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Reed L, Odendal L, Mercurio D, Snyder CW. Identifying injuries suggestive of child physical abuse: An innovative application of the Trauma Quality Improvement Program. J Trauma Acute Care Surg 2024; 97:272-277. [PMID: 38343003 DOI: 10.1097/ta.0000000000004274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
BACKGROUND Child physical abuse (CPA) carries high risk of morbidity and mortality. Screening for CPA may be limited by subjective risk criteria and racial and socioeconomic biases. This study derived, validated, and compared age-stratified International Classification of Diseases, 10th revision (ICD-10) diagnosis codes indicating high risk of CPA. METHODS Injured children younger than 6 years from the Trauma Quality Improvement Program (TQIP) database were included; years 2017 to 2018 were used for derivation and 2019 for validation. Confirmed CPA was defined as a report of abuse plus discharge with alternate caregiver. Patients were classified as high vs. low CPA risk by three methods: (1) abuse-specific ICD-10 codes, (2) previously validated high-risk ICD-9 codes crosswalked to equivalent ICD-10 codes, and (3) empirically-derived ICD-10 codes from TQIP. These methods were compared with respect to sensitivity, specificity, area under the receiver-operator curve (AUROC), and uniformity across race and insurance strata. RESULTS A total of 122,867 children were included (81,347 derivation cohort, 41,520 validation cohort). Age-stratified high-risk diagnoses derived from TQIP consisted of 40 unique codes for ages 0 year to 2 years, 30 codes for ages 3 years to 4 years, and 20 codes for ages 5 years to 6 years. In the validation cohort, 890 children (2.1%) had confirmed CPA. On comparison with abuse-specific and crosswalked ICD-9 codes, TQIP-derived codes had the highest sensitivity (70% vs. 19% vs. 54%) and the highest AUROC (0.74 vs. 0.59 vs. 0.68, p < 0.0001) for confirmed abuse across all age groups. Age-based risk stratification using TQIP-derived codes demonstrated low variability by race (25% White vs. 25% Hispanic vs. 28% Black patients considered high-risk) and insurance status (23% privately insured vs. 26% uninsured). CONCLUSION High-risk CPA injury codes empirically derived from TQIP produced the best diagnostic characteristics and minimized some disparities. This approach, while requiring further validation, has the potential to improve CPA injury surveillance and decrease bias in screening protocols. LEVEL OF EVIDENCE Diagnostic Test/Criteria; Level III.
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Affiliation(s)
- Leighton Reed
- From the Department of Pediatrics (L.R.), Division of Pediatric Emergency Medicine (L.O., D.M.), Division of Pediatric Surgery (C.W.S.), Johns Hopkins All Children's Hospital, St. Petersburg, Florida
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Luebke J, Thomas N, Nkhoma YB, Fernandez AR, Moore KM, Lopez AA, Mkandawire-Valhmu L. "It is like a curse". The lived experiences of the intersection of intergenerational violence, pregnancy, and intimate partner violence among urban Wisconsin Indigenous women. Arch Psychiatr Nurs 2024; 51:274-281. [PMID: 39034089 DOI: 10.1016/j.apnu.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 04/16/2024] [Accepted: 06/09/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Intimate Partner Violence (IPV) is a significant public health concern that disproportionately impacts Indigenous American women more than any other ethnic/racial group in the United States. PURPOSE This study aims to inform the work of nurses and allied health professionals by providing insight into the lived realities of Indigenous women in urban areas and how IPV manifests in the lives of Indigenous women. METHODS Postcolonial and Indigenous feminist frameworks informed this qualitative study. Using thematic analysis, we analyzed data from semi-structured individual interviews with 34 Indigenous women in large urban areas in the upper Midwest. FINDINGS This manuscript discusses one broad theme: experiences of IPV during pregnancy and the devastating impacts on women and their children in the form of intergenerational trauma. Under this broad theme, we identified two sub-themes: impacts of IPV on individual pregnancy experiences and linkages to adverse pregnancy-related outcomes related to physical IPV during the childbearing years. CONCLUSION This Indigenous-led study informs the development of effective Indigenous-specific interventions to minimize barriers to accessing prenatal care and help-seeking when experiencing IPV to reduce the devastating consequences for Indigenous women and their families.
