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Use of biomedical services and traditional healing options among American Indians: sociodemographic correlates, spirituality, and ethnic identity.

https://arctichealth.org/en/permalink/ahliterature179513
Source
Med Care. 2004 Jul;42(7):670-9
Publication Type
Article
Date
Jul-2004
Author
Douglas K Novins
Janette Beals
Laurie A Moore
Paul Spicer
Spero M Manson
Author Affiliation
douglas.novins@uchsc.edu
Source
Med Care. 2004 Jul;42(7):670-9
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Female
Health Care Surveys
Health Services, Indigenous - utilization
Humans
Indians, North American - psychology - statistics & numerical data
Logistic Models
Male
Medicine, Traditional
Mental Disorders - ethnology - therapy
Middle Aged
Multivariate Analysis
Socioeconomic Factors
Southwestern United States
United States
Abstract
The objective of this study was to describe the use of biomedical services and traditional healing options among a reservation-based sample of American Indians from 2 culturally distinct tribes
Participants were 2595 American Indian adolescents and adults ages 15 to 57 randomly selected to represent 2 tribes living on or near their rural reservations. First, we examined the prevalence and correlates of use of biomedical services and traditional healing for both physical health and psychiatric problems. Second, we developed logistic regression models predicting the independent and combined use of biomedical services and traditional healing
The prevalence of combined and independent use of biomedical services and traditional healing varied by tribe. The prevalence of biomedical service use ranged from 40.9% to 59.1% for physical health problems and 6.4% to 6.8% for psychiatric problems. The prevalence of the use of traditional healing ranged from 8.4% to 22.9% for physical health problems and 3.2% to 7.8% for psychiatric problems. Although combined use of both types of services was common (10.4-22.6% of service users), many used only traditional healing (3.5-40.0%). Correlates of service use included age, educational level, and ethnic identity. For example, use of traditional healing was correlated with higher scores on a scale measuring identification with American Indian culture
Both biomedical services and traditional healing are important sources of care in American Indian communities, and are used both independently and in combination with one another.
PubMed ID
15213492 View in PubMed
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Rehabilitation challenges for Aboriginal clients recovering from brain injury: a qualitative study engaging health care practitioners.

https://arctichealth.org/en/permalink/ahliterature152713
Source
Brain Inj. 2009 Mar;23(3):250-61
Publication Type
Article
Date
Mar-2009
Author
Michelle L Keightley
Ruwan Ratnayake
Bruce Minore
Mae Katt
Anita Cameron
Randy White
Alice Bellavance
Claudine Longboat-White
Angela Colantonio
Author Affiliation
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada. michelle.keightley@utoronto.ca
Source
Brain Inj. 2009 Mar;23(3):250-61
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attitude of Health Personnel - ethnology
Brain Injuries - epidemiology - ethnology - rehabilitation
Continuity of Patient Care
Cultural Diversity
Female
Health Services, Indigenous - standards
Humans
Male
Middle Aged
Patient compliance
Qualitative Research
Young Adult
Abstract
To explore the experiences of health care practitioners working with Aboriginal clients recovering from acquired brain injury (ABI).
Participatory research design using qualitative methods.
Fourteen in-depth, semi-structured interviews were conducted. The Framework Method of analysis was used to uncover emerging themes.
Five main categories emerged: practitioners' experience with brain injury, practitioners' experience with Aboriginal clients, specialized needs of Aboriginal clients recovering from brain injury, culturally sensitive care and traditional healing methods. These categories were then further divided into emergent themes and sub-themes where applicable, with particular emphasis on the specialized needs of Aboriginal clients.
Each emergent theme highlighted key challenges experienced by Aboriginal peoples recovering from ABI. A key challenge was that protocols for rehabilitation and discharge planning are often lacking for clients living on reserves or in remote communities. Other challenges included lack of social support; difficulty of travel and socio-cultural factors associated with post-acute care; and concurrent disorders.
Results suggest that developing reasonable protocols for discharge planning of Aboriginal clients living on reserves and/or remote communities should be considered a priority.
PubMed ID
19205962 View in PubMed
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From health care to home community: an Aboriginal community-based ABI transition strategy.

