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Pedersen M, Harris KJ, Brown B, Anderson K, Lewis JP. A Systematic Review of Interventions to Increase Physical Activity Among American Indian and Alaska Native Older Adults. THE GERONTOLOGIST 2022; 62:e328-e339. [PMID: 33605417 PMCID: PMC9335984 DOI: 10.1093/geront/gnab020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Physical activity (PA) is a powerful protective factor known to reduce risk for chronic conditions across the life span. PA levels are lower among American Indians and Alaska Natives (AIANs) when compared with other racial/ethnic groups and decrease with age. This evidence justifies a synthesis of current intervention research to increase PA levels among AIANs. This systematic review examines completed interventions to increase PA among AIAN older adults and considers recommended practices for research with Indigenous communities. RESEARCH DESIGN AND METHODS The systematic review was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement for systematic review protocols and reporting guidelines. Three electronic databases, PubMed, Web of Science, and PsycINFO, were searched for academic literature. Trials investigating interventions to increase PA among AIAN adults older than 50 years were eligible. The Quality Assessment Tool for Quantitative Studies was used to evaluate the quality of evidence. RESULTS Three published trials were identified, including one group-level, clinic-based and two individual-level, home-based interventions. All were 6 weeks in duration, took place in urban areas, and used self-report PA measures. Findings indicated an overall increase in PA levels, improved PA-related outcomes, and improved psychosocial health among participants. None described community-engaged or culture-centered research strategies. DISCUSSION AND IMPLICATIONS The narrow yet promising evidence represents a need for expanded research and a call to action for using culture-centered strategies. An advanced understanding of cultural and contextual aspects of PA may produce more impactful interventions, supporting health and mobility across the life span.
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Affiliation(s)
- Maja Pedersen
- School of Public and Community Health Sciences, University of
Montana, Missoula, Montana, USA
| | - Kari Jo Harris
- School of Public and Community Health Sciences, University of
Montana, Missoula, Montana, USA
| | - Blakely Brown
- School of Public and Community Health Sciences, University of
Montana, Missoula, Montana, USA
| | - Keith Anderson
- School of Social Work, University of Texas at Arlington,
Arlington, Texas, USA
| | - Jordan P Lewis
- Department of Medicine and Biobehavioral Health, University of
Minnesota, Minnesota, Duluth, USA
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Having a Say in Research Directions: The Role of Community Researchers in Participatory Research with Communities of Refugee and Migrant Background. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084844. [PMID: 35457711 PMCID: PMC9024418 DOI: 10.3390/ijerph19084844] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 12/10/2022]
Abstract
Research teams in high-income countries often fail to acknowledge the capacity and contributions of Community Researchers. This qualitative exploratory study used decolonising methodology and the Foundation House ‘Refugee Recovery Framework’ to understand Community Researchers’ perceptions and experiences of their role, and how research teams can integrate the knowledge they bring into research. Purposive sampling was used to facilitate the recruitment of eight Community Researchers from five different community groups working in Melbourne, Victoria. Semi-structured interviews lasting forty to sixty minutes occurred between December 2020 and January 2021. Data were analysed using reflexive thematic analysis. Findings reported in this paper include eight themes: ‘nothing about us without us’; ‘open the door’; a safe space to share; every step of the way; this does not translate; finding the right way to ask; a trauma-informed approach; and support within the workplace. The knowledge obtained demonstrates that Community Researchers facilitate meaningful participation in research for women, families, and communities of refugee or migrant background. Community Researchers’ presence, knowledge, and skills are vital in establishing culturally safe research practices and developing accessible language to facilitate conversations about sensitive research topics across multiple languages. Community Researchers can make important contributions at all stages of research, including data collection and interpretation.
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Pedersen M, Harris KJ, Brown B, Grant M, Kleinmeyer C, Glass A, Graham N, King DK. Physical Activity Intervention Adaptation: Recommendations from Rural American Indian Older Adults. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1067-1077. [PMID: 35092521 DOI: 10.1007/s11121-022-01342-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 12/11/2022]
Abstract
Preventive interventions are critical to improving health equity among American Indian (AI) populations, yet interventions that promote physical activity (PA) among AI populations are scarce. This research addresses the research-to-practice gap by informing the adaption and implementation process of evidence-based interventions (EBIs) among rural AI older adults. We used a community-based approach and an Indigenous-focused adaptation theoretical framework. Qualitative, semi-structured interviews elicited detailed information on preferences for PA intervention among rural AI older adults. We applied a collaborative directed content analysis strategy, and established trustworthiness and relevance using an inter-rater reliability process and member checking. We conducted 21 interviews, all participants identified as AI, the mean age was 66 years (SD = 7.6), and 57% were female. Themes characterized contextual and cultural intervention considerations for adapting and implementing evidence-based PA interventions in rural AI older adults. Key findings included an emphasis on social and community interaction, strategies for targeted engagement, preference for group format, pairing PA sessions with shared meals, and inclusiveness in the PA intervention across ability levels and age groups. This study identified opportunities for adaptation of PA-focused EBIs among rural AI older adults. Findings can be applied to support the adaptation and implementation of effective and relevant PA-focused preventive interventions among this population which is at high risk for chronic disease and health disparities.
