Primary Psychiatric Diagnoses, Commercialized Tobacco Use, and Homelessness: Comparisons Between Urban American Indian/Alaska Native and Non-American Indian/Alaska Native Adult Clinical Samples

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Authors: Daniel Dickerson et al.

Publication Year: 2023

Last Updated:

Journal: American Indian and Alaska Native Mental Health Research

Keywords: Cultural Sensitivity and Appropriateness; Mental and Behavioral Health; Tobacco Use (non-traditional); Homelessness

 

Short Abstract: Although over 70% of American Indians and Alaska Natives (AI/ANs) reside in urban areas, our knowledge of urban AI/AN adults receiving mental health treatment is limited.

 

Abstract: Although over 70% of American Indians and Alaska Natives (AI/ANs) reside in urban areas, our knowledge of urban AI/AN adults receiving mental health treatment is limited. This study compares primary psychiatric diagnoses, commercialized tobacco use, and homelessness between AI/AN and non-AI/AN adults receiving services in an urban public mental health agency serving primarily AI/AN people in southern California. Depressive disorders were the most common psychiatric diagnoses for both groups. However, AI/AN adult clients demonstrated significantly less anxiety disorders and significantly more homelessness. Schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, and commercialized tobacco use were higher among AI/AN adults compared to non-AI/AN adults. Results from this study offer data needed to further understand important public health issues that exist among AI/AN adults receiving mental health services in urban areas. We provide suggestions to enhance integrated and culturally appropriate treatment approaches and homelessness initiatives for this under-resourced, yet resilient population.

 

Source: Link to Original Article.

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Source: https://coloradosph.cuanschutz.edu/docs/librariesprovider205/journal_files/vol30/30_1_2023_14_dickerson.pdf

Type of Resource: Peer-reviewed scientific article

Perspectives of Indigenous University Students in Canada on Mindfulness-Based Interventions and their Adaptation to Reduce Depression and Anxiety Symptoms

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Authors: Shadi Beshai, Sharon M. Desjarlais & Brenda Green

Publication Year: 2023

Last Updated: February 21, 2023

Journal: Mindfulness

Keywords: Cultural Sensitivity and Appropriateness; Health Disparities; Mental and Behavioral Health; Psychology Suicide and Suicide Prevention; Youth; Anxiety; Depression; Mindfulness

 

Short Abstract: Objectives Indigenous university students experience high rates of anxiety and depression due primarily to the pernicious and persistent effects of colonialism, racism, and discrimination. Mindfulness-based interventions (MBIs) hold promise, but likely require adaptation to make them culturally relevant for Indigenous peoples. We sought to gather Indigenous students’ perspectives on the consistency and adaptability of MBIs for Indigenous students experiencing symptoms of depression and anxiety.

 

Abstract: Objectives Indigenous university students experience high rates of anxiety and depression due primarily to the pernicious and persistent effects of colonialism, racism, and discrimination. Mindfulness-based interventions (MBIs) hold promise, but likely require adaptation to make them culturally relevant for Indigenous peoples. We sought to gather Indigenous students’ perspectives on the consistency and adaptability of MBIs for Indigenous students experiencing symptoms of depression and anxiety. Method This three-part longitudinal investigation employed a qualitative design mixed with Indigenous research methods to elicit feedback from students (n = 14; Mage = 28.92) on the acceptability of MBIs and ways to tailor MBIs to make them more consistent with Indigenous cultures and student lifestyles. We subsequently used this feedback to develop an outline for an adapted MBI that was then re-evaluated by the same participants for its cultural relevance and safety. Results Indigenous students emphasized the need for the adapted MBI to incorporate (a) traditional Indigenous practices; (b) Indigenous facilitators; (c) holistic conceptualizations of mental health that include spirituality; and (d) practices and methods that could improve flexibility and accessibility of the adapted intervention. Based on this feedback, we presented students with an outline of an adapted MBI tentatively titled Miyowâyâwin Mindful Wellbeing Program, which received favorable evaluations by students for cultural consistency and safety. Conclusions We confirmed the perceived acceptability and consistency of mindfulness and mindfulness programs with Indigenous cultures. The need for a flexible MBI that centers Indigenous elements and Indigenous facilitators was highlighted by Indigenous participants. This study paves the way for latter steps of the development and subsequent evaluation of the Miyowâyâwin Mindful Wellbeing Program.

