Cultural Sources of Strength and Resilience: A Case Study of Holistic Wellness Boxes for COVID-19 Response in Indigenous Communities

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Authors: Kevin M. W. Aulandez et al.

Publication Year: 2021

Last Updated: February 2021

Journal: Frontiers in Sociology

Keywords: Covid-19; Cultural Sensitivity and Appropriateness; Health Disparities; Mental and Behavioral Health; Nutrition; Holistic Health; Community-Based Participatory Research; Pandemics

 

Short Abstract: The COVID-19 pandemic has had disproportionately severe impacts on Indigenous peoples in the United States compared to non-Indigenous populations. In addition to the threat of viral infection, COVID-19 poses an increased risk for psychosocial stress that may widen already existing physical, mental, and behavioral health inequities experienced by Indigenous communities.

 

Abstract: The COVID-19 pandemic has had disproportionately severe impacts on Indigenous peoples in the United States compared to non-Indigenous populations. In addition to the threat of viral infection, COVID-19 poses an increased risk for psychosocial stress that may widen already existing physical, mental, and behavioral health inequities experienced by Indigenous communities. In recognition of the impact of COVID-19-related psychosocial stressors on our tribal community partners, the Johns Hopkins Center for American Indian Health Great Lakes Hub began sending holistic wellness boxes to our community partners in 11 tribal communities in the Midwestern United States and Canada in the summer of 2020. Designed specifically to draw on culturally relevant sources of strength and resilience, these boxes contained a variety of items to support mental, emotional, cultural, and physical well-being. Feedback from recipients suggests that these wellness boxes provided a unique form of COVID-19 relief. Additional Johns Hopkins Center for American Indian Health offices have begun to adapt wellness boxes for the cultural context of their regions. This case study describes the conceptualization, creation, and contents of these wellness boxes and orients this intervention within a reflection on foundations of community-based participatory research, holistic relief, and drawing on cultural strengths in responding to COVID-19.

 

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Source: https://www.frontiersin.org/articles/10.3389/fsoc.2021.612637/full

Type of Resource: Peer-reviewed scientific article

A Qualitative Study of COVID-19 Vaccine Decision-Making Among Urban Native Americans

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Authors: Anna E. Epperson et al.

Publication Year: 2022

Last Updated:

Journal: Vaccine: X

Keywords: Covid-19; Health Disparities; Vaccination/Immunization; Community-engaged Research

 

Short Abstract: Background: Significant disparities in COVID-19 morbidity and mortality exist for Native American (NA) people, the majority of whom live in urban areas. COVID-19 vaccination is a key strategy for mitigating these disparities; however, vaccination disparities affect NA communities. The current study investigated COVID-19 vaccine decision-making before widespread vaccine rollout occurred, among urban NA communities. We aimed to understand vaccine decision-making factors to develop recommendations about COVID-19 vaccine outreach.

 

Abstract: Background: Significant disparities in COVID-19 morbidity and mortality exist for Native American (NA) people, the majority of whom live in urban areas. COVID-19 vaccination is a key strategy for mitigating these disparities; however, vaccination disparities affect NA communities. The current study investigated COVID-19 vaccine decision-making before widespread vaccine rollout occurred, among urban NA communities. We aimed to understand vaccine decision-making factors to develop recommendations about COVID-19 vaccine outreach. Methods: We conducted three in-depth virtual focus groups with 17 NA adults living in an urban community (Los Angeles County) between December 2020 and January 2021. Participants were recruited through NA community-based organizations and community stakeholders. Reflexive thematic analysis was conducted using Atlas.ti. Findings: Participants in this study identified two overarching themes with implications for health vaccination campaigns. First, participants described a need for tailored information and outreach, including NA vaccine outreach that addresses misconceptions about vaccine development to calm fears of experimentation and support communication of vaccine evidence specific to NA people. Second, participants suggested strategies to improve public health resources in the urban NA community, such as the need for unified, proactive communication across trusted NA entities, navigation support to improve vaccine accessibility, and adequately resourcing health partnerships with and among trusted NA community agencies for improved reach. Conclusion: In this qualitative study, we found that urban NA participants reported several factors that affected their vaccine decision-making, including a lack of tailored information for their communities. Our findings also underscore the need to work with tribes, tribal leadership, and urban NA serving organizations to coordinate vaccine communication and distribution to urban communities where the majority of NAs now reside. Further, these findings have implications for COVID-19 vaccine outreach among urban NA communities and demonstrate the need for clear and tailored engagement about the COVID19 vaccine.