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Affiliation(s)
- Maja Pedersen
- Stanford Prevention Research Center, Stanford School of Medicine, Stanford University, Stanford, USA.
| | - Kari Jo Harris
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
| | - Blakely Brown
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
| | - Mattea Grant
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
| | - Chelsea Kleinmeyer
- Community Health Division, Confederated Salish and Kootenai Tribal Health Department, Saint Ignatius, Montana, USA
| | - Ashley Glass
- Community Health Division, Confederated Salish and Kootenai Tribal Health Department, Saint Ignatius, Montana, USA
| | - Niki Graham
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
| | - Diane K King
- Center for Behavioral Health Research and Services, Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, USA
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Landy R, Worthington C. "Do something with them!": developing "comfortable" engagement with Elders participating in an arts-based sexual health promotion and STBBI prevention workshop for Indigenous Youth in Labrador, Canada. Int J Circumpolar Health 2021; 80:1986250. [PMID: 34720064 PMCID: PMC8567953 DOI: 10.1080/22423982.2021.1986250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Although Indigenous Elders were traditionally involved in cross-generational health promotion and education, colonisation disrupted this role. Little research examines the role of Elders in contemporary health promotion for Indigenous youth and few strategies have been identified to engage Elders in health promotion or sexual health education. We explored engagement of Elders through participatory filmmaking in a sexual health and HIV education workshop for youth. Eleven youth and five Elders participated in this 3.5-day workshop. During the workshop, Elders indicated they wanted to make a film and attend a sexual health and HIV education session. Four Elders were interviewed about their experiences. Interview transcripts and the Elders’ film were analysed using content analysis. Although Elders initially felt hesitant to engage, the process of participatory filmmaking allowed Elders to co-create an environment for their “comfortable” workshop engagement. Elders’ feelings of comfort were created by having control and sense of ownership over their engagement; the presence of youth; peer-based dialogue; inclusion of traditional items; and an Indigenous sexual health educator. Findings suggest participatory filmmaking is a promising approach for engaging and empowering Elders to reclaim traditional roles in sexual health education and health promotion with Indigenous youth.
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Affiliation(s)
- Rachel Landy
- Department of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
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Pedersen M, Harris KJ, Lewis J, Grant M, Kleinmeyer C, Glass A, Graham N, Brown B, King D. Uplifting the voices of rural American Indian older adults to improve understanding of physical activity behavior. Transl Behav Med 2021; 11:1655-1664. [PMID: 34347863 DOI: 10.1093/tbm/ibab107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
American Indian (AI) older adults experience pronounced health disparities and demonstrate one of the lowest levels of physical activity (PA) among racial and ethnic groups. Nearly half of AI older adults live in rural areas, indicating distinct challenges to participation in PA. Research to identify factors influencing PA in this population is missing from the literature, yet is critical to informing culturally relevant PA intervention development and implementation. The purpose was to identify barriers to and facilitators of PA among rural AI older adults using the ecological model and qualitative methods. A community-based approach was used to conduct semi-structured interviews with rural AI older adults. Interview questions were based on a multi-level ecological model. Content analysis was performed, using an iterative coding process to identify findings. The mean age of participants (n = 21) was 66 years. Barriers to and facilitators of PA were identified across ecological model levels. Barriers included factors such as caregiving and community responsibilities, lack of acceptable areas for walking, and overall lack of community-level support for older adult health. Facilitators included a personal connection to the land and ancestors through PA, multigenerational participation, and supportive tribal policies. This study addressed a gap in the literature by identifying barriers to and facilitators of PA among rural AI older adults, which can inform PA intervention development. With barriers and facilitators identified by AI older adults themselves, the voices of those directly affected are uplifted to shape efforts toward addressing longstanding health disparities through relevant public health interventions.
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Affiliation(s)
- Maja Pedersen
- Stanford Prevention Research Center, Stanford University, Stanford, CA 94305, USA
| | - Kari Jo Harris
- School of Public and Community Health Sciences, University of Montana, Missoula, MT 59812, USA
| | - Jordan Lewis
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Duluth, MN, USA
| | - Mattea Grant
- School of Public and Community Health Sciences, University of Montana, Missoula, MT 59812, USA
| | | | - Ashley Glass
- Confederated Salish and Kootenai Tribal Health Department, MT, USA
| | - Niki Graham
- School of Public and Community Health Sciences, University of Montana, Missoula, MT 59812, USA
| | - Blakely Brown
- School of Public and Community Health Sciences, University of Montana, Missoula, MT 59812, USA
| | - Diane King
- Center for Behavioral Health Research and Services, University of Alaska Anchorage, AK, USA
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Eades O, Toombs MR, Cinelli R, Easton C, Hampton R, Nicholson GC, McCabe MP, Busija L. The Path to Eldership: Results from a Contemporary Indigenous Australian Community. THE GERONTOLOGIST 2021; 62:607-615. [PMID: 33978151 DOI: 10.1093/geront/gnab062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Traditionally, Elders have held a unique social position within Indigenous Australian communities. This study aimed to identify the characteristics of Indigenous Elders that distinguish them from other people in their community. RESEARCH DESIGN AND METHODS Using a community-based participatory research approach, the study was conducted in a regional Indigenous community in Southeast Queensland. The design and data collection methods were informed through a community forum, known as a 'Yarning Circle'. One-on-one semi-structured interviews and focus groups with community members were carried out by Indigenous researchers. Data were analysed in NVivo software, using thematic analysis (TA), with themes derived directly from data. RESULTS Fifty individuals participated in the study. The participants' median age was 45 years (range 18-76 years) and 31 (62%) were female. TA identified three overarching themes related to Elders' attributes: (1) distinguishing characteristics of Elders (sub-themes of respect, leadership, reciprocity, life experience, approachability, connection to traditional culture, transmitting knowledge through generations): (2) how one becomes an Elder (earnt eldership, permanency of eldership, mentors and role models, age); and (3) threats to Elders' influence (intergenerational gap, community disconnect, and cultural trauma). DISCUSSION AND IMPLICATIONS Our results build a greater understanding of the contemporary role of Indigenous Australian Elders, which will inform the development of future interventions directed at strengthening Elders' role in their communities.
