NAU publications by CHER
Faculty & staff publications
NAU faculty and staff have the opportunity to publish their findings and knowledge as authors. CHER has many researchers that have been cited multiple times in major publications for their great work. The Center for Health Equity Research has accumulated all faculty publications into one, easy to navigate database.
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Curley, Caleigh; Eddie, Regina; Tallis, Kristen; Lane, Taylor S; Yazzie, Del; Sanderson, Priscilla R; Lorts, Cori; Shin, Sonya; Behrens, Timothy K; George, Carmen; Antone-Nez, Ramona; Ashley, Christine; de Heer, Hendrik D The Navajo Nation Healthy Diné Nation Act: Community Support of a 2% Tax on Unhealthy Foods Journal Article Journal of Public Health Management and Practice: JPHMP, 29(5) (00), pp. 622-632, 2023. @article{Curley2023, title = {The Navajo Nation Healthy Diné Nation Act: Community Support of a 2% Tax on Unhealthy Foods}, author = {Caleigh Curley and Regina Eddie and Kristen Tallis and Taylor S Lane and Del Yazzie and Priscilla R Sanderson and Cori Lorts and Sonya Shin and Timothy K Behrens and Carmen George and Ramona Antone-Nez and Christine Ashley and Hendrik D de Heer}, url = {https://journals.lww.com/jphmp/fulltext/2023/09000/the_navajo_nation_healthy_din__nation_act_.4.aspx}, doi = {10.1097/PHH.0000000000001753}, year = {2023}, date = {2023-05-23}, journal = {Journal of Public Health Management and Practice: JPHMP}, volume = {29(5)}, number = {00}, pages = {622-632}, abstract = {Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value (“junk foods”) on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25000 annually, and 69.7% were female. Half of the respondents said they “support”(37.4%) or “strongly support”(13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P=. 025) and education (P=. 026) and understanding of the legislation (P<. 001 for “very well” vs “not at all”) had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P<. 001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value (“junk foods”) on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25000 annually, and 69.7% were female. Half of the respondents said they “support”(37.4%) or “strongly support”(13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P=. 025) and education (P=. 026) and understanding of the legislation (P<. 001 for “very well” vs “not at all”) had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P<. 001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had … |
Samantha Sabo Louisa O'Meara, Janet Yellowhair Joyce Hamilton JT Nashio Brook Bender Fernando Flores Jr Marianne Bennett Rema Metts Isabella Denton Kim Russell Frontiers in Public Health, 11 , 2023. @article{Sabo2023b, title = {Community Health Representative Workforce: Integration across systems and teams to address the social determinants of indigenous health and wellbeing}, author = {Samantha Sabo, Louisa O'Meara, Janet Yellowhair, Joyce Hamilton, JT Nashio, Brook Bender, Fernando Flores Jr, Marianne Bennett, Rema Metts, Isabella Denton, Kim Russell}, editor = {Lily K. Lee}, url = {https://doi.org/10.3389/fpubh.2023.1047152}, doi = {10.3389/fpubh.2023.1047152}, year = {2023}, date = {2023-03-15}, journal = {Frontiers in Public Health}, volume = {11}, abstract = {Tribally employed, Community Health Representatives (CHRs) serving Indigenous and American Indian and Alaskan Native (AIAN) peoples are culturally and linguistically embedded community leaders, with the unique ability to serve as the link and intermediary between community members and systems. Unique to the CHR workforce scope of practice is the expectation for high level integration within the medical and social service care team. This explicit role outlined in the scope of work sets an expectation for both CHR and care teams to deliver integrated patient, family, and systems level care coordination and case management. This paper aims to build from our previous manuscript published in Volume 1 of the special issue Community Health Workers Practice from Recruitment to Integration. In that Volume, we explored through a Community Case Study CHR Managers’ perspectives on the challenges and opportunities for full CHR integration into health systems and teams serving AIAN. In this paper, we offer new information about the current CHR and CHR Managers’ involvements and perceived level of integration within health care teams and the broader public health systems addressing the social and structural determinants of health. We approach this topic considering the COVID-19 pandemic and how CHRs and CHR Programs were included and not included in tribal pandemic response efforts.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Tribally employed, Community Health Representatives (CHRs) serving Indigenous and American Indian and Alaskan Native (AIAN) peoples are culturally and linguistically embedded community leaders, with the unique ability to serve as the link and intermediary between community members and systems. Unique to the CHR workforce scope of practice is the expectation for high level integration within the medical and social service care team. This explicit role outlined in the scope of work sets an expectation for both CHR and care teams to deliver integrated patient, family, and systems level care coordination and case management. This paper aims to build from our previous manuscript published in Volume 1 of the special issue Community Health Workers Practice from Recruitment to Integration. In that Volume, we explored through a Community Case Study CHR Managers’ perspectives on the challenges and opportunities for full CHR integration into health systems and teams serving AIAN. In this paper, we offer new information about the current CHR and CHR Managers’ involvements and perceived level of integration within health care teams and the broader public health systems addressing the social and structural determinants of health. We approach this topic considering the COVID-19 pandemic and how CHRs and CHR Programs were included and not included in tribal pandemic response efforts. |
Sabo, Samantha; Lee, Naomi; Sears, Grant; Jiménez, Dulce J; Tutt, Marissa; Santos, Jeffersson; Gomez, Omar; Teufel-Shone, Nicolette; Bennet, Marianne; Nashio, Neva T; Flores, Fernando; Baldwin, Julie Community Health Representatives as Trusted Sources for Increasing Representation of American Indian Communities in Clinical Research Journal Article International Journal of Environmental Research and Public Health, 20 (5), 2023. @article{Sabo2023, title = {Community Health Representatives as Trusted Sources for Increasing Representation of American Indian Communities in Clinical Research}, author = {Samantha Sabo and Naomi Lee and Grant Sears and Dulce J. Jiménez and Marissa Tutt and Jeffersson Santos and Omar Gomez and Nicolette Teufel-Shone and Marianne Bennet and T. Neva Nashio and Fernando Flores and Julie Baldwin}, url = {https://doi.org/10.3390/ijerph20054391}, doi = {10.3390/ijerph20054391}, year = {2023}, date = {2023-03-01}, journal = {International Journal of Environmental Research and Public Health}, volume = {20}, number = {5}, abstract = {Indigenous and American Indian Alaskan Native (AI/AN) community members are systematically underrepresented in clinical trial research. This paper focuses on exploratory steps to partner with Native Nations of Arizona to engage Community Health Representatives (CHR) as a trusted source for building COVID-19 clinical trial research, including vaccine trials awareness. CHRs are frontline public health workers who apply a unique understanding of the experience, language, and culture of the population served. This workforce has entered the spotlight as essential to the prevention and control of COVID-19. Methods: Three Tribal CHR programs were engaged to develop and refine culturally centered educational materials and a pre-post survey using a consensus-based decision-making approach. CHRs used these materials in brief education sessions during regular client home visits and community events. At 30 days post CHR intervention, participants (N = 165) demonstrated significantly increased awareness about and ability to enroll in COVID-19 treatment and vaccine trials. Participants also described a significant increase in trust in researchers, decreased perceived barriers related to cost for participation in a clinical trial, and improved belief that participation in a COVID-19 clinical trial for treatment was considered a benefit to American Indian and Alaskan Native people. CHRs as trusted sources of information, coupled with culturally centered education materials designed by CHRs for CHR clients, demonstrated a promising approach to improved awareness of clinical trial research generally and COVID-19 trials specifically among Indigenous and American Indian community members of Arizona.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Indigenous and American Indian Alaskan Native (AI/AN) community members are systematically underrepresented in clinical trial research. This paper focuses on exploratory steps to partner with Native Nations of Arizona to engage Community Health Representatives (CHR) as a trusted source for building COVID-19 clinical trial research, including vaccine trials awareness. CHRs are frontline public health workers who apply a unique understanding of the experience, language, and culture of the population served. This workforce has entered the spotlight as essential to the prevention and control of COVID-19. Methods: Three Tribal CHR programs were engaged to develop and refine culturally centered educational materials and a pre-post survey using a consensus-based decision-making approach. CHRs used these materials in brief education sessions during regular client home visits and community events. At 30 days post CHR intervention, participants (N = 165) demonstrated significantly increased awareness about and ability to enroll in COVID-19 treatment and vaccine trials. Participants also described a significant increase in trust in researchers, decreased perceived barriers related to cost for participation in a clinical trial, and improved belief that participation in a COVID-19 clinical trial for treatment was considered a benefit to American Indian and Alaskan Native people. CHRs as trusted sources of information, coupled with culturally centered education materials designed by CHRs for CHR clients, demonstrated a promising approach to improved awareness of clinical trial research generally and COVID-19 trials specifically among Indigenous and American Indian community members of Arizona. |
Kahn, Carmella B; James, DeeDee; George, Shawndeena; Johnson, Tressica; Kahn-John, Michelle; Teufel-Shone, Nicolette I; Begay, Chassity; Tutt, Marissa; Bauer, Mark C Diné (Navajo) Traditional Knowledge Holders’ Perspective of COVID-19 Journal Article Int. J. Environ. Res. Public Health, 20 (4), pp. 3728, 2023. @article{Kahn2023, title = {Diné (Navajo) Traditional Knowledge Holders’ Perspective of COVID-19}, author = {Carmella B. Kahn and DeeDee James and Shawndeena George and Tressica Johnson and Michelle Kahn-John and Nicolette I. Teufel-Shone and Chassity Begay and Marissa Tutt and Mark C. Bauer}, url = {https://doi.org/10.3390/ijerph20043728}, doi = {10.3390/ijerph20043728}, year = {2023}, date = {2023-02-20}, journal = {Int. J. Environ. Res. Public Health}, volume = {20}, number = {4}, pages = {3728}, abstract = {From the start of the COVID-19 pandemic on the Navajo Nation, Diné (Navajo) traditional knowledge holders (TKHs), such as medicine men and women and traditional practitioners, contributed their services and healing practices. Although TKHs are not always fully acknowledged in the western health care system, they have an established role to protect and promote the health of Diné people. To date, their roles in mitigating the COVID-19 pandemic have not been fully explored. The purpose of this research was to understand the social and cultural contexts of the COVID-19 pandemic and vaccines based on the roles and perspectives of Diné TKHs. A multi-investigator consensus analysis was conducted by six American Indian researchers using interviews with TKHs collected between December 2021–January 2022. The Hózhó Resilience Model was used as a framework to analyze the data using four parent themes: COVID-19, harmony and relationships, spirituality, and respect for self and discipline. These parent themes were further organized into promoters and/or barriers for 12 sub-themes that emerged from the data, such as traditional knowledge, Diné identity, and vaccine. Overall, the analysis showed key factors that could be applied in pandemic planning and public health mitigation efforts based on the cultural perspective of TKHs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } From the start of the COVID-19 pandemic on the Navajo Nation, Diné (Navajo) traditional knowledge holders (TKHs), such as medicine men and women and traditional practitioners, contributed their services and healing practices. Although TKHs are not always fully acknowledged in the western health care system, they have an established role to protect and promote the health of Diné people. To date, their roles in mitigating the COVID-19 pandemic have not been fully explored. The purpose of this research was to understand the social and cultural contexts of the COVID-19 pandemic and vaccines based on the roles and perspectives of Diné TKHs. A multi-investigator consensus analysis was conducted by six American Indian researchers using interviews with TKHs collected between December 2021–January 2022. The Hózhó Resilience Model was used as a framework to analyze the data using four parent themes: COVID-19, harmony and relationships, spirituality, and respect for self and discipline. These parent themes were further organized into promoters and/or barriers for 12 sub-themes that emerged from the data, such as traditional knowledge, Diné identity, and vaccine. Overall, the analysis showed key factors that could be applied in pandemic planning and public health mitigation efforts based on the cultural perspective of TKHs. |
Eddie, Regina S; Karntisching, Laura; Eccleston, Bobby; Schwartz, Anna Addressing Health Inequities through Simulation Training and Education in Rural and Tribal Communities Journal Article International Journal of Nursing and Health Care Research, 6 , 2023. @article{Eddie2023, title = {Addressing Health Inequities through Simulation Training and Education in Rural and Tribal Communities}, author = {Regina S Eddie and Laura Karntisching and Bobby Eccleston and Anna Schwartz}, url = {https://doi.org/10.29011/2688-9501.101388}, doi = {10.29011/2688-9501.101388}, year = {2023}, date = {2023-01-16}, journal = {International Journal of Nursing and Health Care Research}, volume = {6}, abstract = {The nursing shortage is serious and getting worse in medically underserved areas. Nursing education needs to include faculty education in simulation-based education that focuses on public health and cultural education. New nurse graduates are inadequately prepared and need additional training to provide culturally appropriate care to varied and rural populations. Method: This project used simulation-based education and rural clinical placements to enhance the training and education needs of faculty, students and community partners to better address the health care needs of people living in rural and medically underserved areas of the Navajo Nation and northern Arizona. Results: The project increased knowledge and interest among faculty and community partners on simulation-based education as well as positive student learning experiences. Conclusion: Public health and culture can be integrated into simulation-based education. Partnerships with tribal communities can play a valuable role in nursing education.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The nursing shortage is serious and getting worse in medically underserved areas. Nursing education needs to include faculty education in simulation-based education that focuses on public health and cultural education. New nurse graduates are inadequately prepared and need additional training to provide culturally appropriate care to varied and rural populations. Method: This project used simulation-based education and rural clinical placements to enhance the training and education needs of faculty, students and community partners to better address the health care needs of people living in rural and medically underserved areas of the Navajo Nation and northern Arizona. Results: The project increased knowledge and interest among faculty and community partners on simulation-based education as well as positive student learning experiences. Conclusion: Public health and culture can be integrated into simulation-based education. Partnerships with tribal communities can play a valuable role in nursing education. |
