Integrating Professional and Indigenous Therapies: An Urban American Indian Narrative Clinical Case Study

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Authors: Dennis C. Wendt and Joseph P. Gone

Publication Year: 2016

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Journal: Counseling Psychology

Keywords: Cultural Sensitivity and Appropriateness; Ethnicity; Mental and Behavioral Health; Race; Psychotherapy; Spirituality; Religion; Qualitative; Multiculturalism

 

Short Abstract: We present a narrative case study of an urban American Indian male college student who integrated Indigenous and professional therapies during an acute period of stress, loss, and depression.

 

Abstract: We present a narrative case study of an urban American Indian male college student who integrated Indigenous and professional therapies during an acute period of stress, loss, and depression. The first published case of an American Indian in an urban context, this article expands on previous clinical cases by focusing on the perspective of the client relative to his own conceptions of help-seeking behaviors. Based on qualitative analysis of five audio-recorded interviews, this case utilizes an innovative methodology to portray four approaches to healing (medication, counseling, bonding, and spirituality), which contribute to holistic well-being. Implications for counseling psychologists include being aware of how some American Indian clients may (a) view professional treatment dynamics through a Native cultural lens (e.g., seeing ideal communication as a “rhythm”); (b) utilize an expanded range of therapeutic agents; (c) resist medication for cultural and spiritual reasons; and (d) refrain from discussing spiritual matters with professionals.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007066/

Type of Resource: Peer-reviewed scientific article

Urban American Indian Community Perspectives on Resources and Challenges for Youth Suicide Prevention

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Authors: Rachel L. Burrage, Joseph P. Gone, and Sandra L. Momper

Publication Year: 2016

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Journal: American Journal of Community Psychology

Keywords: Cultural Sensitivity and Appropriateness; Mental and Behavioral Health; Suicide and Suicide Prevention; Youth; Prevention; Informal Supports

 

Short Abstract: American Indian (AI) youth have some of the highest rates of suicide of any group in the United States, and the majority of AI youth live in urban areas away from tribal communities. As such, understanding the resources available for suicide prevention among urban AI youth is critical, as is understanding the challenges involved in accessing such resources.

 

Abstract: American Indian (AI) youth have some of the highest rates of suicide of any group in the United States, and the majority of AI youth live in urban areas away from tribal communities. As such, understanding the resources available for suicide prevention among urban AI youth is critical, as is understanding the challenges involved in accessing such resources. Pre-existing interview data from 15 self-identified AI community members and staff from an Urban Indian Health Organization were examined to understand existing resources for urban AI youth suicide prevention, as well as related challenges. A thematic analysis was undertaken, resulting in three principal themes around suicide prevention: formal resources, informal resources, and community values and beliefs. Formal resources that meet the needs of AI youth were viewed as largely inaccessible or nonexistent, and youth were seen as more likely to seek help from informal sources. Community values of mutual support were thought to reinforce available informal supports. However, challenges arose in terms of the community’s knowledge of and views on discussing suicide, as well as the perceived fit between community values and beliefs and formal prevention models.

 

Source: Link to Original Article.

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Source: https://deepblue.lib.umich.edu/bitstream/handle/2027.42/134173/ajcp12080.pdf?sequence=1

Type of Resource: Peer-reviewed scientific article

Urban-Indigenous Therapeutic Landscapes: A Case Study of an Urban American Indian Health Organization

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Authors: Dennis C. Wendt and Joseph P. Gone

Publication Year: 2012

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Journal: Health & Place

Keywords: Cultural Sensitivity and Appropriateness; Health Disparities; Therapeutic Landscapes

 

Short Abstract: We engage and extend the concept of therapeutic landscapes through a case study at an urban American Indian health organization in the Midwestern United States.

 

Abstract: We engage and extend the concept of therapeutic landscapes through a case study at an urban American Indian health organization in the Midwestern United States. This case affords insights at the unique confluence of indigeneity and urbanization, prompting us to coin the construct ‘‘urban indigenous therapeutic landscapes’’ to characterize such sites. These landscapes warrant urgent attention in light of increasing urbanization and health disparities among indigenous peoples internationally. On the basis of thematic content analysis, three themes were identified from 17 open-ended interviews with American Indian community members. Specifically, respondents viewed the health organization as (a) a vital place to be among other American Indians and connected to Native culture, (b) a place where one feels at home and welcome, and (c) a place in which health services are delivered in an especially intimate and hospitable manner. Significant challenges and tensions were also communicated, in terms of unique intersections of health care and indigeneity. Results are interpreted in terms of urban Indian health organizations as urban-indigenous therapeutic landscapes.

 

Source: Link to Original Article.