 

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Type of Resource: Peer-reviewed scientific article

Holistic system of care: a ten-year perspective.

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Authors: Ethan Nebelkopf and Serena Wright

Publication Year: 2011

Last Updated:

Journal: Journal of Psychoactive Drugs

Keywords: Cultural Sensitivity and Appropriateness; HIV/AIDS; Mental and Behavioral Health; Violence; Prevention; Intervention; Recovery

 

Short Abstract: The Holistic System of Care for Native Americans in an Urban Environment is a community-focused intervention that provides behavioral health care, promotes health, and prevents disease.

 

Abstract: The Holistic System of Care for Native Americans in an Urban Environment is a community-focused intervention that provides behavioral health care, promotes health, and prevents disease. This approach is based on a community strategic planning process that honored Native American culture and relationships. Substance abuse, mental illness, homelessness, poverty, crime, physical illness, and violence are symptoms of historical trauma, family dysfunction, and spiritual imbalance. The holistic model links treatment, prevention, and recovery. The link between prevention and treatment is early intervention. Peer support is the link between treatment and recovery. Recovering individuals serve as role models linking recovery to prevention. Culture and spirituality build a strong and resilient foundation for recovery. This article documents the effectiveness of the holistic model over a ten-year period that it has been implemented at the Family & Child Guidance Clinic of the Native American Health Center in the San Francisco Bay Area. The holistic model has produced statistically significant reductions in substance abuse among adult Native American women, men, reentry, and homeless populations; reductions in substance abuse among Native American adolescents; reductions in HIV/AIDS high-risk behavior among Native American men, women, and adolescents; and decreases in acting out behavior among Native American severely emotionally disturbed children.

 

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Source: https://www.thefreelibrary.com/Holistic+system+of+care%3A+a+ten-year+perspective-a0278880917

Type of Resource: Peer-reviewed scientific article

A Collaborative and Trauma-Informed Practice Model for Urban Indian Child Welfare

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Authors: Nancy M. Lucero, Marian Bussey

Publication Year: 2012

Last Updated:

Journal: Child Welfare

Keywords: Childcare; Cultural Sensitivity and Appropriateness; Family; Indian Child Welfare Act (ICWA); Trauma; Case Management

 

Short Abstract: Preventing the breakup of the American Indian family is the fundamental goal of the Indian Child Welfare Act (ICWA). However, few models exist to provide CPS workers and other practitioners with effective and practical strategies to help achieve this goal.

 

Abstract: Preventing the breakup of the American Indian family is the fundamental goal of the Indian Child Welfare Act (ICWA). However, few models exist to provide CPS workers and other practitioners with effective and practical strategies to help achieve this goal. This article presents a collaborative and trauma-informed family preservation practice model for Indian Child Welfare services with urban-based American Indian families. The model encompasses both systemic and direct practice efforts that assist families facing multiple challenges in creating a nurturing and more stable family life. System-level interventions improve the cultural responsiveness of providers, encourage partnerships between CPS and community-based providers, and support ICWA compliance. Direct practice interventions, in the form of intensive case management and treatment services, help parents/caregivers become more capable of meeting their own and their children's needs by addressing challenges such as substance abuse, trauma and other mental health challenges, domestic violence, and housing instability. Evaluation of the practice model suggests that it shows promise in preventing out-of-home placement of Native children, while at the same time improving parental capacity, family safety, child well-being, and family environment.

 

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Source: https://tribalinformationexchange.org/files/resources/ACollaborativeandTrauma-InformedPracticeModelforUrbanIndianChildWelfare.pdf

Type of Resource: Peer-reviewed scientific article

Development and evaluation of an enhanced diabetes prevention program with psychosocial support for urban American Indians and Alaska natives: A randomized controlled trial

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Authors: Lisa G. Rosas et al.

Publication Year: 2016

Last Updated: September 2016

Journal: Contemporary Clinical Trials

Keywords: Cultural Sensitivity and Appropriateness; Diabetes; Nutrition; Population Information; Weight Management and Obesity; Prevention; Prediabetes; Community-based Participatory Research

 

Short Abstract: Diabetes is highly prevalent, affecting over 25 million adults in the US, yet it can be effectively prevented through lifestyle interventions, including the well-tested Diabetes Prevention Program (DPP).