Baldwin, Julie A; A, Alvarado; K, Jarratt-Snider; A, Hunter; C, Keene; A, Castagno; A, Ali-Joseph; J, Roddy; Jr, Begay M; Joseph D, Goldtooth C; C, Camplain; M, Smith; K, McCue; A, Begay; N, Teufel-Shone Understanding Resilience and Mental Wellbeing in Southwest Indigenous Nations and the Impact of COVID-19: Protocol for a Mixed-Methods Study Journal Article JMIR Publications, 2022. @article{Baldwin2022, title = {Understanding Resilience and Mental Wellbeing in Southwest Indigenous Nations and the Impact of COVID-19: Protocol for a Mixed-Methods Study}, author = {Julie A. Baldwin and Alvarado A and Jarratt-Snider K and Hunter A and Keene C and Castagno A and Ali-Joseph A and Roddy J and Begay M Jr and Joseph D, Goldtooth C and Camplain C and Smith M and McCue K and Begay A and Teufel-Shone N}, url = {https://www.researchgate.net/publication/366048977_Understanding_Resilience_and_Mental_Wellbeing_in_Southwest_Indigenous_Nations_and_the_Impact_of_COVID-19_Protocol_for_a_Mixed-Methods_Study_Preprint}, doi = {10.2196/preprints.44727}, year = {2022}, date = {2022-11-09}, journal = {JMIR Publications}, abstract = {Despite experiencing many adversities, American Indians/Alaska Natives (AI/ANs) have demonstrated tremendous resilience during the COVID-19 pandemic, drawing upon Indigenous determinants of health (IDOH) and Indigenous Nation-Building. OBJECTIVE Our multidisciplinary team undertook this study to achieve two aims: 1) to determine the role of IDOH in tribal government policy and action that support Indigenous mental health and wellbeing, and in turn, resilience during the COVID-19 crisis; and 2) to document the impact of IDOH on Indigenous mental health, wellbeing, and resilience of four specific community groups, including first responders, educators, traditional knowledge holders and practitioners, and the substance abuse recovery community, living and/or working in or near three Native nations in Arizona. To guide this study, we developed a conceptual framework based upon IDOH, Indigenous Nation-Building, and concepts of Indigenous Mental Wellbeing and Resilience. The research process was guided by the CARE Principles for Indigenous Data Governance to honor tribal and data sovereignty. Data were collected through a mixed methods research design - including interviews, talking circles, asset mapping, and coding of executive orders - that documented the contextual factors that contribute to mental health and wellbeing among Native nations. Special attention was placed on the assets and culturally, socially, and geographically distinct features of each Native nation and the communities within them. Our study was unique in that our research team consisted of predominantly Indigenous scholars and community researchers representing at least eight tribes and nations in the United States. The members of the team, regardless of whether they identified as Indigenous or non-Indigenous, have many collective years of experience working with Indigenous peoples and are committed to the health and wellbeing of tribal communities. RESULTS: The number of participants enrolled in this study was 105 adults, with a total of 92 individuals interviewed and 13 individuals engaged in four talking circles. Due to time constraints, the team elected to host talking circles with only one nation, with participants ranging from 2-6 in each group. Currently, we are in the process of conducting a qualitative analysis of the transcribed narratives from the interviews, talking circles, and executive orders. These processes and outcomes will be described in future manuscripts. CONCLUSIONS: This community-engaged study lays the groundwork for future studies addressing Indigenous mental health, wellbeing, and resilience. Findings from this study will be shared through presentations and publications to larger Indigenous and non-Indigenous audiences; local recovery groups, treatment centers, and individuals in recovery; K-12 and higher education educators and administrators; directors of first responder agencies; traditional medicine practitioners; and elected community leaders. The findings will also be used to produce wellbeing and resilience education materials, such as print and digital toolkits, in-service training sessions, and future recommendations for stakeholder organizations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Despite experiencing many adversities, American Indians/Alaska Natives (AI/ANs) have demonstrated tremendous resilience during the COVID-19 pandemic, drawing upon Indigenous determinants of health (IDOH) and Indigenous Nation-Building. OBJECTIVE Our multidisciplinary team undertook this study to achieve two aims: 1) to determine the role of IDOH in tribal government policy and action that support Indigenous mental health and wellbeing, and in turn, resilience during the COVID-19 crisis; and 2) to document the impact of IDOH on Indigenous mental health, wellbeing, and resilience of four specific community groups, including first responders, educators, traditional knowledge holders and practitioners, and the substance abuse recovery community, living and/or working in or near three Native nations in Arizona. To guide this study, we developed a conceptual framework based upon IDOH, Indigenous Nation-Building, and concepts of Indigenous Mental Wellbeing and Resilience. The research process was guided by the CARE Principles for Indigenous Data Governance to honor tribal and data sovereignty. Data were collected through a mixed methods research design - including interviews, talking circles, asset mapping, and coding of executive orders - that documented the contextual factors that contribute to mental health and wellbeing among Native nations. Special attention was placed on the assets and culturally, socially, and geographically distinct features of each Native nation and the communities within them. Our study was unique in that our research team consisted of predominantly Indigenous scholars and community researchers representing at least eight tribes and nations in the United States. The members of the team, regardless of whether they identified as Indigenous or non-Indigenous, have many collective years of experience working with Indigenous peoples and are committed to the health and wellbeing of tribal communities. RESULTS: The number of participants enrolled in this study was 105 adults, with a total of 92 individuals interviewed and 13 individuals engaged in four talking circles. Due to time constraints, the team elected to host talking circles with only one nation, with participants ranging from 2-6 in each group. Currently, we are in the process of conducting a qualitative analysis of the transcribed narratives from the interviews, talking circles, and executive orders. These processes and outcomes will be described in future manuscripts. CONCLUSIONS: This community-engaged study lays the groundwork for future studies addressing Indigenous mental health, wellbeing, and resilience. Findings from this study will be shared through presentations and publications to larger Indigenous and non-Indigenous audiences; local recovery groups, treatment centers, and individuals in recovery; K-12 and higher education educators and administrators; directors of first responder agencies; traditional medicine practitioners; and elected community leaders. The findings will also be used to produce wellbeing and resilience education materials, such as print and digital toolkits, in-service training sessions, and future recommendations for stakeholder organizations. |
Rink, Elizabeth; Firemoon, Paula; Anastario, Michael; Johnson, Olivia; GrowingThunder, Ramey; Ricker, Adriann; Peterson, Malory; Baldwin, Julie Frontiers in Public Health, 10 , 2022. @article{Rink2022, title = {Rationale, Design, and Methods for Nen Unkumbi/Edahiyedo ("We Are Here Now"): A Multi-Level Randomized Controlled Trial to Improve Sexual and Reproductive Health Outcomes in a Northern Plains American Indian Reservation Community}, author = {Elizabeth Rink and Paula Firemoon and Michael Anastario and Olivia Johnson and Ramey GrowingThunder and Adriann Ricker and Malory Peterson and Julie Baldwin}, url = {https://www.frontiersin.org/articles/10.3389/fpubh.2022.823228/full}, doi = {10.3389/fpubh.2022.823228}, year = {2022}, date = {2022-07-13}, journal = {Frontiers in Public Health}, volume = {10}, abstract = {American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities. |
Matt Ignacio Sabrina Oesterle, Micaela Mercado Ann Carver Gilberto Lopez Wendy Wolfersteig Stephanie Ayers Seol Ki Kathryn Hamm Sairam Parthasarathy Adam Berryhill Linnea Evans Samantha Sabo Chyke Doubeni Journal of Behavioral Medicine, 46 (1-2), pp. 140-152, 2022. @article{Ignacio2022b, title = {Narratives from African American/Black, American Indian/Alaska Native, and Hispanic/Latinx community members in Arizona to enhance COVID-19 vaccine and vaccination uptake}, author = {Matt Ignacio, Sabrina Oesterle, Micaela Mercado, Ann Carver, Gilberto Lopez, Wendy Wolfersteig, Stephanie Ayers, Seol Ki, Kathryn Hamm, Sairam Parthasarathy, Adam Berryhill, Linnea Evans, Samantha Sabo, Chyke Doubeni}, url = {https://doi.org/10.1007/s10865-022-00300-x}, doi = {10.1007/s10865-022-00300-x}, year = {2022}, date = {2022-03-24}, journal = {Journal of Behavioral Medicine}, volume = {46}, number = {1-2}, pages = {140-152}, abstract = {The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake. |
Dreifuss, Heather M; Belin, Kalvina L; Wilson, Jamie; George, Shawndeena; Waters, Amber-Rose; Bauer, Carmella Kahn 1and Mark B C; Teufel-Shone, Nicolette I Engaging Native American High School Students in Public Health Career Preparation Through the Indigenous Summer Enhancement Program Journal Article Frontiers in Public Heath, 10 , 2022. @article{Dreifuss2022, title = {Engaging Native American High School Students in Public Health Career Preparation Through the Indigenous Summer Enhancement Program}, author = {Heather M Dreifuss and Kalvina L Belin and Jamie Wilson and Shawndeena George and Amber-Rose Waters and Carmella B Kahn 1and Mark C Bauer and Nicolette I Teufel-Shone}, url = {https://pubmed.ncbi.nlm.nih.gov/35273937/10.3389/fpubh.2022.789994}, doi = {10.3389/fpubh.2022.789994}, year = {2022}, date = {2022-02-22}, journal = {Frontiers in Public Heath}, volume = {10}, abstract = {Native American populations are systematically marginalized in the healthcare and public health workforce. One effective approach to reduce health disparities and improve health care delivery among Indigenous populations is to train more Native American health professionals who integrate academic and cultural knowledge to understand and influence health behaviors and perspectives. Diné College partnered with Northern Arizona University to develop the Navajo Native American Research Center for Health (NARCH) Partnership, funded by the National Institutes of Health. The high school component of the Navajo NARCH Partnership created the Indigenous Summer Enhancement Program (ISEP), a 1-week summer training program providing exposure to health careers and mentorship in pursuing public health careers for Native American high school students. ISEP utilizes the Diné Educational Philosophy (DEP), a Navajo conceptual framework to serve as the foundation of the program. In 2020-2021, due to COVID-19 restrictions, the DEP model had to be incorporated in the Navajo NARCH high school virtual program activities. ISEP used 2018 and 2019 past program evaluation data to inform the virtual programming. Students' perception of the program was collected using an online Qualtrics evaluation questionnaire. Students stated appreciation for program staff, fellow students, peer mentors and culturally relevant learning experiences in both virtual and in-person environments. Recommendations included: expanding the length of ISEP and continuing the hands-on activities and Public Health Leadership series}, keywords = {}, pubstate = {published}, tppubtype = {article} } Native American populations are systematically marginalized in the healthcare and public health workforce. One effective approach to reduce health disparities and improve health care delivery among Indigenous populations is to train more Native American health professionals who integrate academic and cultural knowledge to understand and influence health behaviors and perspectives. Diné College partnered with Northern Arizona University to develop the Navajo Native American Research Center for Health (NARCH) Partnership, funded by the National Institutes of Health. The high school component of the Navajo NARCH Partnership created the Indigenous Summer Enhancement Program (ISEP), a 1-week summer training program providing exposure to health careers and mentorship in pursuing public health careers for Native American high school students. ISEP utilizes the Diné Educational Philosophy (DEP), a Navajo conceptual framework to serve as the foundation of the program. In 2020-2021, due to COVID-19 restrictions, the DEP model had to be incorporated in the Navajo NARCH high school virtual program activities. ISEP used 2018 and 2019 past program evaluation data to inform the virtual programming. Students' perception of the program was collected using an online Qualtrics evaluation questionnaire. Students stated appreciation for program staff, fellow students, peer mentors and culturally relevant learning experiences in both virtual and in-person environments. Recommendations included: expanding the length of ISEP and continuing the hands-on activities and Public Health Leadership series |
Harris, Robin B; Brown, Heidi E; Begay, Rachelle L; Sanderson, Priscilla R; Chief, Carmenlita; Monroy, Fernando P; Oren, Eyal Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona Journal Article Int. J. Environ. Res. Public Health, 19 (2), pp. 797, 2022. @article{Harris2022, title = {Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona}, author = {Robin B. Harris and Heidi E. Brown and Rachelle L. Begay and Priscilla R. Sanderson and Carmenlita Chief and Fernando P. Monroy and Eyal Oren }, url = {https://www.mdpi.com/1660-4601/19/2/797}, doi = {10.3390/ijerph19020797}, year = {2022}, date = {2022-01-12}, journal = {Int. J. Environ. Res. Public Health}, volume = {19}, number = {2}, pages = {797}, abstract = {Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of non-cardia gastric cancer. While gastric cancer has decreased in the United States (US), the incidence in the Navajo Nation is nearly four times higher than surrounding Non-Hispanic White populations. Little is known about H. pylori prevalence in this population or other Indigenous communities in the lower 48 states. In this cross-sectional study, 101 adults representing 73 households from three Navajo Nation chapter communities completed surveys and a urea breath test for active H. pylori. Accounting for intrahousehold correlation, H. pylori prevalence was 56.4% (95% CI, 45.4–66.8) and 72% of households had at least one infected person. The odds of having an active infection in households using unregulated water were 8.85 (95% CI, 1.50–53.38) that of the use of regulated water, and males had 3.26 (95% CI, 1.05–10.07) higher odds than female. The prevalence of H. pylori in Navajo is similar to that seen in Alaska Natives. Further investigation into factors associated with prevention of infection is needed as well as understanding barriers to screening and treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of non-cardia gastric cancer. While gastric cancer has decreased in the United States (US), the incidence in the Navajo Nation is nearly four times higher than surrounding Non-Hispanic White populations. Little is known about H. pylori prevalence in this population or other Indigenous communities in the lower 48 states. In this cross-sectional study, 101 adults representing 73 households from three Navajo Nation chapter communities completed surveys and a urea breath test for active H. pylori. Accounting for intrahousehold correlation, H. pylori prevalence was 56.4% (95% CI, 45.4–66.8) and 72% of households had at least one infected person. The odds of having an active infection in households using unregulated water were 8.85 (95% CI, 1.50–53.38) that of the use of regulated water, and males had 3.26 (95% CI, 1.05–10.07) higher odds than female. The prevalence of H. pylori in Navajo is similar to that seen in Alaska Natives. Further investigation into factors associated with prevention of infection is needed as well as understanding barriers to screening and treatment. |
Pro, George; Camplain, Ricky; de Heer, Brooke; Chief, Carmenlita; Teufel-Shone, Nicolette I Journal of Racial and Ethnic Health Disparities, 2020. @article{Pro2020bb, title = {A National Epidemiologic Profile of Physical Intimate Partner Violence, Adverse Childhood Experiences, and Supportive Childhood Relationships: Group Differences in Predicted Trends and Associations}, author = {George Pro and Ricky Camplain and Brooke de Heer and Carmenlita Chief and Nicolette I. Teufel-Shone}, url = {https://doi.org/10.1007/s40615-019-00696-4}, doi = {10.1007/s40615-019-00696-4}, year = {2020}, date = {2020-01-07}, journal = {Journal of Racial and Ethnic Health Disparities}, abstract = {Adverse childhood experiences (ACEs) are common in the USA and associated with multiple health sequelae. Physical intimate partner violence (IPV) is a type of revictimization that some adults with ACEs may be more prone to. Positive and supportive childhood environments may buffer the effects of ACEs, but little is known about the differential associations between physical IPV and ACEs and supportive childhood environments. We sought to illustrate racial/ethnic and gender differences in the adjusted predicted probability of physical IPV across multiple ACE and supportive childhood scores.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Adverse childhood experiences (ACEs) are common in the USA and associated with multiple health sequelae. Physical intimate partner violence (IPV) is a type of revictimization that some adults with ACEs may be more prone to. Positive and supportive childhood environments may buffer the effects of ACEs, but little is known about the differential associations between physical IPV and ACEs and supportive childhood environments. We sought to illustrate racial/ethnic and gender differences in the adjusted predicted probability of physical IPV across multiple ACE and supportive childhood scores. |
