KRC Articles

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

Last Updated:

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

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

Content Analysis Informing the Development of Adapted Harm Reduction Talking Circles (HaRTC) with Urban American Indians and Alaska Natives Experiencing Alcohol Use Disorder

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Authors: Lonnie A. Nelson et al.

Publication Year: 2022

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Journal: International Journal of Indigenous Health

Keywords: Cultural Sensitivity and Appropriateness; Harm Reduction; Talking Circles; Alcohol Use; Qualitative Analysis

 

Short Abstract: Prior studies with Native populations have highlighted concerns about the cultural acceptability of highly directive, Eurocentric approaches, such as cognitive behavioral therapy and 12-step programs in treating alcohol use disorder (AUD).

 

Abstract: Prior studies with Native populations have highlighted concerns about the cultural acceptability of highly directive, Eurocentric approaches, such as cognitive behavioral therapy and 12-step programs in treating alcohol use disorder (AUD). When asked in a prior qualitative study how they would redesign AUD treatment, urban American Indian and Alaska Native (AI/AN) participants reported wanting more low-barrier, harm-reduction treatment options, Native treatment providers, and culturally relevant practices. Talking Circles, which are gatherings where people share what is on their hearts, were the most requested Native cultural practice. After developing and piloting its initial iteration, researchers, community members, and traditional health professionals collaborated on the present qualitative research study to further refine an adapted Harm Reduction Talking Circle (HaRTC) protocol to address AUD with urban AI/ANs. This study features a conventional content analysis of 31 patient interviews, 6 key informant interviews with management and traditional health professionals, and 5 staff and provider focus groups to inform the development of the HaRTC. Specifically, this study describes staff, management, traditional health professionals, provider, and patient participants’ a) perspectives on HaRTC, including potential benefits, risks and mitigating factors, b) preferred traditional medicines and practices, c) preferred approaches/Circle Facilitator stance for engagement and facilitation, and d) HaRTC logistics (e.g., timing, frequency). Analyses indicated a central tendency preference for 8, weekly HaRTC sessions. Although participants expressed concerns about the potential inclusion of intoxicated people in HaRTC sessions, a large majority of staff, management and patient participants felt it was important to have HaRTC be as inclusive and accepting of community members as possible. Participants provided suggestions for how to structure facilitation of the HaRTC and mitigate risks of intoxication and patient escalation. Participants preferred an approach that is acceptance-based, respects individuals’ autonomy and culture, and creates a safe space for recovery. Most participants felt the specific traditions and medicines applied in the HaRTC should be maximally inclusive to honor the diversity of tribal affiliations and backgrounds represented among urban AI/ANs. In conclusion, participants largely supported an integration of harm-reduction principles and the North American Indigenous tradition of the Talking Circle to provide a compassionate, culturally appropriate healing practice to a larger spectrum of AI/ANs with AUD. Future research is planned to test the efficacy of this community-informed approach.

 

Source: Link to Original Article.

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Source: https://jps.library.utoronto.ca/index.php/ijih/article/view/36677

Type of Resource: Peer-reviewed scientific article

Utilizing Drumming for American Indians/Alaska Natives with Substance Use Disorders: A Focus Group Study

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Authors: Daniel Dickerson et al.

Publication Year: 2012

Last Updated: September 2012

Journal:

Keywords: Cultural Sensitivity and Appropriateness; Substance Use; Drumming; Gender Roles; Tradition

 

Short Abstract: Background—Drumming has been utilized among American Indian/Alaska Native (AI/AN) tribes for centuries to promote healing and self-expression. Drum-Assisted Recovery Therapy for Native Americans (DARTNA), currently under development, is a substance abuse treatment utilizing drumming as a core component.

 

Abstract: Background—Drumming has been utilized among American Indian/Alaska Native (AI/AN) tribes for centuries to promote healing and self-expression. Drum-Assisted Recovery Therapy for Native Americans (DARTNA), currently under development, is a substance abuse treatment utilizing drumming as a core component. Objectives—Focus groups were conducted to assist in the development of the DARTNA protocol. Feedback obtained from these focus groups will inform a subsequent pretest of DARTNA and an empirical study analyzing its effectiveness. Methods—Three focus groups were conducted among AIs/ANs with substance use disorders (n = 6), substance abuse treatment providers (n = 8), and a community advisory board (n = 4) to solicit feedback prior to a pretest of the DARTNA protocol. Results—Overall, participants indicated that DARTNA could be beneficial for AIs/ANs with substance use disorders. Four overarching conceptual themes emerged across the focus groups: (1) benefits of drumming, (2) importance of a culture-based focus, (3) addressing gender roles in drumming activities, and (4) providing a foundation of common AI/AN traditions. Conclusions—The DARTNA protocol is a potentially beneficial and culturally appropriate substance abuse treatment strategy for AIs/ANs. In order to optimize the potential benefits of a substance abuse treatment protocol utilizing drumming for AIs/ANs, adequate attention to tribal diversity and gender roles is needed. Scientific Significance—Due to the shortage of substance abuse treatments utilizing traditional healing activities for AIs/ANs, including drumming, results from this study provide an opportunity to develop an intervention that may meet the unique treatment needs of AIs/ANs.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725997/

