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Thompson I, Putman J, Madbull M, Sharp M, Presley J, Jauregui-Dusseau A, Clyma K, Jernigan VBB. The Choctaw Nation's Growing Hope Program. Health Promot Pract 2023; 24:1080-1082. [PMID: 37877633 DOI: 10.1177/15248399231190358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
The Choctaw Nation of Oklahoma's Historic Preservation Department (HPD) and the Center for Indigenous Health Equity (CIIHE) are partnering to implement and evaluate food sovereignty interventions to better understand the potential impact of such programs on individual and community health. The HPD's Growing Hope Program is a food sovereignty initiative that aims to restore traditional Choctaw gardens, which were once a physical, social, and cultural center of Choctaw life. The program combines heirloom seeds and the stories of their origins, gardening education and technical assistance, cooking classes, and a Choctaw youth internship program to support intergenerational knowledge and the restoration of culture and food security. Since its inception the program has provided Choctaw families with ancestral Choctaw cultivar seeds and provided the technical assistance to support the growing of sustainable, healthy, traditional Choctaw foods.
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Affiliation(s)
| | | | | | | | - Jessica Presley
- University of Arkansas for Medical Sciences, Fayetteville, AR, USA
| | | | - Kaylee Clyma
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
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Community-Based Participatory Research to Improve Cardiovascular Health Among US Racial and Ethnic Minority Groups. CURR EPIDEMIOL REP 2022; 9:212-221. [PMID: 36003088 PMCID: PMC9392701 DOI: 10.1007/s40471-022-00298-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 11/11/2022]
Abstract
Purpose of Review This review aims to assess the contemporary community-based participatory research (CBPR) literature seeking to improve the cardiovascular health of racial and ethnic minority groups in the USA with a higher burden of cardiovascular risk factors and social determinants of health. It summarizes recent CBPR studies based on the American Heart Association Life's Simple 7 (LS7) framework, delineating seven modifiable health behaviors and clinical factors to promote cardiovascular health. Recent Findings Although limited in quantity, studies demonstrated preliminary effectiveness in improving individual and a composite of LS7 indicators by employing strategies centered around fortifying social networks, integrating group activities, leveraging technology, incorporating faith-based and spiritual practices, and implementing changes to the built environment. Summary Future directions for investigators engaged in CBPR include building on the existing body of evidence through more comprehensive studies, scaling effective interventions, and translating CBPR findings to influence health policy to better address health disparities.
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Maudrie TL, Colón-Ramos U, Harper KM, Jock BW, Gittelsohn J. A Scoping Review of the Use of Indigenous Food Sovereignty Principles for Intervention and Future Directions. Curr Dev Nutr 2021; 5:nzab093. [PMID: 34345758 PMCID: PMC8321882 DOI: 10.1093/cdn/nzab093] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 05/11/2021] [Accepted: 06/28/2021] [Indexed: 12/19/2022] Open
Abstract
Indigenous food sovereignty (IFS) represents a community-led movement with potential to reduce health inequities, but no scoping review of the impact of taking an IFS approach on intervention research has been conducted. This review sought to: 1) describe intervention studies that employ IFS principles, and 2) describe the impact of studies using IFS principles on food access, eating patterns, diet quality, physical activity, and health. Through a literature review, 4 IFS principles were identified: 1) community ownership, 2) inclusion of traditional food knowledge, 3) inclusion and promotion of cultural foods, and 4) environmental/intervention sustainability. Twenty intervention studies published between January 1, 2000 and February 5, 2020 were included. Most of the studies that scored high in IFS principles saw a positive impact on diet. This review found evidence supporting the value of IFS principles in the development, implementation, and evaluation of health interventions for Indigenous communities.