Dickerson, Daniel; Baldwin, Julie A; Belcourt, Annie; Belone, Lorenda; Gittelsohn, Joel; Kaholokula, Joseph Keawe’aimoku; Lowe, John; Patten, Christi A; Wallerstein, Nina Encompassing Cultural Contexts Within Scientific Research Methodologies in the Development of Health Promotion Interventions Journal Article Prevention Science, 2020. @article{Dickerson2018b, title = {Encompassing Cultural Contexts Within Scientific Research Methodologies in the Development of Health Promotion Interventions}, author = {Daniel Dickerson and Julie A Baldwin and Annie Belcourt and Lorenda Belone and Joel Gittelsohn and Joseph Keawe’aimoku Kaholokula and John Lowe and Christi A Patten and Nina Wallerstein}, url = {https://link.springer.com/article/10.1007%2Fs11121-018-0926-1}, doi = {https://doi.org/10.1007/s11121-018-0926-1}, year = {2020}, date = {2020-01-01}, journal = {Prevention Science}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Hulen, Elizabeth; Hardy, Lisa J; Teufel-Shone, Nicolette; Sanderson, Priscilla R; Schwartz, Anna L; Begay, Cruz R Community Based Participatory Research (CBPR): A Dynamic Process of Health care, Provider Perceptions and American Indian Patients' Resilience Journal Article Journal of Health Care for the Poor and Underserved, 30 (1), pp. 221-237, 2019. @article{Hulen2019, title = {Community Based Participatory Research (CBPR): A Dynamic Process of Health care, Provider Perceptions and American Indian Patients' Resilience}, author = {Elizabeth Hulen and Lisa J Hardy and Nicolette Teufel-Shone and Priscilla R Sanderson and Anna L Schwartz and Cruz R Begay}, url = {https://muse.jhu.edu/article/717742}, year = {2019}, date = {2019-02-01}, journal = {Journal of Health Care for the Poor and Underserved}, volume = {30}, number = {1}, pages = {221-237}, abstract = {American Indians are disproportionately affected by factors that lead to health disparities, however many Native people demonstrate resilience when faced with health risks. Study objectives were to use a resilience framework to identify wellness strategies among American Indian people and to assess health care provider perceptions of American Indian wellness. Participants included 39 American Indian adults who self-reported resilient change and 22 health care providers who served American Indian patients. Thematic categories across American Indian and health care provider data were identified: 1) relationships inform resilience; 2) prejudice stymies resilience; and 3) place shapes resilience. Results indicated the salience of relationships in demonstrating resilience. Identified challenges and supporters of resilience are discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indians are disproportionately affected by factors that lead to health disparities, however many Native people demonstrate resilience when faced with health risks. Study objectives were to use a resilience framework to identify wellness strategies among American Indian people and to assess health care provider perceptions of American Indian wellness. Participants included 39 American Indian adults who self-reported resilient change and 22 health care providers who served American Indian patients. Thematic categories across American Indian and health care provider data were identified: 1) relationships inform resilience; 2) prejudice stymies resilience; and 3) place shapes resilience. Results indicated the salience of relationships in demonstrating resilience. Identified challenges and supporters of resilience are discussed. |
Cordova-Marks, Felina M; Harris, Robin; Teufel-Shone, Nicolette I; Norton, Beatrice; Mastergeorge, Ann M; Gerald, Lynn Characteristics of American Indian Female Caregivers on a Southwest American Indian Reservation Journal Article Journal of Community Health, 44 (1), pp. 52-60, 2019. @article{Cordova-Marks2019, title = {Characteristics of American Indian Female Caregivers on a Southwest American Indian Reservation}, author = {Felina M Cordova-Marks and Robin Harris and Nicolette I Teufel-Shone and Beatrice Norton and Ann M Mastergeorge and Lynn Gerald}, url = {https://link.springer.com/article/10.1007/s10900-018-0552-7}, year = {2019}, date = {2019-02-01}, journal = {Journal of Community Health}, volume = {44}, number = {1}, pages = {52-60}, abstract = {American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress. |
Wilson, Jamie; Sabo, Samantha; Chief, Carmenlita; Clark, Hershel; Yazzie, Alfred; Nahee, Jacqueline; Leischow, Scott; Henderson, Patricia Nez DINÉ (NAVAJO) HEALER PERSPECTIVES ON COMMERCIAL TOBACCO USE IN CEREMONIAL SETTINGS: AN ORAL STORY PROJECT TO PROMOTE SMOKE-FREE LIFE Journal Article American Indian and Alaska Native Mental Health Research, 26 (1), pp. 63-78, 2019. @article{Wilson2019, title = {DINÉ (NAVAJO) HEALER PERSPECTIVES ON COMMERCIAL TOBACCO USE IN CEREMONIAL SETTINGS: AN ORAL STORY PROJECT TO PROMOTE SMOKE-FREE LIFE}, author = {Jamie Wilson and Samantha Sabo and Carmenlita Chief and Hershel Clark and Alfred Yazzie and Jacqueline Nahee and Scott Leischow and Patricia Nez Henderson}, url = {http://www.ucdenver.edu/academics/colleges/PublicHealth/research/centers/CAIANH/journal/Documents/Volume-26/26_1_2019_63_wilson.pdf}, year = {2019}, date = {2019-01-01}, journal = {American Indian and Alaska Native Mental Health Research}, volume = {26}, number = {1}, pages = {63-78}, abstract = {Many American Indian (AI) healers are faced with a dilemma of how to maintain the ceremonial uses of traditional tobacco meant to encourage the restoration and balance of mind, body, and spirit, while discouraging commercial tobacco use and protecting against secondhand smoke exposure in ceremonial settings. To explore this dilemma and offer culturally informed solutions, researchers conducted qualitative interviews with Navajo healers who describe the history and role of commercial tobacco within ceremonial contexts. Healers understand the importance of their role on their community’s health and expressed deep concern about the use of commercial tobacco in the ceremonial setting. Healers play an important role in curbing the use of commercial tobacco and limiting the exposure to secondhand smoke in ceremonial settings and beyond. Study implications include the importance of understanding traditional and cultural knowledge and its potential as a pathway to solve contemporary public health issues facing AI communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Many American Indian (AI) healers are faced with a dilemma of how to maintain the ceremonial uses of traditional tobacco meant to encourage the restoration and balance of mind, body, and spirit, while discouraging commercial tobacco use and protecting against secondhand smoke exposure in ceremonial settings. To explore this dilemma and offer culturally informed solutions, researchers conducted qualitative interviews with Navajo healers who describe the history and role of commercial tobacco within ceremonial contexts. Healers understand the importance of their role on their community’s health and expressed deep concern about the use of commercial tobacco in the ceremonial setting. Healers play an important role in curbing the use of commercial tobacco and limiting the exposure to secondhand smoke in ceremonial settings and beyond. Study implications include the importance of understanding traditional and cultural knowledge and its potential as a pathway to solve contemporary public health issues facing AI communities. |
Teufel-Shone, Nicolette I; Schwartz, Anna L; Hardy, Lisa J; Heer, Hendrik De D; Williamson, Heather J; Dunn, Dorothy J; Polingyumptewa, Kellen; Chief, Carmenlita Supporting New Community-Based Participatory Research Partnerships Journal Article International Journal of Environmental Research and Public Health, 16 (1), pp. 44, 2019. @article{Teufel-Shone2019, title = {Supporting New Community-Based Participatory Research Partnerships}, author = {Nicolette I Teufel-Shone and Anna L Schwartz and Lisa J Hardy and Hendrik De D Heer and Heather J Williamson and Dorothy J Dunn and Kellen Polingyumptewa and Carmenlita Chief}, url = {https://www.mdpi.com/1660-4601/16/1/44/htm}, year = {2019}, date = {2019-01-01}, journal = {International Journal of Environmental Research and Public Health}, volume = {16}, number = {1}, pages = {44}, abstract = {Marginalized communities have a documented distrust of research grounded in negative portrayals in the academic literature. Yet, trusted partnerships, the foundation for Community-Based Participatory Research (CBPR), require time to build the capacity for joint decision-making, equitable involvement of academically trained and community investigators, and co-learning. Trust can be difficult to develop within the short time between a funding opportunity announcement and application submission. Resources to support community- and academic-based investigators’ time to discuss contexts, concerns, integration of expertise and locally acceptable research designs and data collection are limited. The National Institutes of Health (NIH) funded Center for American Indian Resilience and the Southwest Health Equity Research Collaborative have implemented an internal funding mechanism to support community and academic-based investigators’ travel cost and time to discuss complementary areas of interest and skills and to decide if moving forward with a partnership and a collaborative grant proposal would be beneficial to the community. The rationale and administration of this Community-Campus Partnership Support (CCPS) Program are described and four examples of supported efforts are provided. Centers and training programs frequently fund pilot grants to support junior investigators and/or exploratory research. This CCPS mechanism should be considered as precursor to pilot work, to stimulate partnership building without the pressure of an approaching grant application deadline.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Marginalized communities have a documented distrust of research grounded in negative portrayals in the academic literature. Yet, trusted partnerships, the foundation for Community-Based Participatory Research (CBPR), require time to build the capacity for joint decision-making, equitable involvement of academically trained and community investigators, and co-learning. Trust can be difficult to develop within the short time between a funding opportunity announcement and application submission. Resources to support community- and academic-based investigators’ time to discuss contexts, concerns, integration of expertise and locally acceptable research designs and data collection are limited. The National Institutes of Health (NIH) funded Center for American Indian Resilience and the Southwest Health Equity Research Collaborative have implemented an internal funding mechanism to support community and academic-based investigators’ travel cost and time to discuss complementary areas of interest and skills and to decide if moving forward with a partnership and a collaborative grant proposal would be beneficial to the community. The rationale and administration of this Community-Campus Partnership Support (CCPS) Program are described and four examples of supported efforts are provided. Centers and training programs frequently fund pilot grants to support junior investigators and/or exploratory research. This CCPS mechanism should be considered as precursor to pilot work, to stimulate partnership building without the pressure of an approaching grant application deadline. |
Walters, Karina L; Johnson-Jennings, Michelle; Stroud, Sandra; Rasmus, Stacy; Charles, Billy; John, Simeon; Allen, James; Kaholokula, Joseph Keawe‘aimoku; Look, Mele A; de Silva, Māpuana; Lowe, John; Baldwin, Julie A; Lawrence, Gary; Brooks, Jada; Noonan, Curtis W; Belcourt, Annie; Quintana, Eugenia; Semmens, Erin O; Boulafentis, Johna Prevention Science, pp. 1-11, 2018. @article{Walters2018, title = {Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities}, author = {Karina L Walters and Michelle Johnson-Jennings and Sandra Stroud and Stacy Rasmus and Billy Charles and Simeon John and James Allen and Joseph Keawe‘aimoku Kaholokula and Mele A Look and Māpuana de Silva and John Lowe and Julie A Baldwin and Gary Lawrence and Jada Brooks and Curtis W Noonan and Annie Belcourt and Eugenia Quintana and Erin O Semmens and Johna Boulafentis}, url = {https://link.springer.com/article/10.1007%2Fs11121-018-0952-z}, year = {2018}, date = {2018-11-06}, journal = {Prevention Science}, pages = {1-11}, abstract = {Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts “from the ground up.” Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts “from the ground up.” Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions. |
Walters, Karina L; Johnson-Jennings, Michelle; Stroud, Sandra; Rasmus, Stacy; Charles, Billy; John, Simeon; Allen, James; Kaholokula, Joseph Keawe‘aimoku; Look, Mele A; de Silva, Māpuana; Lowe, John; Baldwin, Julie A; Lawrence, Gary; Brooks, Jada; Noonan, Curtis W; Belcourt, Annie; Quintana, Eugenia; Semmens, Erin O; Boulafentis, Johna Prevention Science, pp. 1-11, 2018. @article{Walters2018b, title = {Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities.}, author = {Karina L. Walters and Michelle Johnson-Jennings and Sandra Stroud and Stacy Rasmus and Billy Charles and Simeon John and James Allen and Joseph Keawe‘aimoku Kaholokula and Mele A. Look and Māpuana de Silva and John Lowe and Julie A. Baldwin and Gary Lawrence and Jada Brooks and Curtis W. Noonan and Annie Belcourt and Eugenia Quintana and Erin O. Semmens and Johna Boulafentis}, url = {https://www.ncbi.nlm.nih.gov/pubmed/30397737}, doi = {10.1007/s11121-018-0952-z}, year = {2018}, date = {2018-11-06}, journal = {Prevention Science}, pages = {1-11}, abstract = {Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts "from the ground up." Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts "from the ground up." Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions. |
King, Caroline; Atwood, Sidney; Lozada, Mia; Nelson, Adrianne Katrina; Brown, Chris; Sabo, Samantha; Curley, Cameron; Muskett, Olivia; Orav, Endel John; Shin, Sonya PLoS ONE, 13 (8), 2018. @article{King2018b, title = {Identifying risk factors for 30-day readmission events among American Indian patients with diabetes in the Four Corners region of the southwest from 2009 to 2016.}, author = {Caroline King and Sidney Atwood and Mia Lozada and Adrianne Katrina Nelson and Chris Brown and Samantha Sabo and Cameron Curley and Olivia Muskett and Endel John Orav and Sonya Shin}, editor = {Prabath W. B. Nanayakkara}, url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195476}, doi = {10.1371/journal.pone.0195476}, year = {2018}, date = {2018-08-02}, journal = {PLoS ONE}, volume = {13}, number = {8}, abstract = {OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission.}, keywords = {}, pubstate = {published}, tppubtype = {article} } OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission. |
Cordova-Marks, Felina M; Harris, Robin; Teufel-Shone, Nicolette; Norton, Beatrice; Mastergeorge, Ann M; Gerald, Lynn Characteristics of American Indian female caregivers on a Southwest American Indian reservation Journal Article Journal of Community Health, 2018. @article{Cordova-Marks2018, title = {Characteristics of American Indian female caregivers on a Southwest American Indian reservation}, author = {Felina M Cordova-Marks and Robin Harris and Nicolette Teufel-Shone and Beatrice Norton and Ann M Mastergeorge and Lynn Gerald}, url = {https://link.springer.com/article/10.1007%2Fs10900-018-0552-7}, year = {2018}, date = {2018-07-28}, journal = {Journal of Community Health}, abstract = {American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress. |
2023 |
Curley, Caleigh; Eddie, Regina; Tallis, Kristen; Lane, Taylor S; Yazzie, Del; Sanderson, Priscilla R; Lorts, Cori; Shin, Sonya; Behrens, Timothy K; George, Carmen; Antone-Nez, Ramona; Ashley, Christine; de Heer, Hendrik D The Navajo Nation Healthy Diné Nation Act: Community Support of a 2% Tax on Unhealthy Foods Journal Article Journal of Public Health Management and Practice: JPHMP, 29(5) (00), pp. 622-632, 2023. @article{Curley2023, title = {The Navajo Nation Healthy Diné Nation Act: Community Support of a 2% Tax on Unhealthy Foods}, author = {Caleigh Curley and Regina Eddie and Kristen Tallis and Taylor S Lane and Del Yazzie and Priscilla R Sanderson and Cori Lorts and Sonya Shin and Timothy K Behrens and Carmen George and Ramona Antone-Nez and Christine Ashley and Hendrik D de Heer}, url = {https://journals.lww.com/jphmp/fulltext/2023/09000/the_navajo_nation_healthy_din__nation_act_.4.aspx}, doi = {10.1097/PHH.0000000000001753}, year = {2023}, date = {2023-05-23}, journal = {Journal of Public Health Management and Practice: JPHMP}, volume = {29(5)}, number = {00}, pages = {622-632}, abstract = {Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value (“junk foods”) on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25000 annually, and 69.7% were female. Half of the respondents said they “support”(37.4%) or “strongly support”(13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P=. 025) and education (P=. 026) and understanding of the legislation (P<. 001 for “very well” vs “not at all”) had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P<. 001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value (“junk foods”) on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25000 annually, and 69.7% were female. Half of the respondents said they “support”(37.4%) or “strongly support”(13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P=. 025) and education (P=. 026) and understanding of the legislation (P<. 001 for “very well” vs “not at all”) had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P<. 001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had … |
