Preventive care of older urban American Indians and Alaska Natives in primary care

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Weight-loss practices, nutrition beliefs, and weight-loss program preferences or urban American Indian women

Authors: Sherwood NE, Harnack L., Story M
Publication Year: 2000
Last Updated: 2010-01-21 08:14:08
Journal: Journal of the American Dietetic Association
Keywords: Anti-Obesity Agents; Diet, Reducing; Fasting; Obesity/Prevention & Control; Weight Loss

Short Abstract: Objective. To describe health beliefs, weight concern, dieting practices, and weight-loss program preferences of American Indian women residing in an urban setting.

Abstract: OBJECTIVE: To describe health beliefs, weight concern, dieting practices, and weight-loss program preferences of American Indian women residing in an urban setting. DESIGN: Face-to-face interviews using a semistructured questionnaire were conducted and height and weight were measured. SUBJECTS/SETTING: Subjects were 203 American Indian adult women in an urban community setting. STATISTICAL ANALYSIS: Frequency distributions and chi 2 analysis were performed using the Statistical Analysis System software. RESULTS: About two-thirds of the subjects were overweight. Most women were concerned about obesity and reported attempting to manage their weight. Healthful weight-loss practices (e.g., eating more fruits and vegetables, increasing physical activity) were used most frequently. However, unhealthful practices, such as skipping meals/fasting, using laxatives/diuretics, and self-induced vomiting were also mentioned. Regular bingeing was reported by 10% of respondents. APPLICATIONS: Weight-management intervention efforts should focus on helping clients modify their diet and physical activity patterns. Low-cost programs offered in convenient locations would attract more participants, as would the provision of child care. Education about the dangers and ineffectiveness of unhealthful weight-loss practices will be necessary, given the high rates of such behaviors in this population. 

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Code: 3044
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Urban Native American health issues

Authors: Burhansstipanov L
Publication Year: 2000
Last Updated: 2010-01-21 08:14:08
Journal: Cancer Supplement
Keywords: Breast Neoplasms/Prevention and Control; Health Care Needs and Demands; Health Expenditures; Health Services, Indigenous; Health Services Accessibility; Urban Health Services

Short Abstract: This article presents an overview of urban-dwelling American Indians and Alaska Natives, including a summary of data issues and a brief overview of historical and related social changes resulting in migration from reservations to urban areas.

Abstract: BACKGROUND. This article presents an overview of urban-dwelling American Indians and Alaska Natives, including a summary of data issues and a brief overview of historical and related social changes resulting in migration from reservations to urban areas. METHODS. A literature search was performed and documented focus groups were held; in addition, Native Sisters’ field records from Los Angeles, California, and Denver, Colorado, were reviewed. RESULTS. Urban Indian communities are intertribal and represent over half of the Native American population in the U.S., yet they lack access to sufficient health services. Urban Indian clinics are greatly underfunded. CONCLUSIONS. A greater proportion of funding needs to be allocated to community-driven, culturally respectful, multiyear behavioral research to improve the screening, treatment, and survival of American Indian women with breast carcinoma.

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Code: 3043
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Urban American Indian health programs profile

Authors: Foster-Jones M., Hunter J., Shanda M, Arsten M, Marquez-Baines C
Publication Year: 1993
Last Updated: 2010-01-21 08:14:08
Journal: American Indian Health Care Association
Keywords: Urban Indian population; Indian Health Service; demographic users profile; poverty density; leading causes of death; age distribution; tribal affiliation

Short Abstract: In response to the needs of the growing urban Indian population, this report identifies the Indian Health Service (IHS)-funded urban Indian health programs, providing an overview of the program and the services offered.

Abstract: In response to the needs of the growing urban Indian population, this report identifies the Indian Health Service (IHS)-funded urban Indian health programs, providing an overview of the program and the services offered. Data obtained from statistics collected by each health program provided the following information: 1) demographic users profile; 2) poverty density in each urbanized area; 3) leading causes of death for each program; 4) age distribution of users; 5) number of encounters at each program; 6) percent of Indian users by type of service at each urban program; 7) tribal affiliation of program users; and 8) the staffing requirements of each program along with current staffing assignments. This report provided Native Americans and their health care providers with an outreach and referral services directory. The Urban Indian Health Program was designed to bridge the special needs of the growing urban Indian population

