Promoting Ethical Research With American Indian and Alaska Native People Living in Urban Areas

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Authors: Nicole P. Yuan, Jami Bartgis, and Deirdre Demers

Publication Year: 2014

Last Updated:

Journal: American Journal of Public Health

Keywords: Data Collection; Health Disparities; Ethical Research

 

Short Abstract: Most health research with American Indian and Alaska Native (AI/AN) people has focused on tribal communities on reservation lands. Few studies have been conducted with AI/AN people living in urban settings despite their documented health disparities compared with other urban populations.

 

Abstract: Most health research with American Indian and Alaska Native (AI/AN) people has focused on tribal communities on reservation lands. Few studies have been conducted with AI/AN people living in urban settings despite their documented health disparities compared with other urban populations. There are unique considerations for working with this population. Engaging key stakeholders, including urban Indian health organization leaders, tribal leaders, research scientists and administrators, and policymakers, is critical to promoting ethical research and enhancing capacity of urban AI/AN communities. Recommendations for their involvement may facilitate an open dialogue and promote the development of implementation strategies. Future collaborations are also necessary for establishing research policies aimed at improving the health of the urban AI/AN population.

 

Source: Link to Original Article.

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Source: https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2014.302027?role=tab

Type of Resource: Peer-reviewed scientific article

Prevalence of Mental Health Disorders and Treatment Utilization among Urban Lesbian, Gay, Bisexual, and Transgender American Indians and Alaska Natives

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Authors: Ethel Nicdao et al.

Publication Year: 2023

Last Updated:

Journal: American Indian and Alaska Native Mental Health Research

Keywords: Gender Identity; Mental and Behavioral Health; Sexuality; Treatment Utilization

 

Short Abstract: We examined prevalence of mental health treatment utilization among 447 lesbian, gay, bisexual, transgender, and Two-Spirit (LGBTT-S) American Indian/Alaska Native (AI/AN) adults and the association of mental health treatment utilization with socio-demographic factors, social support, and mental health diagnoses.

 

Abstract: We examined prevalence of mental health treatment utilization among 447 lesbian, gay, bisexual, transgender, and Two-Spirit (LGBTT-S) American Indian/Alaska Native (AI/AN) adults and the association of mental health treatment utilization with socio-demographic factors, social support, and mental health diagnoses. We derived data from the HONOR Project, a multi-site cross-sectional survey of Native LGBTT-S adults from seven U.S. metropolitan cities. Rates of lifetime mental health treatment utilization were higher for women (87%), those who were college educated (84%), and homeowners (92%). Cisgender women and transgender AI/AN adults had a higher prevalence than cisgender men of major depression, generalized anxiety, and panic disorder. Rates of subthreshold and threshold posttraumatic stress disorder were significantly higher for transgender adults. Lower positive social support and higher emotional social support were associated with greater odds of mental health treatment utilization. Mental health diagnoses and lifetime mental health treatment utilization was positively associated.

 

Source: Link to Original Article.

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Source: https://coloradosph.cuanschutz.edu/docs/librariesprovider205/journal_files/vol30/30_1_2023_35_nicdao.pdf

Type of Resource: Peer-reviewed scientific article

Pregnancy Mortality Surveillance System

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Authors: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (CDC)

Publication Year: 2023

Last Updated: March 23, 2023

Journal:

Keywords: Awareness; Ethnicity; Health Disparities; Mental and Behavioral Health; Minority Groups; Misclassification of AI/AN; Population Information; Women's Health; Maternal Health; Pregnancy; Reproductive Health

 

Short Abstract: CDC conducts national pregnancy-related mortality surveillance to better understand the risk factors for and causes of pregnancy-related deaths in the United States.

 

Abstract: CDC conducts national pregnancy-related mortality surveillance to better understand the risk factors for and causes of pregnancy-related deaths in the United States. The Pregnancy Mortality Surveillance System (PMSS) defines a pregnancy-related death as a death while pregnant or within 1 year of the end of pregnancy from any cause related to or aggravated by the pregnancy. Medical epidemiologists review and analyze death records, linked birth records and fetal death records if applicable, and additional available data from all 50 states, New York City, and Washington, DC. PMSS is used to calculate the pregnancy-related mortality ratio, an estimate of the number of pregnancy-related deaths for every 100,000 live births. The birth data used to calculate pregnancy-related mortality ratios were obtained from the National Vital Statistics System (NVSS) via the Centers for Disease Control and Prevention, Wide-ranging Online Data for Epidemiologic Research (CDC WONDER).