Samantha Sabo Louisa O'Meara, Janet Yellowhair Joyce Hamilton JT Nashio Brook Bender Fernando Flores Jr Marianne Bennett Rema Metts Isabella Denton Kim Russell Frontiers in Public Health, 11 , 2023. @article{Sabo2023b, title = {Community Health Representative Workforce: Integration across systems and teams to address the social determinants of indigenous health and wellbeing}, author = {Samantha Sabo, Louisa O'Meara, Janet Yellowhair, Joyce Hamilton, JT Nashio, Brook Bender, Fernando Flores Jr, Marianne Bennett, Rema Metts, Isabella Denton, Kim Russell}, editor = {Lily K. Lee}, url = {https://doi.org/10.3389/fpubh.2023.1047152}, doi = {10.3389/fpubh.2023.1047152}, year = {2023}, date = {2023-03-15}, journal = {Frontiers in Public Health}, volume = {11}, abstract = {Tribally employed, Community Health Representatives (CHRs) serving Indigenous and American Indian and Alaskan Native (AIAN) peoples are culturally and linguistically embedded community leaders, with the unique ability to serve as the link and intermediary between community members and systems. Unique to the CHR workforce scope of practice is the expectation for high level integration within the medical and social service care team. This explicit role outlined in the scope of work sets an expectation for both CHR and care teams to deliver integrated patient, family, and systems level care coordination and case management. This paper aims to build from our previous manuscript published in Volume 1 of the special issue Community Health Workers Practice from Recruitment to Integration. In that Volume, we explored through a Community Case Study CHR Managers’ perspectives on the challenges and opportunities for full CHR integration into health systems and teams serving AIAN. In this paper, we offer new information about the current CHR and CHR Managers’ involvements and perceived level of integration within health care teams and the broader public health systems addressing the social and structural determinants of health. We approach this topic considering the COVID-19 pandemic and how CHRs and CHR Programs were included and not included in tribal pandemic response efforts.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Tribally employed, Community Health Representatives (CHRs) serving Indigenous and American Indian and Alaskan Native (AIAN) peoples are culturally and linguistically embedded community leaders, with the unique ability to serve as the link and intermediary between community members and systems. Unique to the CHR workforce scope of practice is the expectation for high level integration within the medical and social service care team. This explicit role outlined in the scope of work sets an expectation for both CHR and care teams to deliver integrated patient, family, and systems level care coordination and case management. This paper aims to build from our previous manuscript published in Volume 1 of the special issue Community Health Workers Practice from Recruitment to Integration. In that Volume, we explored through a Community Case Study CHR Managers’ perspectives on the challenges and opportunities for full CHR integration into health systems and teams serving AIAN. In this paper, we offer new information about the current CHR and CHR Managers’ involvements and perceived level of integration within health care teams and the broader public health systems addressing the social and structural determinants of health. We approach this topic considering the COVID-19 pandemic and how CHRs and CHR Programs were included and not included in tribal pandemic response efforts. |
Sabo, Samantha; Lee, Naomi; Sears, Grant; Jiménez, Dulce J; Tutt, Marissa; Santos, Jeffersson; Gomez, Omar; Teufel-Shone, Nicolette; Bennet, Marianne; Nashio, Neva T; Flores, Fernando; Baldwin, Julie Community Health Representatives as Trusted Sources for Increasing Representation of American Indian Communities in Clinical Research Journal Article International Journal of Environmental Research and Public Health, 20 (5), 2023. @article{Sabo2023, title = {Community Health Representatives as Trusted Sources for Increasing Representation of American Indian Communities in Clinical Research}, author = {Samantha Sabo and Naomi Lee and Grant Sears and Dulce J. Jiménez and Marissa Tutt and Jeffersson Santos and Omar Gomez and Nicolette Teufel-Shone and Marianne Bennet and T. Neva Nashio and Fernando Flores and Julie Baldwin}, url = {https://doi.org/10.3390/ijerph20054391}, doi = {10.3390/ijerph20054391}, year = {2023}, date = {2023-03-01}, journal = {International Journal of Environmental Research and Public Health}, volume = {20}, number = {5}, abstract = {Indigenous and American Indian Alaskan Native (AI/AN) community members are systematically underrepresented in clinical trial research. This paper focuses on exploratory steps to partner with Native Nations of Arizona to engage Community Health Representatives (CHR) as a trusted source for building COVID-19 clinical trial research, including vaccine trials awareness. CHRs are frontline public health workers who apply a unique understanding of the experience, language, and culture of the population served. This workforce has entered the spotlight as essential to the prevention and control of COVID-19. Methods: Three Tribal CHR programs were engaged to develop and refine culturally centered educational materials and a pre-post survey using a consensus-based decision-making approach. CHRs used these materials in brief education sessions during regular client home visits and community events. At 30 days post CHR intervention, participants (N = 165) demonstrated significantly increased awareness about and ability to enroll in COVID-19 treatment and vaccine trials. Participants also described a significant increase in trust in researchers, decreased perceived barriers related to cost for participation in a clinical trial, and improved belief that participation in a COVID-19 clinical trial for treatment was considered a benefit to American Indian and Alaskan Native people. CHRs as trusted sources of information, coupled with culturally centered education materials designed by CHRs for CHR clients, demonstrated a promising approach to improved awareness of clinical trial research generally and COVID-19 trials specifically among Indigenous and American Indian community members of Arizona.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Indigenous and American Indian Alaskan Native (AI/AN) community members are systematically underrepresented in clinical trial research. This paper focuses on exploratory steps to partner with Native Nations of Arizona to engage Community Health Representatives (CHR) as a trusted source for building COVID-19 clinical trial research, including vaccine trials awareness. CHRs are frontline public health workers who apply a unique understanding of the experience, language, and culture of the population served. This workforce has entered the spotlight as essential to the prevention and control of COVID-19. Methods: Three Tribal CHR programs were engaged to develop and refine culturally centered educational materials and a pre-post survey using a consensus-based decision-making approach. CHRs used these materials in brief education sessions during regular client home visits and community events. At 30 days post CHR intervention, participants (N = 165) demonstrated significantly increased awareness about and ability to enroll in COVID-19 treatment and vaccine trials. Participants also described a significant increase in trust in researchers, decreased perceived barriers related to cost for participation in a clinical trial, and improved belief that participation in a COVID-19 clinical trial for treatment was considered a benefit to American Indian and Alaskan Native people. CHRs as trusted sources of information, coupled with culturally centered education materials designed by CHRs for CHR clients, demonstrated a promising approach to improved awareness of clinical trial research generally and COVID-19 trials specifically among Indigenous and American Indian community members of Arizona. |
Kahn, Carmella B; James, DeeDee; George, Shawndeena; Johnson, Tressica; Kahn-John, Michelle; Teufel-Shone, Nicolette I; Begay, Chassity; Tutt, Marissa; Bauer, Mark C Diné (Navajo) Traditional Knowledge Holders’ Perspective of COVID-19 Journal Article Int. J. Environ. Res. Public Health, 20 (4), pp. 3728, 2023. @article{Kahn2023, title = {Diné (Navajo) Traditional Knowledge Holders’ Perspective of COVID-19}, author = {Carmella B. Kahn and DeeDee James and Shawndeena George and Tressica Johnson and Michelle Kahn-John and Nicolette I. Teufel-Shone and Chassity Begay and Marissa Tutt and Mark C. Bauer}, url = {https://doi.org/10.3390/ijerph20043728}, doi = {10.3390/ijerph20043728}, year = {2023}, date = {2023-02-20}, journal = {Int. J. Environ. Res. Public Health}, volume = {20}, number = {4}, pages = {3728}, abstract = {From the start of the COVID-19 pandemic on the Navajo Nation, Diné (Navajo) traditional knowledge holders (TKHs), such as medicine men and women and traditional practitioners, contributed their services and healing practices. Although TKHs are not always fully acknowledged in the western health care system, they have an established role to protect and promote the health of Diné people. To date, their roles in mitigating the COVID-19 pandemic have not been fully explored. The purpose of this research was to understand the social and cultural contexts of the COVID-19 pandemic and vaccines based on the roles and perspectives of Diné TKHs. A multi-investigator consensus analysis was conducted by six American Indian researchers using interviews with TKHs collected between December 2021–January 2022. The Hózhó Resilience Model was used as a framework to analyze the data using four parent themes: COVID-19, harmony and relationships, spirituality, and respect for self and discipline. These parent themes were further organized into promoters and/or barriers for 12 sub-themes that emerged from the data, such as traditional knowledge, Diné identity, and vaccine. Overall, the analysis showed key factors that could be applied in pandemic planning and public health mitigation efforts based on the cultural perspective of TKHs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } From the start of the COVID-19 pandemic on the Navajo Nation, Diné (Navajo) traditional knowledge holders (TKHs), such as medicine men and women and traditional practitioners, contributed their services and healing practices. Although TKHs are not always fully acknowledged in the western health care system, they have an established role to protect and promote the health of Diné people. To date, their roles in mitigating the COVID-19 pandemic have not been fully explored. The purpose of this research was to understand the social and cultural contexts of the COVID-19 pandemic and vaccines based on the roles and perspectives of Diné TKHs. A multi-investigator consensus analysis was conducted by six American Indian researchers using interviews with TKHs collected between December 2021–January 2022. The Hózhó Resilience Model was used as a framework to analyze the data using four parent themes: COVID-19, harmony and relationships, spirituality, and respect for self and discipline. These parent themes were further organized into promoters and/or barriers for 12 sub-themes that emerged from the data, such as traditional knowledge, Diné identity, and vaccine. Overall, the analysis showed key factors that could be applied in pandemic planning and public health mitigation efforts based on the cultural perspective of TKHs. |
Eddie, Regina S; Karntisching, Laura; Eccleston, Bobby; Schwartz, Anna Addressing Health Inequities through Simulation Training and Education in Rural and Tribal Communities Journal Article International Journal of Nursing and Health Care Research, 6 , 2023. @article{Eddie2023, title = {Addressing Health Inequities through Simulation Training and Education in Rural and Tribal Communities}, author = {Regina S Eddie and Laura Karntisching and Bobby Eccleston and Anna Schwartz}, url = {https://doi.org/10.29011/2688-9501.101388}, doi = {10.29011/2688-9501.101388}, year = {2023}, date = {2023-01-16}, journal = {International Journal of Nursing and Health Care Research}, volume = {6}, abstract = {The nursing shortage is serious and getting worse in medically underserved areas. Nursing education needs to include faculty education in simulation-based education that focuses on public health and cultural education. New nurse graduates are inadequately prepared and need additional training to provide culturally appropriate care to varied and rural populations. Method: This project used simulation-based education and rural clinical placements to enhance the training and education needs of faculty, students and community partners to better address the health care needs of people living in rural and medically underserved areas of the Navajo Nation and northern Arizona. Results: The project increased knowledge and interest among faculty and community partners on simulation-based education as well as positive student learning experiences. Conclusion: Public health and culture can be integrated into simulation-based education. Partnerships with tribal communities can play a valuable role in nursing education.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The nursing shortage is serious and getting worse in medically underserved areas. Nursing education needs to include faculty education in simulation-based education that focuses on public health and cultural education. New nurse graduates are inadequately prepared and need additional training to provide culturally appropriate care to varied and rural populations. Method: This project used simulation-based education and rural clinical placements to enhance the training and education needs of faculty, students and community partners to better address the health care needs of people living in rural and medically underserved areas of the Navajo Nation and northern Arizona. Results: The project increased knowledge and interest among faculty and community partners on simulation-based education as well as positive student learning experiences. Conclusion: Public health and culture can be integrated into simulation-based education. Partnerships with tribal communities can play a valuable role in nursing education. |
2022 |
