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

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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.

 

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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

Tribal Epidemiology Centers: HHS Actions Needed to Enhance Data Access

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Authors: United States Government Accountability Office

Publication Year: 2022

Last Updated: March 2022

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Keywords: Covid-19; Data Collection; IHS

 

Short Abstract: Among the 12 tribal epidemiology centers (TEC), which are public health entities serving American Indian and Alaska Native (AI/AN) communities across the U.S., access to epidemiological data varied.

 

Abstract: Among the 12 tribal epidemiology centers (TEC), which are public health entities serving American Indian and Alaska Native (AI/AN) communities across the U.S., access to epidemiological data varied. Federal law authorizes TECs' access to data from the Department of Health and Human Services (HHS), including data from HHS's Centers for Disease Control and Prevention (CDC) and Indian Health Service (IHS), for a variety of public health purposes. However, according to TEC officials, access to non-public HHS data, such as CDC data on positive COVID-19 tests or IHS data on patient diagnosis codes, varied among TECs. TEC officials also described challenges accessing some CDC and IHS data, such as the inability to access certain CDC data on infectious diseases and other conditions. TECs used available epidemiological data to monitor the spread of COVID-19 and to conduct other analyses that support public health decision-making in AI/AN communities. However, TEC officials told GAO that their access to data influences the analyses they are able to conduct, and that a lack of access can limit their ability to provide AI/AN communities with meaningful information needed for decision-making.

 

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Source: https://www.gao.gov/products/gao-22-104698

Type of Resource: Best Practices Newsletter

An Interview Project with Native American People: A Community-Based Study to Identify Actionable Steps to Reduce Health Disparities

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Authors: J. Leston, C. Crisp, C. Lee, E. Rink

Publication Year: 2019

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Journal:

Keywords: Data Collection; Health Disparities; HIV/AIDS; Mental and Behavioral Health; Programmatic Initiatives; Injection Drug Use; Community-Based Participatory Research (CBPR)

 

Short Abstract: Objectives: The primary objective of this study was to work with tribal communities to define and develop their own healthcare services and strategies for positive change regarding injection drug use, human immunodeficiency virus (HIV), and hepatitis C virus (HCV) infection. The secondary objective of this study was to incorporate community capacity building strategies to develop and sustain programming and resources to optimize tribal communities’ responsiveness to reduce health disparities.

 

Abstract: Objectives: The primary objective of this study was to work with tribal communities to define and develop their own healthcare services and strategies for positive change regarding injection drug use, human immunodeficiency virus (HIV), and hepatitis C virus (HCV) infection. The secondary objective of this study was to incorporate community capacity building strategies to develop and sustain programming and resources to optimize tribal communities’ responsiveness to reduce health disparities. Study design: Semi-structured qualitative interviews. Methods: Interviews were guided by community-based participatory research (CBPR) principles to create programs, projects, and policy recommendations meaningful to American Indian and Alaska Native (AI/AN) people. Results: The study generated a formative understanding of the context of AI/AN people who inject drugs (PWID) in three distinct AI/AN communities as well as developed local capacity for future programming, projects, and policy. Conclusions: This study confirms CBPR methods should be part of an iterative cycle to inform policy and programs. CBPR has helped strengthen local research capacity and has formed ongoing relationships between study investigators, local liaisons, and the community that will be essential for next phases of program design and policy implementation. This cycle of CBPR could be replicated in other tribal communities to bring awareness of the opioid epidemic and its effects and to prioritize local indigenous and community-led responses.

 

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Source: https://www.sciencedirect.com/science/article/pii/S0033350618303767?via%3Dihub

Type of Resource: Best Practices Newsletter

An Urban American Indian Health Clinic’s Response to a Community Needs Assessment

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Authors: Mary Kate Dennis, MSW, PhD, Sandra L. Momper, MSW, PhD, and the Circles of Care Project Team

Publication Year: 2016

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Journal: American Indian and Alaska Native Mental Health Research Journal

Keywords: Cultural Sensitivity and Appropriateness

 

Short Abstract: Utilizing community-based methods, we assessed the behavioral and physical health needs of a Detroit metropolitan Indian health clinic.

 

Abstract: Utilizing community-based methods, we assessed the behavioral and physical health needs of a Detroit metropolitan Indian health clinic. The project goal was to identify health service needs for urban American Indians/Alaska Natives and develop the infrastructure for culturally competent and integrative behavioral and physical health care. We conducted 38 semi-structured interviews and 12 focus groups with service providers and community members. Interview and focus group data indicated a need for 1) more culturally competent services and providers, 2) more specialized health services, and 3) more transportation options. We then report on the Indian health clinic's and community's accomplishments in response to the needs assessment.

 

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Source: https://coloradosph.cuanschutz.edu/docs/librariesprovider205/journal_files/vol23/23_5_2016_15_dennis.pdf?sfvrsn=6fdbe0b9_2

Type of Resource: Peer-reviewed scientific article

COVID Vulnerability and Impact Summary for Urban Natives (VISUN) — February 2023

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Email to Request Report: research@ncuih.org

Authors: Alexander Zeymo

Publication Year: 2023

Last Updated: March 17, 2023

Keywords: Covid-19; Infection Disease; Vaccination/Immunization

 

Short Abstract: This report is created using data that is publicly available and provided directly to the National Council for Urban Indian Health from the Office of Urban Indian Health. ***Please be aware, in Section Two, four counties were mistakenly deleted from the analysis. Estimates for the Portland, Omaha, Reno, and Helena service areas may be inaccurate for tables and statistics in Section Two. (07/11/2023)

 

Type of Resource: NCUIH data products

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.

 

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

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