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Abnormal Papanicolaou smears and colposcopic follow-up among American Indian and Alaska Native women in the Pacific northwest.

https://arctichealth.org/en/permalink/ahliterature4082
Source
J Am Board Fam Pract. 1995 May-Jun;8(3):183-8
Publication Type
Article
Author
T J Gilbert
J R Sugarman
N. Cobb
Author Affiliation
Fred Hutchinson Cancer Research Center, Division of Public Health Services, Seattle, WA, USA.
Source
J Am Board Fam Pract. 1995 May-Jun;8(3):183-8
Language
English
Publication Type
Article
Keywords
Alaska
Cervical Intraepithelial Neoplasia - ethnology - pathology
Colposcopy
Decision Trees
Female
Follow-Up Studies
Humans
Indians, North American
Northwestern United States
Prevalence
Research Support, U.S. Gov't, P.H.S.
Retrospective Studies
Uterine Cervical Neoplasms - ethnology - pathology
Vaginal Smears
Abstract
BACKGROUND: Mortality that is due to cervical cancer among American Indian and Alaska Native women in the Pacific Northwest exceeds that among women of other races. Nevertheless, little information is available regarding the prevalence and follow-up of abnormal Papanicolaou smears among American Indian and Alaska Native women in the region. METHODS: We conducted a retrospective review of medical records of American Indian and Alaska Native women seen at 12 Indian Health Service and tribally operated clinics in Washington, Oregon, and Idaho who had an abnormal Papanicolaou smear in 1992. RESULTS: Of 4547 Papanicolaou smear results reviewed, 280 (6.2 percent) had an abnormal result (dysplasia or carcinoma in situ). Of the recommended colposcopies, 167 of 224 (75 percent) were completed. Women with high-grade squamous intraepithelial lesions were more likely to obtain recommended colposcopy than were women with low-grade squamous intraepithelial lesions. Women treated at clinics that referred patients to outside providers for colposcopy were more likely to have colposcopy than were those who were offered the procedure on site. CONCLUSIONS: The proportion of Pacific Northwest American Indian and Alaska Native women in Indian Health Service and tribal clinics with abnormal Papanicolaou smears and the proportion who receive colposcopy are similar to those in other populations. The higher rate of cervical cancer mortality among American Indian and Alaska Native women could be due to failure to screen high-risk women. Cytologic screening rates, methods to improve adherence to colposcopy recommendations, and the contribution of other factors to the cause of cervical cancer mortality need to be characterized in this population.
PubMed ID
7618496 View in PubMed
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Acculturation and cancer information preferences of Spanish-speaking immigrant women to Canada: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature147531
Source
Health Care Women Int. 2009 Dec;30(12):1131-51
Publication Type
Article
Date
Dec-2009
Author
Maria D Thomson
Laurie Hoffman-Goetz
Author Affiliation
Faculty of Applied Health Sciences, Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada.
Source
Health Care Women Int. 2009 Dec;30(12):1131-51
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Acculturation
Adult
Communication Barriers
Cultural Characteristics
Emigrants and Immigrants - psychology
Female
Health Behavior - ethnology
Health Knowledge, Attitudes, Practice
Hispanic Americans - psychology
Humans
Middle Aged
Neoplasms - ethnology - prevention & control - psychology
Ontario
Patient Acceptance of Health Care - ethnology
Questionnaires
Social Change
Socioeconomic Factors
Women's Health - ethnology
Young Adult
Abstract
To explore the cancer information preferences of immigrant women by their level of acculturation we conducted interviews with 34 Spanish-speaking English-as-a-second-language (ESL) women. Chi-square and Fisher's exact tests were used to look for differences by acculturation. Four themes were identified: What is prevention? What should I do; sources of my cancer information, strategies I use to better understand, and identifying and closing my health knowledge gaps. Acculturation did not differentiate immigrant women's cancer information sources, preferences, or strategies used to address language barriers. We suggest the effect of acculturation is neither direct nor simple and may reflect other factors including self-efficacy.
PubMed ID
19894155 View in PubMed
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Addressing the realities [correction of realties] of health care in northern aboriginal communities through participatory action research.