https://arctichealth.org/en/permalink/ahliterature138013
Source
Brain Inj. 2011;25(2):142-52
Publication Type
Article
Date
2011
Author
Michelle Keightley
Victoria Kendall
Shu-Hyun Jang
Cindy Parker
Sabrina Agnihotri
Angela Colantonio
Bruce Minore
Mae Katt
Anita Cameron
Randy White
Claudine Longboat-White
Alice Bellavance
Author Affiliation
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada. michelle.keightley@utoronto.ca
Source
Brain Inj. 2011;25(2):142-52
Date
2011
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Brain Injuries - ethnology - rehabilitation
Community Health Services - standards
Continuity of Patient Care - standards
Female
Focus Groups
Health Services Accessibility
Health Services, Indigenous - standards
Humans
Longitudinal Studies
Male
Ontario
Patient Discharge
Prospective Studies
Qualitative Research
Self Report
Abstract
To explore the barriers and enablers surrounding the transition from health care to home community settings for Aboriginal clients recovering from acquired brain injuries (ABI) in northwestern Ontario.
Participatory research design using qualitative methods.
Focus groups conducted with clients with ABI, their caregivers and hospital and community health-care workers. The Framework Method of analysis was used to uncover emerging themes.
Six main categories emerged: ABI diagnosis accuracy, acute service delivery and hospital care, transition from hospital to homecare services, transition from hospital to community services, participant suggestions to improve service delivery and transition, and views on traditional healing methods during recovery.
A lack of awareness, education and resources were acknowledged as key challenges to successful transitioning by clients and healthcare providers. Geographical isolation of the communities was highlighted as a barrier to accessibility of services and programmes, but the community was also regarded as an important source of social support. The development of educational and screening tools and needs assessments of remote communities were identified to be strategies that may improve transitions.
Findings demonstrate that the structure of rehabilitation and discharge processes for Aboriginal clients living on reserves or in remote communities are of great concern and warrants further research.
PubMed ID
21219087 View in PubMed
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Rural American Indian and Alaska Native veterans' telemental health: A model of culturally centered care.

https://arctichealth.org/en/permalink/ahliterature285035
Source
Psychol Serv. 2017 Aug;14(3):270-278
Publication Type
Article
Date
Aug-2017
Author
Cynthia W Goss
W J Buck Richardson
Nancy Dailey
Byron Bair
Herbert Nagamoto
Spero M Manson
Jay H Shore
Source
Psychol Serv. 2017 Aug;14(3):270-278
Date
Aug-2017
Language
English
Publication Type
Article
Abstract
American Indian and Alaska Native (AI/AN) veterans living in rural areas have unique health care needs and face numerous barriers to accessing health care services. Among these needs is a disproportionate prevalence of posttraumatic stress disorder and other mental illnesses. Since 2001, 14 rural communities have partnered with the U.S. Department of Veterans Affairs and the Centers for American Indian and Alaska Native Health at the University of Colorado Anschutz Medical Campus to extend telemental health clinics to American Indian veterans. Administrative and, to some extent, clinical considerations of these clinics have been reviewed previously. This paper describes a model of care, evolved over a 14-year period, that weaves together evidence-based Western treatment, traditional Native healing, and rural Native communities into 4 main components: mental health care, technology, care coordination, and cultural facilitation. We delineate improvements to care made by addressing barriers such as system transference, provider-patient trust, and videoconferencing. Similarly, the discussion notes ways that the care model leverages strengths within Native communities, such as social cohesion and spirituality. Future steps include selection of appropriate performance indicators for systematic evaluation. The identification of key constructs of this care model will facilitate comparisons with other models of care in underserved populations with chronic and complex health conditions, and eventually advance the state of care for our warriors. (PsycINFO Database Record
PubMed ID
28805411 View in PubMed
Less detail

Rural American Indian and Alaska Native veterans' telemental health: A model of culturally centered care.

https://arctichealth.org/en/permalink/ahliterature291579
Source
Psychol Serv. 2017 Aug; 14(3):270-278
Publication Type
Journal Article
Date
Aug-2017
Author
Cynthia W Goss
W J Buck Richardson
Nancy Dailey
Byron Bair
Herbert Nagamoto
Spero M Manson
Jay H Shore
Author Affiliation
Veterans Rural Health Resource Center.
Source
Psychol Serv. 2017 Aug; 14(3):270-278
Date
Aug-2017
Language
English
Publication Type
Journal Article
Keywords
Alaska Natives
Culturally Competent Care
Health Services Accessibility
Health services needs and demand
Humans
Indians, North American
Mental health services
Models, Theoretical
Rural Population
Stress Disorders, Post-Traumatic - psychology - therapy
Telemedicine
United States
United States Department of Veterans Affairs
Veterans - psychology
Veterans Health
Abstract
American Indian and Alaska Native (AI/AN) veterans living in rural areas have unique health care needs and face numerous barriers to accessing health care services. Among these needs is a disproportionate prevalence of posttraumatic stress disorder and other mental illnesses. Since 2001, 14 rural communities have partnered with the U.S. Department of Veterans Affairs and the Centers for American Indian and Alaska Native Health at the University of Colorado Anschutz Medical Campus to extend telemental health clinics to American Indian veterans. Administrative and, to some extent, clinical considerations of these clinics have been reviewed previously. This paper describes a model of care, evolved over a 14-year period, that weaves together evidence-based Western treatment, traditional Native healing, and rural Native communities into 4 main components: mental health care, technology, care coordination, and cultural facilitation. We delineate improvements to care made by addressing barriers such as system transference, provider-patient trust, and videoconferencing. Similarly, the discussion notes ways that the care model leverages strengths within Native communities, such as social cohesion and spirituality. Future steps include selection of appropriate performance indicators for systematic evaluation. The identification of key constructs of this care model will facilitate comparisons with other models of care in underserved populations with chronic and complex health conditions, and eventually advance the state of care for our warriors. (PsycINFO Database Record
PubMed ID
28805411 View in PubMed
Less detail