Baldwin, Julie A; A, Alvarado; K, Jarratt-Snider; A, Hunter; C, Keene; A, Castagno; A, Ali-Joseph; J, Roddy; Jr, Begay M; Joseph D, Goldtooth C; C, Camplain; M, Smith; K, McCue; A, Begay; N, Teufel-Shone Understanding Resilience and Mental Wellbeing in Southwest Indigenous Nations and the Impact of COVID-19: Protocol for a Mixed-Methods Study Journal Article JMIR Publications, 2022. @article{Baldwin2022, title = {Understanding Resilience and Mental Wellbeing in Southwest Indigenous Nations and the Impact of COVID-19: Protocol for a Mixed-Methods Study}, author = {Julie A. Baldwin and Alvarado A and Jarratt-Snider K and Hunter A and Keene C and Castagno A and Ali-Joseph A and Roddy J and Begay M Jr and Joseph D, Goldtooth C and Camplain C and Smith M and McCue K and Begay A and Teufel-Shone N}, url = {https://www.researchgate.net/publication/366048977_Understanding_Resilience_and_Mental_Wellbeing_in_Southwest_Indigenous_Nations_and_the_Impact_of_COVID-19_Protocol_for_a_Mixed-Methods_Study_Preprint}, doi = {10.2196/preprints.44727}, year = {2022}, date = {2022-11-09}, journal = {JMIR Publications}, abstract = {Despite experiencing many adversities, American Indians/Alaska Natives (AI/ANs) have demonstrated tremendous resilience during the COVID-19 pandemic, drawing upon Indigenous determinants of health (IDOH) and Indigenous Nation-Building. OBJECTIVE Our multidisciplinary team undertook this study to achieve two aims: 1) to determine the role of IDOH in tribal government policy and action that support Indigenous mental health and wellbeing, and in turn, resilience during the COVID-19 crisis; and 2) to document the impact of IDOH on Indigenous mental health, wellbeing, and resilience of four specific community groups, including first responders, educators, traditional knowledge holders and practitioners, and the substance abuse recovery community, living and/or working in or near three Native nations in Arizona. To guide this study, we developed a conceptual framework based upon IDOH, Indigenous Nation-Building, and concepts of Indigenous Mental Wellbeing and Resilience. The research process was guided by the CARE Principles for Indigenous Data Governance to honor tribal and data sovereignty. Data were collected through a mixed methods research design - including interviews, talking circles, asset mapping, and coding of executive orders - that documented the contextual factors that contribute to mental health and wellbeing among Native nations. Special attention was placed on the assets and culturally, socially, and geographically distinct features of each Native nation and the communities within them. Our study was unique in that our research team consisted of predominantly Indigenous scholars and community researchers representing at least eight tribes and nations in the United States. The members of the team, regardless of whether they identified as Indigenous or non-Indigenous, have many collective years of experience working with Indigenous peoples and are committed to the health and wellbeing of tribal communities. RESULTS: The number of participants enrolled in this study was 105 adults, with a total of 92 individuals interviewed and 13 individuals engaged in four talking circles. Due to time constraints, the team elected to host talking circles with only one nation, with participants ranging from 2-6 in each group. Currently, we are in the process of conducting a qualitative analysis of the transcribed narratives from the interviews, talking circles, and executive orders. These processes and outcomes will be described in future manuscripts. CONCLUSIONS: This community-engaged study lays the groundwork for future studies addressing Indigenous mental health, wellbeing, and resilience. Findings from this study will be shared through presentations and publications to larger Indigenous and non-Indigenous audiences; local recovery groups, treatment centers, and individuals in recovery; K-12 and higher education educators and administrators; directors of first responder agencies; traditional medicine practitioners; and elected community leaders. The findings will also be used to produce wellbeing and resilience education materials, such as print and digital toolkits, in-service training sessions, and future recommendations for stakeholder organizations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Despite experiencing many adversities, American Indians/Alaska Natives (AI/ANs) have demonstrated tremendous resilience during the COVID-19 pandemic, drawing upon Indigenous determinants of health (IDOH) and Indigenous Nation-Building. OBJECTIVE Our multidisciplinary team undertook this study to achieve two aims: 1) to determine the role of IDOH in tribal government policy and action that support Indigenous mental health and wellbeing, and in turn, resilience during the COVID-19 crisis; and 2) to document the impact of IDOH on Indigenous mental health, wellbeing, and resilience of four specific community groups, including first responders, educators, traditional knowledge holders and practitioners, and the substance abuse recovery community, living and/or working in or near three Native nations in Arizona. To guide this study, we developed a conceptual framework based upon IDOH, Indigenous Nation-Building, and concepts of Indigenous Mental Wellbeing and Resilience. The research process was guided by the CARE Principles for Indigenous Data Governance to honor tribal and data sovereignty. Data were collected through a mixed methods research design - including interviews, talking circles, asset mapping, and coding of executive orders - that documented the contextual factors that contribute to mental health and wellbeing among Native nations. Special attention was placed on the assets and culturally, socially, and geographically distinct features of each Native nation and the communities within them. Our study was unique in that our research team consisted of predominantly Indigenous scholars and community researchers representing at least eight tribes and nations in the United States. The members of the team, regardless of whether they identified as Indigenous or non-Indigenous, have many collective years of experience working with Indigenous peoples and are committed to the health and wellbeing of tribal communities. RESULTS: The number of participants enrolled in this study was 105 adults, with a total of 92 individuals interviewed and 13 individuals engaged in four talking circles. Due to time constraints, the team elected to host talking circles with only one nation, with participants ranging from 2-6 in each group. Currently, we are in the process of conducting a qualitative analysis of the transcribed narratives from the interviews, talking circles, and executive orders. These processes and outcomes will be described in future manuscripts. CONCLUSIONS: This community-engaged study lays the groundwork for future studies addressing Indigenous mental health, wellbeing, and resilience. Findings from this study will be shared through presentations and publications to larger Indigenous and non-Indigenous audiences; local recovery groups, treatment centers, and individuals in recovery; K-12 and higher education educators and administrators; directors of first responder agencies; traditional medicine practitioners; and elected community leaders. The findings will also be used to produce wellbeing and resilience education materials, such as print and digital toolkits, in-service training sessions, and future recommendations for stakeholder organizations. |
Rink, Elizabeth; Firemoon, Paula; Anastario, Michael; Johnson, Olivia; GrowingThunder, Ramey; Ricker, Adriann; Peterson, Malory; Baldwin, Julie Frontiers in Public Health, 10 , 2022. @article{Rink2022, title = {Rationale, Design, and Methods for Nen Unkumbi/Edahiyedo ("We Are Here Now"): A Multi-Level Randomized Controlled Trial to Improve Sexual and Reproductive Health Outcomes in a Northern Plains American Indian Reservation Community}, author = {Elizabeth Rink and Paula Firemoon and Michael Anastario and Olivia Johnson and Ramey GrowingThunder and Adriann Ricker and Malory Peterson and Julie Baldwin}, url = {https://www.frontiersin.org/articles/10.3389/fpubh.2022.823228/full}, doi = {10.3389/fpubh.2022.823228}, year = {2022}, date = {2022-07-13}, journal = {Frontiers in Public Health}, volume = {10}, abstract = {American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities. |
Matt Ignacio Sabrina Oesterle, Micaela Mercado Ann Carver Gilberto Lopez Wendy Wolfersteig Stephanie Ayers Seol Ki Kathryn Hamm Sairam Parthasarathy Adam Berryhill Linnea Evans Samantha Sabo Chyke Doubeni Journal of Behavioral Medicine, 46 (1-2), pp. 140-152, 2022. @article{Ignacio2022b, title = {Narratives from African American/Black, American Indian/Alaska Native, and Hispanic/Latinx community members in Arizona to enhance COVID-19 vaccine and vaccination uptake}, author = {Matt Ignacio, Sabrina Oesterle, Micaela Mercado, Ann Carver, Gilberto Lopez, Wendy Wolfersteig, Stephanie Ayers, Seol Ki, Kathryn Hamm, Sairam Parthasarathy, Adam Berryhill, Linnea Evans, Samantha Sabo, Chyke Doubeni}, url = {https://doi.org/10.1007/s10865-022-00300-x}, doi = {10.1007/s10865-022-00300-x}, year = {2022}, date = {2022-03-24}, journal = {Journal of Behavioral Medicine}, volume = {46}, number = {1-2}, pages = {140-152}, abstract = {The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake. |
Dreifuss, Heather M; Belin, Kalvina L; Wilson, Jamie; George, Shawndeena; Waters, Amber-Rose; Bauer, Carmella Kahn 1and Mark B C; Teufel-Shone, Nicolette I Engaging Native American High School Students in Public Health Career Preparation Through the Indigenous Summer Enhancement Program Journal Article Frontiers in Public Heath, 10 , 2022. @article{Dreifuss2022, title = {Engaging Native American High School Students in Public Health Career Preparation Through the Indigenous Summer Enhancement Program}, author = {Heather M Dreifuss and Kalvina L Belin and Jamie Wilson and Shawndeena George and Amber-Rose Waters and Carmella B Kahn 1and Mark C Bauer and Nicolette I Teufel-Shone}, url = {https://pubmed.ncbi.nlm.nih.gov/35273937/10.3389/fpubh.2022.789994}, doi = {10.3389/fpubh.2022.789994}, year = {2022}, date = {2022-02-22}, journal = {Frontiers in Public Heath}, volume = {10}, abstract = {Native American populations are systematically marginalized in the healthcare and public health workforce. One effective approach to reduce health disparities and improve health care delivery among Indigenous populations is to train more Native American health professionals who integrate academic and cultural knowledge to understand and influence health behaviors and perspectives. Diné College partnered with Northern Arizona University to develop the Navajo Native American Research Center for Health (NARCH) Partnership, funded by the National Institutes of Health. The high school component of the Navajo NARCH Partnership created the Indigenous Summer Enhancement Program (ISEP), a 1-week summer training program providing exposure to health careers and mentorship in pursuing public health careers for Native American high school students. ISEP utilizes the Diné Educational Philosophy (DEP), a Navajo conceptual framework to serve as the foundation of the program. In 2020-2021, due to COVID-19 restrictions, the DEP model had to be incorporated in the Navajo NARCH high school virtual program activities. ISEP used 2018 and 2019 past program evaluation data to inform the virtual programming. Students' perception of the program was collected using an online Qualtrics evaluation questionnaire. Students stated appreciation for program staff, fellow students, peer mentors and culturally relevant learning experiences in both virtual and in-person environments. Recommendations included: expanding the length of ISEP and continuing the hands-on activities and Public Health Leadership series}, keywords = {}, pubstate = {published}, tppubtype = {article} } Native American populations are systematically marginalized in the healthcare and public health workforce. One effective approach to reduce health disparities and improve health care delivery among Indigenous populations is to train more Native American health professionals who integrate academic and cultural knowledge to understand and influence health behaviors and perspectives. Diné College partnered with Northern Arizona University to develop the Navajo Native American Research Center for Health (NARCH) Partnership, funded by the National Institutes of Health. The high school component of the Navajo NARCH Partnership created the Indigenous Summer Enhancement Program (ISEP), a 1-week summer training program providing exposure to health careers and mentorship in pursuing public health careers for Native American high school students. ISEP utilizes the Diné Educational Philosophy (DEP), a Navajo conceptual framework to serve as the foundation of the program. In 2020-2021, due to COVID-19 restrictions, the DEP model had to be incorporated in the Navajo NARCH high school virtual program activities. ISEP used 2018 and 2019 past program evaluation data to inform the virtual programming. Students' perception of the program was collected using an online Qualtrics evaluation questionnaire. Students stated appreciation for program staff, fellow students, peer mentors and culturally relevant learning experiences in both virtual and in-person environments. Recommendations included: expanding the length of ISEP and continuing the hands-on activities and Public Health Leadership series |
Harris, Robin B; Brown, Heidi E; Begay, Rachelle L; Sanderson, Priscilla R; Chief, Carmenlita; Monroy, Fernando P; Oren, Eyal Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona Journal Article Int. J. Environ. Res. Public Health, 19 (2), pp. 797, 2022. @article{Harris2022, title = {Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona}, author = {Robin B. Harris and Heidi E. Brown and Rachelle L. Begay and Priscilla R. Sanderson and Carmenlita Chief and Fernando P. Monroy and Eyal Oren }, url = {https://www.mdpi.com/1660-4601/19/2/797}, doi = {10.3390/ijerph19020797}, year = {2022}, date = {2022-01-12}, journal = {Int. J. Environ. Res. Public Health}, volume = {19}, number = {2}, pages = {797}, abstract = {Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of non-cardia gastric cancer. While gastric cancer has decreased in the United States (US), the incidence in the Navajo Nation is nearly four times higher than surrounding Non-Hispanic White populations. Little is known about H. pylori prevalence in this population or other Indigenous communities in the lower 48 states. In this cross-sectional study, 101 adults representing 73 households from three Navajo Nation chapter communities completed surveys and a urea breath test for active H. pylori. Accounting for intrahousehold correlation, H. pylori prevalence was 56.4% (95% CI, 45.4–66.8) and 72% of households had at least one infected person. The odds of having an active infection in households using unregulated water were 8.85 (95% CI, 1.50–53.38) that of the use of regulated water, and males had 3.26 (95% CI, 1.05–10.07) higher odds than female. The prevalence of H. pylori in Navajo is similar to that seen in Alaska Natives. Further investigation into factors associated with prevention of infection is needed as well as understanding barriers to screening and treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of non-cardia gastric cancer. While gastric cancer has decreased in the United States (US), the incidence in the Navajo Nation is nearly four times higher than surrounding Non-Hispanic White populations. Little is known about H. pylori prevalence in this population or other Indigenous communities in the lower 48 states. In this cross-sectional study, 101 adults representing 73 households from three Navajo Nation chapter communities completed surveys and a urea breath test for active H. pylori. Accounting for intrahousehold correlation, H. pylori prevalence was 56.4% (95% CI, 45.4–66.8) and 72% of households had at least one infected person. The odds of having an active infection in households using unregulated water were 8.85 (95% CI, 1.50–53.38) that of the use of regulated water, and males had 3.26 (95% CI, 1.05–10.07) higher odds than female. The prevalence of H. pylori in Navajo is similar to that seen in Alaska Natives. Further investigation into factors associated with prevention of infection is needed as well as understanding barriers to screening and treatment. |
2020 |
Pro, George; Camplain, Ricky; de Heer, Brooke; Chief, Carmenlita; Teufel-Shone, Nicolette I Journal of Racial and Ethnic Health Disparities, 2020. @article{Pro2020bb, title = {A National Epidemiologic Profile of Physical Intimate Partner Violence, Adverse Childhood Experiences, and Supportive Childhood Relationships: Group Differences in Predicted Trends and Associations}, author = {George Pro and Ricky Camplain and Brooke de Heer and Carmenlita Chief and Nicolette I. Teufel-Shone}, url = {https://doi.org/10.1007/s40615-019-00696-4}, doi = {10.1007/s40615-019-00696-4}, year = {2020}, date = {2020-01-07}, journal = {Journal of Racial and Ethnic Health Disparities}, abstract = {Adverse childhood experiences (ACEs) are common in the USA and associated with multiple health sequelae. Physical intimate partner violence (IPV) is a type of revictimization that some adults with ACEs may be more prone to. Positive and supportive childhood environments may buffer the effects of ACEs, but little is known about the differential associations between physical IPV and ACEs and supportive childhood environments. We sought to illustrate racial/ethnic and gender differences in the adjusted predicted probability of physical IPV across multiple ACE and supportive childhood scores.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Adverse childhood experiences (ACEs) are common in the USA and associated with multiple health sequelae. Physical intimate partner violence (IPV) is a type of revictimization that some adults with ACEs may be more prone to. Positive and supportive childhood environments may buffer the effects of ACEs, but little is known about the differential associations between physical IPV and ACEs and supportive childhood environments. We sought to illustrate racial/ethnic and gender differences in the adjusted predicted probability of physical IPV across multiple ACE and supportive childhood scores. |
Dickerson, Daniel; Baldwin, Julie A; Belcourt, Annie; Belone, Lorenda; Gittelsohn, Joel; Kaholokula, Joseph Keawe’aimoku; Lowe, John; Patten, Christi A; Wallerstein, Nina Encompassing Cultural Contexts Within Scientific Research Methodologies in the Development of Health Promotion Interventions Journal Article Prevention Science, 2020. @article{Dickerson2018b, title = {Encompassing Cultural Contexts Within Scientific Research Methodologies in the Development of Health Promotion Interventions}, author = {Daniel Dickerson and Julie A Baldwin and Annie Belcourt and Lorenda Belone and Joel Gittelsohn and Joseph Keawe’aimoku Kaholokula and John Lowe and Christi A Patten and Nina Wallerstein}, url = {https://link.springer.com/article/10.1007%2Fs11121-018-0926-1}, doi = {https://doi.org/10.1007/s11121-018-0926-1}, year = {2020}, date = {2020-01-01}, journal = {Prevention Science}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
2019 |