https://arctichealth.org/en/permalink/ahliterature175481
Source
J Interprof Care. 2004 Nov;18(4):360-8
Publication Type
Article
Date
Nov-2004
Author
Bruce Minore
Margaret Boone
Mae Katt
Peggy Kinch
Stephen Birch
Author Affiliation
Center for Rural and Northern Health Research, Lakehead University, Thunder Bay, Ontario, Canada. bruce.minore@lakeheadu.ca
Source
J Interprof Care. 2004 Nov;18(4):360-8
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Community Health Services - economics - supply & distribution
Consumer Participation
Continuity of Patient Care - economics - organization & administration
Diabetes Mellitus - ethnology - therapy
Female
Health Services Accessibility - organization & administration
Humans
Indians, North American
Male
Mental Health Services - supply & distribution
Neoplasms - ethnology - therapy
Rural Health Services - economics - supply & distribution
Abstract
To address concerns about disruptions in the continuity of health care delivered to residents in three remote aboriginal communities in northern Ontario, Canada, the local health authority initiated a study in collaboration with the department of Health Canada responsible for ensuring that aboriginal reserves receive mandatory health services, and an inter-disciplinary team of researchers from two universities. The study focussed on the delivery of oncology, diabetes and mental health care, specifically, as well as systems issues such as recruitment and retention of health human resources and financial costs. The paper discusses the procedures involved, the benefits derived and the challenges encountered in doing this as a community driven participatory action research project. It also summarizes the findings that led to community formulated policy and program recommendations.
PubMed ID
15801551 View in PubMed
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Alaska Native cancer epidemiology in the Arctic.

https://arctichealth.org/en/permalink/ahliterature3515
Source
Public Health. 1998 Jan;112(1):7-13
Publication Type
Article
Date
Jan-1998
Author
R J Bowerman
Author Affiliation
Department of Health and Social Services, Barrow, Alaska 99723, USA.
Source
Public Health. 1998 Jan;112(1):7-13
Date
Jan-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska - epidemiology
Child
Child, Preschool
Environmental Exposure - adverse effects
Female
Humans
Incidence
Infant
Infant, Newborn
Inuits
Lung Neoplasms - ethnology - etiology
Male
Middle Aged
Neoplasms - ethnology - etiology
Risk factors
Smoking - adverse effects
Abstract
Cancer incidence and its possible relation to environmental contaminants, including radiation, continues to be a perceived health threat for the arctic-dwelling Alaska Native (Inupiat Eskimo) people despite the lack of a direct link to high-dose exposure. To better understand this concern, all known malignancies diagnosed in this population (n = 177) in three consecutive eight-year periods (1971-1994) were evaluated. The most recent average incidence rate (age-adjusted to world standard population) of 315 per 100,000 (95% confidence interval, CI = 248-382) represents a 33% surge (albeit non-significant) in Alaska Native cancer incidence over the initial period studied. The male rate 366 (95% CI = 266-466) for the same period exceeds the female rate 258 (95% CI = 169-347) by 42%. Two patterns of cancer incidence are seen at the village level. One, a 24 y upward trend found in the villages of Barrow, Point Hope and Kaktovik (combined rate of increase significant [P = 0.047]) associated with lung cancer; and the other, a stable trend over the past 16 y, associated with colon and rectal cancer. Lung cancer is the predominant cancer by site and is primarily a male disease. The recent male lung cancer incidence rate of 137 (95% CI = 73-201) exceeds the female rate by greater than five times. Total lung cancer cases are primarily confined to four villages where the incidence significantly (P = 0.0043) exceeds the remaining population. The major female cancers are colon/rectal and breast with cancer of the cervix virtually eliminated. Breast cancer is found primarily in two villages where its excess is significant (P = 0.025). Inupiat Eskimo cancer epidemiology is unique, differing from both the Alaska Native and other Circumpolar populations. At present, this uniqueness cannot be explained by an overt environmental contaminant exposure. Although tobacco very likely plays a central role, it by itself cannot fully explain the extremely high male lung cancer rate and why only specific villages are affected. Genetic predisposition and environmental factors may play a synergistic role as cofactors. A cooperative investigative effort with the Inupiat population is indicated and may go a long way in reducing cancer concern in the region.
PubMed ID
9490882 View in PubMed
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Alaskan teenagers receive awards for work to counter chew and snuff.