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Code: 3100
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Trauma among Indians in an urban county

Authors: Sugarman JR., Grossman DC.
Publication Year: 1996
Last Updated: 2010-01-21 08:14:08
Journal: Public Health Reports
Keywords: Adolescence; Adult; Aged; Alcoholism/Complications; Female; Headache; Hospitalization/Statistics & Numerical Data; Incidence; Male; Middle Age; Multiple Trauma/Etiology; Registries; Risk Factors; Trauma Centers; Urban Health; Violence; Wounds and Injuries/Epidemiology

Short Abstract: The authors describe patterns of serious injury among American Indians in an urban area by comparing characteristics of injuries leading to hospitalization among American Indians and persons of other races. Data are collected from the Harborview Medical Center Trauma Registry.

Abstract: American Indians have been reported to have high injury morbidity and mortality rates. Data describing serious injuries among American Indians not using Indian Health Service (IHS) or tribal facilities in Washington State are sparse. The authors describe patterns of serious injury among American Indians in an urban area by comparing characteristics of injuries leading to hospitalization among American Indians and persons of other races. Data are collected from the Harborview Medical Center Trauma Registry. In order to describe rates, mechanisms, and intentionality of severe injury among American Indians in a large metropolitan county, the authors conducted a retrospective analysis of a hospital-based trauma registry for the years 1986-1992. The facility at which the Harborview Medical Center Trauma Registry is based is the only Level 1 trauma center in King County, Washington. King County is a metropolitan county with the seventh largest number of urban American Indians in the United States. Of 14,851 King County residents included in the registry, 593 (4%) were classified as American Indian. With King County Anglos as the reference, the age-standardized incidence ratio (SIR) for inclusion of American Indians in the registry was 4.4. SIRs and proportional incidence ratios (PIRS) showed significant differences in mechanisms and intent of injury among American Indians compared to Anglos. Hospitalizations for stab wounds, bites, and other blunt trauma were significantly more frequent among American Indians and trauma admissions were disproportionately associated with assaults. A high proportion of American Indians tested had blood alcohol levels exceeding 0.1 percent. Urban Indians experience high rates of trauma with the distribution of mechanisms and intents differing from among Whites. Efforts to reduce injury in urban areas should include collaboration with representative urban American Indian organizations

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Code: 3076
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The role of race and ethnic status on the psychosocial correlates of smokeless tobacco use in adolescent males.

Authors: Riley WT, Barenie, JT, Mabe PA, Myers DR, Barenie JT
Publication Year: 1991
Last Updated: 2010-01-21 08:14:08
Journal: Journal of Adolescent Health
Keywords: male adolescents,health behavior, smokeless,tobacco, race, substance use/deviant style, modeling, perceived negative consequences

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From a statified, random sampling of non-urban high schools in the Southeast, survey data were obtained from 5374 adolescent males.  Over half reported trying smokeless tobacco, and approximately one third of these reported a regular, substantial level of use. Factor analysis of the psychosocial items resulted in four factors: substance use/deviant style, modeling, perceived negative consequences, and health behavior.

Abstract: From a stratified, random sampling of non-urban high schools in the Southeast, survey data were obtained from 5374 adolescent males. Over half reported trying smokeless tobacco, and approximately one third of these reported a regular, substantial level of use. The average age at initial use was 12.2 yr. and was negatively correlated with the level of use. Factor analysis of the psychosocial items resulted in four factors: substance use/deviant style, modeling, perceived negative consequences, and health behavior. Discriminant analysis of initial use indicated that substance use and modeling influences were the strongest predictors of trying smokeless tobacco. Regression analysis of level of smokeless tobacco use indicated that substance use, modeling, and perceived negative consequences were equivalent in their contribution. Separate analyses were performed for American Indian, Black, and White males. Although predictors of initial use were similar, level of smokeless tobacco use was most associated with the use of other substances in Blacks and with modeling influences in Whites.

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Code: 258
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Social epidemiology of chronic liver disease and cirrhosis mortality in the United States, 1935-1997: trends and differentials by ethnicity, socioeconomic status, and alcohol consumption.

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Patient and smoking patterns in northern California American Indian clinics. Urban and rural contrasts

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Native women, violence, substance abuse and HIV risk.