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Affiliation(s)
- Jeneile Luebke
- School of Nursing, University of Wisconsin-Madison, United States of America.
| | - Nicole Thomas
- School of Nursing, University of Wisconsin-Madison, United States of America
| | - Yamikani B Nkhoma
- School of Nursing, University of Wisconsin-Madison, United States of America
| | | | - Kaylen Marua Moore
- College of Nursing, University of Wisconsin-Milwaukee, United States of America
| | - Alexa A Lopez
- College of Nursing, University of Wisconsin-Milwaukee, United States of America
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Schultz K, Taylor E, McKinney S, Hamby S. Exploring strengths, psychological functioning and youth victimization among American Indians and Alaska Natives in four southern states. CHILD ABUSE & NEGLECT 2024; 148:106197. [PMID: 37208233 DOI: 10.1016/j.chiabu.2023.106197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 04/03/2023] [Accepted: 04/11/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Identifying factors that support healthy psychological functioning after experiencing violence or other adversities in youth can lead to better prevention and intervention efforts. This is particularly important among communities with disproportionately high rates of adversity resulting from legacies of social and political injustices, such as American Indian and Alaska Native populations. METHODS Data were pooled from four studies in the southern U.S. to examine a subsample of American Indian/Alaska Native participants (N = 147; mean age 28.54 years, SD = 16.3). Using the resilience portfolio model, we investigate the impact of three categories of psychosocial strengths (regulatory, meaning making, and interpersonal) on psychological functioning (subjective well-being and trauma symptoms), controlling for youth victimization, lifetime adversities, age, and gender. RESULTS In examining subjective well-being, the full model accounted for 52 % of the variance, with strengths explaining more variance than adversities (45 % vs 6 %). For trauma symptoms, the full model accounted for 28 % of the variance, with strengths and adversities accounting nearly equally for the variance (14 % and 13 %). DISCUSSION Psychological endurance and sense of purpose showed the most promise for bolstering subjective well-being while poly-strengths (having a diversity of multiple strengths) was most predictive of fewer trauma symptoms. Building psychosocial strengths offers promising strategies for prevention and intervention in Native nations and communities.
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Affiliation(s)
- Katie Schultz
- University of Michigan School of Social Work, 1080 S University Ave, Ann Arbor, MI 48109, USA,.
| | - Elizabeth Taylor
- Life Paths Research Center, Oakland University, 654 Pioneer Drive, Pryale Hall, Rochester, MI 48309, USA.
| | - Sherise McKinney
- University of Michigan School of Social Work, 1080 S University Ave, Ann Arbor, MI 48109, USA.
| | - Sherry Hamby
- Life Paths Research Center, University of the South, PO Box 187, Sewanee, TN 37375, USA.
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Gilbert SL, Gillespie LK, Lee JG, King LL. We Have a Voice: An Examination of Intimate Partner Violence in a Native American Community. VIOLENCE AND VICTIMS 2023; 38:799-818. [PMID: 37907248 DOI: 10.1891/vv-2023-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Indigenous people experience a higher rate of intimate partner violence (IPV) than other racial/ethnic groups; however, limited research examines IPV among this population. In collaboration with a tribe in the western United States, this study surveyed a sample of indigenous people (N = 27) to learn about their experiences with victimization. Results show that respondents experienced high amounts of recent relationship and lifetime victimization, mostly consistent with previous literature. Additional issues and challenges emerged from the data, such as low reporting rates and service accessibility. These findings are contextualized within prior IPV literature, and we offer recommendations for future research.
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Affiliation(s)
- Sheena L Gilbert
- School of Criminology and Criminal Justice, University of Nebraska at Omaha, Omaha, NE, USA
| | | | - Jacqueline G Lee
- Criminal Justice Program, Boise State University, Boise, ID, USA
| | - Laura L King
- Criminal Justice Program, Boise State University, Boise, ID, USA
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Hamby S, Schultz K, Taylor E. Health-Related Quality of Life among American Indian and Alaska Native People: Exploring Associations with Adversities and Psychosocial Strengths. HEALTH & SOCIAL WORK 2023; 48:105-114. [PMID: 36928132 DOI: 10.1093/hsw/hlad007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/10/2022] [Accepted: 05/02/2022] [Indexed: 06/18/2023]
Abstract
Identifying psychosocial strengths that support physical health can lead to better pathways to prevention and intervention. Relying on the resilience portfolio model as a conceptual framework, this study explores strengths in three domains (regulation, meaning making, and interpersonal) to identify promising protective factors to support physical health-related quality of life (P-HRQOL), controlling for prior exposure to adversity, age, and gender. This study uses data from four resilience portfolio model studies collected in the southern United States, combined to increase the number of people who identified as American Indian/Alaska Native. The sample included 147 people (M age = 28.5 years; SD = 16.26), of which 57 percent are female. The surveys collected data on adversities (polyvictimization, other adversities, county poverty), psychosocial strengths (psychological endurance, sense of purpose, religious meaning making, compassion, and community support), and P-HRQOL. The full model accounted for 24 percent of the variance in P-HRQOL, with strengths explaining more than twice as much variance as adversities (13 percent versus 6 percent). A sense of purpose showed the most promise for supporting P-HRQOL. Regarding implications, authors recommend exploring a wider range of protective factors that might improve resilience in Native communities. Several evidence-based pathways to meaning making, such as narrative and mindfulness, may improve health outcomes for Native people.