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Affiliation(s)
- Tara L Maudrie
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Uriyoán Colón-Ramos
- Department of Global Health, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health at The George Washington University, Washington, DC, USA
| | - Kaitlyn M Harper
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brittany W Jock
- School of Human Nutrition, Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill University, Montreal, Quebec, Canada
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Blue Bird Jernigan V, D'Amico EJ, Duran B, Buchwald D. Multilevel and Community-Level Interventions with Native Americans: Challenges and Opportunities. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:65-73. [PMID: 29860640 DOI: 10.1007/s11121-018-0916-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Multilevel and community-level interventions that target the social determinants of health and ultimately health disparities are seldom conducted in Native American communities. To contextualize the importance of multilevel and community-level interventions, major contributors to and causes of health disparities in Native communities are highlighted. Among the many documented socioeconomic factors influencing health are poverty, low educational attainment, and lack of insurance. Well-recognized health disparities include obesity, diabetes, and hypertension. Selected challenges of implementing community-level and multilevel interventions in Native communities are summarized such as the shortage of high-quality population health data and validated measurement tools. To address the lack of multilevel and community-level interventions, the National Institutes of Health created the Intervention Research to Improve Native American Health (IRINAH) program which solicits proposals that develop, adapt, and test strategies to address these challenges and create interventions appropriate for Native populations. A discussion of the strategies that four of the IRINAH grantees are implementing underscores the importance of community-based participatory policy work, the development of new partnerships, and reconnection with cultural traditions. Based on the work of the nearly 20 IRINAH grantees, ameliorating the complex social determinants of health disparities among Native people will require (1) support for community-level and multilevel interventions that examine contemporary and historical factors that shape current conditions; (2) sustainability plans; (3) forefronting the most challenging issues; (4) financial resources and time to collaborate with tribal leaders; and (5) a solid evidence base.
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Affiliation(s)
- Valarie Blue Bird Jernigan
- College of Public Health, University of Oklahoma Health Sciences Center, 4502 E 41st St, Tulsa, OK, 74135-2512, USA.
| | | | - Bonnie Duran
- University of Washington School of Social Work, 4101 15th Ave NE, Seattle, WA, 98105, USA
| | - Dedra Buchwald
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA
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Breathett K, Sims M, Gross M, Jackson EA, Jones EJ, Navas-Acien A, Taylor H, Thomas KL, Howard BV. Cardiovascular Health in American Indians and Alaska Natives: A Scientific Statement From the American Heart Association. Circulation 2020; 141:e948-e959. [PMID: 32460555 PMCID: PMC7351358 DOI: 10.1161/cir.0000000000000773] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death among American Indians and Alaska Natives. Over the past 50 years, the prevalence of CVD has been rising among American Indians and Alaska Natives. The objective of this statement is to summarize population-level risk factors and management techniques tailored for the American Indian and Alaska Native populations. METHODS PubMed/MEDLINE, the Centers for Disease Control and Prevention, and the annual Heart Disease and Stroke Statistics report from the American Heart Association were used to identify risk factors and interventions specific to American Indians and Alaska Natives. RESULTS Diabetes mellitus is a major contributor to disproportionately higher rates of coronary heart disease among American Indians and Alaska Natives compared with other racial and ethnic groups. Additional risk factors for CVD include low-density lipoprotein cholesterol levels, hypertension, renal disease, age, and sex. Smoking and exposure to toxic metals are risk factors for some subpopulations. A quarter of American Indians live below the federal poverty line, and thus, low socioeconomic status is an important social determinant of cardiovascular health. Community-based interventions have reduced CVD risk in American Indians and Alaska Natives. Underreporting of American Indian and Alaska Native race could underestimate the extent of CVD in this population. CONCLUSIONS Prevention and treatment of CVD in American Indians and Alaska Natives should focus on control of risk factors and community-based interventions that address social determinants of health, particularly among individuals with diabetes mellitus. Accurate reporting of race/ethnicity is encouraged to address race-specific risk factors.
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John-Henderson NA, Gruman HE, Counts CJ, Ginty AT. American Indian young adults display diminished cardiovascular and cortisol responses to acute psychological stress. Psychoneuroendocrinology 2020; 114:104583. [PMID: 32000056 PMCID: PMC7096252 DOI: 10.1016/j.psyneuen.2020.104583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/29/2019] [Accepted: 01/07/2020] [Indexed: 12/18/2022]
Abstract
American Indian adults are at an increased risk for cardiovascular disease compared with non-Hispanic white adults. Scant research exists examining the underlying physiological and psychological mechanisms associated with these risks. This study aimed to examine possible psychological and physiological stress-related mechanisms related to cardiovascular disease risk in healthy American Indian and non-Hispanic white adults. Forty American Indian (60% female, Mean age = 19.93, SD = 2.08 years) and 45 non-Hispanic white (70% female, Mean age = 20.18, SD = 2.22 years) participants attended an in-person laboratory session. Salivary cortisol and cardiovascular activity were measured before (baseline), during, and after exposure to a 10-minute mental arithmetic task. Compared to non-Hispanic white participants, American Indian had diminished salivary cortisol (p < .001), blood pressure (p's < .001), and heart rate (p = .041) responses to acute psychological stress. These effects could not be accounted for by differences in task performance or self-reported engagement. Previous research has shown that exaggerated responses to stress are associated with increased risk of cardiovascular disease. However, diminished responses to stress are associated with early childhood stress and future adverse behaviors (e.g., addiction, obesity). Diminished reactivity may influence behaviors that can impact future development of cardiovascular disease in American Indian populations.