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Affiliation(s)
- Owen Eades
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Maree R Toombs
- School of Public Health, Faculty of Medicine, The University of Queensland, Heston, Queensland, Australia
| | - Renata Cinelli
- Faculty of Education and Arts, Australian Catholic University, Strathfield, New South Wales, Australia
| | - Caitlin Easton
- Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Queensland, Australia
| | - Ron Hampton
- Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Queensland, Australia
| | - Geoffrey C Nicholson
- Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Queensland, Australia
| | - Marita P McCabe
- Health and Ageing Group, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Lucy Busija
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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George A, Villarosa AR, Ingram S, Fatema K, Elliott K, Grace R, Kemp L, Scharkie S, Anderson C, Bucknall N, Wright DC, Comino E. Oral health status, behaviours, food and beverage consumption of aboriginal children in Australia. Health Promot J Austr 2020; 32:208-215. [PMID: 32338802 DOI: 10.1002/hpja.354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open
Abstract
ISSUE ADDRESSED Dental decay is prevalent among Australian Aboriginal children, yet little is known about their oral health-related behaviours. This study explored the oral health status, behaviours, food and beverage consumption of Aboriginal school children aged 7-9 years in Sydney, Australia. METHODS Parents who were part of an existing longitudinal birth cohort ("Gudaga") were surveyed when their child was between 7 and 9 years. Children (n = 110) also received oral health screening by a trained nurse. RESULTS A number of children (62%-91%) had at least one visible oral health problem across the 2 years. Around two thirds (62%-67%) of parents rated their child's oral health as excellent/very good and less than half the children (32%-45%) had received dental check-ups. Most children (79%-90%) brushed their teeth and drank water (97%) but more than half (57%-70%) also drank sugar sweetened beverages daily. CONCLUSIONS Parents are instilling good oral health behaviours, however, the oral health screening suggests children are experiencing oral health issues of which parents may be unaware. Parents also seem to be unaware of beverage consumption practices that can increase the risk of childhood decay. SO WHAT?: The findings highlight the need for greater oral health awareness among Aboriginal families on how to recognise early symptoms dental decay and risk factors like sugar sweetened beverages among school going children. This suggests that existing health promotion strategies may not be reaching many Aboriginal families in the urban areas and more culturally appropriate programs may be needed.
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Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, University of Sydney, Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool, NSW, Australia
| | - Amy R Villarosa
- COHORT, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool, NSW, Australia
| | - Suzanne Ingram
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
| | - Kaniz Fatema
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
| | - Koby Elliott
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
| | - Rebekah Grace
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Lynn Kemp
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Sheryl Scharkie
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | | | - Natasha Bucknall
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | | | - Elizabeth Comino
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
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8
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Thirlway F. Explaining the social gradient in smoking and cessation: the peril and promise of social mobility. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:565-578. [PMID: 31769046 PMCID: PMC7079060 DOI: 10.1111/1467-9566.13039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Smoking in high-income countries is now concentrated in poor communities whose relatively high smoking prevalence is explained by greater uptake but above all by lower quit rates. Whilst a number of barriers to smoking cessation have been identified, this is the first paper to situate cessation itself as a classed and cultural practice. Drawing on ethnographic research carried out in a working-class community in the North of England between 2012 and 2015, I theorise smoking cessation as a symbolic practice in relation to the affective experience of class and social mobility. I show that ambivalence about upward mobility as separation and loss translated into ambivalence about smoking cessation. The reason for this was that the social gradient in smoking operated dynamically at the level of the individual life course, i.e. smoking cessation followed upward mobility. A serious health problem was an appropriate reason to quit but older women continued to smoke despite serious health problems. This was linked to historical gender roles leading to women placing a low priority on their own health as well as the intergenerational reproduction of smoking through close affective links with smoking parents.