 

Source: Link to Original Article.

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Source: https://link.springer.com/article/10.1007/s12671-023-02087-7

Type of Resource: Peer-reviewed scientific article

Determinants of Lung Cancer Screening in a Minnesota Urban Indigenous Community: A Community-Based, Participatory, Action-Oriented Study

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Authors: Madison D. Anderson, Wyatt J. Pickner, Abbie Begnaud

Publication Year: 2023

Last Updated:

Journal: Cancer Prevention Research

Keywords: Cancer; Cultural Sensitivity and Appropriateness; Health Disparities

 

Short Abstract: Although lung cancer screening (LCS) with annual low-dose chest CT has been shown to reduce lung cancer deaths, it remains underutilized. Northern Plains American Indian and Alaska Native (AI/AN) communities experience extreme lung cancer disparities, and little is known about the acceptance and adoption of LCS in these groups.

 

Abstract: Although lung cancer screening (LCS) with annual low-dose chest CT has been shown to reduce lung cancer deaths, it remains underutilized. Northern Plains American Indian and Alaska Native (AI/AN) communities experience extreme lung cancer disparities, and little is known about the acceptance and adoption of LCS in these groups. We conducted interviews with healthcare professionals and focus groups with patients in an urban Minnesota community clinic serving AI/AN. Data collection took place during winter 2019–2020. Indigenous researchers collected and analyzed the data for emergent themes using simultaneous collaborative consensus with a LCS researcher. Participants reported some similar barriers to LCS as previous studies reported but also shared some new insights into traditional ways of knowing and recommendations for effectively implementing this evidence-based preventive care service. Lung screening is largely acceptable to patients and healthcare personnel in an AI/AN–serving community clinic. We identified barriers as previously reported in other populations but also identified some unique barriers and motivators. For example, the concept of the seven generations may provide motivation to maintain one's health for future generations while providing additional support during screening for persons traumatized by the Western medicine health system may facilitate increased screening uptake. Prevention Relevance: Secondary prevention of lung cancer through screening is potentially lifesaving considering that overall survival of lung cancer is 20% at 5 years but curable if detected at an early stage. This work provides insight into culturally tailored approaches to implementing the service in individuals at high risk of the disease.

 

Source: Link to Original Article.

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Source: https://aacrjournals.org/cancerpreventionresearch/article/16/4/239/718841/Determinants-of-Lung-Cancer-Screening-in-a

Type of Resource: Peer-reviewed scientific article

Report on Adult Vaccination Equity for Natives (RAVEN II) — March-May, 2023

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Authors: Alexander Zeymo

Publication Year: 2023

Last Updated: May 6, 2023

Keywords: Vaccination/Immunization

 

Short Abstract: Throughout COVID-19 pandemic, the general population has paid higher attention to issues of health equity and vaccine equity. In addition to a concern that public health authorities and healthcare providers respond adequately to the seriousness of the pandemic, there was increased attention to existing perennial gaps in healthcare disparities and equity. The Native American community has been one such population; having long suffered from increased disease burden, stretched resources, and low trust in institutions that have historically failed them.

