American Indian and Alaska Native Mental Health Research最新文献

Southcentral Foundation, a tribal health organization serving Alaska Native and American Indian (AN/AI) people in southcentral Alaska, convened the Alaska Native Health Research Forum (Forum) for AN/AI people in May 2016. The purpose of the Forum was to obtain AN/AI community member feedback about sharing health research results. This article describes the funding mechanism that provided resources for the Forum and other factors that were considered when designing the Forum. This is followed by a description of how attendees were invited, the audience response system, and process used to collect quantitative data on participants and qualitative feedback from small group discussions with Forum attendees. Finally, we describe the quantitative and qualitative data analysis processes used to evaluate responses.

Cardiovascular disease is the number one cause of death among American Indians and Alaska Natives (AI/AN). Utilizing narratives from members of a Pacific Northwest tribe, this paper explores perceptions about behaviors affecting cardiovascular health through tribal members' lived experiences related to place-based environmental historical trauma. Findings from narrative analysis indicate that ambivalence is an effect of historical trauma and complicates the adoption of protective cardiovascular health behaviors. Tribal narratives indicate a path to overcome this ambivalence stemming from historical environmental trauma through revitalization, adaptation, and re-integration of traditional cultural practices to contemporary contexts. By creating their own health promotion response, one that is not imposed or colonizing, tribal members are re-generating cultural practices and health behaviors associated with lowered risks of cardiovascular disease.

Exposure to trauma is consistently associated with co-occurrence of behavioral health disorders. Primary care settings are opportune places to screen for traumatic experiences and symptoms, as they are often the initial point of care for behavioral health concerns by the Alaska Native and American Indian (AN/AI) population. In this case study, we examine results dissemination activities at the SCF Research Department-hosted 2016 Alaska Native Health Research Forum (Forum) of a pilot study of a trauma-focused screening, brief intervention, and referral to treatment (T-SBIRT) process for AN/AI adults in primary care. Feedback included audience responses to the presentation delivered at the Forum and recommendations to guide future community dissemination of T-SBIRT results. Attendees (N = 31) found the presentation clear, interesting, and included the right amount of detail. Four broad dissemination themes were identified in discussion groups: 1) share results with everyone; 2) share results in ways that reach all AN audiences; 3) provide a summarized status update at each stage of the study; and 4) use results to improve care for trauma and related symptoms.

We sought to examine behavioral health indicators for an early adolescent population of American Indians/Alaska Natives (AI/AN) within an urban setting in Washington State. We conducted secondary data analyses from a randomized clinical trial implemented in local middle schools that compared AI/ANs (n = 43), non-Hispanic Whites (n = 620), and other racial/ethnic minority youth (n = 527) across a variety of behavioral health risks. AI/AN youth reported significantly more depressive symptoms than other racial/ethnic minorities as well as non-Hispanic Whites. They also reported more discrimination, more generalized anxiety, and were more likely to have initiated substance use, in comparison to non-Hispanic Whites. Psychosocial screening and early intervention are critically needed for AI/AN youth.

Background: American Indian (AI) children suffer from high rates of obesity, obesity-related disease, obesogenic behaviors, and depressive symptoms.

Objective: Study was designed to determine the associations between depressive symptoms and obesogenic behaviors in school-aged AI children in Oklahoma.

Methods: Study design was cross-sectional. Depressive symptoms, beverage intake, fruit and vegetable intake, meal frequency, physical activity, and screen time were self-reported.

Results: Mean participant age was 10.5 ± 1.6 years (n = 121); 64% were overweight/obese. Depressive symptoms were associated with dieting and screen time.

Conclusion: AI chronic disease prevention efforts will benefit by including measures for depression and associations of obesogenic behaviors and depressive symptoms in treatment planning.

Measuring mental health accurately is an important endeavor for screening purposes. Depression scales, such as the Center for Epidemiologic Studies Depression (CES-D) scale, have been well-established among different populations. Yet, little work has been done to examine the reliability and validity of the CES-D among older American Indians and Alaska Natives. The purpose of our study was to examine the factor structure, reliability, and concurrent validity of the full 20-item and abbreviated 12-item CES-D scale with a sample of older American Indians. Our findings demonstrate excellent internal reliability and concurrent validity of the full and abbreviated CES-D scales in our study sample.

BASC-2 SRP-A scores of 162 American Indian (AI) youth were compared with those of an ethnically diverse sample (N = 200) to explore group equivalence. A MANOVA indicated group differences among the five composites. AIs outscored non-Natives in Inattention/Hyperactivity. We examined AIs' ADHD scores in relation to their acculturation strategies, measured using the Bicultural Ethnic Identity Scale. Culturally marginalized AIs (low White and low Indian acculturation) reported stronger ADHD symptoms than bicultural, assimilated, or separated youth. The potential impact of culture on clinical measures is discussed.

The present study examined costs of two residential substance abuse treatment programs designed for urban American Indians and Alaska Natives (AI/ANs). Costs for one agency were well within national norms, while costs at the other program were less than expected from nationwide data. Economies of scale accounted for much of the difference between observed and expected costs. Culturally specific residential substance abuse treatment services can be provided to urban AI/ANs within budgets typically found at mainstream programs.

The objective of the present study was to assess whether selfreported physical activity barriers could be reduced among American Indian elders who participated in a 6-week randomized physical activity trial that compared the use of a pedometer only to that of pedometers with step-count goal setting. Elders (N = 32) were compared on the Barriers to Being Physically Active Quiz after participating in a pilot physical activity trial. Elders were classified into high- and low-barrier groups at baseline and compared on self-reported physical activity, health-related quality of life, pedometer step counts, and 6-minute walk performance. At the conclusion of the 6-week trial, only the lack of willpower subscale significantly decreased. The low-barrier group reported significantly higher physical activity engagement and improved mental health quality of life than the high-barrier group. The groups did not differ on daily step counts or 6-minute walk performance. Additional research is needed with a larger sample to understand relevant activity barriers in this population and assess whether they can be modified through participation in structured physical activity and exercise programs.

Objectives: We explored the association between stressful life events and postpartum depressive symptoms among non-Hispanic American Indian and Alaska Native (AI/AN) mothers.

Methods: We analyzed self-reports of stressful life events and depressive symptoms from 298 AI/AN respondents and conducted logistic regression to examine their association.

Results: Of the AI/AN mothers who responded, 29.7% reported depressive symptoms during their second postpartum year. Partner-related and traumatic stressful life events were significantly associated with increased risk of postpartum depressive symptoms.

Conclusions: AI/AN women should receive intensive screening for depression through the second postpartum year. Programs that address stressful life events may be part of a plan to decrease postpartum depression.