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Edinoff AN, Maudrie TL, Chiwiwi C, Kjerland TM, Contreras L, Gone JP. A complex psychosocial portrait of substance use disorders among Indigenous people in the United States: A scoping review. Am J Addict 2024. [PMID: 38591758 DOI: 10.1111/ajad.13539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/19/2024] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVES There has been a prevailing but erroneous belief in the medical community that there is a biological vulnerability in the American Indian/Alaskan Native (AI/AN) community to substance use disorders (SUDs), with alcohol use disorder (AUD) being the most prevalent. This scoping review aimed to examine what possible psychosocial issues could lead to the development of the perpetuation of SUDs in the AI/AN population. METHODS The protocol for this scoping review followed Arksey and O'Malley's methodological framework. There were 405 articles included for full-text review. Further inclusion criteria were applied which included: Directly looking at participants who had a SUD, including either in the discussion or conclusion a statement linking their data to psychosocial issues as a possible explanation for their data, and having measured the psychosocial issue with a research device. The final review included 15 studies. RESULTS Four psychosocial themes were uncovered using an inductive process, where recurring words related to identity, prejudice, isolation, discrimination, and self-concept in the literature. These themes were trauma/historical loss, mood, and discrimination/self-esteem. All of these themes are interrelated, and all influence the development or sustainment of a SUD. DISCUSSION AND CONCLUSIONS Complex psychosocial factors in the AI/AN community are associated with SUDs. This trauma and historical loss should be addressed with culturally tailored treatments. SCIENTIFIC SIGNIFICANCE There are not many manuscripts that specifically look at the interplay of mood, trauma, self-worth, and discrimination with SUD in the AI/AN community. This scoping review aims to highlight these issues as well as discuss how culture should play a part in treatment.
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Affiliation(s)
- Amber N Edinoff
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA
| | - Tara L Maudrie
- Department of International Health, Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carly Chiwiwi
- Contra Costa Health, Department of Family and Community Medicine, Martinez, California, USA
| | - Tonya M Kjerland
- Department of Indigenous Health, University of North Dakota, Grand Forks, North Dakota, USA
| | - Liz Contreras
- Harvard Graduate School of Education, Cambridge, Massachusetts, USA
| | - Joseph P Gone
- Department of Anthropology, Harvard University, Cambridge, Massachusetts, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Maudrie TL, Grubin F, Conrad M, Velasquez Baez J, Saniguq Ullrich J, Allison-Burbank J, Martin L, Austin C, Joyner J, Ronyak M, Masten K, Ingalls A, Haroz EE, O’Keefe VM. Honoring our teachings: children's storybooks as indigenous public health practice. Front Public Health 2024; 12:1354761. [PMID: 38463160 PMCID: PMC10924303 DOI: 10.3389/fpubh.2024.1354761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/12/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction American Indian and Alaska Native (AIAN) communities continue to flourish and innovate in the face of the COVID-19 pandemic. Storytelling is an important tradition for AIAN communities that can function as an intervention modality. To support the needs of AIAN children and caregivers, we (a collaborative workgroup of Indigenous health researchers) developed a culturally grounded storybook that provides pandemic-related public health guidance and mental health coping strategies woven with Inter-Tribal values and teachings. Methods A collaborative workgroup, representing diverse tribal affiliations, met via four virtual meetings in early 2021 to discuss evolving COVID-19 pandemic public health guidance, community experiences and responses to emerging challenges, and how to ground the story in shared AIAN cultural strengths. We developed and distributed a brief survey for caregivers to evaluate the resulting book. Results The workgroup iteratively reviewed versions of the storyline until reaching a consensus on the final text. An AI artist from the workgroup created illustrations to accompany the text. The resulting book, titled Our Smallest Warriors, Our Strongest Medicine: Honoring Our Teachings during COVID-19 contains 46 pages of text and full-color illustrations. An online toolkit including coloring pages, traditional language activities, and caregiver resources accompanies the book. We printed and distributed 50,024 physical copies of the book and a free online version remains available. An online survey completed by N = 34 caregivers who read the book with their child(ren) showed strong satisfaction with the book and interest in future books. Discussion The development of this storybook provides insights for creative dissemination of future public health initiatives, especially those geared toward AIAN communities. The positive reception and widespread interest in the storybook illustrate how braiding AIAN cultural teachings with public health guidance can be an effective way to disseminate health information. This storybook highlights the importance of storytelling as an immersive learning experience through which caregivers and children connect to family, community, culture, and public health guidance. Culturally grounded public health interventions can be effective and powerful in uplifting AIAN cultural values and promoting health and well-being for present and future generations.