 

Source: Link to Original Article.

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Source: https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm

Type of Resource: Other

Narratives from African American/Black, American Indian/Alaska Native, and Hispanic/Latinx community members in Arizona to enhance COVID-19 vaccine and vaccination uptake

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Authors: Matt Ignacio, Sabrina Oesterl , Micaela Mercado, Ann Carver, Gilberto Lopez 3, Wendy Wolfersteig 2, Stephanie Ayers, Seol Ki , Kathryn Hamm, Sairam Parthasarathy, Adam Berryhill, Linnea Evans, Samantha Sabo, Chyke Doubeni

Publication Year: 2023

Last Updated: April 2023

Journal:

Keywords: Awareness; Covid-19; Cultural Sensitivity and Appropriateness; Health Disparities; Infection Disease; Minority Groups; Vaccination/Immunization

 

Short 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.

 

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.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8942760/

Type of Resource: Peer-reviewed scientific article

Alcoholics Anonymous-Related Benefit for Urban Native Americans: Does Urban Native American Gender Moderate AA Engagement and Outcomes?

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Authors: Rosa E. Munoz and J. Scott Tonigan

Publication Year: 2017

Last Updated:

Journal: Alcoholism Treatment Quarterly

Keywords: Gender Identity; Substance Use; Alcoholics Anonymous; Addiction; Moderation

 

Short Abstract: Alcoholics Anonymous (AA) is one of the most commonly accessed resources for individuals seeking to reduce their drinking.

 

Abstract: Alcoholics Anonymous (AA) is one of the most commonly accessed resources for individuals seeking to reduce their drinking. How urban Native Americans fare in AA is only beginning to be investigated in spite of circumstantial evidence suggesting that a majority of treatment-seeking urban Native Americans will receive 12-step treatment. Even less is known about Native American gender differences with regard to AA-related benefit. The current study addressed this gap by investigating urban Native American gender differences in AA attendance rates and outcomes. To this end, as part of two larger NIH-funded studies we recruited 63 Native American men and women and followed them for 9 months in this naturalistic study (n= 35 males, n = 28 females). Urban Native Americans significantly reduced their drinking over the study period, and AA attendance explained, in part, increased abstinence of study participants. No significant differences in AA attendance and drinking outcomes were observed between Native American men and women; however, descriptively men reported greater reductions in hazardous drinking relative to women. Clinical implications and future directions are discussed.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731782/

Type of Resource: Peer-reviewed scientific article

Psychotherapy With American Indians: An Exploration of Therapist-Rated Techniques in Three Urban Clinics

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Authors: Mark Beitel et al.

Publication Year: 2018

Last Updated:

Journal: Psychotherapy

Keywords: Mental and Behavioral Health; Psychotherapy;

 

Short Abstract: The aim of the project was to conduct psychotherapy research in American Indian mental health clinics.

 

Abstract: The aim of the project was to conduct psychotherapy research in American Indian mental health clinics. To date, very little psychotherapy research has been conducted in this area. We report the findings from a multisite investigation of psychotherapy techniques used with American Indians. Psychotherapists, working in three American Indian clinics, were asked to self-report the therapeutic interventions that they used in sessions with 93 separate adult American Indian outpatients. Each therapist rated each client exactly once, and thus data on 93 sessions were collected. Therapists’ self-reported technique use with the Multitheoretical List of Therapist Interventions (McCarthy & Barber, 2009). Ratings were made immediately following the delivery of a session. The common factors approach was the most reported approach, followed by person-centered and interpersonal approaches. However, the therapists reported using techniques from all of the main therapeutic approaches. Technique use was affected by client- (demographic and diagnostic), therapist-, and therapy-related variables. This project represents a promising start to systematic psychotherapy research in busy, urban American Indian clinics. Many psychotherapeutic techniques are utilized, and there are many avenues for future research. A replication with client and observer ratings will be an important next step.

 

Source: Link to Original Article.