Authors: Saylors K, Daliparthy N
Publication Year: 2005
Last Updated: 2010-01-21 08:14:08
Journal: Journal of Psychoactive Drugs
Keywords: violence; Native American women & children; substance use; physical and sexual abuse; mental health; trauma; psychological distress; high-risk behavior; social role impairment; HIV/AIDS

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Violence has become a critical public health issue in the United States.  It has had a particularly devastating impact on the health and well being of Native Amerian women and children.  The relationship between aggression and substance use is an intrinsic one: Native women often bear the brunt of violence in drinking situations, which places them and their children at extremely high risk for physical and sexual abuse.

Abstract: Violence has become a critical public health issue in the United States. It has had a particularly devastating impact on the health and well being of Native American women and children. The relationship between aggression and substance use is an intrinsic one: Native women often bear the brunt of violence in drinking situations, which places them and their children at extremely high risk for physical and sexual abuse. In urban environments, many Native American women find themselves in adult relationships that mirror the abuse they experienced and witnessed as children or adolescents. Not only does violence often occur while substances are being used, but conversely, substance use is a frequent consequence of sexual abuse. Clearly, the mental health repercussions of physical or sexual abuse are often severe. Trauma is associated not only with psychological distress, but also with risky behavior and social role impairment. Traumatized women engaging in substance abuse and unsafe sex are at high risk for contracting HIV/AIDS. This article explores the intersection of substance abuse, sexual and physical abuse, and increased HIV risk among urban Native American women in the San Francisco Bay Area.

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Code: 16
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Evaluation of the IHS urban health business office concept

Authors: Foster MA.
Publication Year: 1992
Last Updated: 2010-01-21 08:14:08
Journal: Native Health Database - UNM Health Sciences Library and Informatics Center
Keywords: Indian Health Service; Office Concept; Social Security Administration; minority populations; benefit enrollment; American Indian/Alaska Natives; outreach programs; data collection; income; access to assistance services; health care benefits

Short Abstract: Purpose: The "Evaluation of the IHS Urban Health Business Office Concept," commonly called the Supplementary Security Income (SSI) Project, was a ten month grant demonstration project that was contracted to the American Indian Health Care Association (AIHCA) by the Indian Health Service (IHS) with cooperation of the Social Security Administration (SSA).

Abstract: Purpose: The "Evaluation of the IHS Urban Health Business Office Concept," commonly called the Supplementary Security Income (SSI) Project, was a ten month grant demonstration project that was contracted to the American Indian Health Care Association (AIHCA) by the Indian Health Service (IHS) with cooperation of the Social Security Administration (SSA). The SSA was mandated to increase minority and target population enrollment for SSA benefits. The SSA provided funding to the IHS to oversee a project designed to locate and assist urban American Indians and Alaska Natives (AI/ANs) in applying for SSI. Methods Originally, the project was to be administered from the urban Indian clinics' business offices. Since many urban clinics do not have a "business office," AIHCA , IHS, and SSA agreed that locating eligible candidates would be more effectively conducted through established outreach programs. Three urban Indian health programs were chosen as project sites: Minneapolis, Minnesota; Seattle, Washington; and Detroit, Michigan. An AI/AN outreach worker was hired at each site with the responsibility to locate and assist potentially eligible clients from the clinic. The outreach worker reported their findings weekly to the Project Coordinator at AIHCA. Conference calls between the Project Coordinator and outreach workers allowed staff to exchange support and site information. The Project Coordinator made three site visits to each site over the course of the data collection period (March to June 1992). Results A total of 78 people participated in the SSI Project by completing the pre-screening forms and speaking to an outreach worker about the SSI program: 17 from Minneapolis; 13 from Seattle; and 48 from Detroit. Results from this analysis have shown that before this project, 41% of the clients that had completed the intake form had incorrect information about SSI; 17.9% had never heard of SSI before; and 11.5% did not know how to contact SSI. In addition, most staff at the urban Indian health programs had little or no information about SSI. Conclusion: The SSI Project has furthered the objectives of the Social Security Administration as well as the American Indian Health Care Association, and has assisted the urban Indian health programs by identifying AI/ANs eligible for SSI as well as other SSA program benefits. This SSI study improved recipients' lives and qualities of life by increasing their income, access to assistance services and health care benefits.

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Funding:
Code: 3102
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