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Affiliation(s)
- Tara L. Maudrie
- Johns Hopkins Center for Indigenous Health, Baltimore, MD, United States
| | - Fiona Grubin
- Johns Hopkins Center for Indigenous Health, Baltimore, MD, United States
| | - Maisie Conrad
- Johns Hopkins Center for Indigenous Health, Baltimore, MD, United States
| | - Jocelyn Velasquez Baez
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, United States
| | - Jessica Saniguq Ullrich
- Institute for Research and Education to Advance Community Health (IREACH), Washington State University, Spokane, WA, United States
| | | | - Lisa Martin
- Johns Hopkins Center for Indigenous Health, Baltimore, MD, United States
| | - Crystal Austin
- Johns Hopkins Center for Indigenous Health, Baltimore, MD, United States
| | - Joelle Joyner
- Department of Public Health, Wayne State University, Detroit, MI, United States
| | | | - Kristin Masten
- Johns Hopkins Center for Indigenous Health, Baltimore, MD, United States
| | - Allison Ingalls
- Johns Hopkins Center for Indigenous Health, Baltimore, MD, United States
| | - Emily E. Haroz
- Johns Hopkins Center for Indigenous Health, Baltimore, MD, United States
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Maudrie TL, Nguyen CJ, Wilbur RE, Mucioki M, Clyma KR, Ferguson GL, Jernigan VBB. Food Security and Food Sovereignty: The Difference Between Surviving and Thriving. Health Promot Pract 2023; 24:1075-1079. [PMID: 37877640 DOI: 10.1177/15248399231190366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Previous research in American Indian and Alaska Native (AI/AN) communities has documented high prevalence of food insecurity. Yet many AI/AN scholars and communities have expressed concerns that the dominant societal conceptions of food security are not reflective of the teachings, priorities, and values of AI/AN communities. Food security initiatives often focus on access to food and, at times, nutrition but little consideration is given to cultural foods, the spirituality carried through foods, and whether the food was stewarded in a way that promotes well-being not just for humans but also for plants, animals, land, and water. Despite the concerns of AI/AN communities that their needs are not centered in dominant societal food conceptualizations and food security programming, the food sovereignty efforts of AI/AN communities have captured national attention as a solution to modern food system inequities. Indigenous Food Sovereignty (IFS) is a holistic approach to food that incorporates values of relationality, reciprocity, and relationships. Fundamental differences exist between food security and food sovereignty, yet dominant society often reduces IFS as a solution to food security, rather than an entirely different food system that is predicated on values that contrast with that of dominant society. Despite calls to decolonize the definition and measurement of food security, we explore whether fixing the concept of food security is a worthy endeavor or whether efforts would be better spent supporting the resurgence and revitalization of AI/AN food values, food knowledge, and community food sovereignty initiatives.
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Affiliation(s)
- Tara L Maudrie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Megan Mucioki
- The Pennsylvania State University, University Park, PA, USA
| | - Kaylee R Clyma
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Jernigan VBB, Nguyen CJ, Maudrie TL, Demientieff LX, Black JC, Mortenson R, Wilbur RE, Clyma KR, Lewis M, Lopez SV. Food Sovereignty and Health: A Conceptual Framework to Advance Research and Practice. Health Promot Pract 2023; 24:1070-1074. [PMID: 37877639 DOI: 10.1177/15248399231190367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Settler colonialism disrupted traditional Indigenous foodways and practices and created high rates of diet-related disease among Indigenous peoples. Food sovereignty, the rights of Indigenous peoples to determine their own food systems, is a culturally centered movement rooted in traditional Indigenous knowledge. This approach directly intervenes upon systems-level barriers to health, making it an important strategy for health equity. While food sovereignty initiatives can be found within many Indigenous communities, the conceptual linkages between food sovereignty and health have not been well documented within the public health literature. We present a practice-informed conceptual framework developed as part of the Center for Indigenous Innovation and Health Equity (CIIHE) initiative, a community-academic partnership with the goal of strengthening Indigenous food systems and practices to promote health and well-being. The framework emphasizes connectedness, including the transmission of knowledge across generations and the restoration of relational responsibilities, as central to Indigenous concepts of health and wellness.