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Affiliation(s)
| | | | | | - Annie T. Ginty
- Department of Psychology & Neuroscience, Baylor University
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Taniguchi TE, Salvatore AL, Williams MB, Love CV, Noonan CJ, Cannady TK, Standridge J, Fox J, Spiegel J, Owens J, Grammar M, Wiley A, Jernigan VBB. Process Evaluation Tool Development and Fidelity of Healthy Retail Interventions in American Indian Tribally Owned Convenience Stores: the Tribal Health Resilience in Vulnerable Environments (THRIVE) Study. Curr Dev Nutr 2020; 4:33-41. [PMID: 32258997 PMCID: PMC7101486 DOI: 10.1093/cdn/nzz073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/16/2019] [Accepted: 06/17/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Tribal Health Resilience in Vulnerable Environments (THRIVE) study aimed to increase healthy food access in 2 rural American Indian communities. The intervention sought to increase fruit and vegetable availability, variety, and convenience through placement, promotion, and pricing of healthy foods and beverages in tribal convenience stores. OBJECTIVE The aim of this study was to describe the development and implementation of the study process evaluation tool to assess intervention fidelity as part of this cluster-controlled trial. METHODS Eight stores (2 intervention and 2 control stores per Nation) participated in the study, implemented from May 2016 to May 2017. A web-based survey tailored to store layouts and intervention components assessed how often intervention items were available, approximate quantity available, and whether placement of healthier food items and promotional materials were implemented as designed. After pilot testing the survey, tribal staff members implemented it to collect process evaluation data in the 8 stores during a period of 9-12 mo, assessing study implementation and potential changes in control stores. RESULTS Promotional materials were available ≥75% of the time for most intervention locations. Fruit availability was similar in Nation A and Nation B intervention stores (79-100% compared with 70-100%), whereas fresh vegetable availability was higher in Nation B compared with Nation A (95-96% compared with 55-75%). Both control stores in Nation A and 1 control store in Nation B had moderate fruit and vegetable availability, ranging from 45% to 52%. No control stores in either Nation used intervention promotional materials. CONCLUSIONS Process evaluation data indicate that the study was implemented with moderate to high fidelity. The development and implementation of the tool can inform future healthy retail interventions that aim to improve rural and tribal food environments.
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Affiliation(s)
- Tori E Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Alicia L Salvatore
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, OK, USA
| | - Mary B Williams
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, OK, USA
| | - Charlotte V Love
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Carolyn J Noonan
- Initiative for Research and Education to Advance Community Health, Washington State University, Pullman, WA, USA
| | - Tamela K Cannady
- Choctaw Nation of Oklahoma Health Services Authority, Durant, OK, USA
| | - Joy Standridge
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Jill Fox
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Jennifer Spiegel
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - JoAnna Owens
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Mandy Grammar
- Choctaw Nation of Oklahoma Health Services Authority, Durant, OK, USA
| | - AnDina Wiley
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Shadrina SS, Sivtseva AI, Sivtseva EN, Donskaya AA, Ivanova ON. Behavioural risk factors of arterial hypertension in the Evenk population of the Russian Arctic. Int J Circumpolar Health 2019; 78:1611329. [PMID: 31116098 PMCID: PMC6534235 DOI: 10.1080/22423982.2019.1611329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/25/2019] [Accepted: 04/19/2019] [Indexed: 11/29/2022] Open
Abstract
The urgency of the problem under study is determined by the high prevalence of arterial hypertension among the indigenous minorities of the North in modern socio-economic conditions. The following article is aimed to evaluate the prevalence of behavioural arterial hypertension risk factors according to the results of single-step epidemiological research of Evenk people in the Republic of Sakha (Yakutia), Russian Federation. The leading approach to the study of this problem was the questioning of the population using the international questionnaire for behavioural risk factors (CYNDI). As a result of research, widespread smoking was found among native population (52.0% of men and 23.7% of women). The frequency of alcohol consumption among the male Evenki is comparable to that in the Yakut population, and among the female, the number is much lower. Evenks including young men belong to the physically inactive population. The frequency of arterial hypertension (AH) cases along with the factors listed above are significantly influenced by: marital status, employment, education, and housing conditions. Article materials may be useful for a differentiated approach in the development of prevention and rehabilitation programs for the indigenous peoples of the North.