Hulen, Elizabeth; Hardy, Lisa J; Teufel-Shone, Nicolette; Sanderson, Priscilla R; Schwartz, Anna L; Begay, Cruz R Community Based Participatory Research (CBPR): A Dynamic Process of Health care, Provider Perceptions and American Indian Patients' Resilience Journal Article Journal of Health Care for the Poor and Underserved, 30 (1), pp. 221-237, 2019. @article{Hulen2019, title = {Community Based Participatory Research (CBPR): A Dynamic Process of Health care, Provider Perceptions and American Indian Patients' Resilience}, author = {Elizabeth Hulen and Lisa J Hardy and Nicolette Teufel-Shone and Priscilla R Sanderson and Anna L Schwartz and Cruz R Begay}, url = {https://muse.jhu.edu/article/717742}, year = {2019}, date = {2019-02-01}, journal = {Journal of Health Care for the Poor and Underserved}, volume = {30}, number = {1}, pages = {221-237}, abstract = {American Indians are disproportionately affected by factors that lead to health disparities, however many Native people demonstrate resilience when faced with health risks. Study objectives were to use a resilience framework to identify wellness strategies among American Indian people and to assess health care provider perceptions of American Indian wellness. Participants included 39 American Indian adults who self-reported resilient change and 22 health care providers who served American Indian patients. Thematic categories across American Indian and health care provider data were identified: 1) relationships inform resilience; 2) prejudice stymies resilience; and 3) place shapes resilience. Results indicated the salience of relationships in demonstrating resilience. Identified challenges and supporters of resilience are discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indians are disproportionately affected by factors that lead to health disparities, however many Native people demonstrate resilience when faced with health risks. Study objectives were to use a resilience framework to identify wellness strategies among American Indian people and to assess health care provider perceptions of American Indian wellness. Participants included 39 American Indian adults who self-reported resilient change and 22 health care providers who served American Indian patients. Thematic categories across American Indian and health care provider data were identified: 1) relationships inform resilience; 2) prejudice stymies resilience; and 3) place shapes resilience. Results indicated the salience of relationships in demonstrating resilience. Identified challenges and supporters of resilience are discussed. |
Cordova-Marks, Felina M; Harris, Robin; Teufel-Shone, Nicolette I; Norton, Beatrice; Mastergeorge, Ann M; Gerald, Lynn Characteristics of American Indian Female Caregivers on a Southwest American Indian Reservation Journal Article Journal of Community Health, 44 (1), pp. 52-60, 2019. @article{Cordova-Marks2019, title = {Characteristics of American Indian Female Caregivers on a Southwest American Indian Reservation}, author = {Felina M Cordova-Marks and Robin Harris and Nicolette I Teufel-Shone and Beatrice Norton and Ann M Mastergeorge and Lynn Gerald}, url = {https://link.springer.com/article/10.1007/s10900-018-0552-7}, year = {2019}, date = {2019-02-01}, journal = {Journal of Community Health}, volume = {44}, number = {1}, pages = {52-60}, abstract = {American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress. |
Wilson, Jamie; Sabo, Samantha; Chief, Carmenlita; Clark, Hershel; Yazzie, Alfred; Nahee, Jacqueline; Leischow, Scott; Henderson, Patricia Nez DINÉ (NAVAJO) HEALER PERSPECTIVES ON COMMERCIAL TOBACCO USE IN CEREMONIAL SETTINGS: AN ORAL STORY PROJECT TO PROMOTE SMOKE-FREE LIFE Journal Article American Indian and Alaska Native Mental Health Research, 26 (1), pp. 63-78, 2019. @article{Wilson2019, title = {DINÉ (NAVAJO) HEALER PERSPECTIVES ON COMMERCIAL TOBACCO USE IN CEREMONIAL SETTINGS: AN ORAL STORY PROJECT TO PROMOTE SMOKE-FREE LIFE}, author = {Jamie Wilson and Samantha Sabo and Carmenlita Chief and Hershel Clark and Alfred Yazzie and Jacqueline Nahee and Scott Leischow and Patricia Nez Henderson}, url = {http://www.ucdenver.edu/academics/colleges/PublicHealth/research/centers/CAIANH/journal/Documents/Volume-26/26_1_2019_63_wilson.pdf}, year = {2019}, date = {2019-01-01}, journal = {American Indian and Alaska Native Mental Health Research}, volume = {26}, number = {1}, pages = {63-78}, abstract = {Many American Indian (AI) healers are faced with a dilemma of how to maintain the ceremonial uses of traditional tobacco meant to encourage the restoration and balance of mind, body, and spirit, while discouraging commercial tobacco use and protecting against secondhand smoke exposure in ceremonial settings. To explore this dilemma and offer culturally informed solutions, researchers conducted qualitative interviews with Navajo healers who describe the history and role of commercial tobacco within ceremonial contexts. Healers understand the importance of their role on their community’s health and expressed deep concern about the use of commercial tobacco in the ceremonial setting. Healers play an important role in curbing the use of commercial tobacco and limiting the exposure to secondhand smoke in ceremonial settings and beyond. Study implications include the importance of understanding traditional and cultural knowledge and its potential as a pathway to solve contemporary public health issues facing AI communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Many American Indian (AI) healers are faced with a dilemma of how to maintain the ceremonial uses of traditional tobacco meant to encourage the restoration and balance of mind, body, and spirit, while discouraging commercial tobacco use and protecting against secondhand smoke exposure in ceremonial settings. To explore this dilemma and offer culturally informed solutions, researchers conducted qualitative interviews with Navajo healers who describe the history and role of commercial tobacco within ceremonial contexts. Healers understand the importance of their role on their community’s health and expressed deep concern about the use of commercial tobacco in the ceremonial setting. Healers play an important role in curbing the use of commercial tobacco and limiting the exposure to secondhand smoke in ceremonial settings and beyond. Study implications include the importance of understanding traditional and cultural knowledge and its potential as a pathway to solve contemporary public health issues facing AI communities. |
Teufel-Shone, Nicolette I; Schwartz, Anna L; Hardy, Lisa J; Heer, Hendrik De D; Williamson, Heather J; Dunn, Dorothy J; Polingyumptewa, Kellen; Chief, Carmenlita Supporting New Community-Based Participatory Research Partnerships Journal Article International Journal of Environmental Research and Public Health, 16 (1), pp. 44, 2019. @article{Teufel-Shone2019, title = {Supporting New Community-Based Participatory Research Partnerships}, author = {Nicolette I Teufel-Shone and Anna L Schwartz and Lisa J Hardy and Hendrik De D Heer and Heather J Williamson and Dorothy J Dunn and Kellen Polingyumptewa and Carmenlita Chief}, url = {https://www.mdpi.com/1660-4601/16/1/44/htm}, year = {2019}, date = {2019-01-01}, journal = {International Journal of Environmental Research and Public Health}, volume = {16}, number = {1}, pages = {44}, abstract = {Marginalized communities have a documented distrust of research grounded in negative portrayals in the academic literature. Yet, trusted partnerships, the foundation for Community-Based Participatory Research (CBPR), require time to build the capacity for joint decision-making, equitable involvement of academically trained and community investigators, and co-learning. Trust can be difficult to develop within the short time between a funding opportunity announcement and application submission. Resources to support community- and academic-based investigators’ time to discuss contexts, concerns, integration of expertise and locally acceptable research designs and data collection are limited. The National Institutes of Health (NIH) funded Center for American Indian Resilience and the Southwest Health Equity Research Collaborative have implemented an internal funding mechanism to support community and academic-based investigators’ travel cost and time to discuss complementary areas of interest and skills and to decide if moving forward with a partnership and a collaborative grant proposal would be beneficial to the community. The rationale and administration of this Community-Campus Partnership Support (CCPS) Program are described and four examples of supported efforts are provided. Centers and training programs frequently fund pilot grants to support junior investigators and/or exploratory research. This CCPS mechanism should be considered as precursor to pilot work, to stimulate partnership building without the pressure of an approaching grant application deadline.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Marginalized communities have a documented distrust of research grounded in negative portrayals in the academic literature. Yet, trusted partnerships, the foundation for Community-Based Participatory Research (CBPR), require time to build the capacity for joint decision-making, equitable involvement of academically trained and community investigators, and co-learning. Trust can be difficult to develop within the short time between a funding opportunity announcement and application submission. Resources to support community- and academic-based investigators’ time to discuss contexts, concerns, integration of expertise and locally acceptable research designs and data collection are limited. The National Institutes of Health (NIH) funded Center for American Indian Resilience and the Southwest Health Equity Research Collaborative have implemented an internal funding mechanism to support community and academic-based investigators’ travel cost and time to discuss complementary areas of interest and skills and to decide if moving forward with a partnership and a collaborative grant proposal would be beneficial to the community. The rationale and administration of this Community-Campus Partnership Support (CCPS) Program are described and four examples of supported efforts are provided. Centers and training programs frequently fund pilot grants to support junior investigators and/or exploratory research. This CCPS mechanism should be considered as precursor to pilot work, to stimulate partnership building without the pressure of an approaching grant application deadline. |
2018 |
Walters, Karina L; Johnson-Jennings, Michelle; Stroud, Sandra; Rasmus, Stacy; Charles, Billy; John, Simeon; Allen, James; Kaholokula, Joseph Keawe‘aimoku; Look, Mele A; de Silva, Māpuana; Lowe, John; Baldwin, Julie A; Lawrence, Gary; Brooks, Jada; Noonan, Curtis W; Belcourt, Annie; Quintana, Eugenia; Semmens, Erin O; Boulafentis, Johna Prevention Science, pp. 1-11, 2018. @article{Walters2018, title = {Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities}, author = {Karina L Walters and Michelle Johnson-Jennings and Sandra Stroud and Stacy Rasmus and Billy Charles and Simeon John and James Allen and Joseph Keawe‘aimoku Kaholokula and Mele A Look and Māpuana de Silva and John Lowe and Julie A Baldwin and Gary Lawrence and Jada Brooks and Curtis W Noonan and Annie Belcourt and Eugenia Quintana and Erin O Semmens and Johna Boulafentis}, url = {https://link.springer.com/article/10.1007%2Fs11121-018-0952-z}, year = {2018}, date = {2018-11-06}, journal = {Prevention Science}, pages = {1-11}, abstract = {Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts “from the ground up.” Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts “from the ground up.” Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions. |
Walters, Karina L; Johnson-Jennings, Michelle; Stroud, Sandra; Rasmus, Stacy; Charles, Billy; John, Simeon; Allen, James; Kaholokula, Joseph Keawe‘aimoku; Look, Mele A; de Silva, Māpuana; Lowe, John; Baldwin, Julie A; Lawrence, Gary; Brooks, Jada; Noonan, Curtis W; Belcourt, Annie; Quintana, Eugenia; Semmens, Erin O; Boulafentis, Johna Prevention Science, pp. 1-11, 2018. @article{Walters2018b, title = {Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities.}, author = {Karina L. Walters and Michelle Johnson-Jennings and Sandra Stroud and Stacy Rasmus and Billy Charles and Simeon John and James Allen and Joseph Keawe‘aimoku Kaholokula and Mele A. Look and Māpuana de Silva and John Lowe and Julie A. Baldwin and Gary Lawrence and Jada Brooks and Curtis W. Noonan and Annie Belcourt and Eugenia Quintana and Erin O. Semmens and Johna Boulafentis}, url = {https://www.ncbi.nlm.nih.gov/pubmed/30397737}, doi = {10.1007/s11121-018-0952-z}, year = {2018}, date = {2018-11-06}, journal = {Prevention Science}, pages = {1-11}, abstract = {Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts "from the ground up." Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts "from the ground up." Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions. |
King, Caroline; Atwood, Sidney; Lozada, Mia; Nelson, Adrianne Katrina; Brown, Chris; Sabo, Samantha; Curley, Cameron; Muskett, Olivia; Orav, Endel John; Shin, Sonya PLoS ONE, 13 (8), 2018. @article{King2018b, title = {Identifying risk factors for 30-day readmission events among American Indian patients with diabetes in the Four Corners region of the southwest from 2009 to 2016.}, author = {Caroline King and Sidney Atwood and Mia Lozada and Adrianne Katrina Nelson and Chris Brown and Samantha Sabo and Cameron Curley and Olivia Muskett and Endel John Orav and Sonya Shin}, editor = {Prabath W. B. Nanayakkara}, url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195476}, doi = {10.1371/journal.pone.0195476}, year = {2018}, date = {2018-08-02}, journal = {PLoS ONE}, volume = {13}, number = {8}, abstract = {OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission.}, keywords = {}, pubstate = {published}, tppubtype = {article} } OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission. |
Cordova-Marks, Felina M; Harris, Robin; Teufel-Shone, Nicolette; Norton, Beatrice; Mastergeorge, Ann M; Gerald, Lynn Characteristics of American Indian female caregivers on a Southwest American Indian reservation Journal Article Journal of Community Health, 2018. @article{Cordova-Marks2018, title = {Characteristics of American Indian female caregivers on a Southwest American Indian reservation}, author = {Felina M Cordova-Marks and Robin Harris and Nicolette Teufel-Shone and Beatrice Norton and Ann M Mastergeorge and Lynn Gerald}, url = {https://link.springer.com/article/10.1007%2Fs10900-018-0552-7}, year = {2018}, date = {2018-07-28}, journal = {Journal of Community Health}, abstract = {American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress. |
Dickerson, Daniel; Baldwin, Julie A; Belcourt, Annie; Belone, Lorenda; Gittelsohn, Joel; Kaholokula, Joseph Keawe'aimoku; Lowe, John; Patten, Christi A; Wallerstein, Nina Encompassing cultural contexts within scientific research methodologies in the development of health promotion interventions Journal Article Prevention Science, 2018. @article{Dickerson2018, title = {Encompassing cultural contexts within scientific research methodologies in the development of health promotion interventions}, author = {Daniel Dickerson and Julie A Baldwin and Annie Belcourt and Lorenda Belone and Joel Gittelsohn and Joseph Keawe'aimoku Kaholokula and John Lowe and Christi A Patten and Nina Wallerstein}, url = {https://link.springer.com/article/10.1007%2Fs11121-018-0926-1}, doi = {10.1007/s11121-018-0926-1}, year = {2018}, date = {2018-06-29}, journal = {Prevention Science}, abstract = {American Indians/Alaska Natives/Native Hawaiians (AI/AN/NHs) disproportionately experience higher rates of various health conditions. Developing culturally centered interventions targeting health conditions is a strategy to decrease the burden of health conditions among this population. This study analyzes characteristics from 21 studies currently funded under the Interventions for Health Promotion and Disease Prevention in Native American (NA) Populations program among investigators currently funded under this grant mechanism. Four broad challenges were revealed as critical to address when scientifically establishing culturally centered interventions for Native populations. These challenges were (a) their ability to harness culture-centered knowledge and perspectives from communities; (b) their utilization of Indigenous-based theories and knowledge systems with Western-based intervention paradigms and theories; (c) their use of Western-based methodologies; and (d) their cultural adaptation, if based on an evidence-based treatment. Findings revealed that qualitative methodologies and community-based participatory research (CBPR) approaches were very commonly used to finalize the development of interventions. Various Indigenous-based theories and knowledge systems and Western-based theories were used in the methodologies employed. Cultural adaptations were made that often used formative mixed qualitative and quantitative methods. Illustrative examples of strategies used and suggestions for future research are provided. Findings underscored the importance of CBPR methods to improve the efficacy of interventions for AI/AN/NH communities by integrating Indigenous-based theories and knowledge systems with Western science approaches to improve health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indians/Alaska Natives/Native Hawaiians (AI/AN/NHs) disproportionately experience higher rates of various health conditions. Developing culturally centered interventions targeting health conditions is a strategy to decrease the burden of health conditions among this population. This study analyzes characteristics from 21 studies currently funded under the Interventions for Health Promotion and Disease Prevention in Native American (NA) Populations program among investigators currently funded under this grant mechanism. Four broad challenges were revealed as critical to address when scientifically establishing culturally centered interventions for Native populations. These challenges were (a) their ability to harness culture-centered knowledge and perspectives from communities; (b) their utilization of Indigenous-based theories and knowledge systems with Western-based intervention paradigms and theories; (c) their use of Western-based methodologies; and (d) their cultural adaptation, if based on an evidence-based treatment. Findings revealed that qualitative methodologies and community-based participatory research (CBPR) approaches were very commonly used to finalize the development of interventions. Various Indigenous-based theories and knowledge systems and Western-based theories were used in the methodologies employed. Cultural adaptations were made that often used formative mixed qualitative and quantitative methods. Illustrative examples of strategies used and suggestions for future research are provided. Findings underscored the importance of CBPR methods to improve the efficacy of interventions for AI/AN/NH communities by integrating Indigenous-based theories and knowledge systems with Western science approaches to improve health. |