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Affiliation(s)
- Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
| | | | - Tara L Maudrie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Jessica C Black
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
| | | | | | - Kaylee R Clyma
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
| | | | - Susanna V Lopez
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
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5
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Nguyen CJ, Wilbur RE, Henderson A, Sowerwine J, Mucioki M, Sarna-Wojcicki D, Ferguson GL, Maudrie TL, Moore-Wilson H, Wark K, Jernigan VBB. Framing an Indigenous Food Sovereignty Research Agenda. Health Promot Pract 2023; 24:1117-1123. [PMID: 37877643 DOI: 10.1177/15248399231190362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Access to healthy and appealing food is essential for individuals to be able to live a healthy and quality life. For decades, food security has been a priority issue for public health professionals. Food sovereignty expands upon the concept of food insecurity (i.e., having access to nutritious and culturally relevant food) by incorporating people's rights to define their own food system. The expanded focus of food sovereignty on food systems prioritizes public health professionals' role in supporting environmental- and systems-level initiatives and evaluating their implications for health, economics, and the natural environment. Food sovereignty is of particular importance for Indigenous peoples (i.e., American Indian, Alaska Native, Native Hawaiian, and Pacific Islander communities). Colonization had demonstrable consequences, with many Indigenous communities being forcibly relocated from traditional lands, alongside the destruction of traditional food sources. Indigenous food sovereignty aligns with the sovereign nation status that American Indian tribes and Alaska Native communities have with the United States. Furthermore, the worldviews that incorporate Indigenous communities' relational responsibilities to care for their food systems, according to their traditional practices and beliefs (Coté, 2016; Morrison, 2011), uniquely positions Indigenous peoples to lead food sovereignty initiatives. In this article, we explore what is currently known regarding food sovereignty and health. We then discuss opportunities to expand the evidence on Indigenous food sovereignty's relationships with (1) health and well being, (2) economics, (3) the natural environment, and (4) programming facilitators and barriers.
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Affiliation(s)
| | | | | | | | - Megan Mucioki
- Pennsylvania State University, State College, PA, USA
| | | | | | - Tara L Maudrie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Kyle Wark
- Southcentral Foundation, Anchorage, AK, USA
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
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Jernigan VBB, Taniguchi T, Nguyen CJ, London SM, Henderson A, Maudrie TL, Blair S, Clyma KR, Lopez SV, Jacob T. Food Systems, Food Sovereignty, and Health: Conference Shares Linkages to Support Indigenous Community Health. Health Promot Pract 2023; 24:1109-1116. [PMID: 37877645 DOI: 10.1177/15248399231190360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
The Center for Indigenous Innovation and Health Equity (CIIHE) at Oklahoma State University Center for Health Sciences (OSU-CHS) is a community-academic partnership with Indigenous peoples from Alaska, Hawai'i, and Oklahoma. The CIIHE supports communities to strengthen traditional food practices and food sovereignty and evaluate the impact of those efforts on health. In February 2022, the CIIHE sponsored and hosted a virtual conference to better understand how food sovereignty initiatives can improve health. More than 600 participants gathered to hear the latest research and practice in the areas of public health and agriculture, nutrition, community-based and Indigenous knowledge, and health economics. Community-led food sovereignty initiatives being implemented as part of the CIIHE were featured along with other Indigenous initiatives in urban, rural, and reservation communities. A survey was administered to conference participants to assess food sovereignty topics and priorities for future research. In this Practice Note, we describe innovative community-led initiatives presented as part of the conference and recommendations for action emerging from qualitative and quantitative data collected from conference participants.
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Affiliation(s)
- Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
| | - Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
| | | | | | | | - Tara L Maudrie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Kaylee R Clyma
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
| | - Susanna V Lopez
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
| | - Tvli Jacob
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
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7
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Nguyen CJ, French BF, Maudrie TL, Ferguson GL, Blue Bird Jernigan V, Sinclair KIA. Measuring Food Security among American Indian and Alaska Native Adults: Validity Evidence Supports the Use of the US Department of Agriculture Module. J Acad Nutr Diet 2023; 123:S76-S88. [PMID: 37730308 DOI: 10.1016/j.jand.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Inequities in access, availability, and affordability of nutritious foods produced by settler colonialism contribute to high rates of food insecurity among American Indian and Alaska Native (AI/AN) households. Efforts to understand the influences of food security programming among AI/AN individuals in the United States are constrained by the absence of validity evidence for food security assessments for this population. OBJECTIVE This study assessed whether AI/AN adult responses on the Food Security Survey Module provide an accurate assessment of food security prevalence, especially when compared with other racial and ethnic groups. DESIGN A correlational design with the cross-sectional 2019 National Health Interview Survey was used to address the research objective. PARTICIPANTS AND SETTING The 2019 National Health Interview Survey contains a sample (N = 30,052) representative of the resident civilian noninstitutionalized population. MAIN OUTCOME MEASURES The primary outcome was food security, as characterized by the 10-item US Department of Agriculture Adult Food Security Survey Module. The module evaluates whether insufficient finances result in perceived food shortages and a reduction in the quantity and/or quality of food intake during the prior 30 days. STATISTICAL ANALYSES PERFORMED Data were analyzed by racial and ethnic subsamples to assess scale dimensionality (confirmatory factor analysis), Item Response Theory item analysis, differential item functioning, and external validity (χ2 tests). RESULTS Results supported the use of the 10-item module for racial and ethnic groups. However, differential item functioning effect sizes exceeded criteria for the Asian, AI/AN, and Hispanic respondents when compared with White respondents. Food security was not significantly related to all expected correlates in the AI/AN subsample. CONCLUSIONS Compelling evidence is presented for validity of the FSSM scores in determining food security status of AI/AN adults. Qualitative inquiry that explores how culture influences the way food security is conceptualized and experienced is warranted.
