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Aboriginal health and family physicians.

https://arctichealth.org/en/permalink/ahliterature31534
Source
Can Fam Physician. 2002 Apr;48:680-1; author reply 681-2
Publication Type
Article
Date
Apr-2002
Author
Jane McGillivray
Source
Can Fam Physician. 2002 Apr;48:680-1; author reply 681-2
Date
Apr-2002
Language
English
Publication Type
Article
Keywords
Canada
Child
Child Welfare
Empathy
Family Practice - standards
Health Services, Indigenous - standards
Humans
Inuits
Newfoundland
Physician-Patient Relations
Notes
Comment On: Can Fam Physician. 2001 Dec;47:2444-6, 2452-511785273
PubMed ID
12046355 View in PubMed
Less detail
Source
Pages 487-494 in P. Bjerregaard et al., eds. Part II, Proceedings of the 11th International Congress on Circumpolar Health, Harstad, Norway, June 5-9, 2000. International Journal of Circumpolar Health. 2001;60(4)
Publication Type
Article
Date
Nov-2001
  1 document  
Author
Schraer, C.D
Mayer, A.M
Vogt, A.M
Naylor, J
Brown, T.L
Hastie, J
Moore, J
Author Affiliation
Alaska Native Medical Center Diabetes Program, Anchorage 99508, USA. cdschraer@anthc.org
Source
Pages 487-494 in P. Bjerregaard et al., eds. Part II, Proceedings of the 11th International Congress on Circumpolar Health, Harstad, Norway, June 5-9, 2000. International Journal of Circumpolar Health. 2001;60(4)
Date
Nov-2001
Language
English
Geographic Location
U.S.
Publication Type
Article
Digital File Format
Text - PDF
Keywords
Alaska - epidemiology
Alaska Natives
Community health centers - standards
Diabetes Complications
Diabetes mellitus - epidemiology - ethnology - prevention & control - therapy
Health Services, Indigenous - standards
Humans
Indians, North American - statistics & numerical data
Inuits - statistics & numerical data
Medical Audit
Patient care team
Practice Guidelines
Prevalence
Registries
Risk factors
Abstract
OBJECTIVES: To provide optimum health care to indigenous people with diabetes, to prevent diabetes, and to monitor the epidemiology of diabetes and selected complications. The purposes of this paper are to describe the program and to present data that highlights the major problems and successes. STUDY DESIGN: Descriptive epidemiology report of diabetes and population service program based on yearly chart review data. METHODS: Almost half of Alaska Natives with diabetes have no direct access to physicians or hospitals. Health care delivery is now managed by the tribes themselves. Program emphases include maintenance of a population-based registry, formal training for village health aides, physical activity programs, patient education, primary prevention activities and adherence to standards of care to prevent complications. A centralized registry is maintained to assure that epidemiological data is available and patients are not lost to follow-up. Each year a random sample of charts at each major facility is audited against nationally standardized care guidelines. RESULTS: The prevalence of diabetes among Alaska Natives increased 80% over the 13 years from 1985 to 1998 (15.7/1000 to 28.3/1000, age adjusted to U.S. 1980 population). For the years 1986-1998 the incidence rates of lower extremity amputation and end stage renal disease were 6.1/1000 and 2.0/1000 respectively. The level of care provided to Alaska Native patients is comparable to that provided to the general diabetic patient population seen in Alaskan urban clinics. CONCLUSIONS: In spite of logistic challenges, care provided to Alaska Native people with diabetes compares favorably to that provided in other settings. Incidence rates of lower extremity amputation and end stage renal disease also remain comparable to or lower than those in other U.S. populations. Many aspects of our system could be extended to other chronic disease programs serving isolated indigenous populations. Primary prevention of diabetes remains a major challenge as life styles change.
PubMed ID
11768423 View in PubMed
Documents
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Beyond the barriers: family medicine residents' attitudes towards providing Aboriginal health care.

https://arctichealth.org/en/permalink/ahliterature136201
Source
Med Educ. 2011 Apr;45(4):400-6
Publication Type
Article
Date
Apr-2011
Author
Bonnie Larson
Leonie Herx
Tyler Williamson
Lynden Crowshoe
Author Affiliation
Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada. bonnierae.larson@gmail.com
Source
Med Educ. 2011 Apr;45(4):400-6
Date
Apr-2011
Language
English
Publication Type
Article
Keywords
American Native Continental Ancestry Group - psychology
Attitude of Health Personnel
Canada - ethnology
Curriculum
Education, Medical - standards
Family Practice - standards
Health Services Accessibility - standards
Health Services, Indigenous - standards
Humans
Internship and Residency
Prejudice
Rural Health Services - standards
Abstract
Health care is one of many under-resourced areas in Aboriginal communities in Canada. Aboriginal people have substandard health compared with the general population, yet have less access to health care services. Not only is there a paucity of Aboriginal doctors, but it also appears that few non-Aboriginal doctors are willing or able to work in Aboriginal contexts.
This study examines the attitudes of family medicine residents towards providing health care to Aboriginal patients. The goal of this study was to assess the willingness of family medicine residents to work in Aboriginal health care and to elucidate the major factors that inform these attitudes.
We conducted a cross-sectional survey of an urban cohort of family medicine residents using a convenience sample. Our survey instrument consisted of a questionnaire comprising a mixture of open-ended and closed questions.
Although a majority (52%, n = 27) of the family medicine residents were willing to work in Aboriginal contexts, many felt underprepared to do so (40%, n = 21). Residents who have had some exposure to Aboriginal issues and have had community experiences are more likely to state an intention to work in Aboriginal settings.
The results of this study encourage the creation of educational experiences for medical residents that may promote a desire to work in Aboriginal communities.
PubMed ID
21401688 View in PubMed
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Bringing safety and responsiveness into the forefront of care for pregnant and parenting aboriginal people.