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Kruger H, Zumwalt C, Guenther R, Jansen R, Warne D, Dyke C. Disparities in Secondary Prevention of Atherosclerotic Heart Disease After Coronary Artery Bypass Grafting in Northern Plains American Indians. Health Equity 2019; 3:520-526. [PMID: 31656939 PMCID: PMC6814079 DOI: 10.1089/heq.2019.0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Introduction: Cardiovascular disease has become the leading cause of death in American Indians (AIs). For patients with severe disease requiring coronary artery bypass grafting (CABG), AIs have been demonstrated to present with increased risk factors. Guideline-directed medical therapy after CABG effectively reduces mortality and recurrent ischemic events in all patients and is especially important in high-risk populations such as AIs. Methods: Isolated CABG patients between 2012 and 2017 were studied and 74 AI patients were identified. Propensity matching was performed and the resulting 148 patients were followed for a year after surgery. Guideline-directed medical therapy (GDMT) for secondary prevention of atherosclerotic disease after CABG was detailed in all patients. Results: GDMT was similar between groups (85% AI vs. 89% non-AI; p=NS), and the incidence of prescribed antiplatelet medications, beta-blockers, and statins was similar. AIs were more likely to receive insulin therapy (p=0.002) and opioids (p=0.03) at discharge, while non-AIs were more likely to receive anti-arrhythmic medications (p=0.002). One year after discharge, GDMT trended lower in AIs (75% AI vs. 85% non-AI; p=0.2) and AIs were less likely to be on a statin 1 year after surgery (81% AI vs. 93% non-AI; p=0.04). Opioid use trended higher after 1 year in AIs (28% AI vs. 18% non-AI; p=NS) and fewer AI patients participated in cardiac rehabilitation (CR) after CABG. Conclusions: Disparities in GDMT for secondary prevention of coronary artery disease after CABG exist, with fewer AI patients receiving statins and undergoing CR 1 year after surgery. Increased use of opioids in AIs is troubling and deserves further investigation. Improved adherence to GDMT would be expected to improve long-term outcomes after CABG in this high risk population.
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Affiliation(s)
- Hannah Kruger
- University of North Dakota School of Medicine and Health Sciences-Southeast Campus, Fargo, North Dakota
| | - Christopher Zumwalt
- University of North Dakota School of Medicine and Health Sciences-Southeast Campus, Fargo, North Dakota
| | - Rory Guenther
- University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Rick Jansen
- Department of Public Health, North Dakota State University, Fargo, North Dakota
| | - Donald Warne
- University of North Dakota School of Medicine and Health Sciences-Southeast Campus, Fargo, North Dakota
| | - Cornelius Dyke
- Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
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Love CV, Taniguchi TE, Williams MB, Noonan CJ, Wetherill MS, Salvatore AL, Jacob T, Cannady TK, Standridge J, Spiegel J, Jernigan VBB. Diabetes and Obesity Associated with Poor Food Environments in American Indian Communities: the Tribal Health and Resilience in Vulnerable Environments (THRIVE) Study. Curr Dev Nutr 2019; 3:63-68. [PMID: 31453429 PMCID: PMC6700455 DOI: 10.1093/cdn/nzy099] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/19/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND American Indians (AIs) have significantly higher rates of diet-related chronic diseases than other racial/ethnic groups, and many live in environments with limited access to healthy food. OBJECTIVE As part of the Tribal Resilience in Vulnerable Environments (THRIVE) study, we examined the relations between the perceived food environment, utilization of food retailers, fruit and vegetable intake, and chronic diseases, including obesity, hypertension, and type 2 diabetes among AI adults. METHODS Through a community-based participatory research partnership, we surveyed a cross-sectional sample of 513 AIs living within the Chickasaw Nation and the Choctaw Nation of Oklahoma. RESULTS Only 57% of participants reported that it was easy to purchase fruits and vegetables in their town, and fewer (35%) reported that available fruits and vegetables were of high quality. Additionally, over half (56%) reported traveling ≥20 miles round trip to shop for food. Few participants met the recommended daily intake for fruit (44%) or vegetables (25%). Obesity (55%), hypertension (49%), and diabetes (25%) were commonly reported. Obesity was significantly higher among participants who reported that the price of fruits and vegetables were cost-prohibitive (prevalence proportion ratio (PPR): 1.24; 95% CI: 1.02, 1.50) and those who shopped frequently for food at nontraditional food retailers, such as Dollar Stores (PPR: 1.35; 95% CI: 1.08, 1.69) and small markets (PPR: 1.38; 95% CI: 1.02, 1.86). Diabetes was significantly higher among participants who frequently shopped at convenience stores/gas stations (PPR: 2.26; 95% CI: 1.22, 4.19). CONCLUSIONS Our study found that the use of nontraditional food retailers, including convenience stores, gas stations, and Dollar Stores, as a regular source of food was associated with obesity and diabetes. These results underscore the importance of interventions to improve rural Tribal food environments. Healthy retail interventions in nontraditional retail settings, such as those implemented through the THRIVE study, may contribute to reducing AI health disparities.
