Empowering Indigenous Communities Through a Participatory, Culturally Responsive Evaluation of a Federal Program for Older Americans

Building connection and improving health for Indigenous elders: Findings from the Title VI evaluation

BACKGROUND

As the older Indigenous population in the United States expands, there is a growing demand for programs to address age-related needs. Although Title VI of the OAA provides culturally responsive strategies to support elders through home- and community-based nutrition services, these programs have not been the subject of a national evaluation; our study is the first.

METHODS

We conducted a mixed-methods study to assess the impact of the Title VI programs on elders. We used quantitative data from a national survey of Indigenous elders (n = 1175) and qualitative data collected through interviews (n = 36) and focus groups (18, n = 161) with a subgroup of elders receiving services. We compared outcomes for social and cultural connectedness and physical and mental well-being for different subgroups within our sample of elders based on elders' use of Title VI services and the level of services provided to these elders. Results were adjusted for community characteristics.

RESULTS

Elders receiving Title VI services had significantly fewer hospitalizations and falls per year (hospitalizations: 0.9 vs. 1.2, p < 0.05; falls: 1.0 versus 1.1, p < 0.05) and significantly more social and cultural engagements per month (social engagements: 92.6% vs. 75.6%, p < 0.05; cultural practices: 78.8% vs. 64.8%, p < 0.05) compared with elders who did not participate in Title VI services. These findings were confirmed by our qualitative data.

CONCLUSIONS

Our findings highlight the vital role that the Title VI program plays in promoting elders' overall health and well-being through decreased hospitalizations and falls and increased connectedness.