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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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A National Study of American Indian and Alaska Native Substance Abuse Treatment: Provider and Program Characteristics.

https://arctichealth.org/en/permalink/ahliterature287548
Source
J Subst Abuse Treat. 2016 Sep;68:46-56
Publication Type
Article
Date
Sep-2016
Author
Traci Rieckmann
Laurie A Moore
Calvin D Croy
Douglas K Novins
Gregory Aarons
Source
J Subst Abuse Treat. 2016 Sep;68:46-56
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Alaska Natives
Evidence-Based Practice
Female
Health Care Surveys
Health Services Accessibility
Healthcare Disparities - ethnology
Humans
Indians, North American
Male
Program Evaluation
Quality of Health Care
Rural Health Services - organization & administration - standards
Substance Abuse Treatment Centers - organization & administration - standards
Substance-Related Disorders - rehabilitation
Suburban Health Services - organization & administration - standards
Urban Health Services - organization & administration - standards
Abstract
American Indians and Alaska Natives (AIANs) experience major disparities in accessing quality care for mental health and substance use disorders. There are long-standing concerns about access to and quality of care for AIANs in rural and urban areas including the influence of staff and organizational factors, and attitudes toward evidence-based treatment for addiction. We conducted the first national survey of programs serving AIAN communities and examined workforce and programmatic differences between clinics located in urban/suburban (n=50) and rural (n=142) communities. We explored the correlates of openness toward using evidence-based treatments (EBTs). Programs located in rural areas were significantly less likely to have nurses, traditional healing consultants, or ceremonial providers on staff, to consult outside evaluators, to use strategic planning to improve program quality, to offer pharmacotherapies, pipe ceremonies, and cultural activities among their services, and to participate in research or program evaluation studies. They were significantly more likely to employ elders among their traditional healers, offer AA-open group recovery services, and collect data on treatment outcomes. Greater openness toward EBTs was related to a larger clinical staff, having addiction providers, being led by directors who perceived a gap in access to EBTs, and working with key stakeholders to improve access to services. Programs that provided early intervention services (American Society of Addiction Medicine level 0.5) reported less openness. This research provides baseline workforce and program level data that can be used to better understand changes in access and quality for AIAN over time.
PubMed ID
27431046 View in PubMed
Less detail