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Affiliation(s)
- Cassandra J Nguyen
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington; Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington.
| | - Brian F French
- College of Education, Washington State University, Pullman, Washington
| | - Tara L Maudrie
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Gary L Ferguson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Ka Imi A Sinclair
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington; College of Nursing, Washington State University, Seattle, Washington
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O'Keefe VM, Maudrie TL, Cole AB, Ullrich JS, Fish J, Hill KX, White LA, Redvers N, Jernigan VBB, Lewis JP, West AE, Apok CA, White EJ, Ivanich JD, Schultz K, Lewis ME, Sarche MC, Gonzalez MB, Parker M, Neuner Weinstein SE, McCray CJ, Warne D, Black JC, Richards JR, Walls ML. Conceptualizing Indigenous strengths-based health and wellness research using group concept mapping. Arch Public Health 2023; 81:71. [PMID: 37101194 PMCID: PMC10134608 DOI: 10.1186/s13690-023-01066-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/20/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND In recent years public health research has shifted to more strengths or asset-based approaches to health research but there is little understanding of what this concept means to Indigenous researchers. Therefore our purpose was to define an Indigenous strengths-based approach to health and well-being research. METHODS Using Group Concept Mapping, Indigenous health researchers (N = 27) participated in three-phases. Phase 1: Participants provided 218 unique responses to the focus prompt "Indigenous Strengths-Based Health and Wellness Research…" Redundancies and irrelevant statements were removed using content analysis, resulting in a final set of 94 statements. Phase 2: Participants sorted statements into groupings and named these groupings. Participants rated each statement based on importance using a 4-point scale. Hierarchical cluster analysis was used to create clusters based on how statements were grouped by participants. Phase 3: Two virtual meetings were held to share and invite researchers to collaboratively interpret results. RESULTS A six-cluster map representing the meaning of Indigenous strengths-based health and wellness research was created. Results of mean rating analysis showed all six clusters were rated on average as moderately important. CONCLUSIONS The definition of Indigenous strengths-based health research, created through collaboration with leading AI/AN health researchers, centers Indigenous knowledges and cultures while shifting the research narrative from one of illness to one of flourishing and relationality. This framework offers actionable steps to researchers, public health practitioners, funders, and institutions to promote relational, strengths-based research that has the potential to promote Indigenous health and wellness at individual, family, community, and population levels.
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Affiliation(s)
- Victoria M O'Keefe
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Tara L Maudrie
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Ashley B Cole
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | | | - Jillian Fish
- Minneapolis VA Health Care System, Center for Care Delivery and Outcomes Research, Minneapolis, MN, USA
| | - Kyle X Hill
- Department of Indigenous Health, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA
| | - Lauren A White
- Joint Program for Social Work and Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Nicole Redvers
- Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | | | - Jordan P Lewis
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth, MN, USA
| | - Amy E West
- Keck School of Medicine, Children's Hospital Los Angeles, Department of Pediatrics, University of Southern California, Los Angeles, CA, USA
| | | | - Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Jerreed D Ivanich
- University of Colorado Anschutz Medical Campus, Centers for American Indian and Alaska Native Health, Aurora, CO, USA
| | - Katie Schultz
- University of Michigan School of Social Work, Ann Arbor, MI, USA
| | - Melissa E Lewis
- Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - Michelle C Sarche
- School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Miigis B Gonzalez
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Myra Parker
- School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Sophie E Neuner Weinstein
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Obstetrics and Gynecology, Oregon Health and Sciences University, Portland, OR, USA
| | - Celena J McCray
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Donald Warne
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jessica C Black
- Department of Alaska Native Studies and Rural Development, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Jennifer R Richards
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Melissa L Walls
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center for Indigenous Health--Great Lakes Hub, Johns Hopkins Bloomberg School of Public Health, Duluth, MN, USA