Type of Resource: Best Practices Newsletter

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

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:

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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

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

Last Updated:

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

The Sweat Lodge Ceremony: A Healing Intervention for Intergenerational Trauma and Substance Use

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Authors: Teresa Naseba Marsh, David C. Marsh, Julie Ozawagosh, Frank Ozawagosh

Publication Year: 2018

Last Updated:

Journal: The International Indigenous Policy Journal

Keywords: Cultural Sensitivity and Appropriateness; Mental and Behavioral Health

 

Short Abstract: Many traditional healers and Elders agree that strengthening cultural identity, incorporating traditional healing practices, and encouraging community integration can enhance and improve mental health and reduce substance use disorders (SUD) in Indigenous populations.

 

Abstract: Many traditional healers and Elders agree that strengthening cultural identity, incorporating traditional healing practices, and encouraging community integration can enhance and improve mental health and reduce substance use disorders (SUD) in Indigenous populations. Despite the fact that traditional healing practices have always been valued by Indigenous Peoples, there is very little research on efficacy. Recent research by one of the authors in this group (T. Marsh) has shown that the blending of Indigenous traditional healing practices and a Western treatment model, Seeking Safety, resulted in a reduction in intergenerational trauma (IGT) symptoms and substance use disorders (SUD). This article focuses on the qualitative evidence concerning the impact of the traditional healing practices, specifically the sweat lodge ceremony. Participants reported an increase in spiritual and emotional well-being that they said was directly attributable to the ceremony. This study demonstrates that it would be beneficial to incorporate Indigenous traditional healing practices, including the sweat lodge ceremony, into Seeking Safety to enhance the health and well-being of Indigenous Peoples with IGT and SUD.

 

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Source: https://ojs.lib.uwo.ca/index.php/iipj/article/view/7544/6188

Type of Resource: Peer-reviewed scientific article

Feasibility and Acceptability of Virtual Implementation of a Sexual Reproductive Health Teen Pregnancy Prevention Program for Native Youth

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Authors: Hima Patel et al.

Publication Year: 2022

Last Updated:

Journal: American Indian and Alaska Native Mental Health Research

Keywords: Communication Technologies; Covid-19; HIV/AIDS; Pregnancy; Women's Health; Substance Use; Youth; Virtual; Telehealth

 

Short Abstract: American Indian/Alaska Native (Native) youth face high rates of substance use, teen pregnancy and sexually transmitted infections. In response to the COVID-19 pandemic, Respecting the Circle of Life (RCL), a sexual reproductive health and teen pregnancy prevention program for Native youth and their trusted adult, was adapted and delivered in a virtual format with Native youth in a rural, reservation-based Native community.

 

Abstract: American Indian/Alaska Native (Native) youth face high rates of substance use, teen pregnancy and sexually transmitted infections. In response to the COVID-19 pandemic, Respecting the Circle of Life (RCL), a sexual reproductive health and teen pregnancy prevention program for Native youth and their trusted adult, was adapted and delivered in a virtual format with Native youth in a rural, reservation-based Native community. This manuscript describes the adaptation process, feasibility, and acceptability of virtual program implementation. The manuscript describes the process of rapidly shifting the RCL program into a virtual format. In addition, a mixed-methods process evaluation of implementation forms, program feedback forms, in-depth interviews with participants, and staff debriefing sessions was completed. Results show virtual implementation of RCL is both feasible and acceptable for Native youth and their trusted adults. A key benefit of virtual implementation is the flexibility in scheduling and ability to have smaller groups of youth, which offers greater privacy for youth participants compared to in-person implementation with larger groups. However, internet connectivity did present a challenge for virtual implementation. Ultimately, sexual and reproductive health programs seeking to reach Native youth and families should consider virtual implementation methods, both during and outside of pandemic situations. NOTE: This project was conducted to better understand how the virtual implementation of the program was received by participants and not to draw any conclusions about its utility or impact.

 

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Source: https://coloradosph.cuanschutz.edu/docs/librariesprovider205/journal_files/vol29/29_2_2022_63_patel.pdf

Type of Resource: Peer-reviewed scientific article