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Source: http://gonetowar.com/wp-content/uploads/2019/04/AI-Therapy-Techniques.pdf

Type of Resource: Peer-reviewed scientific article

Oral Health Knowledge and the Utilization of Dental Services: A Survey of Urban Native Americans

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Authors: Divesh Byrappagari, Megan K. Kemink, and Jessica J. Ray

Publication Year: 2017

Last Updated:

Journal: Journal of Dental and Oral Health

Keywords: Health Care Access; Health Disparities; Dental Utilization; Oral Health Knowledge;

 

Short Abstract: The purpose of this study is to understand the oral health knowledge among the Native American patients of American Indian Health and Family Services and how it affects the utilization of dental care by these patients.

 

Abstract: The purpose of this study is to understand the oral health knowledge among the Native American patients of American Indian Health and Family Services and how it affects the utilization of dental care by these patients. In collaboration with American Indian Health and Family Services, a non-profit health center serving the Native American community of southeastern Michigan, a paper based survey was administered to all the individuals who sought care at the health center. A total of 55 surveys were collected. A majority of the respondents identified themselves as Native American (71%). Analysis revealed that, a majority of respondents were knowledgeable about the importance of brushing (98%), flossing (96%) and diet (78%) to maintain good oral health. About 91% reported that good oral health was very important to them and about half of them reported having good to very good oral health. A large percent of the respondents did not practice good oral hygiene and seek dental care when needed even though they scored high on the knowledge questions. A majority of the respondents reported not seeking dental care in spite of having dental needs (58%) and listed barriers like; cost of dental care (48%), transportation (10%), and inability to take time off from work (10%) among others. The results of the study indicated that good oral health knowledge alone does not translate to better utilization of dental services, and there are other barriers to seeking care.

 

Source: Link to Original Article.

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Source: https://scientonline.org/open-access/oral-health-knowledge-and-the-utilization-of-dental-services-a-survey-of-urban-native-americans.pdf

Type of Resource: Peer-reviewed scientific article

Responsible Research With Urban American Indians and Alaska Natives

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Authors: Rosalina D. James et al.

Publication Year: 2018

Last Updated:

Journal: American Journal of Public Health

Keywords: Data Collection; Mistrust

 

Short Abstract: American Indian and Alaska Native (AI/AN) communities harbor understandable mistrust of research. Outside researchers have historically controlled processes, promulgating conclusions and recommended policies with virtually no input from the communities studied.

 

Abstract: American Indian and Alaska Native (AI/AN) communities harbor understandable mistrust of research. Outside researchers have historically controlled processes, promulgating conclusions and recommended policies with virtually no input from the communities studied. Reservation-based communities can apply sovereignty rights conferred by the federal government to change this research trajectory. Many tribes now require review and approval before allowing research activities to occur, in part through the development of regulatory codes and oversight measures. Tribal oversight ensures that research is directed toward questions of importance to the community and that results are returned in ways that optimize problem solving. Unfortunately, tribal governance protections do not always extend to AI/ANs residing in urban environments. Although they represent the majority of AI/ANs, urban Indians face an ongoing struggle for visibility and access to health care. It is against this backdrop that urban Indians suffer disproportionate health problems. Improved efforts to ensure responsible research with urban Indian populations requires attention to community engagement, research oversight, and capacity building. We consider strategies to offset these limitations and develop a foundation for responsible research with urban Indians.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236730/pdf/AJPH.2018.304708.pdf

Type of Resource: Peer-reviewed scientific article

Disparity in Access to Virtual Care for Urinary Tract Infections During the COVID-19 Era

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Authors: Molly E DeWitt-Foy, Jacob A Albersheim, Shawn T Grove, Lina Hamid, Sally Berryman, Sean P Elliot

Publication Year: 2023

Last Updated: January 2023

Journal: Société Internationale d'Urologie Journal

Keywords: Covid-19; Infection Disease; Urinary; Telehealth

 

Short Abstract: Objective: To characterize the difference in uptake of virtual care for urinary tract infections (UTIs) by demographic variables in the COVID-19 era.