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Maudrie TL, Aulandez KMW, O'Keefe VM, Whitfield FR, Walls ML, Hautala DS. Food Stress and Diabetes-Related Psychosocial Outcomes in American Indian Communities: A Mixed Methods Approach. J Nutr Educ Behav 2022; 54:1051-1065. [PMID: 36244877 PMCID: PMC9742178 DOI: 10.1016/j.jneb.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Explore the relationship between diabetes-related psychosocial outcomes and food stress in American Indian communities. DESIGN Convergence model of a mixed methods triangulation study. SETTING Five American Indian reservation communities in the Midwest. PARTICIPANTS One-hundred ninety-two participants were randomly selected from tribal health centers using clinic patient records and were surveyed about diabetes distress, empowerment, and food stress across 4 different time points. Seventeen focus group discussions were conducted and transcribed, and a mix of purposive and convenience sampling was used. PHENOMENON OF INTEREST Psychosocial outcomes associated with (or related to) diabetes and food stress. ANALYSIS Quantitative: Multiple linear regression was performed to explore relationships between food stress and diabetes distress and empowerment. Qualitative: Open coding of data identified portions of the transcripts related to food followed by a deductive approach on the basis of the components of quantitative food stress. RESULTS Food stress in the forms of (1) not having enough money for food and not having enough time for cooking or shopping (P = 0.08) and (2) inadequate food access and being on a special diet (P = 0.032) were associated with increased diabetes distress. Lower diabetes empowerment was associated with not having enough money for food and being on a special diet (P = 0.030). Our qualitative data mirrored quantitative findings that experiencing multiple forms of food stress negatively impacted diabetes psychosocial outcomes and illuminated the cyclical role mental health can play in relationships to food. CONCLUSIONS AND IMPLICATIONS Our findings highlight that experiencing food stress negatively affects diabetes empowerment and diabetes distress. These findings emphasize the importance of improving community food environments and addressing individual food access for diabetes management and prevention initiatives in American Indian communities.
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Affiliation(s)
- Tara L Maudrie
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
| | - Kevalin M W Aulandez
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Victoria M O'Keefe
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | | | - Melissa L Walls
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Dane S Hautala
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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Grubin F, Maudrie TL, Neuner S, Conrad M, Waugh E, Barlow A, Coser A, Hill K, Pioche S, Haroz EE, O'Keefe VM. Development and Cultural Adaptation of Psychological First Aid for COVID-19 Frontline Workers in American Indian/Alaska Native Communities. J Prev (2022) 2022; 43:697-717. [PMID: 35841432 PMCID: PMC9288204 DOI: 10.1007/s10935-022-00695-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 11/07/2022]
Abstract
The coronavirus disease 19 (COVID-19) pandemic is broadly affecting the mental health and well-being of people around the world, and disproportionately affecting some groups with already pre-existing health inequities. Two groups at greater risk of physical and/or mental health detriments from COVID-19 and more profoundly impacted by the pandemic include frontline workers and American Indian/Alaska Native (AI/AN) communities. To provide support and prevent long-term mental health problems, we culturally adapted a psychological first aid guide specifically for COVID-19 frontline workers serving AI/AN communities. We engaged a diverse, collaborative work group to steer the adaptation content and process. We also held two focus group discussions with frontline workers in AI/AN communities to incorporate their perspectives into the adapted guide. Results from the group discussions and the collaborative work group were compiled, analyzed to extract themes and suggestions, and integrated into the adapted content of the guide. Main adaptations included updating language (i.e., to be more culturally appropriate, less prescriptive, and less text heavy), framing the guide from a harm-reduction lens, incorporating cultural activities, values, and teachings common across diverse AI/AN communities (e.g., importance of being a good relative), and validating feelings and experiences of frontline workers. The resulting adapted guide includes four modules and is available as a free online training. Our adaptation process may serve as a guiding framework for future adaptations of similar resources for specific groups. The adapted guide may stand as an enduring resource to support mental well-being, the prevention of mental health problems, and reduction of health inequities during the pandemic and beyond.
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Affiliation(s)
- Fiona Grubin
- Department of International Health, Social and Behavioral Interventions, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St. 4th Floor, Baltimore, MD, 21231, USA.
