American Indian and Alaska Native Mental Health Research最新文献

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.

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 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.

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.

Colonial policies in Canada have led to social disruption and intergenerational trauma across Indigenous nations, contributing to high rates of sexualized violence within many communities. While mental health and social science discourse has identified the harmful impacts of violence against Indigenous women in Canada, there continues to be a lack of focus on the unique mental health needs of Indigenous men in this regard. This article reviews the results of a nationally funded research study which looked at the mental health and healing needs of Indigenous men in Toronto who have experienced sexualized trauma. This study followed Indigenous protocols for research and was conducted in partnership with Anishnawbe Health Toronto, a culture-based community health center. The methodology utilized a narrative inquiry and interviewed six community men about their recovery journeys and ten community healers and counselors about recovery through a gendered lens. The results explore the discourses that contribute to the social construction of masculinity(ies) and the impacts of these social norms on help-seeking behaviors. These results inform culturally appropriate and gender-relevant mental health service provision for Indigenous male clients recovering from sexualized trauma.

This study examined the 2013 New Mexico Youth Risk and Resiliency Survey (NM-YRRS) to determine whether cultural connectedness and positive relationships with adults protected against suicide attempts among American Indian and Alaska Native (AI/AN) youth and whether these relationships differed by gender. The sample included 2,794 AI/AN students in grades 9 to 12 who answered the question about past-year suicide attempts. Protective factor variables tested included relationships with adults at home, school, and the community. The language spoken at home was used as a proxy measure for cultural connectedness. Positive relationships with adults were negatively associated with the prevalence of past-year suicide attempts in bivariate analysis. However, language spoken at home was not associated with the prevalence of suicide attempts. Multivariate analysis showed that among girls, relationships with adults at home, at school, and in the community were independently associated with lower suicide-attempt prevalence. Among boys, only relationships with adults at home showed such an association. These results have important implications for the direction of future research about protective factors associated with AI/AN youth suicide risk as well as in the design of suicide intervention and prevention programs.

Adult adoptees are at increased risk for mental health problems compared to nonadoptees. However, little is known about subsets of adoptees that may be more or less vulnerable to mental health problems. The purpose of this study was to explore the presence of mental health problems of American Indian (AI) persons compared to White persons who were separated from their birth families during childhood by foster care and/or adoption. Family systems theory guided the study. AI adoptees reported higher percentages of problems than White adoptees on all mental health problems measures (e.g., substance abuse, mental health, self-injury, and suicide). Data analysis included a series of chi-square statistics and logistic regression models. AI adoptees were more likely to report mental health problems, including alcohol addiction, alcohol recovery, drug recovery, self-assessed eating disorder, eating disorder diagnosis, self-harm, and suicidal ideation than were whites.

Introduction: The integration of behavioral health into medical care is related to positive results including improved patient health outcomes, provider satisfaction, and cost-offset. Indigenous people suffer from the highest health disparities in the nation and disproportionately experience barriers to health care; yet it is unknown if integrated care is effective for this population.

Methods: A systematic literature review was completed on the state of integrated care at Indigenous-serving health care sites in 2014 and was updated in 2016. Three databases were selected (Eric, Medline, and PsycInfo) and keywords pertaining to an Indigenous population and integrated care services (e.g., Native American, American Indian, or First Nations with integrated care, primary care, or family medicine) were used. After inclusion and exclusion criteria were applied, nine articles were selected out of the 2,889 articles found. Five additional articles were added in the 2016-update search. The selected articles were then evaluated using standards of integrated care.

Results: The selected articles demonstrated wide-ranging and positive results including improved physical and mental health symptoms, reduced substance use, improvements in education and employment status, as well as a decreased involvement with the criminal justice system. It appears that interventions that additionally integrated culturally relevant health beliefs and practices experienced the largest gains in health outcomes.

Discussion: Integrated care appears to be an intervention that can ameliorate these disparities by reducing stigma for those seeking care and providing coordinated care to prevent or reduce health care disparities in this population. While integrated care appears to be an effective system of care for Indigenous people, it must be noted that integration of local Indigenous health beliefs and practices is equally necessary.