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Affiliation(s)
- Charlotte V Love
- Center for Indigenous Health Research and Action, University of Oklahoma-Tulsa, Tulsa, OK
| | - Tori E Taniguchi
- Center for Indigenous Health Research and Action, University of Oklahoma-Tulsa, Tulsa, OK
| | - Mary B Williams
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, OK
| | - Carolyn J Noonan
- Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA
| | - Marianna S Wetherill
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, OK
| | - Alicia L Salvatore
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, OK
| | - Tvli Jacob
- Center for Indigenous Health Research and Action, University of Oklahoma-Tulsa, Tulsa, OK
| | - Tamela K Cannady
- Choctaw Nation of Oklahoma Health Services Authority, McAlester, OK
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Salvatore AL, Noonan CJ, Williams MB, Wetherill MS, Jacob T, Cannady TK, Standridge J, Grammar M, Fox J, Wiley A, Spiegel J, Jernigan VBB. Social Support and Physical Activity Among American Indians in Oklahoma: Results From a Community-based Participatory Research Study. J Rural Health 2019; 35:374-384. [PMID: 30353951 PMCID: PMC6482099 DOI: 10.1111/jrh.12331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Little is known about the contribution of social support to physical activity (PA) behavior among American Indians (AIs). This community-based participatory research study examined the prevalence of and associations between different types of PA social support and PA among AIs in rural Oklahoma. METHODS Our tribal-academic partnership surveyed AI adults (N = 513) living within the tribal jurisdictional areas of 2 tribal nations. We used the Physical Activity Social Support (PASS) scale to assess 3 types of PA social support and Poisson regression to investigate associations between PASS types and self-reported PA behavior. FINDINGS Over a third of participants perceived high levels of PA social support from friends (37%), family (35%), and overall (34%), yet only 29% reported regular PA (ie, 150 minutes or more weekly). Participants who exercised with pets/other were significantly more likely to achieve regular PA than those who exercised alone (PR 2.0, 95% CI: 1.4-2.9). Although not significant, compared with those reporting no/low support, participants with high friend PASS (PR 1.2, 95%: CI 0.9-1.6), medium family PASS (PR 1.2, 95% CI: 0.9-1.7), and overall PASS (PR 1.1, 95% CI: 0.8-1.6) were more likely to report regular PA. CONCLUSIONS The majority of participants did not meet current recommendations for PA behavior, which underscores the ongoing need for PA effective interventions among AIs living in rural areas. Results suggest that exercising with pets/other could be an important factor for future intervention. Further research is needed to elucidate determinants of PA and test interventions to increase PA among AIs.