| | - Tara L Maudrie
- Department of International Health, Social and Behavioral Interventions, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St. 4th Floor, Baltimore, MD, 21231, USA
| | - Sophie Neuner
- Department of International Health, Social and Behavioral Interventions, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St. 4th Floor, Baltimore, MD, 21231, USA
| | - Maisie Conrad
- Department of International Health, Social and Behavioral Interventions, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St. 4th Floor, Baltimore, MD, 21231, USA
| | - Emma Waugh
- Department of International Health, Social and Behavioral Interventions, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St. 4th Floor, Baltimore, MD, 21231, USA
| | - Allison Barlow
- Department of International Health, Social and Behavioral Interventions, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St. 4th Floor, Baltimore, MD, 21231, USA
| | | | - Kyle Hill
- Department of Indigenous Health, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, USA
| | - Shardai Pioche
- Department of International Health, Social and Behavioral Interventions, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St. 4th Floor, Baltimore, MD, 21231, USA
| | - Emily E Haroz
- Department of International Health, Social and Behavioral Interventions, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St. 4th Floor, Baltimore, MD, 21231, USA
| | - Victoria M O'Keefe
- Department of International Health, Social and Behavioral Interventions, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St. 4th Floor, Baltimore, MD, 21231, USA
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11
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O’Keefe VM, Fish J, Maudrie TL, Hunter AM, Tai Rakena HG, Ullrich JS, Clifford C, Crawford A, Brockie T, Walls M, Haroz EE, Cwik M, Whitesell NR, Barlow A. Centering Indigenous Knowledges and Worldviews: Applying the Indigenist Ecological Systems Model to Youth Mental Health and Wellness Research and Programs. Int J Environ Res Public Health 2022; 19:6271. [PMID: 35627809 PMCID: PMC9140847 DOI: 10.3390/ijerph19106271] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022]
Abstract
Globally, Indigenous communities, leaders, mental health providers, and scholars have called for strengths-based approaches to mental health that align with Indigenous and holistic concepts of health and wellness. We applied the Indigenist Ecological Systems Model to strengths-based case examples of Indigenous youth mental health and wellness work occurring in CANZUS (Canada, Australia, New Zealand, and United States). The case examples include research, community-led programs, and national advocacy. Indigenous youth development and well-being occur through strengths-based relationships across interconnected environmental levels. This approach promotes Indigenous youth and communities considering complete ecologies of Indigenous youth to foster their whole health, including mental health. Future research and programming will benefit from understanding and identifying common, strengths-based solutions beyond narrow intervention targets. This approach not only promotes Indigenous youth health and mental health, but ripples out across the entire ecosystem to promote community well-being.
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Affiliation(s)
- Victoria M. O’Keefe
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Jillian Fish
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN 55417, USA;
| | - Tara L. Maudrie
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Amanda M. Hunter
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ 86011, USA;
| | - Hariata G. Tai Rakena
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | | | - Carrie Clifford
- Department of Psychology, University of Otago, Dunedin 9016, New Zealand;
| | - Allison Crawford
- Department of Psychiatry, University of Toronto, Toronto, ON M5G 1X5, Canada;
| | - Teresa Brockie
- School of Nursing, Johns Hopkins University, Baltimore, MD 21231, USA;
| | - Melissa Walls
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Emily E. Haroz
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Mary Cwik
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Allison Barlow
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
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12
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Blue Bird Jernigan V, Taniguchi T, Haslam A, Williams MB, Maudrie TL, Nikolaus CJ, Wetherill MS, Jacob T, Love CV, Sisson S. Design and Methods of a Participatory Healthy Eating Intervention for Indigenous Children: The FRESH Study. Front Public Health 2022; 10:790008. [PMID: 35296044 PMCID: PMC8920553 DOI: 10.3389/fpubh.2022.790008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/26/2022] [Indexed: 12/23/2022] Open
Abstract
Objective To increase vegetable and fruit intake, reduce body mass index (BMI), and improve parental blood pressure among American Indian families. Design Randomized, wait-list controlled trial testing a multi-level (environmental, community, family, and individual) multi-component intervention with data collection at baseline and 6 months post-intervention. Setting Tribally owned and operated Early Childhood Education (ECE) programs in the Osage Nation in Oklahoma. Participants American Indian families (at least one adult and one child in a ECE program). A sample size of 168 per group will provide power to detect differences in fruit and vegetable intake. Intervention The 6-month intervention consisted of a (1) ECE-based nutrition and gardening curriculum; (2) nutrition education and food sovereignty curriculum for adults; and (3) ECE program menu modifications. Main Outcome Measures The primary outcome is increase in fruit and vegetable intake, assessed with a 24-h recall for adults and plate weight assessments for children. Secondary outcomes included objective measures of BMI among adults and children and blood pressure among adults.
