American Indian and Alaska Native Mental Health Research最新文献

The growing national racial and ethnic diversity has created a greater need for health care delivery systems and health care providers to be more responsive to unique patient needs, that goes beyond meeting the immediate health problems to include attention to other critical component of patient care that take into account cultural competency such as health literacy, health beliefs and behaviors, cultural practices, etc.

The purpose of this project was to describe experiences of reservation-based American Indian (AI) veterans with the Department of Veterans Affairs (VA), and to identify opportunities for improving care and services. Focus group discussions and individual interviews were conducted with AI veterans, family members, and community members in three diverse tribes. Results showed that many veterans in tribal communities experienced challenges receiving services and benefits from the VA, including lack of culturally competent care, transportation problems, and difficulties navigating the system. Family members, often main caregivers for AI veterans, lacked necessary resources, including sources for information, support services, and financial means to procure adequate care. A number of strengths also were identified, including local leadership and a strong community commitment to improve care for veterans.

Background: The Ceremony of Research Project was implemented to strengthen tribal communities' ability to harmonize Western research processes with Indigenous ways of knowing.

Methods: Focus groups were conducted with tribal members to understand Indigenous processes, beliefs, and practices necessary to promote positive research experiences with tribal communities.

Results: Findings address time; relationship building and maintenance; inclusion of diverse tribal members in the research design, as well as American Indian epistemology; respect for tribal values, beliefs, and customs throughout the research process; and the reciprocity of research.

Conclusions: Our study has important implications for how researchers can take a strengthbased approach to conducting research with tribal communities.

National concerns about reducing the persistent health disparities found among varying racial and ethnic populations have led to initiatives to improve health care delivery systems. Many of these initiatives also promote the cultural competence of health care providers as a way to meet unique patient needs that go beyond immediate health problems, and to account for other critical components of patient care, such as health literacy, health beliefs and behaviors, and cultural practices. This case study describes a patient-centered care model developed by the Chinle Comprehensive Health Care Facility on the Navajo Reservation in Arizona, a model that has added a cadre of traditional tribal practitioners as part of its hospital and other clinical service resources.

The Fresno American Indian Health Project (FAIHP) Youth Council developed and pilot tested a strength-based, holistic, and youth-friendly self-assessment tool grounded in the Medicine Wheel, a framework and theoretical orientation for teaching wellness in many tribal communities. This paper summarizes the development of the Youth Personal Balance Tool and the methods used for tool revisions through two separate pilot studies and ongoing process evaluations across 3 years. Using a community-based participatory evaluation model, FAIHP leveraged community resources to implement an annual youth Gathering of Native Americans to support youth in healing from historical and intergenerational trauma and restoring communities to balance by making them a part of the solution. This tool is one of many outcomes of their work. The Youth Council is offering the tool as a gift (in line with the cultural value of generosity) to other Indigenous communities that are searching for culturally competent self-assessment tools for youth. The authors believe this tool has the potential to progress the field in strength-based, holistic, youth-friendly assessment as a culturally competent method for Indigenous evaluation and research.

American Indian (AI) adolescents have the highest suicide death and attempt rates of any U.S. group, yet few interventions have been developed or evaluated for this population. This paper presents the first adaptation of a brief evidence-based intervention for AI adolescents from one reservation who made a suicide attempt. We describe our community-driven approach to intervention development and a small pilot study (n = 13). Preliminary findings indicate reductions in adolescents' negative thinking, depression, and suicidal ideation, and an increase in psychological service utilization. Key innovations include delivery by AI paraprofessionals and potential to strengthen the continuum of care between emergency department and outpatient settings.

Although there is literature concentrating on cross-cultural approaches to academic and community partnerships with Native communities, few address the process and experiences of American Indian women leading federally funded and culturally grounded behavioral health intervention research in Native communities. This paper summarizes relevant literature on community-engaged research with Native communities, examines traditional roles and modern challenges for American Indian women, describes the culturally grounded collaborative process for the authors' behavioral health intervention development with Native communities, and considers emergent themes from our own research experiences navigating competing demands from mainstream and Native communities. It concludes with recommendations for supporting and enhancing resilience.