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Affiliation(s)
- Alicia L. Salvatore
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, Oklahoma
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, Oklahoma
| | - Carolyn J. Noonan
- Initiative for Research and Education to Advance Community Health, Washington State University, Spokane, Washington
| | - Mary B. Williams
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, Oklahoma
| | - Marianna S. Wetherill
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, Oklahoma
| | - Tvli Jacob
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, Oklahoma
| | - Tamela K. Cannady
- Choctaw Nation of Oklahoma Health Services Authority, Talihina, Oklahoma
| | - Joy Standridge
- Chickasaw Nation Nutrition Services Department, Ada, Oklahoma
| | - Mandy Grammar
- Choctaw Nation of Oklahoma Health Services Authority, Talihina, Oklahoma
| | - Jill Fox
- Chickasaw Nation Nutrition Services Department, Ada, Oklahoma
| | - Andina Wiley
- Chickasaw Nation Nutrition Services Department, Ada, Oklahoma
| | | | - Valarie Blue Bird Jernigan
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, Oklahoma
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12
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Bird Jernigan VB, Salvatore AL, Williams M, Wetherill M, Taniguchi T, Jacob T, Cannady T, Grammar M, Standridge J, Fox J, Tingle Owens J, Spiegel J, Love C, Teague T, Noonan C. A Healthy Retail Intervention in Native American Convenience Stores: The THRIVE Community-Based Participatory Research Study. Am J Public Health 2018; 109:132-139. [PMID: 30495999 DOI: 10.2105/ajph.2018.304749] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To assess a healthy retail intervention in Tribal convenience stores in Oklahoma.Methods. We adapted healthy retail strategies to the context of 8 Tribally owned stores. We assessed individual- and store-level outcomes in a cluster-controlled intervention trial (April 2016-June 2017). We measured fruit and vegetable intake, store environment perceptions, and purchases before and after the intervention among a cohort of 1637 Native American shoppers. We used mixed-effects linear regression to estimate pre- to postintervention changes in and between groups.Results. We followed 74% of participants (n = 1204) 9 to 12 months. Intervention and control participants perceived healthier stores after intervention. Higher shopping frequency was related to purchases of fruits, vegetables, and healthy items.Conclusions. Intervention exposure was associated with healthy purchasing but not fruit and vegetable intake. Research is needed to further assess impacts of environmental interventions on intake.Public Health Implications. As the first healthy retail intervention in Tribally owned stores, our results contribute evidence for environmental and policy interventions to address obesity in Tribal Nations. Multicomponent interventions, led by Tribal leaders from diverse sectors, are needed to create healthy environments and sustainable improvements in Native American health.
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Affiliation(s)
- Valarie Blue Bird Jernigan
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Alicia L Salvatore
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Mary Williams
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Marianna Wetherill
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Tori Taniguchi
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Tvli Jacob
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Tamela Cannady
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Mandy Grammar
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Joy Standridge
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Jill Fox
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - JoAnna Tingle Owens
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Jennifer Spiegel
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Charlotte Love
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Travis Teague
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Carolyn Noonan
- Valarie Blue Bird Jernigan, Tori Taniguchi, Tvli Jacob, Charlotte Love, and Travis Teague are with the Center for Indigenous Health Research and Action, University of Oklahoma, Tulsa. Alicia L. Salvatore, Mary Williams, and Marianna Wetherill are with the Schusterman Center, University of Oklahoma, Tulsa. Tamela Cannady and Mandy Grammar are with the Choctaw Nation Health Services, Talihina, OK. Joy Standridge, Jill Fox, JoAnna Tingle Owens, and Jennifer Spiegel are with the Chickasaw Nation Nutrition Services Department, OK. Carolyn Noonan is with the Elson S. Floyd College of Medicine, Washington State University, Spokane
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13
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Wetherill MS, Williams MB, Taniguchi T, Salvatore AL, Jacob T, Cannady T, Grammar M, Standridge J, Fox J, Spiegel J, Blue Bird Jernigan V. A Nutrition Environment Measure to Assess Tribal Convenience Stores: The THRIVE Study. Health Promot Pract 2018; 21:410-420. [PMID: 30238822 DOI: 10.1177/1524839918800968] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In rural American Indian (AI) communities, where supermarkets are rare, tribally owned and operated convenience stores are an important food source. Food environment measures for these settings are needed to understand and address the significant diet-related disparities among AIs. Through a tribal-university partnership that included tribal health and commerce representatives from two Native Nations in rural southeastern Oklahoma, we developed the Nutrition Environment Measures Survey for Tribal Convenience Stores (NEMS-TCS) to inform the development and evaluation of a healthy food retail intervention. The NEMS-TCS assessed four scored domains of the rural convenience store food environment-food availability, pricing, quality, and placement-and included 11 food categories that emphasized ready-to-eat food items. Trained raters administered the NEMS-TCS using a sample of 18 rural convenience stores (primarily ranging between 2,400 and 3,600 square feet). We assessed interrater reliability with kappa statistics for dichotomized variables and intraclass correlation coefficients (ICC) for continuous variables. NEMS-TCS demonstrated high inter-rater reliability for all food categories (>85% agreement), subscores (ICC = 0.73-1.00), and the total score (ICC = 0.99). The NEMS-TCS responds to recent calls for reliable measures for rural food environments and may be valuable for studying food environments of large convenience stores in other Native Nations as well as other rural settings.