https://arctichealth.org/en/permalink/ahliterature82144
Source
ANS Adv Nurs Sci. 2006 Apr-Jun;29(2):E27-44
Publication Type
Article
Author
Smith Dawn
Edwards Nancy
Varcoe Colleen
Martens Patricia J
Davies Barbara
Author Affiliation
School of Nursing, University of Ottawa, Canada. dsmith@uottawa.ca
Source
ANS Adv Nurs Sci. 2006 Apr-Jun;29(2):E27-44
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
British Columbia
Colonialism
Communication
Communication Barriers
Community-Institutional Relations
Culture
Emotions
Female
Health Services, Indigenous - standards
Humans
Inuits
Male
Nurse-Patient Relations
Parenting - ethnology
Pregnancy
Prenatal Care - standards
Quality of Health Care
Safety
Abstract
Poor access to prenatal care for Aboriginal people is well documented, and is explicated as an unethical barrier to care resulting from colonial and neocolonial values, attitudes, and practices. A postcolonial standpoint, participatory research principles, and a case study design were used to investigate 2 Aboriginal organizations' experiences improving care for pregnant and parenting Aboriginal people. Data were collected through exploratory interviews and small-group discussions with purposefully selected community leaders, providers, and community members. The study found that safety in healthcare relationships and settings, and responsiveness to individuals' and families' unique experiences and capacities must be brought into the forefront of care. Results suggest that the intention of care must be situated within a broader view of colonizing relations to improve early access to, and relevance of, care during pregnancy and parenting for Aboriginal people.
PubMed ID
16717484 View in PubMed
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Canada must do more to tackle poorer health of indigenous people, says national chief.

https://arctichealth.org/en/permalink/ahliterature106223
Source
BMJ. 2013;347:f6785
Publication Type
Article
Date
2013

A Canadian survey of postgraduate education in Aboriginal women's health in obstetrics and gynaecology.

https://arctichealth.org/en/permalink/ahliterature108535
Source
J Obstet Gynaecol Can. 2013 Jul;35(7):647-53
Publication Type
Article
Date
Jul-2013
Author
Naana Afua Jumah
Don Wilson
Rajiv Shah
Author Affiliation
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.
Source
J Obstet Gynaecol Can. 2013 Jul;35(7):647-53
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Clinical Competence - standards
Curriculum - standards
Faculty, Medical - organization & administration
Gynecology - education
Health Care Surveys
Health Services, Indigenous - standards
Humans
Internship and Residency - standards
Needs Assessment
Obstetrics - education
Population Groups
Program Development
Qualitative Research
Women's Health - ethnology
Women's Health Services - standards
Abstract
To assess Canadian obstetrics and gynaecology residents' knowledge of and experience in Indigenous women's health (IWH), including a self-assessment of competency, and to assess the ability of residency program directors to provide a curriculum in IWH and to assess the resources available to support this initiative.
Surveys for residents and for program directors were distributed to all accredited obstetrics and gynaecology residency programs in Canada. The resident survey consisted of 20 multiple choice questions in four key areas: general knowledge regarding Indigenous peoples in Canada; the impact of the residential school system; clinical experience in IWH; and a self-assessment of competency in IWH. The program director survey included an assessment of the content of the curriculum in IWH and of the resources available to support this curriculum.
Residents have little background knowledge of IWH and the determinants of health, and are aware of their knowledge gap. Residents are interested in IWH and recognize the importance of IWH training for their future practice. Program directors support the development of an IWH curriculum, but they lack the resources to provide a comprehensive IWH curriculum and would benefit from having a standardized curriculum available.
A nationwide curriculum initiative may be an effective way to facilitate the provision of education in IWH while decreasing the need for resources in individual programs.
PubMed ID
23876643 View in PubMed
Less detail
Source
Health Soc Serv J. 1985 May 2;95(4946):550-1
Publication Type
Article
Date
May-2-1985

Commentary: quality of alcohol, drug, and mental health services for American Indian children and adolescents.

https://arctichealth.org/en/permalink/ahliterature10398
Source
Am J Med Qual. 2000 Jul-Aug;15(4):148-56
Publication Type
Article
Author
D K Novins
C M Fleming
J. Beals
S M Manson
Author Affiliation
Faculty of the National Center for American Indian and Alaska Native Mental Health Research, University of Colorado Health Sciences Center, Denver 80210, USA.douglas.novins@uchsc.edu
Source
Am J Med Qual. 2000 Jul-Aug;15(4):148-56
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Demography
Diagnosis, Dual (Psychiatry)
Health Services Accessibility
Health Services, Indigenous - standards
Humans
Indians, North American - psychology
Mental Disorders - epidemiology - therapy
Mental Health Services - organization & administration - standards
Outcome and Process Assessment (Health Care)
Prevalence
Quality of Health Care
Research Support, U.S. Gov't, P.H.S.
Socioeconomic Factors
Substance-Related Disorders - epidemiology - therapy
United States - epidemiology
United States Indian Health Service - organization & administration - standards
Abstract
American Indian children and adolescents suffer from a high prevalence of alcohol, drug, and mental (ADM) disorders. Unfortunately, the systems of services for these children and youth have never been able to address adequately their mental health needs. Thus, the revolutionary changes now taking place within these service systems, in particular the marked increase in the direct provision of services by Indian tribes and organizations, provides a unique opportunity to address these historical shortcomings. In this paper, we describe our existing knowledge concerning the quality of ADM services for American Indian children and adolescents and their critical sociodemographic, sociocultural, and epidemiologic contexts. We then consider the implications of these studies for improving the quality of care as well as its measurement and monitoring.
PubMed ID
10948787 View in PubMed
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