https://arctichealth.org/en/permalink/ahliterature1537
Source
Journal of the National Cancer Institute. 1989 Jun 21;81(12):894-896.
Publication Type
Article
Date
1989
Author
Mahaney, Jr., F.X.
Source
Journal of the National Cancer Institute. 1989 Jun 21;81(12):894-896.
Date
1989
Language
English
Geographic Location
U.S.
Publication Type
Article
Physical Holding
Alaska Medical Library
Keywords
Levelock
St. Michael
Point Hope
Barrow
Tobacco, chewing
Snuff
Smoking
Adolescent
Alaska
Awards and Prizes
Child
Child, Preschool
Female
Humans
Inuits
Male
Neoplasms - ethnology - prevention & control
Plants, Toxic
Tobacco
Tobacco, Smokeless
Notes
From: Fortuine, Robert et al. 1993. The Health of the Inuit of North America: A Bibliography from the Earliest Times through 1990. University of Alaska Anchorage. Citation 2365.
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All-cause, cardiovascular, and cancer mortality in western Alaska Native people: western Alaska Tribal Collaborative for Health (WATCH).

https://arctichealth.org/en/permalink/ahliterature103040
Source
Am J Public Health. 2014 Jul;104(7):1334-40
Publication Type
Article
Date
Jul-2014
  1 document  
Author
Barbara V Howard
Jesse S Metzger
Kathryn R Koller
Stacey E Jolly
Elvin D Asay
Hong Wang
Abbie W Wolfe
Scarlett E Hopkins
Cristiane Kaufmann
Terry W Raymer
Brian Trimble
Ellen M Provost
Sven O E Ebbesson
Melissa A Austin
William James Howard
Jason G Umans
Bert B Boyer
Author Affiliation
Barbara V. Howard, Hong Wang, and Jason G. Umans are with the MedStar Health Research Institute, Hyattsville, MD. Jesse S. Metzger is with the University of Alaska, Anchorage. Kathryn R. Koller, Elvin D. Asay, Abbie W. Wolfe, and Ellen M. Provost are with the Alaska Native Tribal Health Consortium Division of Community Health Services, Anchorage. Stacey E. Jolly is with the Cleveland Clinic Medicine Institute, Cleveland, OH. Scarlett E. Hopkins, Cristiane Kaufmann, and Bert B. Boyer are with the University of Alaska Fairbanks Center for Alaska Native Health Research. Terry W. Raymer and Brian Trimble are with the Alaska Native Medical Center, Anchorage. Sven O.?E. Ebbesson is with the Norton Sound Health Corporation, Nome, AK. Melissa A. Austin is with the Department of Epidemiology, University of Washington, Seattle. William James Howard is with the MedStar Washington Hospital Center, Washington, DC.
Source
Am J Public Health. 2014 Jul;104(7):1334-40
Date
Jul-2014
Language
English
Geographic Location
U.S.
Publication Type
Article
File Size
611632
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Alaska - epidemiology
Cardiovascular Diseases - ethnology - mortality
Cause of Death
Female
Health Surveys
Humans
Male
Middle Aged
Mortality - ethnology
Neoplasms - ethnology - mortality
Young Adult
Abstract
We determined all-cause, cardiovascular disease (CVD), and cancer mortality in western Alaska Native people and examined agreement between death certificate information and adjudicated cause of deaths.
Data from 4 cohort studies were consolidated. Death certificates and medical records were reviewed and adjudicated according to standard criteria. We compared adjudicated CVD and cancer deaths with death certificates by calculating sensitivity, specificity, predictive values, and ? statistics.
Men (n = 2116) and women (n = 2453), aged 18 to 95 years, were followed an average of 6.7 years. The major cause of death in men was trauma (25%), followed by CVD (19%) and cancer (13%). The major cause of death in women was CVD (24%), followed by cancer (19%) and trauma (8%). Stroke rates in both genders were higher than those of US Whites. Only 56% of deaths classified as CVD by death certificate were classified as CVD by standard criteria; discordance was higher among men (55%) than women (32%; ?s = 0.4 and 0.7).
We found lower rates for coronary heart disease death but high rates of stroke mortality. Death certificates overestimated CVD mortality; concordance between the 2 methods is better for cancer mortality. The results point to the importance of cohort studies in this population in providing data to assist in health care planning.
PubMed ID
24754623 View in PubMed
Documents
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American Indian and Alaska Native Cancer Patients' Perceptions of a Culturally Specific Patient Navigator Program.