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Affiliation(s)
- Marianna S Wetherill
- University of Oklahoma Tulsa Schusterman Center, College of Public Health, Tulsa, OK, USA
| | - Mary B Williams
- University of Oklahoma Tulsa Schusterman Center, College of Public Health, Tulsa, OK, USA
| | - Tori Taniguchi
- University of Oklahoma Tulsa Schusterman Center, College of Public Health, Tulsa, OK, USA
| | - Alicia L Salvatore
- University of Oklahoma Tulsa Schusterman Center, College of Public Health, Tulsa, OK, USA
| | - Tvli Jacob
- University of Oklahoma Tulsa Schusterman Center, College of Public Health, Tulsa, OK, USA
| | - Tamela Cannady
- Choctaw Nation of Oklahoma Health Services, Talihina, OK, USA
| | - Mandy Grammar
- Choctaw Nation of Oklahoma Health Services, Talihina, OK, USA
| | - Joy Standridge
- Chickasaw Nation Nutrition Services Department, Ada, OK, USA
| | - Jill Fox
- Chickasaw Nation Nutrition Services Department, Ada, OK, USA
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14
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Anderson E, Glogoza M, Bettenhausen A, Guenther R, Dangerfield D, Jansen R, Newman R, Warne D, Dyke C. Disparities in Cardiovascular Risk Factors in Northern Plains American Indians Undergoing Coronary Artery Bypass Grafting. Health Equity 2018; 2:152-160. [PMID: 30283862 PMCID: PMC6110186 DOI: 10.1089/heq.2018.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: Heart disease is the leading cause of death in American Indians (AIs). For AI patients with severe coronary artery disease requiring coronary artery bypass graft (CABG) surgery, little data exist. The purpose of this study was to evaluate short-term outcomes of Northern Plains AI undergoing CABG and identify variations in patient presentation. Methods: All patients undergoing isolated CABG between June 2012 and June 2017 were studied. Seventy-four AI and 1236 non-American Indian (non-AI) patients were identified. Risk factors, preoperative characteristics, cardiac status, procedural information, and outcomes were collected. Univariate analysis comparing short-term clinical outcomes between AI and non-AI populations was performed. Multivariable logistic regression models were constructed and outcome differences assessed. Unadjusted Kaplan-Meier survival estimates were produced using 5-year survival data. Results: AI patients presented with increased risk factors, including higher rates of diabetes mellitus (AI 63.5% vs. non-AI 38.7% p=< 0.001) and smoking/tobacco use (AI 60.8% vs. non-AI 20.0% p=> 0.001). Seventy-nine percent of AI patients resided on or near federal reservations and presented from rural locations. Internal mammary artery (IMA) graft use in both groups was high (AI 95.9% vs. non-AI 94.9% p=0.904), and multiarterial grafting with left internal mammary artery and radial artery use was common in both groups (AI 67.6% vs. non-AI 69.6% p=0.814). No significant differences in unadjusted 30-day mortality or short-term outcomes were detected. Adjusted Kaplan-Meier survival curves were similar between race groups up through 5 years after CABG (p-value=0.38). Conclusion: AIs presented with significantly more risk factors for cardiovascular disease compared with the general population, with especially high rates of insulin-dependent diabetes and active tobacco use. Despite this, outcomes were similar between groups. In propensity-matched groups, AIs were at decreased risk for prolonged length of stay and combined morbidity/mortality. In contrast to previous reports, AI racial identity did not adversely affect survival up to 5 years after CABG.
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Affiliation(s)
- Eric Anderson
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota
| | - Matthew Glogoza
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota
| | - Aaron Bettenhausen
- Department of Cardiothoracic Surgery, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Rory Guenther
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota
| | - Dylan Dangerfield
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota
| | - Rick Jansen
- Department of Public Health, North Dakota State University, Fargo, North Dakota
| | - Roxanne Newman
- Department of Cardiothoracic Surgery, Sanford Health Fargo, Fargo, North Dakota
| | - Donald Warne
- Department of Public Health, North Dakota State University, Fargo, North Dakota
| | - Cornelius Dyke
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota
- Department of Cardiothoracic Surgery, Sanford Health Fargo, Fargo, North Dakota
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