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Affiliation(s)
- Frances Thirlway
- Department of SociologyWentworth CollegeUniversity of YorkYorkUK
- Anthropology DepartmentDurham UniversityDurhamUK
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Tane MP, Hefler M, Thomas DP. Smokefree leadership among the Yolŋu peoples of East Arnhem Land, Northern Territory: a qualitative study. Glob Health Promot 2019; 27:100-108. [PMID: 31232171 DOI: 10.1177/1757975919829405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This qualitative study examined smokefree leadership among the Yolŋu people, Indigenous landowners of East Arnhem Land. Despite disproportionately high smoking prevalence, the study found that most people enacted smokefree leadership within families and communities. While there was broad concern about not impinging on the autonomy of others, Indigenous health workers regularly advised clients, family and community members to quit smoking. This followed a general belief that the issue of smoking was best raised by health workers, rather than traditional leaders. Protecting children from second-hand smoke and preventing smoking initiation was important to all participants irrespective of their smoking status. An enduring and highly valued cultural connection to ŋarali' (tobacco) remains an essential part of the sacred practices of the funeral ceremony, an important and unique social utility. The study found consensus among participants that this would not change. Navigating traditional connections to ŋarali' in a context where most people are still addicted to commercial tobacco is challenging and requires respectful and culturally compelling approaches. Tobacco control initiatives with the Yolŋu should therefore utilise existing smokefree leaders within the social context in which ŋarali' is valued and used, an approach that may resonate with other Indigenous Australian nations and communities.
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Affiliation(s)
- Moana Pera Tane
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - David P Thomas
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
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Pedersen M, Brown B, Harris K, France S, Tryon M, Cooksley A. Rural Parent Support of Child Health Behavior in the Home Environment: A Qualitative Study on an American Indian Reservation. Glob Pediatr Health 2019; 6:2333794X19847451. [PMID: 31106246 PMCID: PMC6506919 DOI: 10.1177/2333794x19847451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 01/31/2023] Open
Abstract
Background. Obesity rates are disproportionately high among
rural and American Indian (AI) children. Health behaviors contributing to child
obesity are influenced by parents at home. Engaging parents remains a challenge,
particularly among low-income and ethnic minority families.
Aims. The aim of this study was to learn how AI parents
living on a rural AI reservation support and engage with their children’s
nutrition and physical activity behaviors at home. Methods.
Parents with children ages 6 to 12 years living on one, rural AI reservation
participated. Focus groups and interviews were conducted, using a 14-question
moderator’s guide. A systematic, iterative content analysis was applied to the
transcripts. Results. Twenty-five parents (52% AI or Alaska
Native) participated in 3 focus groups (n = 17) and interviews (n = 8). Themes
related to enhancers included role modeling and whole family and child-initiated
activities. Barriers included resources, child safety concerns, driving
distances, and competing family priorities. Themes related to strategies for
change included opportunities for peer learning from other local families,
creating fun, program support for all supplies and incentives, and incorporation
of storytelling and multicultural activities. Discussion. This
study advances knowledge to promote parental engagement with child health
behavior in the home, including unique themes of inclusiveness, culture-focused,
and intergenerational activities. Conclusion. Results may
inform interventions seeking to engage parents living in rural and AI
reservation communities in home-based child behavior change efforts.
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Affiliation(s)
| | | | | | | | - Mike Tryon
- Summit Medical Fitness Center, Kalispell, MT, USA
| | - Aric Cooksley
- Boys and Girls Club of the Flathead Reservation and Flathead County, Ronan, MT, USA
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Ratelle M, Laird M, Majowicz S, Skinner K, Swanson H, Laird B. Design of a human biomonitoring community-based project in the Northwest Territories Mackenzie Valley, Canada, to investigate the links between nutrition, contaminants and country foods. Int J Circumpolar Health 2019; 77:1510714. [PMID: 30157724 PMCID: PMC6116701 DOI: 10.1080/22423982.2018.1510714] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Community-based projects place emphasis on a collaborative approach and facilitate research among Indigenous populations regarding local issues and challenges, such as traditional foods consumption, climate change and health safety. Country foods (locally harvested fish, game birds, land animals and plants), which contribute to improved food security, can also be a primary route of contaminant exposure among populations in remote regions. A community-based project was launched in the Dehcho and Sahtù regions of the Northwest Territories (Canada) to: 1) assess contaminants exposure and nutrition status; 2) investigate the role of country food on nutrient and contaminant levels and 3) understand the determinants of message perception on this issue. Consultation with community members, leadership, local partners and researchers was essential to refine the design of the project and implement it in a culturally relevant way. This article details the design of a community-based biomonitoring study that investigates country food use, contaminant exposure and nutritional status in Canadian subarctic First Nations in the Dehcho and Sahtù regions. Results will support environmental health policies in the future for these communities. The project was designed to explore the risks and benefits of country foods and to inform the development of public health strategies.
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Affiliation(s)
- Mylene Ratelle
- a School of Public Health and Health Systems , University of Waterloo , Waterloo , Canada
| | - Matthew Laird
- a School of Public Health and Health Systems , University of Waterloo , Waterloo , Canada
| | - Shannon Majowicz
- a School of Public Health and Health Systems , University of Waterloo , Waterloo , Canada
| | - Kelly Skinner
- a School of Public Health and Health Systems , University of Waterloo , Waterloo , Canada
| | - Heidi Swanson
- b Department of Biology , University of Waterloo , Waterloo , Canada
| | - Brian Laird
- a School of Public Health and Health Systems , University of Waterloo , Waterloo , Canada
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12
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Busija L, Cinelli R, Toombs MR, Easton C, Hampton R, Holdsworth K, Macleod, BPsySc(Hons) A, Nicholson GC, Nasir BF, Sanders KM, McCabe MP. The Role of Elders in the Wellbeing of a Contemporary Australian Indigenous Community. THE GERONTOLOGIST 2018; 60:513-524. [DOI: 10.1093/geront/gny140] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Objectives
Traditional Elders are integral to the social structure of Australian Indigenous communities. Due to progressive loss of traditional way of life, however, the role of Elders has been eroding. This study aims to develop a conceptual model of the role of Elders in an Australian Indigenous community, with the goal of attaining strategies to strengthen the role of Elders.