 

Abstract: Diabetes is highly prevalent, affecting over 25 million adults in the US, yet it can be effectively prevented through lifestyle interventions, including the well-tested Diabetes Prevention Program (DPP). American Indian/Alaska Native (AIAN) adults, the majority of whom live in urban settings, are more than twice as likely to develop diabetes as non-Hispanic whites. Additionally, prevalent mental health issues and psychosocial stressors may facilitate progression to diabetes and hinder successful implementation of lifestyle interventions for AIAN adults. This 2-phased study first engaged community stakeholders to develop culturally-tailored strategies to address mental health concerns and psychosocial stressors. Pilot testing (completed) refined those strategies that increase engagement in an enhanced DPP for urban AIAN adults. Second, the enhanced DPP will be compared to a standard DPP in a randomized controlled trial (ongoing) with a primary outcome of body mass index (BMI) and a secondary outcome of quality of life (QoL) over 12 months. Obese self-identified AIAN adults residing in an urban setting with one or more components of the metabolic syndrome (excluding waist circumference) will be randomized to the enhanced or standard DPP (n = 204). They hypothesized that addressing psychosocial barriers within a culturally-tailored DPP will result in clinical (BMI) and superior patient-centered (QoL) outcomes as compared to a standard DPP. Exploratory outcomes will include cardiometabolic risk factors (e.g., waist circumference, blood pressure, fasting glucose) and health behaviors (e.g., diet, physical activity). Results of this trial may be applicable to other urban AIAN or minority communities or even diabetes prevention in general.

 

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691492/pdf/nihms-1044257.pdf

Type of Resource: Peer-reviewed scientific article

Indigenous Evaluation Toolkit: An Actionable Guide for Organizations Serving American Indian / Alaska Native Communities through Opioid Prevention Programming

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Authors: Seven Directions: A Center for Indigenous Public Health

Publication Year: 2023

Last Updated:

Journal:

Keywords: Awareness; Cultural Sensitivity and Appropriateness; Data Collection; Ethnicity; Mental and Behavioral Health; Race; Substance Use; Data Collection; Research Methodology; Toolkit

 

Short Abstract: Indigenous communities have always engaged in review and reflection. Western research and evaluation frameworks may not align with ancestral and cultural wisdom, and we hope to address this through our Indigenous Evaluation Toolkit.

 

Abstract: Indigenous communities have always engaged in review and reflection. Western research and evaluation frameworks may not align with ancestral and cultural wisdom, and we hope to address this through our Indigenous Evaluation Toolkit. As Indigenous communities continue to shape programming to reflect their own stories, ways of knowing, and cultural perspectives, there is a growing need for frameworks that support the infusion of this knowledge into the evaluation of their programs focused on substance use prevention, treatment, and recovery support. Through step-by-step guidance, worksheets, and storytelling, this toolkit offers communities an iterative, reflective, continuous learning process for beginning or incorporating Indigenous evaluation.

 

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Source: https://www.indigenousphi.org/tribal-opioid-use-disorders-prevention/indigenous-evaluation-toolkit

Type of Resource: Toolkit

Social Determinants of Cancer Risk Among American Indian and Alaska Native Populations: An Evidence Review and Map

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Authors: Stephanie Melkonian, Jolie Crowder, Emily Adam, Mary White, Lucy Peipins

Publication Year: 2022

Last Updated: September 21, 2022

Journal: Health Equity

Keywords: Cancer; Health Disparities; Social Determinants of Health

 

Short Abstract: Objectives: To explore current literature on social determinants of health (SDOH) and cancer among American Indian and Alaska Native (AI/AN) populations.

 

Abstract: Objectives: To explore current literature on social determinants of health (SDOH) and cancer among American Indian and Alaska Native (AI/AN) populations. Methods: We searched Ovid MEDLINE®️, CINAHL, and PsycINFO databases for articles published during 2000 to 2020, which included terms for SDOH and cancer occurrence in AI/AN populations. We derived the data extraction elements from the PROGRESS-Plus framework. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Equity extension guided the evidence map. Results: From 2180 screened articles, 297 were included. Most were observational (93.9%), employed a cross-sectional design (83.2%), were categorized as cancer occurrence and surveillance research (62%), and included no cancer-related risk factors (70.7%). Race, gender, and place were the most frequently included PROGRESS-Plus categories. Religion, relationship features, and characteristics of discrimination were least common. Only 12% of articles mentioned historical/current trauma or historical context. Conclusions: Gaps exist in our understanding of SDOH as drivers of cancer disparities in AI/AN populations. Future studies in health equity science may incorporate historical and cultural factors into SDOH frameworks tailored for AI/AN populations.

