened health care system. Multiple subthemes represent stressors and impact breastfeeding knowledge, translation, and practice within this community including formula beliefs, historical traumas, societal pressures, mistrust, and substance abuse. CONCLUSIONS Interventions designed to raise breastfeeding rates in the study site community would ideally be grounded in tribal resources and involve a collaborative approach that engages the greater community, grandmothers, health care professionals, and scientific partners with varying skills. More research is needed to determine stressors and any potential impact on infant feeding practices among other AI groups. Application of the research approach presented here to other AI communities may be beneficial for understanding opportunities and challenges to breastfeeding practices.
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Affiliation(s)
- Bailey Houghtaling
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA.
| | - Carmen Byker Shanks
- Food and Health Lab at Montana State University, Department of Health and Human Development, 960 Technology Blvd., Room 215, Bozeman, MT 59717, USA.
| | - Selena Ahmed
- Food and Health Lab at Montana State University, Department of Health and Human Development, 960 Technology Blvd., Room 215, Bozeman, MT 59717, USA.
| | - Elizabeth Rink
- Department of Health and Human Development, Montana State University-Bozeman, P.O. Box 173540, Bozeman, MT 59717, USA.
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Wallace HJ, McDonald S, Belton S, Miranda AI, da Costa E, da Conceicao Matos L, Henderson H, Taft A. Body Mapping to Explore Reproductive Ethno-Physiological Beliefs and Knowledge of Contraception in Timor-Leste. QUALITATIVE HEALTH RESEARCH 2018; 28:1171-1184. [PMID: 29290149 DOI: 10.1177/1049732317750382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Maternal mortality remains a significant public health challenge for Timor-Leste. Although access to quality family planning measures may greatly reduce such deaths, consideration of indigenous perceptions, and how they influence reproductive health decision-making and behavior, is crucial if health services are to provide initiatives that are accepted and helpful in improving reproductive health outcomes. We aimed to demonstrate that body mapping is an effective method to traverse language and culture to gain emic insights and indigenous worldviews. The authors' two qualitative research projects (2013 and 2015) used a decolonizing methodology in four districts of Timor-Leste, body mapping with 67 men and 40 women to illuminate ethno-physiology and indigenous beliefs about conception, reproduction, and contraception. Body mapping provided a beneficial conduit for identifying established indigenous reproductive perceptions, understandings, and vocabulary, plus fears surrounding contraception. This may inform health service provision and engagement, ultimately improving the reproductive health of community members.
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Affiliation(s)
| | | | - Suzanne Belton
- 2 Charles Darwin University, Darwin, The Northern Territory, Australia
| | | | | | | | | | - Angela Taft
- 1 La Trobe University, Melbourne, Victoria, Australia
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Nugus P, Désalliers J, Morales J, Graves L, Evans A, Macaulay AC. Localizing Global Medicine: Challenges and Opportunities in Cervical Screening in an Indigenous Community in Ecuador. QUALITATIVE HEALTH RESEARCH 2018; 28:800-812. [PMID: 29571278 DOI: 10.1177/1049732317742129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This participatory research study examines the tensions and opportunities in accessing allopathic medicine, or biomedicine, in the context of a cervical cancer screening program in a rural indigenous community of Northern Ecuador. Focusing on the influence of social networks, the article extends research on "re-appropriation" of biomedicine. It does so by recognizing two competing tensions expressed through social interactions: suspicion of allopathic medicine and the desire to maximize one's health. Semistructured individual interviews and focus groups were conducted with 28 women who had previously participated in a government-sponsored cervical screening program. From inductive thematic analysis, the article traces these women's active agency in navigating coherent paths of health. Despite drawing on social networks to overcome formidable challenges, the participants faced enduring system obstacles-the organizational effects of the networks of allopathic medicine. Such obstacles need to be understood to reconcile competing knowledge systems and improve health care access in underresourced communities.
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Affiliation(s)
- Peter Nugus
- 1 McGill University, Montreal, Québec, Canada
| | | | | | - Lisa Graves
- 4 Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Andrea Evans
- 5 University of Toronto, Toronto, Ontario, Canada
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Ojwang BO. Linguistic Conceptualizations of Disease Among the Luo of Kenya. QUALITATIVE HEALTH RESEARCH 2018; 28:433-445. [PMID: 29313465 DOI: 10.1177/1049732317747875] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The region inhabited by the Luo ethnic group in Kenya is disease endemic. However, disease awareness initiatives register low acceptance due to the sociocultural images of disease and illness conceptualized in the local Dholuo language in ways that may contradict modern biomedical knowledge and practice. This article evaluates the sociocultural basis of encoding descriptions of disease in the Luo indigenous knowledge system and their implications for modern medical practice. The methodology entailed use of qualitative interviews of purposively sampled Dholuo-speaking patient escorts in a provincial referral hospital. Nonparticipant observation was also conducted at funerals to monitor contextualized usage of the discourse of disease, illness, and death. The data were analyzed using qualitative content analysis and categorized into emergent themes and categories. The results revealed that Dholuo is replete with expressions that emphasize the vulnerability and discrimination of the sick. Such attitudes cause rejection of interventions and negatively influence health-seeking behavior. The expressions were relevant and acceptable to cultural insiders; hence, they could determine their understanding of health conditions thereby influencing how they make medical decisions. It emerges that the unique Luo worldview controls their perceptions on the causes of disease and prescribes community-driven remedies which may depart from the expectations of the biomedical model.
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Bell SL, Foley R, Houghton F, Maddrell A, Williams AM. From therapeutic landscapes to healthy spaces, places and practices: A scoping review. Soc Sci Med 2018; 196:123-130. [DOI: 10.1016/j.socscimed.2017.11.035] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/18/2017] [Accepted: 11/17/2017] [Indexed: 10/18/2022]
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Abstract
Indigenous peoples have poorer health outcomes than their non-indigenous counterparts and this applies to cancer outcomes for Māori in Aotearoa/New Zealand. Differential access to and quality of healthcare contributes to poorer survival rates for Māori. This research provides insight into some of the mechanisms that hinder and facilitate care access. Thirty four people who had undergone cancer treatment (19 Māori and 15 non-Māori) were interviewed by two Māori researchers. The analysis of the interview transcripts was informed by membership categorization analysis. This form of analysis attends to the categories that are used and the activities and characteristics associated with those categories. From this analysis it is argued that the classical patient role, or sick role, inadequately captures the kind of role that some Māori take in relation to their healthcare. Māori can also have culturally specific family (whānau) influences and a greater draw towards alternative approaches to healthcare. Dissonant roles contribute to a different experience for Māori. A better understanding of the categories and roles that are relevant to those who have cancer provides opportunities to attenuate the monocultural impacts of healthcare.
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