Research Design and Methods
The study, conducted in a regional Indigenous community in Australia, adopted a community-based participatory approach. Design and focus of the project were informed by a community forum (Yarning Circle). One-on-one semistructured interviews and focus groups with community members were conducted by Indigenous researchers. Group concept mapping (GCM) was applied to elicit major themes in qualitative data, from the point of view of community members, and to derive a conceptual model of the role of Elders.
Results
Fifty members of the Indigenous community took part in interviews and focus groups. The participants’ median age was 45 years (range 18–76 years); 31 (62%) were female. An additional 24 Indigenous community members took part in the data sorting task of GCM. GCM identified seven major aspects of the role of Elders, including Community relations, Passing down the knowledge, Dealing with racism and oppression, Building a better resourced community, Intergenerational connectedness, Safeguarding our identity, and Caring for our youth.
Discussion and Implications
Elders fulfill many important roles in contemporary Indigenous communities. Our results can be used to assist the community to codesign a program to increase community wellbeing.
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Affiliation(s)
- Lucy Busija
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Renata Cinelli
- Faculty of Education and Arts, Australian Catholic University, East Melbourne, Victoria, Australia
| | - Maree R Toombs
- Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Australia
| | - Caitlin Easton
- Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Australia
| | - Ron Hampton
- Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Australia
| | - Kristen Holdsworth
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
- School of Health Sciences, Swinburne University, Hawthorn, Victoria, Australia
| | - Ashley Macleod, BPsySc(Hons)
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
- School of Health Sciences, Swinburne University, Hawthorn, Victoria, Australia
| | - Geoffrey C Nicholson
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
- Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Australia
| | - Bushra F Nasir
- Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Australia
| | - Kerrie M Sanders
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
- Department of Medicine, Sunshine Hospital (Western Health), The University of Melbourne, Parkville, Victoria, Australia
| | - Marita P McCabe
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
- School of Health Sciences, Swinburne University, Hawthorn, Victoria, Australia
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Keith JF, Stastny S, Brunt A, Agnew W. Barriers and Strategies for Healthy Food Choices among American Indian Tribal College Students: A Qualitative Analysis. J Acad Nutr Diet 2018; 118:1017-1026. [PMID: 29066177 DOI: 10.1016/j.jand.2017.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 08/02/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND American Indian and Alaskan Native individuals experience disproportionate levels of chronic health conditions such as type 2 diabetes and overweight and obesity that are influenced by dietary patterns and food choices. Understanding factors that influence healthy food choices among tribal college students can enrich education and programs that target dietary intake. OBJECTIVE To build an understanding of factors that influence healthy food choices among tribal college students at increased risk for college attrition. DESIGN A nonexperimental cohort design was used for qualitative descriptive analysis. PARTICIPANTS/SETTING Participants (N=20) were purposively sampled, newly enrolled, academically underprepared tribal college students enrolled in a culturally relevant life skills course at an upper Midwest tribal college between September 2013 and May 2015. Participant demographic characteristics included various tribal affiliations, ages, and number of dependents. MAIN OUTCOME MEASURES Participant responses to qualitative research questions about dietary intake, food choices, self-efficacy for healthy food choices, psychosocial determinants, and barriers to healthy food choices during telephone interviews were used as measures. ANALYSIS Qualitative analysis included prestudy identification of researcher bias/assumptions, audiorecording and transcription, initial analysis (coding), secondary analysis (sorting and identifying meaning), and verification (comparative pattern analysis). RESULTS Qualitative analysis revealed a variety of themes and subthemes about healthy food choices. Main themes related to barriers included taste, food gathering and preparation, and difficulty clarifying healthy food choices. Main themes related to strategies included taste, cultural traditions and practices, and personal motivation factors. CONCLUSIONS Qualitative analysis identified barrier and strategy themes that may assist nutrition and dietetics practitioners working with tribal/indigenous communities, tribal college educators and health specialists, and tribal community health workers who target health and dietary intake of American Indian and Alaskan Native students.