 

Abstract: Throughout COVID-19 pandemic, the general population has paid higher attention to issues of health equity and vaccine equity. In addition to a concern that public health authorities and healthcare providers respond adequately to the seriousness of the pandemic, there was increased attention to existing perennial gaps in healthcare disparities and equity. The Native American community has been one such population; having long suffered from increased disease burden, stretched resources, and low trust in institutions that have historically failed them. As the immediate response to COVID-19 is winding down, with the ending of the Emergency Declaration in May of 2023, attention should now be shifted to other adult vaccinations. With the same energy and concern that was paid to COVID-19 vaccinations, there should be increased attention to vaccine equity across all types of immunizations against preventable diseases. Therefore, NCUIH creates this report, to summarize the data around adult vaccines and immunizations in the urban Native American population. This report will show available data indicating a continued gap in vaccination coverage among AI/AN. This is the age where data defines the parameters of the story. With the story leading our action, having Native American and Urban Native American representation in data and research is essential to achieve vaccine equity.

 

Source: Link to Original Article.

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Type of Resource: NCUIH data products

 

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Patterns of Health Care Access and Use in an Urban American Indian and Alaska Native Population

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Authors: Garcia, A. N., Venegas-Murrillo, A., Martinez-Hollingsworth, A., Smith, L. V., Wells, K., Heilemann, M. V., Fischbach, L., Cummings, P. L., & Kuo, T.

Publication Year: 2023

Last Updated: 2023 May 18

Journal:

Keywords: Federal Health Care; Health Care Access; IHS

 

Short Abstract: Studies of health care access and use among historically resilient populations, while common, often field a limited sample size and rarely ask the groups most impacted by health inequities to weigh in. This is especially so for research and programs that focus on the American Indian and Alaska Native (AIAN) population. The present study addresses this gap by examining data from a cross-sectional survey of AIANs in Los Angeles County.

 

Abstract: Studies of health care access and use among historically resilient populations, while common, often field a limited sample size and rarely ask the groups most impacted by health inequities to weigh in. This is especially so for research and programs that focus on the American Indian and Alaska Native (AIAN) population. The present study addresses this gap by examining data from a cross-sectional survey of AIANs in Los Angeles County. To better interpret project findings and generate culturally relevant contexts, qualitative feedback was gathered at a community forum held in Spring 2018. Because recruitment of AIANs has historically been challenging, purposive sampling was employed to strategically identify a larger eligible pool. Among those who were eligible, 94% completed the survey (n = 496). AIANs who were enrolled in a tribe were 32% more likely to use the Indian Health Service (IHS), compared with those who were not enrolled (95% CI: 20.4%, 43.2%; p < .0001). In multivariable modeling, the strongest factors influencing IHS access and use were: tribal enrollment, preference for culturally-specific health care, proximity of the services to home or work, having Medicaid, and having less than a high school education. Feedback from the community forum indicated cost and trust (of a provider) were important considerations for most AIANs. Study findings reveal heterogeneous patterns of health care access and use in this population, suggesting a need to further improve the continuity, stability, and the image of AIANs’ usual sources of care (e.g., IHS, community clinics).

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195651/

Type of Resource: Peer-reviewed scientific article

The Culture is Prevention Project: Measuring Cultural Connectedness and Providing Evidence that Culture is a Social Determinant of Health for Native Americans

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Authors: Paul Masotti, John Dennem, Karina Bañuelos, Cheyenne Seneca, Gloryanna Varlerio-Leonce, Christina Tlatilpa Inong, Janet King

Publication Year: 2023

Last Updated:

Journal:

Keywords: Social Determinants of Health

 

Short Abstract: Background It is important for non-Native persons to understand that the meaning of culture to Native American/Indigenous Peoples is not about esteem, taste or music but rather is described as a cognitive map on how to be. Native American/Indigenous culture can be thought of as all the things and ways in which Native/Indigenous people understand who they are, where they come from and how they are to interact with others.