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Source: http://gonetowar.com/wp-content/uploads/2013/11/TxLandscapes.pdf

Type of Resource: Peer-reviewed scientific article

Adaptation of a Smoking Cessation and Prevention Website for Urban American Indian/Alaska Native Youth

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Authors: Maile Taualii

Publication Year: 2010

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Journal: Journal of Cancer Education

Keywords: Cultural Sensitivity and Appropriateness; Tobacco Use (non-traditional); Youth; eHealth Intervention

 

Short Abstract: Tobacco use among American Indian youth is a disproportionately significant problem. We adapted and modified an existing web-based and youth-focused tobacco control program to make it appropriate for young urban American Indian/Alaska Natives (AI/ANs).

 

Abstract: Tobacco use among American Indian youth is a disproportionately significant problem. We adapted and modified an existing web-based and youth-focused tobacco control program to make it appropriate for young urban American Indian/Alaska Natives (AI/ANs). The results of the focus group indicate that AI/AN youth were very receptive to the use of a web-based Zine-style intervention tool. They wanted the look and feel of the website to be more oriented toward their cultural images. Future research should examine if successful programs for reducing non-ceremonial tobacco use among urban AI/AN youth can keep young irregular smokers from becoming adult smokers.

 

Source: Link to Original Article.

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Source: https://link.springer.com/article/10.1007/s13187-009-0004-2

Type of Resource: Peer-reviewed scientific article

Racial Misidentification of American Indians/Alaska Natives in the HIV/AIDS Reporting Systems of Five States and One Urban Health Jurisdiction, U.S., 1984–2002

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Authors: Jeanne Bertolli et al.

Publication Year: 2007

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Journal: Public Health Reports

Keywords: HIV/AIDS; IHS; Misclassification of AI/AN; Race

 

Short Abstract: Objectives. We examined racial misidentification of American Indians/Alaska Natives (AI/AN) reported to the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) Reporting Systems (HARS) of five U.S. states and one county.

 

Abstract: Objectives. We examined racial misidentification of American Indians/Alaska Natives (AI/AN) reported to the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) Reporting Systems (HARS) of five U.S. states and one county. Methods. To identify AI/AN records with misidentified race, we linked HARS data from 1984 through 2002 to the Indian Health Service National Patient Information and Reporting System (NPIRS), excluding non-AI/AN dependents, using probabilistic matching with clerical review. We used chi-square tests to examine differences in proportions and logistic regression to examine the associations of racial misidentification with HARS site, degree of AI/AN ancestry, mode of exposure to HIV, and urban or rural location of residence at time of diagnosis. Results. A total of 1,523 AI/AN individuals was found in both NPIRS and HARS; race was misidentified in HARS for 459 (30%). The percentages of racially misidentified ranged from 3.7% (in Alaska) to 55% (in California). AI/AN people were misidentified as white (70%), Hispanic (16%), black (11%), and Asian/Pacific Islander (2%); for 0.9%, race was unspecified. Logistic regression results (data from all areas, all variables) indicated that urban residence at time of diagnosis, degree of AI/AN ancestry, and mode of exposure to HIV were significantly associated with racial misidentification of AI/AN people reported to HARS. Conclusions. Our findings add to the evidence that racial misidentification of AI/AN in surveillance data can result in underestimation of AI/AN HIV/AIDS case counts. Racial misidentification must be addressed to ensure that HIV/ AIDS surveillance data can be used as the basis for equitable resource allocation decisions, and to inform and mobilize public health action.

 

Source: Link to Original Article.

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Source: https://journals.sagepub.com/doi/pdf/10.1177/003335490712200312

Type of Resource: Peer-reviewed scientific article

HIV/AIDS Protective Factors among Urban American Indian Youths

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Authors: Flavio F. Marsiglia, Tanya Nieri, Arlene Rubin Stiffman

Publication Year: 2006

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Journal: Journal of Health Care for the Poor and Underserved

Keywords: Cultural Sensitivity and Appropriateness; HIV/AIDS; Youth; Family; Substance Use; Sexual Risk

 

Short Abstract: This research examined how family and individual factors influence three HIV/AIDS risk behaviors: having more than one sexual partner in the last three months, substance use at last sexual intercourse, and condom non-use at last sexual intercourse.

 

Abstract: This research examined how family and individual factors influence three HIV/AIDS risk behaviors: having more than one sexual partner in the last three months, substance use at last sexual intercourse, and condom non-use at last sexual intercourse. The sample includes 89 sexually active American Indian adolescents living in a large Southwestern city. Logistic regression results revealed that family communication acts as a protective factor against HIV risk through a lower reported substance use during last sexual intercourse, but it did not appear to affect the number of multiple recent sex partners. Family and personal involvement in American Indian cultural activities, both low on average, had no effect on the outcomes. This study helps to fill the gap in knowledge on sexual health risk and protective factors among American Indian adolescents, an understudied group, and provides implications for intervention with American Indian youths and their families.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038781/

Type of Resource: Peer-reviewed scientific article

Integrating traditional practices and social network visualization to prevent substance use: study protocol for a randomized controlled trial among urban Native American emerging adults

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Authors: Elizabeth J. D'Amico et al.