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Affiliation(s)
- Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States,*Correspondence: Valarie Blue Bird Jernigan
| | - Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Alyson Haslam
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Mary B. Williams
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Tulsa, OK, United States
| | - Tara L. Maudrie
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Cassandra J. Nikolaus
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, United States
| | - Marianna S. Wetherill
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Tulsa, OK, United States
| | - Tvli Jacob
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Charlotte V. Love
- School of Health Care Administration, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Susan Sisson
- Department of Nutritional Sciences, University of Oklahoma College of Allied Health, Oklahoma City, OK, United States
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13
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Maudrie TL, Nguyen CJ, Jernigan VBB, Lessard KH, Richardson D, Gittelsohn J, O’Keefe VM. Impacts of COVID-19 on a Food Security Study with the Baltimore Native Community. Am Indian Alsk Native Ment Health Res 2022; 29:8-31. [PMID: 35881979 PMCID: PMC9351982 DOI: 10.5820/aian.2902.2022.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Urban American Indian/Alaska Native peoples experience disproportionate levels of food insecurity when compared to the general US population. Through a collaborative research partnership between Native American Lifelines of Baltimore, an Urban Indian Health Program, and a Johns Hopkins Bloomberg School of Public Health student-led research team, food security was identified as a priority issue. A sequential explanatory mixed methods study was planned to explore food security and food sovereignty in the Baltimore Native community prior to the COVID-19 pandemic. Due to the local impact of COVID-19, a community-based participatory research approach guided the community-academic team to revise the original study and increase understanding of how the pandemic impacted food security in the community. This article highlights the lessons learned and strengths of using a community-based participatory approach to guide adaptations made due to COVID-19 to this research study. By utilizing a co-learning approach and emphasizing flexibility, we were able to collaboratively collect meaningful data to drive future community solutions to food insecurity while building an evidence base for policy changes to better support urban Native food security.
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Affiliation(s)
- Tara L. Maudrie
- Center for American Indian Health at Johns Hopkins Bloomberg School of Public Health in Baltimore, MD
| | - Cassandra J. Nguyen
- Institute for Research and Education to Advance Community Health in the Department of Medical Education and Clinical Sciences at Washington State University in Spokane, WA
| | | | | | | | - Joel Gittelsohn
- Center for Human Nutrition in the Department of International Health at Johns Hopkins Bloomberg School of Public Health in Baltimore, MD
| | - Victoria M. O’Keefe
- Center for American Indian Health at Johns Hopkins Bloomberg School of Public Health in Baltimore, MD
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14
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Blue Bird Jernigan V, Maudrie TL, Nikolaus CJ, Benally T, Johnson S, Teague T, Mayes M, Jacob T, Taniguchi T. Food Sovereignty Indicators for Indigenous Community Capacity Building and Health. Front Sustain Food Syst 2021. [DOI: 10.3389/fsufs.2021.704750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Food insecurity, defined as a lack of stable access to sufficient and nutritious food, is a global public health priority due to its relationships with diminished mental and physical human health. Indigenous communities experience disproportionality high rates of food insecurity as a byproduct of settler-colonial activities, which included forced relocation to rural reservation lands and degradation of traditional subsistence patterns. Many Indigenous communities have worked to revitalize their local food systems by pursuing food sovereignty, regularly expressed as the right and responsibility of people to have access to healthy and culturally appropriate foods, while defining their own food systems. Food sovereignty is a promising approach for improving health. However, limited literature is available that identifies the diverse practices of food sovereignty or strategies communities can implement to strengthen their food sovereignty efforts. This article reviews the scientific literature and highlights key indicators that may support community capacity building for food sovereignty and health. The seven indicators are: (1) access to resources, (2) production, (3) trade, (4) food consumption, (5) policy, (6) community involvement, and (7) culture. A total of 25 sub-indicators are outlined to allow communities to understand how an indicator is operationalized as well as explore their own community's progress within each indicator. It is not expected that every indicator and their subcategories will apply fully to any given Indigenous community, and the application of these indicators must be adapted for each community's local context, however the indicators may provide support for building and assessing efforts to create more sustainable Indigenous food systems.
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15
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Maudrie TL, Colón-Ramos U, Harper KM, Jock BW, Gittelsohn J. A Scoping Review of the Use of Indigenous Food Sovereignty Principles for Intervention and Future Directions. Curr Dev Nutr 2021; 5:nzab093. [PMID: 34345758 PMCID: PMC8321882 DOI: 10.1093/cdn/nzab093] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 05/11/2021] [Accepted: 06/28/2021] [Indexed: 12/19/2022] Open
Abstract
Indigenous food sovereignty (IFS) represents a community-led movement with potential to reduce health inequities, but no scoping review of the impact of taking an IFS approach on intervention research has been conducted. This review sought to: 1) describe intervention studies that employ IFS principles, and 2) describe the impact of studies using IFS principles on food access, eating patterns, diet quality, physical activity, and health. Through a literature review, 4 IFS principles were identified: 1) community ownership, 2) inclusion of traditional food knowledge, 3) inclusion and promotion of cultural foods, and 4) environmental/intervention sustainability. Twenty intervention studies published between January 1, 2000 and February 5, 2020 were included. Most of the studies that scored high in IFS principles saw a positive impact on diet. This review found evidence supporting the value of IFS principles in the development, implementation, and evaluation of health interventions for Indigenous communities.
