American Indian and Alaska Native Mental Health Research最新文献

Increased attention to diagnostic accuracy in depression screening and management within primary care has demonstrated inadequate care when patients prematurely discontinue recommended treatments such as medication and counseling. Decision-support tools can enhance the medical decision-making process. In 2010, the Southcentral Foundation (SCF) Research Department developed a stakeholder-driven decision support tool to aid in depression management. This paper describes feedback from attendees at SCF's 2016 Alaska Native Health Research Forum (Forum) regarding a dissemination product highlighting the aforementioned study. Forum attendees participated in a small group discussion and responded to a brief survey using the audience response system. Thematic analysis was conducted on data from the small group discussion. Overall, Forum attendees responded favorably to the dissemination product. Most agreed the presentation was clear, the amount of information presented was appropriate, and that results were presented in an interesting way. Small group discussion participants provided constructive feedback about why depression-related research results should be shared; how they believed results should be best shared; who results should be shared with; when and where results should be shared; and what level of research results should be shared. The stigma associated with depression treatment may be assuaged if results are shared in a way that normalizes support for depression treatment. Community member involvement in disseminating results has potential to make information more acceptable and meaningful.

The Psychological Sense of School Membership (PSSM) scale is widely used to measure school belongingness among adolescents. However, previous studies identify inconsistencies in factor structures across different populations. The factor structure of the PSSM has yet to be examined with American Indian/Alaska Native (AI/AN) youth, a population of keen interest given reports of their educational and health disparities, and the potential of belongingness as a protective factor against risk behaviors. Thus, this study examined the factor structure of the PSSM in two samples of AI adolescents (N = 349). The two main aims of this study were to 1) determine if a comparable factor structure exists between the two AI groups and 2) examine the factor structure of the PSSM for use in AI/AN populations. Randomization analysis was used to test research aim one, and exploratory factor analysis was used to test research aim two. Analyses revealed that comparable factor structures existed based on responses from the two AI groups. Analyses also identified two factors: school identification/peer support and connection with teachers. Moreover, negatively worded statements were found to be unreliable and were removed from the final scale, reducing the PSSM to 13 items. Findings from this study will assist researchers and clinicians with assessing sense of school belongingness in AI/AN adolescents and with appropriately interpreting aspects of belongingness for this population.

Binge drinking appears to be a risk factor, facilitator, and method of suicidal and non-suicidal self-injury for some American Indian (AI) youth. We examined characteristics, patterns, and motivations for binge use among AI adolescents (N = 69; 10-19 years-old) who recently engaged in binge drinking. The majority used alcohol alone (53.7%) or a combination of alcohol and marijuana (31.3%) for their binge event. Gender differences emerged with boys more severely affected than girls. Forty-seven percent reported lifetime suicidal thoughts. This study represents one of the first in-depth examinations of substance use and related behaviors among AI adolescents who have engaged in recent binge use.

American Indians and Alaska Natives (AI/ANs) constitute 2.2% of Hawai'i's population. Unfortunately, very little is known about the mental health of AI/AN youth in Hawai'i. The purpose of this study (N = 7,214; 1992-1996) was to describe AI/AN adolescents versus non-AI/AN youth regarding demographic, social, and mental health variables. The results suggested that AI/AN adolescents were more open to different types of social-emotional supports, had relatively more non-traditional families with a smaller social network, and may be more vulnerable to academic and health difficulties, with particular risk for mental health issues for mixed AI/AN-Native Hawaiians. Implications are discussed, including intervention, socio-political issues, and future research.

This study uses data from the 2012 National Inpatient Sample to determine if mortality, length of stay, and discharge disposition are different between rural and urban American Indians and Alaska Natives (AI/ANs) with alcohol abuse, depression, diabetes, and post-traumatic stress disorder. Results show no difference in mortality between groups. Alcohol abuse, depression, and diabetes are less prevalent in rural AI/ANs, and rural patients have shorter lengths of stay and fewer chronic conditions, diagnoses, and procedures. Finally, urban patients are discharged to short-term hospitals or skilled nursing facilities at higher rates. Rural diabetes patients exhibit increased mortality, but there is little evidence that rurality adversely affects the AI/AN population for the conditions we studied.

In May 2016, Southcentral Foundation (SCF), a regional tribal health corporation based in Anchorage, Alaska convened a half-day health research forum for Alaska Native and American Indian community members to obtain feedback on communication of research findings. Thirty one individuals attended the Forum and 22 completed a pre and post survey. Respondents found the Forum to be a useful method to learn about research projects and their willingness to participate in health research reportedly increased because of the event. Forum attendees also endorsed use of direct mail, electronic mail, and messages via an electronic health record patient portal as communication methods for health researchers to inform potential participants about research studies occurring at SCF and for return of individual and community level results.

Physical activity (PA) may improve quality of life and survival among cancer survivors; however, little is known about Navajo cancer survivor PA. We evaluated Navajo cancer survivor PA habits, barriers, and preferences through focus groups and interviews (n = 32). Transcripts were coded in NVivo and major themes summarized by consensus. Survivor exercise guidelines were largely unknown, but movement, resilience and life balance were valued. Most participants reported at ≥1 mode of current PA (n = 24; 71% walking, 46% work/homesteading). Barriers to PA included treatment side effects, limited access to programs, fear of "over doing it," and family/friends encouraging rest. Preferences for PA varied.

Southcentral Foundation (SCF), a tribal health organization based in Anchorage, Alaska, operates and plans health care services in response to the priorities and tribal values of Alaska Native and American Indian (AN/AI) people, including traditional concepts of wellness, reciprocity, and working in relationship. In an effort to better incorporate AN/AI priorities and values in research dissemination, the SCF Research Department hosted the Alaska Native Health Research Forum (Forum) in May 2016. In this paper, we describe the communication strategies used by the SCF Public Relations Department, which were shared with Forum attendees, describe attendee recommendations for researchers to consider and implement, and then discuss future directions for dissemination. Lessons learned through the Forum were 1) customer-owners are interested in learning more about research, 2) dissemination should be done throughout all stages of projects using a variety of media channels, and 3) SCF Research Department dissemination should continue to shape health care.

Alaska Native and American Indian (AN/AI) people have negative research experiences, including lack of timely, respectful, and relevant communication about research findings. Southcentral Foundation (SCF), a tribally owned and operated health care organization in Alaska, has redesigned the health care system, enacted research policies, and established a research department which uses best practices of Community Engaged Research with AN/AI people. Department staff and community members, however, perceive significant limitations in the reach of and satisfaction with ongoing engagement and dissemination efforts. Background information is delineated which supports new approaches in research engagement using SCF as an example.