Publication Year: 2021

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Journal: Addiction Science & Clinical Practice

Keywords: Cultural Sensitivity and Appropriateness; Substance Use; Emerging Adults; Resiliency; TACUNA; Opioids

 

Short Abstract: Nonmedical use of prescription opioids (defined as taking opioid medications for hedonic effects or in a manner other than prescribed) and the use of heroin have emerged in recent years as major public health concerns in the United States. Of particular concern is the prevalence of opioid use among emerging adults (ages 18–25), as this is a developmental period of heightened vulnerability and critical social, neurological, and psychological development.

 

Abstract: Background Nonmedical use of prescription opioids (defined as taking opioid medications for hedonic effects or in a manner other than prescribed) and the use of heroin have emerged in recent years as major public health concerns in the United States. Of particular concern is the prevalence of opioid use among emerging adults (ages 18–25), as this is a developmental period of heightened vulnerability and critical social, neurological, and psychological development. Data from 2015 show that American Indian/Alaska Native (AI/AN) people have the highest rates of diagnosis for opioid use disorders (OUDs). One recent study found that the overdose death rate among urban-dwelling AI/AN individuals was 1.4 times higher compared to those living in rural areas. To date, there are no evidence-based prevention programs addressing opioid use among urban AI/AN emerging adults that integrate culturally-appropriate strategies with evidence-based treatment. Traditions and Connections for Urban Native Americans (TACUNA) builds on our prior work with AI/AN communities across California to develop and evaluate culturally appropriate programming to address opioid, alcohol, and cannabis use among urban AI/AN emerging adults. Methods/design In a randomized controlled trial, 18–25 year old urban AI/AN emerging adults will receive either TACUNA (n = 185), which comprises three virtual workshops utilizing motivational interviewing, social network visualization, and integrating traditional practices and a wellness circle, or one virtual culturally sensitive opioid education workshop (n = 185). We will evaluate intervention effects on primary outcomes of frequency of opioid, alcohol, and cannabis use, as well as secondary outcomes of social network characteristics and cultural connectedness, over a 12-month period. Discussion This project has the potential to expand the range and effectiveness of opioid, alcohol, and cannabis services for urban AI/AN emerging adults by addressing the opioid epidemic and use of other substances at both the community and individual level. In addition, it provides important culturally grounded conceptual and practical information to advance the field of substance use interventions and enhance resiliency among this population.

 

Source: Link to Original Article.

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Source: https://link.springer.com/article/10.1186/s13722-021-00265-3

Type of Resource: Peer-reviewed scientific article

Motivational interviewing and culture for urban Native American youth (MICUNAY): A randomized controlled trial

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Authors: Elizabeth J. D'Amico et al.

Publication Year: 2020

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Journal: Journal of Substance Abuse Treatment

Keywords: Cultural Sensitivity and Appropriateness; Substance Use; Adolescents; Motivational Interviewing; Intervention; Traditional Practices

 

Short Abstract: To date, few programs that integrate traditional practices with evidence-based practices have been developed, implemented, and evaluated with urban American Indians/Alaska Natives (AI/ANs) using a strong research design.

 

Abstract: To date, few programs that integrate traditional practices with evidence-based practices have been developed, implemented, and evaluated with urban American Indians/Alaska Natives (AI/ANs) using a strong research design. The current study recruited urban AI/AN teens across northern, central, and southern California during 2014–2017 to participate in a randomized controlled trial testing two cultural interventions that addressed alcohol and other drug (AOD) use. Adolescents were 14–18 years old (inclusive), and either verbally self-identified as AI/AN or were identified as AI/AN by a parent or community member. We tested the added benefit of MICUNAY (Motivational Interviewing and Culture for Urban Native American Youth) to a CWG (Community Wellness Gathering). MICUNAY was a group intervention with three workshops that integrated traditional practices with motivational interviewing. CWGs were cultural events held monthly in each city. AI/AN urban adolescents (N = 185) completed a baseline survey, were randomized to MICUNAY + CWG or CWG only, and then completed a three- and six-month follow-up. We compared outcomes on AOD use, spirituality, and cultural identification. Overall, AOD use remained stable over the course of the study, and we did not find significant differences between these two groups over time. It may be that connecting urban AI/AN adolescents to culturally centered activities and resources is protective, which has been shown in other work with this population. Given that little work has been conducted in this area, longer term studies of AOD interventions with urban AI/AN youth throughout the U.S. are suggested to test the potential benefits of culturally centered interventions.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7477923/

Type of Resource: Peer-reviewed scientific article

Food Insecurity, Sleep, and Cardiometabolic Risks in Urban American Indian/Alaska Native Youth

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Authors: Lu Dong et al.