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Affiliation(s)
- Tara L Maudrie
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Uriyoán Colón-Ramos
- Department of Global Health, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health at The George Washington University, Washington, DC, USA
| | - Kaitlyn M Harper
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brittany W Jock
- School of Human Nutrition, Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill University, Montreal, Quebec, Canada
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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16
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O'Keefe VM, Maudrie TL, Ingalls A, Kee C, Masten KL, Barlow A, Haroz EE. Development and Dissemination of a Strengths-Based Indigenous Children's Storybook: "Our Smallest Warriors, Our Strongest Medicine: Overcoming COVID-19". Front Sociol 2021; 6:611356. [PMID: 33869558 PMCID: PMC8022673 DOI: 10.3389/fsoc.2021.611356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
The traditions, strengths, and resilience of communities have carried Indigenous peoples for generations. However, collective traumatic memories of past infectious diseases and the current impact of the coronavirus disease 2019 (COVID-19) pandemic in many Indigenous communities point to the need for Indigenous strengths-based public health resources. Further, recent data suggest that COVID-19 is escalating mental health and psychosocial health inequities for Indigenous communities. To align with the intergenerational strengths of Indigenous communities in the face of the pandemic, we developed a strengths- and culturally-based public health education and mental health coping resource for Indigenous children and families. Using a community-engaged process, the Johns Hopkins Center for American Indian Health collaborated with 14 Indigenous and allied child development, mental health, health communications experts and public health professionals, as well as a Native American youth artist. Indigenous collaborators and Indigenous Johns Hopkins project team members collectively represented 12 tribes, and reservation-based, off-reservation, and urban geographies. This group shared responsibility for culturally adapting the children's book "My Hero is You: How Kids Can Fight COVID-19!" developed by the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings and developing ancillary materials. Through an iterative process, we produced the storybook titled "Our Smallest Warriors, Our Strongest Medicine: Overcoming COVID-19" with content and illustrations representing Indigenous values, experiences with COVID-19, and strengths to persevere. In addition, parent resource materials, children's activities, and corresponding coloring pages were created. The book has been disseminated online for free, and 42,364 printed copies were distributed to early childhood home visiting and tribal head start programs, Indian Health Service units, tribal health departments, intertribal, and urban Indigenous health organizations, Johns Hopkins Center for American Indian Health project sites in partnering communities, schools, and libraries. The demand for and response to "Our Smallest Warriors, Our Strongest Medicine: Overcoming COVID-19" demonstrates the desire for Indigenous storytelling and the elevation of cultural strengths to maintain physical, mental, emotional, and spiritual health during the COVID-19 pandemic.
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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. Front Sociol 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] [What about the content of this article? (0)] [Affiliation(s)] [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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18
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Maudrie TL, Lessard KH, Dickerson J, Aulandez KMW, Barlow A, O’Keefe VM. Our Collective Needs and Strengths: Urban AI/ANs and the COVID-19 Pandemic. Front Sociol 2021; 6:611775. [PMID: 33869561 PMCID: PMC8022783 DOI: 10.3389/fsoc.2021.611775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic has raised national consciousness about health inequities that disproportionately impact American Indian/Alaska Native (AI/AN) communities, yet urban AI/AN communities continue to remain a blind spot for health leaders and policymakers. While all United States cities have been the traditional homelands of AI/AN peoples since time immemorial, urban AI/ANs are consistently excluded in local and national health assessments, including recent reports pertaining to COVID-19. Today the majority of AI/ANs (71%) live in urban areas, and many cities have strong Urban Indian Health Programs (UIHPs) that provide space for medical care, community gatherings, cultural activities, and traditional healing. Many of these UIHPs are currently scrambling to meet the needs of their AI/AN service communities during the pandemic. While the COVID-19 pandemic brought new sources of funding to UIHPs, the lack of local AI/AN data and arbitrary funding restrictions precluded some UIHPs from addressing their communities' most immediate challenges such as food and economic insecurities. Despite these challenges, urban AI/AN communities carry the historical resilience of their ancestors as they weave strong community networks, establish contemporary traditions, and innovate to meet community needs. This article focuses on the experiences of one UIHP in Baltimore City during the COVID-19 pandemic to illustrate present-day challenges and strengths, as well as illuminate the urgency for tailored, local data-driven public health approaches to urban AI/AN health.
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Affiliation(s)
- Tara L. Maudrie
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | | | - Kevalin M. W. Aulandez
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Allison Barlow
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Victoria M. O’Keefe
- Johns Hopkins Center for American Indian Health, International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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