Spiritual connectedness through prayer as a mediator of the relationship between Indigenous language use and positive mental health

Community member perspectives on adapting the cascade of care for opioid use disorder for a tribal nation in the United States

BACKGROUND AND AIMS

The Opioid Use Disorder (OUD) Cascade of Care is a public health model that has been used to measure population-level OUD risk, treatment engagement, retention, service and outcome indicators. However, no studies have examined its relevance for American Indian and Alaska Native (AI/AN) communities. Thus, we aimed to understand (1) the utility of existing stages and (2) the relative 'fit' of the OUD Cascade of Care from a tribal perspective.

DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS

Qualitative analysis of in-depth interviews with 20 individuals who were knowledgeable regarding the treatment of OUD in an Anishinaabe tribal setting in Minnesota, USA. Community member roles included clinicians, peer support specialists and cultural practitioners, among others. Thematic analysis was used to analyze the data.

FINDINGS

Participants identified the key transition points of prevention, assessment, inpatient/outpatient pathways and recovery as relevant to their community. They re-imagined an Aanji'bide (Changing our Paths) model of opioid recovery and change that was non-linear; included developmental stage and individual pathways; and demonstrated resilience through connection to culture/spirituality, community and others.

CONCLUSIONS

Community members living/working in a rural tribal nation in Minnesota, USA identified non-linearity and cultural connection as key elements to include in an Anishinaabe-centered model of opioid recovery and change.

Health effects of Indigenous language use and revitalization: a realist review

BACKGROUND

Indigenous populations across the world are more likely to suffer from poor health outcomes when compared to other racial and ethnic groups. Although these disparities have many sources, one protective factor that has become increasingly apparent is the continued use and/or revitalization of traditional Indigenous lifeways: Indigenous language in particular. This realist review is aimed at bringing together the literature that addresses effects of language use and revitalization on mental and physical health.

METHODS

Purposive bibliographic searches on Scopus were conducted to identify relevant publications, further augmented by forward citation chaining. Included publications (qualitative and quantitative) described health outcomes for groups of Indigenous people who either did or did not learn and/or use their ancestral language. The geographical area studied was restricted to the Americas, Australia or New Zealand. Publications that were not written in English, Spanish, French, Portuguese or German were excluded. A realist approach was followed to identify positive, neutral or negative effects of language use and/or acquisition on health, with both qualitative and quantitative measures considered.

RESULTS

The bibliographic search yielded a total of 3508 possible publications of which 130 publications were included in the realist analysis. The largest proportion of the outcomes addressed in the studies (62.1%) reported positive effects. Neutral outcomes accounted for 16.6% of the reported effects. Negative effects (21.4%) were often qualified by such issues as possible cultural use of tobacco, testing educational outcomes in a student's second language, and correlation with socioeconomic status (SES), health access, or social determinants of health; it is of note that the positive correlations with language use just as frequently occurred with these issues as the negative correlations did.

CONCLUSIONS

Language use and revitalization emerge as protective factors in the health of Indigenous populations. Benefits of language programs in tribal and other settings should be considered a cost-effective way of improving outcomes in multiple domains.

Predictors of Land-Based Activity Participation in a National Representative Sample of Indigenous Individuals Living Off-Reserve

This study examined data from the 2017 Aboriginal Peoples Survey to consider predictors of land-based activity engagement. We hypothesized that higher self-reported mental and physical health scores, an increased sense of cultural belonging, living in a rural community, and no prior individual or family history of residential school attendance would predict a higher frequency of land-based activity engagement among First Nations individuals living off-reserve. Results from linear regression analyses suggested that an increased sense of cultural belonging, being male, and living in a rural community with a population of less than 1000 people were significant predictors of the frequency of land-based activity engagement. With these preliminary findings, further research can explore how physical and mental health outcomes influence the frequency of land-based activity engagement, in addition to how community-specific indicators may promote higher frequency of these activities, particularly among First Nations individuals living off-reserve.

Centering Indigenous Knowledges and Worldviews: Applying the Indigenist Ecological Systems Model to Youth Mental Health and Wellness Research and Programs

Globally, Indigenous communities, leaders, mental health providers, and scholars have called for strengths-based approaches to mental health that align with Indigenous and holistic concepts of health and wellness. We applied the Indigenist Ecological Systems Model to strengths-based case examples of Indigenous youth mental health and wellness work occurring in CANZUS (Canada, Australia, New Zealand, and United States). The case examples include research, community-led programs, and national advocacy. Indigenous youth development and well-being occur through strengths-based relationships across interconnected environmental levels. This approach promotes Indigenous youth and communities considering complete ecologies of Indigenous youth to foster their whole health, including mental health. Future research and programming will benefit from understanding and identifying common, strengths-based solutions beyond narrow intervention targets. This approach not only promotes Indigenous youth health and mental health, but ripples out across the entire ecosystem to promote community well-being.