 

Abstract: Objective: To characterize the difference in uptake of virtual care for urinary tract infections (UTIs) by demographic variables in the COVID-19 era. Methods: We conducted a retrospective review of outpatient encounters for UTIs across a large health care system. The cohort was defined as patients with an encounter diagnosis of UTI via in-person or virtual care (telephone or technology-supported care), between March 1, 2020, and February 28, 2021. Analysis was limited to the first UTI encounter of the year for each patient. We compared the use of in-person and virtual visits by demographic variables using chi-square tests and multivariate logistic regression. Results: A total of 6744 patients, with a mean age of 61 years, were seen for UTI during the study period. The majority of patients were White (85.5%) and female (83.7%) and were seen in person (55.9%). Of those seen virtually, 52.0% participated in telephone-only visits, and 47.9% were seen via technology-supported care, using video or chat-based platforms. On multivariate logistic regression, age under 30, lowest-quartile income, male sex, and a primary language other than English increased the odds that patients had been seen in person. Among those seen virtually, age over 50 significantly increased the odds of a telephone visit, as did being Black or Native American, having a lower-quartile income, and speaking a non-English primary language. Conclusions: Although the expansion in virtual care has given some patients easier access to necessary care, the “digital divide” has worsened existing disparities for certain vulnerable populations. We demonstrate a difference in uptake of virtual health care by age, race, primary language, and income.

 

Source: Link to Original Article.

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Source: https://www.siuj.org/index.php/siuj/article/view/233/180

Type of Resource: Peer-reviewed scientific article

Impact of the COVID-19 pandemic on liver disease-related mortality rates in the United States

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Authors: Xu Gao, Fan Lv, Xinyuan He, Yunyu Zhao, Yi Liu, Jian Zu, Linda Henry, Jinhai Wang, Yee Hui Yeo, Fanpu Ji, Mindie H. Nguyen

Publication Year: 2023

Last Updated: January 2023

Journal: Journal of Hepatology

Keywords: Covid-19; Liver Disease

 

Short Abstract: Background & Aims The pandemic has resulted in an increase of deaths not directly related to COVID-19 infection. We aimed to use a national death dataset to determine the impact of the pandemic on people with liver disease in the USA, focusing on alcohol-associated liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD).

 

Abstract: Background & Aims The pandemic has resulted in an increase of deaths not directly related to COVID-19 infection. We aimed to use a national death dataset to determine the impact of the pandemic on people with liver disease in the USA, focusing on alcohol-associated liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Methods Using data from the National Vital Statistic System from the Center for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) platform and ICD-10 codes, we identified deaths associated with liver disease. We evaluated observed vs. predicted mortality for 2020–2021 based on trends from 2010–2019 with joinpoint and prediction modelling analysis. Results Among 626,090 chronic liver disease-related deaths between 2010 and 2021, Age-standardised mortality rates (ASMRs) for ALD dramatically increased between 2010–2019 and 2020–2021 (annual percentage change [APC] 3.5% to 17.6%, p <0.01), leading to a higher observed ASMR (per 100,000 persons) than predicted for 2020 (15.67 vs. 13.04) and 2021 (17.42 vs. 13.41). ASMR for NAFLD also increased during the pandemic (APC: 14.5%), whereas the rates for hepatitis B and C decreased. Notably, the ASMR rise for ALD was most pronounced in non-Hispanic Whites, Blacks, and Alaska Indians/Native Americans (APC: 11.7%, 10.8%, 18.0%, all p <0.05), with similar but less critical findings for NAFLD, whereas rates were steady for non-Hispanic Asians throughout 2010–2021 (APC: 4.9%). The ASMR rise for ALD was particularly severe for the 25–44 age group (APC: 34.6%, vs. 13.7% and 12.6% for 45–64 and ≥65, all p <0.01), which were also all higher than pre-COVID-19 rates (all p <0.01). Conclusions ASMRs for ALD and NAFLD increased at an alarming rate during the COVID-19 pandemic with the largest disparities among the young, non-Hispanic White, and Alaska Indian/Native American populations. Impact and implications The pandemic has led to an increase of deaths directly and indirectly related to SARS-CoV-2 infection. As shown in this study, age-standardised mortality rates for alcohol-associated liver disease and non-alcoholic fatty liver disease substantially increased during the COVID-19 pandemic in the USA and far exceeded expected levels predicted from past trends, especially among the young, non-Hispanic White, and Alaska Indian/Native American populations. However, much of this increase was not directly related to COVID-19. Therefore, for the ongoing pandemic as well as its recovery phase, adherence to regular monitoring and care for people with chronic liver disease should be prioritised and awareness should be raised among patients, care providers, healthcare systems, and public health policy makers.

 

Source: Link to Original Article.

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Source: https://www.sciencedirect.com/science/article/pii/S0168827822029944

Type of Resource: Peer-reviewed scientific article