 

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536331/#!po=1.19048

Type of Resource: Best Practices Newsletter

Standards of Care in Diabetes—2023 Abridged for Primary Care Providers

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Authors: American Diabetes Association

Publication Year: 2023

Last Updated: February 16, 2023

Journal: American Diabetes Association

Keywords: Awareness; Diabetes; General Materials; Health Disparities; Health Care Reform; NCUIH Newsletters; Social Determinants of Health

 

Short Abstract: This abridged version of the current Standards of Care contains the evidence-based recommendations most pertinent to primary care. The recommendations, tables, and figures included here retain the same numbering used in the complete Standards of Care.

 

Abstract: This abridged version of the current Standards of Care contains the evidence-based recommendations most pertinent to primary care. The recommendations, tables, and figures included here retain the same numbering used in the complete Standards of Care. All recommendations included here are substantively the same as in the complete Standards of Care. The abridged version does not include references. The complete 2023 Standards of Care, including all supporting references, is available at professional. diabetes.org/standards.

 

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Source: https://diabetesjournals.org/clinical/article/doi/10.2337/cd23-er02a/148453/Erratum-Standards-of-Care-in-Diabetes-2023

Type of Resource: Peer-reviewed scientific article

A Diabetes Self-Management Program Designed for Urban American Indians

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Authors: Sarah Castro et al.

Publication Year: 2009

Last Updated:

Journal: Preventing Chronic Disease: Public Health Research, Practice, and Policy

Keywords: Cultural Sensitivity and Appropriateness; Diabetes; Self-Management; Holistic

 

Short Abstract: Background: Although the American Indian population has a disproportionately high rate of type 2 diabetes, little has been written about culturally sensitive self-management programs in this population.

 

Abstract: Background: Although the American Indian population has a disproportionately high rate of type 2 diabetes, little has been written about culturally sensitive self-management programs in this population. Context: Community and clinic partners worked together to identify barriers to diabetes self-management and to provide activities and services as part of a holistic approach to diabetes self-management, called the Full Circle Diabetes Program. Methods: The program activities and services addressed 4 components of holistic health: body, spirit, mind, and emotion. Seven types of activities or services were available to help participants improve diabetes self-management; these included exercise classes, educational classes, and talking circles. Consequences: Ninety-eight percent of program enrollees participated in at least 1 activity, and two-thirds participated in 2 or more activities. Program participation resulted in a significant improvement in knowledge of resources for managing diabetes. Interpretation: The Full Circle Diabetes Program developed and implemented culturally relevant resources and supports for diabetes self-management in an American Indian population. Lessons learned included that a holistic approach to diabetes self-management, community participation, and stakeholder partnerships are needed for a successful program.

 

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774645/pdf/PCD64A131.pdf

Type of Resource: Peer-reviewed scientific article

Interviews with American Indian and Alaska Native People Who Inject Drugs

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Authors: Jessica Leston, Carolyn Crisp, Murilynn Crystal Lee, Elizabeth Rink

Publication Year: 2020

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Journal: American Indian and Alaska Native Mental Health Research

Keywords: Awareness; Health Care Access; Health Disparities; Social Determinants of Health; Injection Drug Use

 

Short Abstract: Abstract: This project gathered opinions, attitudes, and beliefs from American Indian and Alaska Native (AI/AN) people who inject drugs (PWID).

 

Abstract: Abstract: This project gathered opinions, attitudes, and beliefs from American Indian and Alaska Native (AI/AN) people who inject drugs (PWID). The primary objective of this study was to build formative knowledge around AI/AN PWID to help define and develop health care services and strategies by better understanding existing services, barriers, and challenges to seeking care. A total of 32 semi-structured in-depth interviews were conducted. AI/AN PWID reported a number of structural, social, and geographical barriers when trying to access health care. PWID communities critically need integrative health care service strategies and improved education about injection drug use (IDU), outreach, and prevention programs and resources. More low-barrier and streamlined access to needles should be coupled with other health care services for PWID. PWID are a key resource to help health care providers and community members correct misconceptions and better understand IDU.

 

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Source: https://coloradosph.cuanschutz.edu/docs/librariesprovider205/journal_files/vol27/27_1_2020_64_leston.pdf?sfvrsn=57fee0b9_2

Type of Resource: Peer-reviewed scientific article