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Establishing Smoke-Free Homes in the Indigenous Populations of Australia, New Zealand, Canada and the United States: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111382. [PMID: 29135950 PMCID: PMC5708021 DOI: 10.3390/ijerph14111382] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/05/2017] [Accepted: 11/08/2017] [Indexed: 11/21/2022]
Abstract
A smoke-free home can have multiple benefits by reducing exposure to secondhand smoke (SHS), supporting quit attempts among active smokers, and discouraging adolescents from taking up smoking. The aim of this review was to summarize the literature on the establishment of smoke-free homes in Indigenous populations and identify the supporting influences and barriers, using the Social Cognitive Theory lens. A search of the Medline, CINAHL, Cochrane Collaboration and PyscINFO databases and manual searches of relevant peer-reviewed literature was completed, focusing on Indigenous populations in developed economies of North America and Oceania. Of 2567 articles identified, 15 studies were included. Ten studies included Indigenous participants only, and of these just three focused entirely on SHS in the home. Knowledge of the harms associated with SHS was the most common theme represented in all the studies. This knowledge fueled parents’ motivation to protect their children from SHS by establishing smoke-free homes. Individuals who approached implementation with confidence, coupled with clear communication about smoke-free home rules were more successful. Barriers included challenges for families with multiple smokers living in the same dwelling. There is limited research regarding managing smoking behaviors in the home among Indigenous populations, even though this approach is a successful catalyst for smoking prevention and cessation. Research to understand the influences that support the establishment of smoke-free homes is required for better-informed intervention studies.
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Gould GS, Patten C, Glover M, Kira A, Jayasinghe H. Smoking in Pregnancy Among Indigenous Women in High-Income Countries: A Narrative Review. Nicotine Tob Res 2017; 19:506-517. [PMID: 28403465 PMCID: PMC5896479 DOI: 10.1093/ntr/ntw288] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 02/08/2017] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Pregnant women in socioeconomically disadvantaged circumstances, such as Indigenous women, have a high prevalence of smoking. Tobacco smoking is the most significant reversible risk factor for the health of Indigenous pregnant women and their babies. METHODS As researchers working in this specialized area, we conducted a narrative review of the literature on smoking among Indigenous pregnant women in the United States, Canada, New Zealand, and Australia. We summarize prevalence and factors influencing tobacco use, interventions, and evidence gaps for tobacco control and smoking cessation. Recommendations are made for future interventions, policy changes, and much-needed research. RESULTS Common themes emerging across the four countries reveal opportunities for cross-cultural collaborative studies and trials. These include the social-normative use of tobacco as barriers to quitting in pregnancy and the need for evaluations of interventions at the family and community level. Socioeconomic disparities underscore the importance of enhancing the implementation and reach of strategies to prevent and reduce prenatal tobacco smoking among Indigenous women. Elders and community health care providers as role models for nontobacco use could be explored. Qualitative work is needed to understand the barriers and opportunities, such as cultural strengths supporting quitting tobacco to develop more effective approaches. CONCLUSIONS Although a high-priority group, there remains a dearth of research on Indigenous women's smoking in pregnancy. Studies have assessed knowledge and attitudes to smoking in pregnancy, and small feasibility studies and a few empirical trials have been conducted. Recommendations for promising culturally appropriate cessation interventions have been made. Larger trials are warranted. IMPLICATIONS Strategies to support quitting among pregnant Indigenous women need to be multifactorial and take account of the social determinants of smoking including historical antecedents, community norms, cultural strengths, and recognition of individual and community needs. Cross-country research collaborations have the potential to leverage funding, share expertise, and strengthen approaches to tackle an important and poorly attended health disparity that has a profound impact on the entire life course for Indigenous peoples.
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Affiliation(s)
- Gillian S Gould
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Christi Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Marewa Glover
- School of Public Health, College of Health, Massey University, Auckland, New Zealand
| | - Anette Kira
- Independent Researcher, Manawatu, New Zealand
| | - Harshani Jayasinghe
- University of Adelaide, Adelaide, South Australia, Australia
- Basil Hetzel Institute for Translational Health Research, Adelaide, South Australia, Australia
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Browne AJ, Varcoe C, Lavoie J, Smye V, Wong ST, Krause M, Tu D, Godwin O, Khan K, Fridkin A. Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study. BMC Health Serv Res 2016; 16:544. [PMID: 27716261 PMCID: PMC5050637 DOI: 10.1186/s12913-016-1707-9] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 08/24/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Structural violence shapes the health of Indigenous peoples globally, and is deeply embedded in history, individual and institutional racism, and inequitable social policies and practices. Many Indigenous communities have flourished, however, the impact of colonialism continues to have profound health effects for Indigenous peoples in Canada and internationally. Despite increasing evidence of health status inequities affecting Indigenous populations, health services often fail to address health and social inequities as routine aspects of health care delivery. In this paper, we discuss an evidence-based framework and specific strategies for promoting health care equity for Indigenous populations. METHODS Using an ethnographic design and mixed methods, this study was conducted at two Urban Aboriginal Health Centres located in two inner cities in Canada, which serve a combined patient population of 5,500. Data collection included in-depth interviews with a total of 114 patients and staff (n = 73 patients; n = 41 staff), and over 900 h of participant observation focused on staff members' interactions and patterns of relating with patients. RESULTS Four key dimensions of equity-oriented health services are foundational to supporting the health and well-being of Indigenous peoples: inequity-responsive care, culturally safe care, trauma- and violence-informed care, and contextually tailored care. Partnerships with Indigenous leaders, agencies, and communities are required to operationalize and tailor these key dimensions to local contexts. We discuss 10 strategies that intersect to optimize effectiveness of health care services for Indigenous peoples, and provide examples of how they can be implemented in a variety of health care settings. CONCLUSIONS While the key dimensions of equity-oriented care and 10 strategies may be most optimally operationalized in the context of interdisciplinary teamwork, they also serve as health equity guidelines for organizations and providers working in various settings, including individual primary care practices. These strategies provide a basis for organizational-level interventions to promote the provision of more equitable, responsive, and respectful PHC services for Indigenous populations. Given the similarities in colonizing processes and Indigenous peoples' experiences of such processes in many countries, these strategies have international applicability.