https://arctichealth.org/en/permalink/ahliterature289968
Source
J Prim Prev. 2017 Apr; 38(1-2):121-135
Publication Type
Journal Article
Date
Apr-2017
Author
Carol Grimes
Jenine Dankovchik
Megan Cahn
Victoria Warren-Mears
Author Affiliation
Northwest Portland Area Indian Health Board, 918 NE Rosa Parks Way, Portland, OR, 97211, USA.
Source
J Prim Prev. 2017 Apr; 38(1-2):121-135
Date
Apr-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Alaska Natives - psychology
Attitude to Health - ethnology
Cultural Competency
Female
Humans
Idaho
Indians, North American - psychology
Interviews as Topic
Male
Middle Aged
Models, organizational
Neoplasms - ethnology - psychology
Oregon
Patient Navigation - methods - organization & administration - standards
Patient Satisfaction - ethnology
Qualitative Research
Young Adult
Abstract
Lack of access to care, funding limitations, cultural, and social barriers are challenges specific to tribal communities that have led to adverse cancer outcomes among American Indians/Alaska Natives (AI/AN). While the cancer navigator model has been shown to be effective in other underserved communities, it has not been widely implemented in Indian Country. We conducted in-depth interviews with 40 AI/AN patients at tribal clinics in Idaho and Oregon. We developed the survey instrument in partnership with community members to ensure a culturally appropriate semi-structured questionnaire. Questions explored barriers to accessing care, perceptions of the navigator program, satisfaction, and recommendations. AI/AN cancer patients reported physical, emotional, financial, and transportation barriers to care, but most did not feel there were any cultural barriers to receiving care. Navigator services most commonly used included decision making, referrals, transportation, scheduling appointments, and communication. Satisfaction with the program was high. Our study provides a template to develop a culturally appropriate survey instrument for use with an AI/AN population, which could be adapted for use with other indigenous patient populations. Although our sample was small, our qualitative analysis facilitated a deeper understanding of the barriers faced by this population and how a navigator program may best address them. The results reveal the strengths and weakness of this program, and provide baseline patient satisfaction numbers which will allow future patient navigator programs to better create evaluation benchmarks.
Notes
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PubMed ID
27838858 View in PubMed
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American Indian cancer survivors: exploring social network topology and perceived social supports.

https://arctichealth.org/en/permalink/ahliterature3871
Source
J Cancer Educ. 2005;20(1 Suppl):23-7
Publication Type
Article
Date
2005
Author
Joseph E Bauer
Jessica J Englert
Arthur M Michalek
Patricia Canfield
Martin C Mahoney
Author Affiliation
Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Buffalo, NY 14623, USA. Joseph.Bauer@RoswellPark.org
Source
J Cancer Educ. 2005;20(1 Suppl):23-7
Date
2005
Language
English
Publication Type
Article
Keywords
Aged
Family
Female
Humans
Indians, North American - psychology
Male
Middle Aged
Neoplasms - ethnology - psychology
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Social Support
Survivors - psychology
Abstract
BACKGROUND: The literature on social networks and social supports attests to the powerful influence of social relationships on health; there is a dearth of such studies with American Indians/Alaska Natives. METHOD: This exploratory study assesses the social network topology and perceived social supports received among American Indian cancer survivors and matched controls. RESULTS: Although there did not appear to be marked differences overall among cases and controls, expressive social supports (eg, companionship, moral support, encouragement, advice, and friendship) were ranked highly across each component of the network. CONCLUSIONS: The family appears to be the principal source of social supports relative to either best/closest friend or church/community.
PubMed ID
15916516 View in PubMed
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American Indian families and home care: macro social and cultural considerations.

https://arctichealth.org/en/permalink/ahliterature4072
Source
Alaska Med. 1995 Oct-Dec;37(4):139-41
Publication Type
Article
Author
B J Kramer
Author Affiliation
Sepulveda Veterans Health Administration Medical Center.
Source
Alaska Med. 1995 Oct-Dec;37(4):139-41
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alaska
Comparative Study
Cross-Cultural Comparison
Cultural Characteristics
Female
Forecasting
Health Services Needs and Demand - trends
Home Care Services - trends
Humans
Indians, North American
Male
Middle Aged
Neoplasms - ethnology - rehabilitation
Patient Care Team - trends
Abstract
Administration on Aging and the Indian Health Service are developing or examining the feasibility of programs to support home health care on reservations and American Indian colleges are training home care paraprofessionals to provide high quality home care for frail American Indian elders. Home care links formal and informal systems of health care and is affected by social and cultural issues. These macro-level considerations provide a context for home care of cancer patients and are the focus of this article.
PubMed ID
8742158 View in PubMed
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274 records – page 1 of 28.