Publication Year: 2023

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Journal: Sleep Health

Keywords: Health Disparities; Nutrition; Weight Management and Obesity; Adolescents; Food Insecurity; Sleep

 

Short Abstract: Objectives: Food insecurity contributes to racial/ethnic disparities in health. This is the first study to examine associations among food insecurity, sleep, and cardiometabolic outcomes in urban American Indian/Alaska Native (AI/AN) youth.

 

Abstract: Objectives: Food insecurity contributes to racial/ethnic disparities in health. This is the first study to examine associations among food insecurity, sleep, and cardiometabolic outcomes in urban American Indian/Alaska Native (AI/AN) youth. Design: Participants were 142 urban AI/AN youth (mean age = 14 years, 58% female). Food insecurity and self-reported sleep disturbance were measured using validated surveys. A multi-dimensional sleep health composite was derived using questionnaires (ie, satisfaction, alertness) and actigraphy-derived indices (ie, duration, efficiency, regularity, timing). Cardiometabolic measures included body mass index, blood pressure, glycosylated hemoglobin, waist circumference, cholesterol, and triglycerides. Covariates were sex, age, and single-parent household. Results: Greater food insecurity was significantly associated with greater body mass index (b = 0.12, p = .015), higher systolic blood pressure (b = 0.93, p = .03), and greater sleep disturbance (b = 1.49, p < .001), and marginally associated with lower sleep health composite scores (b = -0.09, p = .08). There was a significant indirect path from greater food insecurity to greater waist circumference through poorer sleep health (0.11, 95% bootstrapping CI: [0.01, 0.30]). Conclusion: Food insecurity is an important correlate of sleep and cardiometabolic health among urban AI/AN youth and should be addressed to reduce emerging health risks during this important developmental period. Policies to reduce food insecurity and increase access to healthy foods as well as sleep interventions for these youth could help, as preliminary findings suggest that sleep health may mediate the negative impact of food insecurity on cardiometabolic risks.

 

Source: Link to Original Article.

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Source: https://reader.elsevier.com/reader/sd/pii/S235272182200184X?token=D0AFE479963D406B2D8C578BD1D0B286F2B4FFF59CE871829F638E0249B1CB336BE10B8CEA257BA010E8AD6456D89D4B&originRegion=us-east-1&originCreation=20230317145114

Type of Resource: Peer-reviewed scientific article

Reaching Unvaccinated Urban Native Americans: A COVID-19 Study for the Department of Indian Work

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Authors: Maria Robisnon

Publication Year: 2022

Last Updated: June 2022

Journal:

Keywords: Covid-19; Cultural Sensitivity and Appropriateness; Health Disparities; Vaccination/Immunization; Messaging; Mistrust

 

Short Abstract: Through interviews with experts in the field, unvaccinated individuals, and a scan of what other organizations around the U.S. that serve urban Native American populations are doing, we found that COVID-19 vaccine-related messaging and strategies should use a culturally based approach centering the Native American community.

 

Abstract: Through interviews with experts in the field, unvaccinated individuals, and a scan of what other organizations around the U.S. that serve urban Native American populations are doing, we found that COVID-19 vaccine-related messaging and strategies should use a culturally based approach centering the Native American community. Organizations should focus their efforts on targeting messages and strategies to those who may be on the fence about vaccinations and should not waste time and resources trying to convince those who feel strongly that they will not get vaccinated. With this in mind, some key findings are:  Communities of color, especially Native American communities, experience significant health disparities, such as higher rates of infectious and chronic diseases including COVID-19. Disparities have always existed but have been exacerbated by COVID-19.  Those least like to get vaccinated in the Native American community are: people age 20-50; those who identify as traditionalists or religious; women who are pregnant, nursing, or breastfeeding; and community members who are transient.  There is a lack of trust in government and western medical entities among the Native American community rooted in multigenerational experiences of racism and discrimination.  Use trusted messengers like family and friends to disseminate information about COVID-19 and the vaccine.  Education and understanding of how vaccines are created and approved would help address common misconceptions and concerns in the Native American community.

 

Source: Link to Original Article.

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Source: https://www.wilder.org/sites/default/files/imports/InterfaithAction_COVIDHotlineEvaluation_6-22revised.pdf

Type of Resource: Wilder Research Study Report