 

Abstract: Background It is important for non-Native persons to understand that the meaning of culture to Native American/Indigenous Peoples is not about esteem, taste or music but rather is described as a cognitive map on how to be. Native American/Indigenous culture can be thought of as all the things and ways in which Native/Indigenous people understand who they are, where they come from and how they are to interact with others. Hundreds of years across many generations have taught that culture-based activities and interventions improve Native/Indigenous health and wellbeing. We explore if increased Native American culture/cultural connectedness is associated with better mental health/well-being and physical health. Methods We analyzed data from a two-phased study (N = 259 and N = 102) of 361 urban Native Americans in California (2018–2021). The 29 items validated Cultural Connectedness Scale-California (CCS-CA) measured Native culture/cultural connectedness. Mental health/well-being and physical health were assessed using the: modified Herth Hope Index (mHHI), Satisfaction with Life (SWL), Center for Epidemiologic Studies Depression Scale-Revised (CESD-R-10), Substance Abuse (CAGE-AID), and Health Related Quality of Life (HRQOL). We conducted Pearson correlations and stepwise regression analyses with CCS-CA as the independent (predictor) variable to explore our main research questions: 1) Is increased Native American/Indigenous culture associated with: 1) better mental health/well-being; and 2) better physical health? Results Increased Native/Indigenous culture (CCS-CA scores) is significantly associated with better mental health/well-being (mHHI, p < .001) and satisfaction with life (SWL, p < .001) predicts good physical health days (HRQOL, p < .001). Increased connection to Native American/Indigenous culture (CCS-CA scores) is significantly associated with decreased risk for depression (CESD-R-10, p < .0) and substance abuse and (CAGE-AID, p < .07). Significant results for culture as protective against risk for substance abuse (CAGE-AID) was most likely affected (p value approaching significance) due to an error in language on the measure (i.e., created double negative). Conclusions Native American/Indigenous culture is a predictor of improved outcomes for mental health/well-being and physical healthy days. Native culture is an important social determinant of health. We add to the evidence that Native/Indigenous culture (i.e., cultural connectedness) be considered an important intervention objective and health-related outcome measure.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10120477/pdf/12889_2023_Article_15587.pdf

Type of Resource: Peer-reviewed scientific article

“If You Fall Down, You Get Back Up”: Creating a Space for Testimony and Witnessing by Urban Indigenous Women and Girls

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Authors: Elizabeth Cooper and S Michelle Dreidger

Publication Year: 2019

Last Updated:

Journal: The International Indigenous Policy Journal

Keywords: Cultural Sensitivity and Appropriateness; Gender Identity; Women's Health; Cultural Memory; Advocacy

 

Short Abstract: Historical trauma and the negative effects of colonialism continue to be played out within Canadian culture. These processes have a deleterious effect on physical and psychological health outcomes among Indigenous Peoples.

 

Abstract: Historical trauma and the negative effects of colonialism continue to be played out within Canadian culture. These processes have a deleterious effect on physical and psychological health outcomes among Indigenous Peoples. Through the creation of a safe space as part of a decolonizing, participatory activity program spanning 7 weeks, First Nations and Metis women and girls (aged 8-12) were able to begin to unpack what it means to be happy, healthy, and safe, and what is needed to actualize these goals. A community engaged, asset-based workshop approach provided a forum for participants to discuss the impact of traumatic experiences on the ability of adults to model a positive image of strength, independence, and confidence for their daughters, while creating a space to discuss change.

 

Source: Link to Original Article.

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Source: https://ojs.lib.uwo.ca/index.php/iipj/article/view/7559

Type of Resource: Peer-reviewed scientific article

COVID-VISUN: COVID Vulnerability and Impact Summary for Urban Natives March 2023

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Email to Request Report: research@ncuih.org

Authors: Alexander Zeymo

Publication Year: 2023

Last Updated: May 26, 2023

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

 

Short Abstract: This is a summary report compiled by NCUIH on the impact of the COVID-19 pandemic in the urban Native American community during the month of March 2023. This report highlights the level and severity of COVID-19 infections in UIO service areas, tracking recent trends in vaccinations, and reviewing recent news and research relevant to the urban AI/AN community. If you would like to have access to this report, please send an email to research@ncuih.org. ***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

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