American Indian Behavioral Health Treatment Preferences as Perceived by Urban Indian Health Program Providers

2021 ◽  
pp. 104973232110578
Author(s):  
Andrew Pomerville ◽  
Anna Kawennison Fetter ◽  
Joseph P. Gone

Behavioral health services specifically targeted for ethnoracial clients are typically tailored to the specific needs and preferences of these populations; however, little research has been done with American Indian clients specifically. To better understand how clinicians handle provision of treatment to this population, we interviewed 28 behavioral health staff at six Urban Indian Health Programs in the United States and conducted focus groups with 23 staff at five such programs. Thematic analysis of transcripts from these interviews and focus groups suggests that these staff attempt to blend and tailor empirically supported treatments with American Indian cultural values and practices where possible. Simultaneously, staff try to honor the client’s specific preferences and needs and to encourage clients to seek cultural practices and connection outside of the therapy room. In so doing staff members were acutely aware of the limitations of the evidence base and the lack of research with American Indian clients.

2021 ◽  
Vol 6 ◽  
Author(s):  
Kevalin M. W. Aulandez ◽  
Melissa L. Walls ◽  
Nicole M. Weiss ◽  
Kelley J. Sittner ◽  
Stefanie L. Gillson ◽  
...  

The COVID-19 pandemic has had disproportionately severe impacts on Indigenous peoples in the United States compared to non-Indigenous populations. In addition to the threat of viral infection, COVID-19 poses increased risk for psychosocial stress that may widen already existing physical, mental, and behavioral health inequities experienced by Indigenous communities. In recognition of the impact of COVID-19 related psychosocial stressors on our tribal community partners, the Johns Hopkins Center for American Indian Health Great Lakes Hub began sending holistic wellness boxes to our community partners in 11 tribal communities in the Midwestern United States and Canada in summer of 2020. Designed specifically to draw on culturally relevant sources of strength and resilience, these boxes contained a variety of items to support mental, emotional, cultural, and physical wellbeing. Feedback from recipients suggest that these wellness boxes provided a unique form of COVID-19 relief. Additional Johns Hopkins Center for American Indian Health offices have begun to adapt wellness boxes for the cultural context of their regions. This case study describes the conceptualization, creation, and contents of these wellness boxes and orients this intervention within a reflection on foundations of community-based participatory research, holistic relief, and drawing on cultural strengths in responding to COVID-19.


2020 ◽  
Vol 3 (2) ◽  
pp. e66-e89
Author(s):  
Ka`imi Sinclair ◽  
Kelly Gonzales ◽  
Claire Woosley ◽  
Tish Rivera-Cree ◽  
Dedra Buchwald

This study used a parallel, convergent, mixed-methods design with TribalCrit theory and intersectionality as analytical frameworks to identify how the identities of American Indian men intersect with broader structures and systems in shaping their eating and physical activity choices and behaviors, and in eliciting recommendations for a men’s lifestyle intervention. American Indian men were recruited in Minneapolis, Minnesota, and Portland, Oregon, between March and December 2017, and in Phoenix, Arizona, in December 2019 to participate in a survey and focus groups. The survey included questions on demographics and physical and cultural activities men engage in, perceived social support for lifestyle behaviors, masculine characteristics, and values important to American Indian men. The six-item Kessler Psychological Distress Scale was used to assess psychological distress. Focus groups were audio recorded and transcribed for a phenomenological analysis. Descriptive statistics and correlations were computed for survey data. We conducted 15 focus groups with 151 adult American Indian men in three urban sites. The mean age of participants ranged from 36 to 51 across the sites; 7–32% were college graduates; 13–22% were currently married, and 28–41% were working full time. The most important values reported by participants were being strong mentally and emotionally, a good parent, responsible, spiritual, and a good spouse or partner. On the K6 psychological distress scale, 63–70% scored ≥5 but <13 (moderate mental distress), and 8–15% scored ≥13, indicating severe mental distress. Younger age was significantly correlated with higher mean K6 score (P < 0.0001). Settler colonialism that took root in the United States imposed cultural and gender hegemony, which in turn enforced a patriarchal capitalist system that has had long-lasting and deleterious effects on American Indians, particularly American Indian men.


2011 ◽  
Author(s):  
◽  
Mary E. Ratchford

This study explored one public school on a tribal reservation to construct understanding of leadership effect on policy supporting academic achievement. Primary data were collected between June 2011 and August 2011 providing sequential opportunities to collect School Culture Survey (SCS) (Gruenert, 1998) data and follow-up interviews with stakeholder groups. The SCS and interviews gathered data about cultural values and beliefs, patterns of behavior and relationships from multiple stakeholder groups. Secondary data included school report cards, websites, Board of Education meeting minutes, school forms, and professional development in-service training documents. The data described strengths including unity of purpose, transformational leadership, faculty collaboration, professional development, equality development, culture departmental support, the new school building, tangible assets of lands and enterprises, and intangible assets that are the people and their unique culture. Areas of concern were expectation of failure, equity measures, parent involvement, discipline, health services, a culture clash, attendance, and community infrastructure. This study brought together American scholarly expertise and indigenous scholarly expertise from the United States, New Zealand and Canada. The findings suggest a formative comprehensive systemic school improvement plan process can be developed as recommended practice for replication in other schools serving American Indian children across North America.


2018 ◽  
Vol 13 (5) ◽  
pp. 735-745 ◽  
Author(s):  
Jennifer E. Flythe ◽  
Tandrea Hilliard ◽  
Graciela Castillo ◽  
Kourtney Ikeler ◽  
Jazmine Orazi ◽  
...  

Background and objectivesIndividuals receiving in-center hemodialysis experience a high symptom burden that detrimentally affects their quality of life. There are few evidence-based interventions for symptom relief in this population. To stimulate innovation in symptom management, data on patient symptom prioritization and treatment preferences are needed. We undertook this study to (1) identify patient-prioritized symptoms for the development of symptom relief therapies and (2) elicit preferences for treatments among individuals receiving hemodialysis.Design, setting, participants, & measurementsWe conducted a mixed methods study that included focus groups in Carrboro, North Carolina; Tucson, Arizona; and Seattle, Washington and a nationally distributed online survey. Focus group transcripts were analyzed for patterns, and the highest priority symptoms were determined on the basis of frequency and report severity. We used focus group findings to inform survey items. Focus group and survey results were crossvalidated and synthesized for final symptom prioritization.ResultsThere were 32 participants across three focus groups and 87 survey respondents from 27 states in the United States. The physical symptoms of insomnia, fatigue, muscle cramping, and nausea/vomiting and the mood symptoms of anxiety and depressed mood were reported by participants in all focus groups. Among survey respondents, fatigue (94%), cramping (79%), and body aches (76%) were the most common physical symptoms, and feeling depressed (66%), worried (64%), and frustrated (63%) were the most common mood symptoms. The top-prioritized symptoms were consistent across focus group and survey participants and included the physical symptoms insomnia, fatigue, and cramping and the mood symptoms anxiety, depression, and frustration. Participants indicated that symptom frequency, duration, unpredictability, and social and financial effects factored most heavily into symptom prioritization.ConclusionsPatients prioritized the physical symptoms of insomnia, fatigue, and cramping and the mood symptoms of anxiety, depression, and frustration as the top symptoms for which to find new therapies.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_03_20_CJASNPodcast_18_5_F.mp3


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