King, Caroline; Atwood, Sidney; Brown, Chris; Nelson, Adrianne Katrina; Lozada, Mia; Wei, Jennie; Merino, Maricruz; Curley, Cameron; Muskett, Olivia; Sabo, Samantha; Gampa, Vikas; Orav, John; Shin, Sonya Primary Care Diabetes, 12 (3), pp. 212-217, 2018. @article{King2018, title = {Primary care and survival among American Indian patients with diabetes in the Southwest United States: Evaluation of a cohort study at Gallup Indian Medical Center, 2009-2016}, author = {Caroline King and Sidney Atwood and Chris Brown and Adrianne Katrina Nelson and Mia Lozada and Jennie Wei and Maricruz Merino and Cameron Curley and Olivia Muskett and Samantha Sabo and Vikas Gampa and John Orav and Sonya Shin}, url = {https://www.primary-care-diabetes.com/article/S1751-9918(17)30184-5/fulltext}, year = {2018}, date = {2018-06-01}, journal = {Primary Care Diabetes}, volume = {12}, number = {3}, pages = {212-217}, abstract = {Objectives To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States. Methods Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses. Results Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider. Conclusions Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objectives To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States. Methods Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses. Results Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider. Conclusions Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission. |
Teufel-Shone, Nicolette; Jiang, Luohua; Rockwell, Jennifer; Chang, Jennifer; Beals, Janette; Bullock, Ann; Manson, Spero M Food choices and distress in reservation-based American Indians and Alaska Natives with type 2 diabetes Journal Article Public Health Nutrition, pp. 1-9, 2018. @article{Teufel-Shone2018, title = {Food choices and distress in reservation-based American Indians and Alaska Natives with type 2 diabetes}, author = {Nicolette Teufel-Shone and Luohua Jiang and Jennifer Rockwell and Jennifer Chang and Janette Beals and Ann Bullock and Spero M Manson}, url = {https://doi.org/10.1017/S1368980018000897}, doi = {10.1017/S1368980018000897}, year = {2018}, date = {2018-03-12}, journal = {Public Health Nutrition}, pages = {1-9}, abstract = {Objective: To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes. Design: Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as ‘healthy’ or ‘unhealthy’ using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson’s correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes. Setting: Rural AI reservations and AN villages. Subjects: AI/AN (n 2484) with type 2 diabetes. Results: Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β = 0·078}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objective: To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes. Design: Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as ‘healthy’ or ‘unhealthy’ using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson’s correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes. Setting: Rural AI reservations and AN villages. Subjects: AI/AN (n 2484) with type 2 diabetes. Results: Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β = 0·078 |
2017 |
Henson, Michele; Sabo, Samantha; Trujillo, Aurora; Teufel-Shone, Nicolette Identifying protective factors to promote health in American Indian and Alaska Native adolescents: A literature review Journal Article Journal of Primary Prevention, 38 (1-2), pp. 5-26, 2017. @article{Henson2017, title = {Identifying protective factors to promote health in American Indian and Alaska Native adolescents: A literature review}, author = {Michele Henson and Samantha Sabo and Aurora Trujillo and Nicolette Teufel-Shone}, url = {https://link.springer.com/article/10.1007/s10935-016-0455-2}, year = {2017}, date = {2017-11-08}, journal = {Journal of Primary Prevention}, volume = {38}, number = {1-2}, pages = {5-26}, abstract = {Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent’s environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent’s environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents. |
2016 |
Chief, Carmenlita; Sabo, Samantha; Clark, Hershel; Henderson, Patricia Nez; Yazzie, Alfred; Nahee, Jacqueline; Leischow, Scott J Tobacco Control, 25 , pp. 19-25, 2016. @article{Chief2016, title = {Breathing clean air is Są’áh Naagháí Bik'eh Hózhóó (SNBH): a culturally centered approach to understanding commercial smoke-free policy among the Diné (Navajo People)}, author = {Carmenlita Chief and Samantha Sabo and Hershel Clark and Patricia Nez Henderson and Alfred Yazzie and Jacqueline Nahee and Scott J Leischow}, url = {http://dx.doi.org/10.1136/tobaccocontrol-2016-053081}, year = {2016}, date = {2016-10-03}, journal = {Tobacco Control}, volume = {25}, pages = {19-25}, abstract = {Introduction Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide. Objective: We describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy. Methods Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy. Results Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments. Conclusions Indigenous-centered approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide. Objective: We describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy. Methods Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy. Results Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments. Conclusions Indigenous-centered approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people. |
2015 |
Laurila, Kelly; Ingram, Jani C; Briehl, Margaret M; Trotter, Robert Weaving the Web: Evaluation Strategies to Help Native-American Undergraduate Research Training Programs Navigate Students to Success Journal Article CURQ on the Web, 35 (3), pp. 4-11, 2015. @article{Laurila2015, title = {Weaving the Web: Evaluation Strategies to Help Native-American Undergraduate Research Training Programs Navigate Students to Success}, author = {Kelly Laurila and Jani C Ingram and Margaret M Briehl and Robert Trotter}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671630/}, year = {2015}, date = {2015-12-07}, journal = {CURQ on the Web}, volume = {35}, number = {3}, pages = {4-11}, abstract = {Native-American cultures are characterized by strong connections to community, family, and the land. These connections are integrated into Native-American education, resulting in curricula that are different from those in Western educational systems. Differences between Native-American and Western cultures create challenges for those educated in Native-American education systems when they pursue postsecondary education in Western cultures. The under-representation of Native-Americans among those earning degrees reflects both extremely low enrollment rates and generally poor retention rates for Native-American college students (UA 2009). Obstacles for Native-American students include inadequate academic preparation, cultural differences, vague constructs of educational or vocational goals, insufficient financial aid, and social isolation (McClellan et al. 2005). Engaging Native-American students in research is one strategy for overcoming these obstacles and improving their college experience. Here we describe a research-based training program focused on Native-American undergraduates, the evaluation model and process used to evaluate this program, and the paradigm-shifting insights that emerged from the evaluation data.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Native-American cultures are characterized by strong connections to community, family, and the land. These connections are integrated into Native-American education, resulting in curricula that are different from those in Western educational systems. Differences between Native-American and Western cultures create challenges for those educated in Native-American education systems when they pursue postsecondary education in Western cultures. The under-representation of Native-Americans among those earning degrees reflects both extremely low enrollment rates and generally poor retention rates for Native-American college students (UA 2009). Obstacles for Native-American students include inadequate academic preparation, cultural differences, vague constructs of educational or vocational goals, insufficient financial aid, and social isolation (McClellan et al. 2005). Engaging Native-American students in research is one strategy for overcoming these obstacles and improving their college experience. Here we describe a research-based training program focused on Native-American undergraduates, the evaluation model and process used to evaluate this program, and the paradigm-shifting insights that emerged from the evaluation data. |
Teufel-Shone, Nicolette; Cordova-Marks, Felina; Susanyatame, Gloria; Teufel-Shone, Louis; Irwin, Sandra L Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program Journal Article Journal of Community Health, 43 (5), pp. 891-898, 2015. @article{Teufel-Shone2015, title = {Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program}, author = {Nicolette Teufel-Shone and Felina Cordova-Marks and Gloria Susanyatame and Louis Teufel-Shone and Sandra L Irwin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25791877}, doi = {10.1007/s10900-015-0009-1}, year = {2015}, date = {2015-10-01}, journal = {Journal of Community Health}, volume = {43}, number = {5}, pages = {891-898}, abstract = {Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk. |
2014 |
Teufel-Shone, Nicolette; Gamber, Michelle; Watahomigie, Helen; Siyuja, Jr T J; Crozier, Laurie; Irwin, Sandra L Preventing Chronic Disease, 11 (E166), 2014. @article{Teufel-Shone2014, title = {Using a participatory research approach in a school-based physical activity intervention to prevent diabetes in the Hualapai Indian community, Arizona, 2002-2006}, author = {Nicolette Teufel-Shone and Michelle Gamber and Helen Watahomigie and Jr T. J. Siyuja and Laurie Crozier and Sandra L Irwin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25254984}, doi = {10.5888/pcd11.130397}, year = {2014}, date = {2014-09-25}, journal = {Preventing Chronic Disease}, volume = {11}, number = {E166}, abstract = {INTRODUCTION: In the United States, type 2 diabetes has reached epidemic proportions among indigenous people. Community-based participatory research offers American Indian communities and university partners an opportunity to integrate skills in community action and systematic inquiry to develop locally acceptable primary prevention interventions to combat diabetes risk factors. The Hualapai Tribe and the University of Arizona designed, implemented, and assessed a school-based physical activity intervention to reduce diabetes risk factors among youth. METHODS: During a 2-year period, trained community members led in-school physical activity classes 2 times per week among students in grades 3 through 8. Body mass index (BMI), fitness measures, and fasting blood glucose level were measured on 6 occasions. Descriptive statistics and t tests were used to assess change in outcome measures. RESULTS: Of the more than 100 youth who took part in the physical activity classes for 2 years, 71 youth (38 male, 33 female) participated in 3 or more data collection sessions. Over time, the percentage of youth with a high fasting blood glucose level of more than 125 mg/dL decreased concurrently with significant improvements in fitness measures. However, BMI increased in both male and female participants. The high number of youth who missed more than 3 data collection sessions was attributed to poor school attendance and tardiness. CONCLUSION: Classes led by lay physical activity leaders can affect diabetes risk factors in youth. Incongruous health and fitness outcomes suggest that one indicator does not adequately define the risk profile; BMI alone may not be sufficient as a measure of diabetes risk in youth.}, keywords = {}, pubstate = {published}, tppubtype = {article} } INTRODUCTION: In the United States, type 2 diabetes has reached epidemic proportions among indigenous people. Community-based participatory research offers American Indian communities and university partners an opportunity to integrate skills in community action and systematic inquiry to develop locally acceptable primary prevention interventions to combat diabetes risk factors. The Hualapai Tribe and the University of Arizona designed, implemented, and assessed a school-based physical activity intervention to reduce diabetes risk factors among youth. METHODS: During a 2-year period, trained community members led in-school physical activity classes 2 times per week among students in grades 3 through 8. Body mass index (BMI), fitness measures, and fasting blood glucose level were measured on 6 occasions. Descriptive statistics and t tests were used to assess change in outcome measures. RESULTS: Of the more than 100 youth who took part in the physical activity classes for 2 years, 71 youth (38 male, 33 female) participated in 3 or more data collection sessions. Over time, the percentage of youth with a high fasting blood glucose level of more than 125 mg/dL decreased concurrently with significant improvements in fitness measures. However, BMI increased in both male and female participants. The high number of youth who missed more than 3 data collection sessions was attributed to poor school attendance and tardiness. CONCLUSION: Classes led by lay physical activity leaders can affect diabetes risk factors in youth. Incongruous health and fitness outcomes suggest that one indicator does not adequately define the risk profile; BMI alone may not be sufficient as a measure of diabetes risk in youth. |
2011 |
Sanderson, Priscilla R; Weinstein, Neil; Teufel-Shone, Nicolette; Martínez, María Elena Assessing colorectal cancer screening knowledge at tribal fairs Journal Article Preventing Chronic Disease, 8 (1), pp. 1-10, 2011. @article{Sanderson2011, title = {Assessing colorectal cancer screening knowledge at tribal fairs}, author = {Priscilla R Sanderson and Neil Weinstein and Nicolette Teufel-Shone and María Elena Martínez}, url = {https://www.ncbi.nlm.nih.gov/pubmed/21159228}, year = {2011}, date = {2011-01-01}, journal = {Preventing Chronic Disease}, volume = {8}, number = {1}, pages = {1-10}, abstract = {INTRODUCTION: Increasing public awareness and knowledge about the need for colorectal cancer (CRC) screening among American Indians is key to reducing health disparities. The objective of this study was to assess Navajo adults' knowledge of CRC risk factors and prevention, CRC screening, and self-reported experience with CRC screening. METHODS: We collected data generated by a self-administered survey given to Navajo adults, most of whom lived on the reservation. Data were collected at 2 annual tribal fairs in 2006. Fair attendees who visited an exhibit booth completed a CRC knowledge survey. The study design was nonrandomized. RESULTS: Of the 285 Navajo adults who participated, most were bilingual (74%) and female (80%). Of the respondents aged 50 years or older, 77% had heard of CRC screening and 28% reported being screened for colon or colorectal cancer. Knowledge was high (mean, 5.78 [standard deviation (SD), 1.28]) (8.0 was the highest possible knowledge score). Respondents with little or no formal schooling had lower scores (mean, 5.4), indicating less knowledge of CRC and associated screening tests than did those with more education (mean, 6.0). CONCLUSION: Among a sample of Navajo adults aged 50 years or older, participants with more education were more likely to be knowledgeable about CRC and to have received screening. This survey, led by a Navajo investigator with Navajo surveyors, revealed a high awareness of CRC and screening, but overall CRC screening was low. CRC education for Navajo adults who have little or no formal schooling should be improved.}, keywords = {}, pubstate = {published}, tppubtype = {article} } INTRODUCTION: Increasing public awareness and knowledge about the need for colorectal cancer (CRC) screening among American Indians is key to reducing health disparities. The objective of this study was to assess Navajo adults' knowledge of CRC risk factors and prevention, CRC screening, and self-reported experience with CRC screening. METHODS: We collected data generated by a self-administered survey given to Navajo adults, most of whom lived on the reservation. Data were collected at 2 annual tribal fairs in 2006. Fair attendees who visited an exhibit booth completed a CRC knowledge survey. The study design was nonrandomized. RESULTS: Of the 285 Navajo adults who participated, most were bilingual (74%) and female (80%). Of the respondents aged 50 years or older, 77% had heard of CRC screening and 28% reported being screened for colon or colorectal cancer. Knowledge was high (mean, 5.78 [standard deviation (SD), 1.28]) (8.0 was the highest possible knowledge score). Respondents with little or no formal schooling had lower scores (mean, 5.4), indicating less knowledge of CRC and associated screening tests than did those with more education (mean, 6.0). CONCLUSION: Among a sample of Navajo adults aged 50 years or older, participants with more education were more likely to be knowledgeable about CRC and to have received screening. This survey, led by a Navajo investigator with Navajo surveyors, revealed a high awareness of CRC and screening, but overall CRC screening was low. CRC education for Navajo adults who have little or no formal schooling should be improved. |