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Affiliation(s)
- Annette J. Browne
- School of Nursing, The University of British Columbia, T201 -- 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Colleen Varcoe
- School of Nursing, The University of British Columbia, T201 -- 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Josée Lavoie
- Manitoba First Nations Centre for Aboriginal Health Research, 715 John Buhler Research Centre, 727 McDermot Ave, Winnipeg, Manitoba R3E 3P5 Canada
| | - Victoria Smye
- Faculty of Health Sciences, University of Ontario Institute of Technology, 2000 Simcoe Street North, Science building, Room 3000, Oshawa, Ontario L1H 7 K4 Canada
| | - Sabrina T. Wong
- School of Nursing and the Centre for Health Services and Policy Research, The University of British Columbia, T201 -- 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Murry Krause
- Central Interior Native Health Society, 365 George Street, Prince George, British Columbia V2L 1R4 Canada
| | - David Tu
- Department of Family Practice, The University of British Columbia, 5950 University Boulevard, Vancouver, V6T 1Z3 British Columbia Canada
| | - Olive Godwin
- Prince George Division of Family Practice, 1302 7 Ave, Prince George, British Columbia V2L 3P1 Canada
| | - Koushambhi Khan
- School of Nursing, The University of British Columbia, T201 -- 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Alycia Fridkin
- Indigenous Health Program, Provincial Health Services Authority of British Columbia, 201-601 West Broadway, Vancouver, British Columbia V5Z 4C2 Canada
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Ziabakhsh S, Pederson A, Prodan-Bhalla N, Middagh D, Jinkerson-Brass S. Women-Centered and Culturally Responsive Heart Health Promotion Among Indigenous Women in Canada. Health Promot Pract 2016; 17:814-826. [PMID: 27052639 DOI: 10.1177/1524839916633238] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs.
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Affiliation(s)
- Shabnam Ziabakhsh
- BC Women's Hospital & Health Centre, Vancouver, British Columbia, Canada
| | - Ann Pederson
- BC Women's Hospital & Health Centre, Vancouver, British Columbia, Canada
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Doucette HJ, Maillet PJ, Brillant MG, Tax CL. Dental Hygiene Students’ Perceptions of a Cultural Competence Component in a Tobacco Dependence Education Curriculum: A Pilot Study. J Dent Educ 2015. [DOI: 10.1002/j.0022-0337.2015.79.6.tb05941.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Peggy J. Maillet
- School of Dental Hygiene; Faculty of Dentistry; Dalhousie University
| | | | - Cara L. Tax
- School of Dental Hygiene; Faculty of Dentistry; Dalhousie University
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Flicker S, O'Campo P, Monchalin R, Thistle J, Worthington C, Masching R, Guta A, Pooyak S, Whitebird W, Thomas C. Research Done in "A Good Way": The Importance of Indigenous Elder Involvement in HIV Community-Based Research. Am J Public Health 2015; 105:1149-54. [PMID: 25880963 DOI: 10.2105/ajph.2014.302522] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the role that Indigenous Elders can play in ensuring that community-based research (CBR) is conducted ethically. METHODS We present data from a larger qualitative study exploring ethical issues that occur in HIV-related CBR through the experiences of researchers engaged in CBR. Between May 2010 and July 2011, we interviewed 51 academic and community research team leaders of federally funded HIV CBR studies. We used thematic analysis techniques to identify themes. RESULTS Participating researchers engage Elders in research because Elders are keepers of Indigenous knowledge, dynamic ethical consultants, community protectors, and credible sources of information who are able to counsel and support, mediate conflict, provide local context and history, and conduct ceremonial roles. Potential challenges cited by participants to engaging Elders in research include finding the right "fit," approaching Elders in a culturally appropriate way, and bureaucratic environments that do not honor Indigenous processes. CONCLUSIONS Culturally appropriate Elder engagement in HIV CBR with Indigenous communities is vital for promoting positive relationships and culturally safe research that respects ceremony and Indigenous ways of knowing.
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Affiliation(s)
- Sarah Flicker
- Sarah Flicker, Renée Monchalin, and Jesse Thistle are with the Faculty of Environmental Studies, York University, Toronto, Ontario. Patricia O'Campo is with the Centre for Research on Inner City Health, St. Michael's Hospital, University of Toronto, Toronto, Ontario. Catherine Worthington is with the School of Public Health and Social Policy, Victoria, British Columbia. Renée Masching is with the Canadian Aboriginal AIDS Network, Dartmouth, Nova Scotia. Adrian Guta is with Carleton University, Ottawa, Ontario. Sherri Pooyak is with the Canadian Aboriginal AIDS Network, Victoria, British Columbia. Wanda Whitebird is with the Ontario Aboriginal HIV/AIDS Strategy, Toronto, Ontario. Cliff Thomas is with the Canadian Aboriginal AIDS Network, Ottawa, Ontario
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Eni R, Phillips-Beck W, Mehta P. At the edges of embodiment: determinants of breastfeeding for first nations women. Breastfeed Med 2014; 9:203-14. [PMID: 24606065 DOI: 10.1089/bfm.2013.0129] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND In Canada, First Nations women are far less likely to breastfeed than other women. First Nations people have been subjected to massive health and social disparities and are at the lowest end of the scale on every measure of well-being. The purpose of this study is to understand the experiences, strengths, and challenges of breastfeeding for First Nations women. Central to the current research is the notion of an embodiment within indigenous women's health and, more specifically, breastfeeding perspectives. MATERIALS AND METHODS Guided by an indigenous feminist standpoint, our research study evolved through honest discussions and is informed by relevant public health literature on breastfeeding. We collected quantitative data through a survey on demographics and feeding practices, and we conducted focus groups in three Canadian provinces (British Columbia, Manitoba, and Ontario) over a period of 1 year (2010) from 65 women in seven First Nation communities. RESULTS Three overarching themes are discussed: social factors, including perceptions of self; breastfeeding environments; and intimacy, including the contribution of fathers. The main findings are that breastfeeding is conducive to bed sharing, whereas a history of residential school attendance, physical and psychological trauma, evacuations for childbirth, and teen pregnancy are obstacles to breastfeeding. Also, fathers play a pivotal role in a woman's decision to breastfeed. CONCLUSIONS Findings from this study contribute to informing public health by reconsidering simplistic health promotion and public health policies and, instead, educating First Nations communities about the complexity of factors associated with multiple breastfeeding environments.
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Affiliation(s)
- Rachel Eni
- 1 Department of Family Social Sciences, Faculty of Human Ecology, University of Manitoba , Winnipeg, Manitoba, Canada
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21
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Geana MV, Greiner KA, Cully A, Talawyma M, Daley CM. Improving health promotion to American Indians in the midwest United States: preferred sources of health information and its use for the medical encounter. J Community Health 2013; 37:1253-63. [PMID: 22477671 DOI: 10.1007/s10900-012-9564-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
American Indians and Alaska Natives suffer significant health disparities for many infectious and chronic diseases as compared to the general population. Providing accurate and culturally tailored health information to underserved groups has been shown to influence health behaviors and health outcomes. Little prior research has explored American Indians health information use and preferences. National representative sample surveys such as the Health Information National Trends Survey provide some data on minority groups but are underpowered to provide useful information on American Indians. The present study analyzes data from a survey of over 900 American Indians from the Midwest United States and explores their sources of health information, their preferences for information presentation, and their use of health information prior to and during medical encounters. We conclude that campaigns targeting Natives should be narrowly focused and be community driven or employing community resources. American Indians use a diversity of media sources to obtain health information, with the Internet being underutilized compared to the general population. Partnership with Indian Health Service providers and pharmacists, as well as traditional healers, in the development and dissemination of new health information for Natives may provide the "expert" tone needed to promote health improvements in American Indians.
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Affiliation(s)
- Mugur V Geana
- William Allen White School of Journalism and Mass Communications, University of Kansas, Lawrence, KS 66045, USA.
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Jardine CG, James A. Youth researching youth: benefits, limitations and ethical considerations within a participatory research process. Int J Circumpolar Health 2012; 71:1-9. [PMID: 22584512 PMCID: PMC3417519 DOI: 10.3402/ijch.v71i0.18415] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 03/18/2012] [Accepted: 03/19/2012] [Indexed: 11/30/2022] Open
Abstract
Objectives To examine the benefits, limitations and ethical issues associated with conducting participatory research on tobacco use using youth to research other youth. Study design Community-based participatory research. Methods Research on tobacco use was conducted with students in the K’àlemì Dene School and Kaw Tay Whee School in the Northwest Territories, Canada, using PhotoVoice. The Grade 9–12 students acted as researchers. Researcher reflections and observations were assessed using “member checking,” whereby students, teachers and community partners could agree or disagree with the researcher's interpretation. The students and teachers were further asked informally to share their own reflections and observations on this process. Results and conclusions Using youth to research other youth within a participatory research framework had many benefits for the quality of the research, the youth researchers and the community. The research was perceived by the researchers and participants to be more valid and credible. The approach was more appropriate for the students, and the youth researchers gained valuable research experience and a sense of ownership of both the research process and results. Viewing smoking through their children's eyes was seen by the community to be a powerful and effective means of creating awareness of the community environment. Limitations of the approach were residual response bias of participants, the short period of time to conduct the research and failure to fully explore student motivations to smoke or not to smoke. Ethical considerations included conducting research with minors, difficulties in obtaining written parental consent, decisions on cameras (disposable versus digital) and representation of all participants in the final research product.
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Affiliation(s)
- Cynthia G Jardine
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
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Kang Y. A concept analysis of health promotion for women with urinary incontinence. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2011. [DOI: 10.1111/j.1749-771x.2011.01127.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hulko W, Camille E, Antifeau E, Arnouse M, Bachynski N, Taylor D. Views of First Nation Elders on Memory Loss and Memory Care in Later Life. J Cross Cult Gerontol 2010; 25:317-42. [DOI: 10.1007/s10823-010-9123-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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