2010 |
Sanderson, Priscilla R; Teufel-Shone, Nicolette; Baldwin, Julie A; Sandoval, Nellie; Robinson, Frances Breast cancer education for Navajo women: a pilot study evaluating a culturally relevant video Journal Article Journal of Cancer Education, 25 (2), pp. 217-223, 2010. @article{Sanderson2010, title = {Breast cancer education for Navajo women: a pilot study evaluating a culturally relevant video}, author = {Priscilla R Sanderson and Nicolette Teufel-Shone and Julie A Baldwin and Nellie Sandoval and Frances Robinson}, url = {https://www.ncbi.nlm.nih.gov/pubmed/20111913}, doi = {10.1007/s13187-009-0036-7}, year = {2010}, date = {2010-06-01}, journal = {Journal of Cancer Education}, volume = {25}, number = {2}, pages = {217-223}, abstract = {This pilot study evaluated a culturally specific video designed to teach Navajo women about breast cancer treatment options. Fourteen Navajo women diagnosed with breast cancer and 26 healthcare providers participated in a mixed-method evaluation that documented their perceptions immediately and 6 months after viewing the video. After initial viewing, women reported reduced anxiety about treatment and interest in support groups. Six months later, women said the video prompted them to seek more information from printed sources and their provider. Younger Navajo women who were 44 to 51 years old were more likely to attend support groups than women who were 55-67 years. Providers corroborated the positive effects of the video. The providers believed the video encouraged patients to seek information about breast cancer and to ask questions about treatment plans and side effects. A culturally relevant video for Navajo women can be an effective teaching tool and can enhance patient-provider communication.}, keywords = {}, pubstate = {published}, tppubtype = {article} } This pilot study evaluated a culturally specific video designed to teach Navajo women about breast cancer treatment options. Fourteen Navajo women diagnosed with breast cancer and 26 healthcare providers participated in a mixed-method evaluation that documented their perceptions immediately and 6 months after viewing the video. After initial viewing, women reported reduced anxiety about treatment and interest in support groups. Six months later, women said the video prompted them to seek more information from printed sources and their provider. Younger Navajo women who were 44 to 51 years old were more likely to attend support groups than women who were 55-67 years. Providers corroborated the positive effects of the video. The providers believed the video encouraged patients to seek information about breast cancer and to ask questions about treatment plans and side effects. A culturally relevant video for Navajo women can be an effective teaching tool and can enhance patient-provider communication. |
Henson, Michele; Sabo, Samantha; Trujillo, Aurora; Teufel-Shone, Nicolette Identifying Protective Factors to Promote Health in American Indian and Alaska Native Adolescents: A Literature Review Journal Article The Journal of Primary Prevention, 38 (1), pp. 5-26, 2010. @article{Henson2010, title = {Identifying Protective Factors to Promote Health in American Indian and Alaska Native Adolescents: A Literature Review}, author = {Michele Henson and Samantha Sabo and Aurora Trujillo and Nicolette Teufel-Shone}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27826690}, doi = {10.1007/s10935-016-0455-2}, year = {2010}, date = {2010-03-01}, journal = {The Journal of Primary Prevention}, volume = {38}, number = {1}, pages = {5-26}, abstract = {Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent's environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent's environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents. |
Johnson, Jeannette; Baldwin, Julie A; Gryczynski, Jan; Wiechelt, Shelly A; Haring, Rodney C The Native American experience: From displacement and cultural trauma to resilience Book Chapter Multiethnicity and Multiethnic Families: Development, Identity, and Resilience, Chapter 14, pp. 277-302, Xlibris Corporation, 2010, ISBN: 9781450003407. @inbook{Johnson2010, title = {The Native American experience: From displacement and cultural trauma to resilience}, author = {Jeannette Johnson and Julie A Baldwin and Jan Gryczynski and Shelly A Wiechelt and Rodney C Haring}, url = {https://books.google.com/books?hl=en&lr=&id=VidnMGRDFdwC&oi=fnd&pg=PR2&dq=Multiethnicity+and+Multiethnic+Families:+Development,+Identity,+and+Resilience,+Chapter+14&ots=Z610xp1ePw&sig=8M8O6UAUJvfcnTvZO92e4atv-6c#v=onepage&q=Multiethnicity%20and%20Multiethnic%20Families%3A%20Development%2C%20Identity%2C%20and%20Resilience%2C%20Chapter%2014&f=false}, isbn = {9781450003407}, year = {2010}, date = {2010-01-01}, booktitle = {Multiethnicity and Multiethnic Families: Development, Identity, and Resilience}, pages = {277-302}, publisher = {Xlibris Corporation}, chapter = {14}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } |
Harris, Kelly A; Trotter, Robert Community Health Status Assessment Navajo County, Arizona Journal Article 2010. @article{Harris2010, title = {Community Health Status Assessment Navajo County, Arizona}, author = {Kelly A Harris and Robert Trotter}, url = {https://repository.asu.edu/items/23700}, year = {2010}, date = {2010-01-01}, abstract = {The CHSA focuses on 11 health status indicators which include: demographic characteristics, socioeconomic characteristics, health resource availability, quality of life, behavioral risk factors, environmental health, social and mental health, maternal and child health, death, illness and injury, communicable disease, and sentinel events.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The CHSA focuses on 11 health status indicators which include: demographic characteristics, socioeconomic characteristics, health resource availability, quality of life, behavioral risk factors, environmental health, social and mental health, maternal and child health, death, illness and injury, communicable disease, and sentinel events. |
2009 |
Baldwin, Julie A; Johnson, Jeannette L; Benally, Christine C Building partnerships between indigenous communities and universities: lessons learned in HIV/AIDS and substance abuse prevention research Journal Article American Journal of Public health, 99 (S1), pp. S77-S82, 2009. @article{Baldwin2009, title = {Building partnerships between indigenous communities and universities: lessons learned in HIV/AIDS and substance abuse prevention research}, author = {Julie A Baldwin and Jeannette L Johnson and Christine C Benally}, url = {https://www.ncbi.nlm.nih.gov/pubmed/19246672}, doi = {10.2105/AJPH.2008.134585}, year = {2009}, date = {2009-04-01}, journal = {American Journal of Public health}, volume = {99}, number = {S1}, pages = {S77-S82}, abstract = {Many HIV/AIDS and substance abuse prevention studies in American Indian and Alaska Native communities have been directed by academic researchers with little community input. We examined the challenges in conducting HIV/AIDS-related research in American Indian and Alaska Native communities and the benefits of changing the research paradigm to a community-based participatory model. The lessons we learned illustrate that the research process should be a cyclical one with continual involvement by community members. Steps in the process include (1) building and sustaining collaborative relationships, (2) planning the program together, (3) implementing and evaluating the program in culturally acceptable ways, and (4) disseminating research findings from a tribal perspective. These steps can enhance the long-term capacity of the community to conduct HIV/AIDS and substance abuse prevention research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Many HIV/AIDS and substance abuse prevention studies in American Indian and Alaska Native communities have been directed by academic researchers with little community input. We examined the challenges in conducting HIV/AIDS-related research in American Indian and Alaska Native communities and the benefits of changing the research paradigm to a community-based participatory model. The lessons we learned illustrate that the research process should be a cyclical one with continual involvement by community members. Steps in the process include (1) building and sustaining collaborative relationships, (2) planning the program together, (3) implementing and evaluating the program in culturally acceptable ways, and (4) disseminating research findings from a tribal perspective. These steps can enhance the long-term capacity of the community to conduct HIV/AIDS and substance abuse prevention research. |
Mmari, Kristin N; Blum, Robert Wm.; Teufel-Shone, Nicolette What Increases Risk and Protection for Delinquent Behaviors Among American Indian Youth? Findings from Three Tribal Communities Journal Article Youth and Society, 41 (3), pp. 382-413, 2009. @article{Mmari2009, title = {What Increases Risk and Protection for Delinquent Behaviors Among American Indian Youth? Findings from Three Tribal Communities}, author = {Kristin N Mmari and Robert Wm. Blum and Nicolette Teufel-Shone}, url = {http://journals.sagepub.com/doi/pdf/10.1177/0044118X09333645}, doi = {10.1177/0044118X09333645}, year = {2009}, date = {2009-03-24}, journal = {Youth and Society}, volume = {41}, number = {3}, pages = {382-413}, abstract = {The primary purpose of this study was to compare the risk and protective factors for delinquent behaviors among American Indian youth in three distinct tribal communities. Focus group discussions were used to gather data from elders, parents, youth workers, and youth in each tribal community. Findings showed that the key source for increasing risk and protection for delinquent behaviors among American Indian youth is the family. In particular is the protective presence of a parent and having a parent available for discussing problems. Participants also revealed how many parents lack the knowledge and confidence to discipline their children. These findings suggest a need for programs that strengthen parent-adolescent communication, parenting skills, and offer cultural teachings and sensitivity training for school personnel. Interventions also need to be specific to the cultural context and cannot assume the same risk and protective factors will apply to all American Indian youth.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The primary purpose of this study was to compare the risk and protective factors for delinquent behaviors among American Indian youth in three distinct tribal communities. Focus group discussions were used to gather data from elders, parents, youth workers, and youth in each tribal community. Findings showed that the key source for increasing risk and protection for delinquent behaviors among American Indian youth is the family. In particular is the protective presence of a parent and having a parent available for discussing problems. Participants also revealed how many parents lack the knowledge and confidence to discipline their children. These findings suggest a need for programs that strengthen parent-adolescent communication, parenting skills, and offer cultural teachings and sensitivity training for school personnel. Interventions also need to be specific to the cultural context and cannot assume the same risk and protective factors will apply to all American Indian youth. |
2008 |
Johnson, Jeannette L; Baldwin, Julie A; Haring, Rodney C; Wiechelt, Shelly A; Roth, Susan; Gryczynski, Jan; Lozano, Henry Essential information for disaster management and trauma specialists working with American Indians Book Chapter Marsella, A; Johnson, J; Watson, P; Gryczynski, J (Ed.): Ethnocultural Perspectives on Disaster and Trauma: Foundations, Issues, and Applications, Chapter 4, pp. 73-113, 2008, ISBN: 978-0-387-73285-5. @inbook{Johnson2008, title = {Essential information for disaster management and trauma specialists working with American Indians}, author = {Jeannette L Johnson and Julie A Baldwin and Rodney C Haring and Shelly A Wiechelt and Susan Roth and Jan Gryczynski and Henry Lozano}, editor = {A Marsella and J Johnson and P Watson and J Gryczynski}, url = {http://www.springer.com/us/book/9780387732848}, isbn = {978-0-387-73285-5}, year = {2008}, date = {2008-01-01}, booktitle = {Ethnocultural Perspectives on Disaster and Trauma: Foundations, Issues, and Applications}, pages = {73-113}, chapter = {4}, abstract = {In this pioneering volume, experts on individual and collective trauma experience, posttraumatic stress and related syndromes, and emergency and crisis intervention – share knowledge and insights on the cultural context of working with ethnic and racial minority communities during disasters. In each chapter, emotional, psychological, and social needs as well as communal strengths and coping skills that arise in disasters are documented for major minority groups in the United States including specific chapters on African Americans, Native Americans, Arab Americans, Asian Indians, Chinese Americans, Caribbean Americans, Latin Americans, Native Hawaiians, and Vietnamese Americans. Each chapter features information on: Demographics, major historical events, and core values of each population Important cultural insights, including communication styles, culture-specific disorders, and valid assessment instruments Therapeutic and healing traditions versus conventional medicine and therapy Perspectives specific to the population’s experience with disaster and trauma Authors’ recommendations for improving services to the population Practical appendices for readers new to the field This unique volume is a cultural competency compendium that will increase to the effectiveness of all who respond to disasters. It will also be of interest and value to scholars, policy makers, and health professionals working in the areas of disaster management, crisis intervention, and trauma. Ethnocultural Perspectives on Disaster and Trauma points readers to what the editors call the path "beyond simple assistance to healing and the restoration of hope and meaning."}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } In this pioneering volume, experts on individual and collective trauma experience, posttraumatic stress and related syndromes, and emergency and crisis intervention – share knowledge and insights on the cultural context of working with ethnic and racial minority communities during disasters. In each chapter, emotional, psychological, and social needs as well as communal strengths and coping skills that arise in disasters are documented for major minority groups in the United States including specific chapters on African Americans, Native Americans, Arab Americans, Asian Indians, Chinese Americans, Caribbean Americans, Latin Americans, Native Hawaiians, and Vietnamese Americans. Each chapter features information on: Demographics, major historical events, and core values of each population Important cultural insights, including communication styles, culture-specific disorders, and valid assessment instruments Therapeutic and healing traditions versus conventional medicine and therapy Perspectives specific to the population’s experience with disaster and trauma Authors’ recommendations for improving services to the population Practical appendices for readers new to the field This unique volume is a cultural competency compendium that will increase to the effectiveness of all who respond to disasters. It will also be of interest and value to scholars, policy makers, and health professionals working in the areas of disaster management, crisis intervention, and trauma. Ethnocultural Perspectives on Disaster and Trauma points readers to what the editors call the path "beyond simple assistance to healing and the restoration of hope and meaning." |