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Affiliation(s)
- Sherry Hamby
- PhD, is distinguished research professor of psychology, Psychology Department, University of the South, 735 University Avenue, Sewanee, TN 37383, USA; and director, Life Paths Research Center, Sewanee, TN 37375, USA
| | - Katie Schultz
- PhD, MSW, is assistant professor of social work, School of Social Work, University of Michigan, Ann Arbor, MI, USA
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Koch TA, Anderson M, Weaver M. Establishing Victim Services in an American Indian Tribal Community: A Needs Assessment. J Transcult Nurs 2022; 33:715-722. [PMID: 36062425 DOI: 10.1177/10436596221119488] [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: 11/15/2022] Open
Abstract
INTRODUCTION American Indian/Alaska Native (AIAN) communities experience a disproportionate number of violent crimes compared with other populations. Tribal-based services for victims are lacking on smaller reservations. A needs assessment was conducted for a tribe in the Pacific Northwest addressing this issue. METHOD Utilizing a framework of community-based participatory research (CBPR), a survey study was conducted with tribal members and local service providers. Survey A was composed of questions constructed by a tribal working group and Survey B questions were from an existing survey. RESULTS Tribal members (n = 5) indicated violence was experienced by all and witnessed by 80% of participants. Service providers (n = 17) perceived adequate but underutilization of resources. DISCUSSION The presence of violence in the community was confirmed. Services were not routinely accessed by members. Service providers indicated knowledge gaps in the community and cultural barriers for AIAN people. The study raised awareness of violence in AIAN communities and need for additional research.
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Crowder J, Burnett C, Byon HD, Laughon K, Acierno R, Yan G, Hinton I, Teaster PB. Exploration and Comparison of Contextual Characteristics and Mistreatment Prevalence Among Older American Indian and Alaska Native Respondents: Secondary Analysis of the National Elder Mistreatment Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:1456-1483. [PMID: 32478601 DOI: 10.1177/0886260520922356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Limited research on elder abuse among American Indians and Alaska Natives (AIANs) suggests a higher prevalence of abuse. Using data from the National Elder Mistreatment Study (NEMS), we compared contextual characteristics and elder mistreatment prevalence rates from a community-based sample of AIAN (n = 195) and Black (n = 437) and White (n = 5,013) respondents. There were differences in the prevalence of 16 abuse types and the 23 contextual variables. AIAN respondents had more similarities compared with Black respondents than White respondents, though differences existed. The cumulative prevalence of emotional, physical, and sexual mistreatment in the past year, neglect, and financial abuse by a family member for the AIAN group was 33%, almost double the 17.1% reported in the NEMS study. Over their lifetime, 29.7% of AIAN respondents reported experiencing two or more types of neglect, exploitation, or mistreatment. Almost one fourth of AIAN respondents reported emotional abuse since 60 years of age (the most commonly occurring abuse type)-nearly double that of White respondents. This is the first study to offer comparative prevalence of elder abuse for both AIAN older males and females that draws from a nationally representative sample. The study also provides descriptive analysis of important contextual information within the AIAN population, an underrepresented racial group in elder abuse research. Disaggregating nonmajority racial groups to examine contextual variables and the prevalence of elder mistreatment in the NEMS data set specific to AIAN respondents fills a knowledge gap. Known prevalence of various abuse typologies among AIAN elders can be useful in setting priorities for community planning and response, and in prioritization of funding for future research on causative mechanisms by abuse type, screening, and interventions at various levels. Findings may facilitate development of culturally specific evidence-based prevention and intervention practices aimed at needs specific to AIAN older adults.
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Affiliation(s)
| | | | - Ha Do Byon
- University of Virginia, Charlottesville, USA
| | | | - Ronald Acierno
- The University of Texas Health Science Center at Houston, USA
| | - Guofen Yan
- University of Virginia, Charlottesville, USA
| | | | - Pamela B Teaster
- Virginia Polytechnic Institute and State University, Blacksburg, USA
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Giacci E, Straits KJ, Gelman A, Miller-Walfish S, Iwuanyanwu R, Miller E. Intimate Partner and Sexual Violence, Reproductive Coercion, and Reproductive Health Among American Indian and Alaska Native Women: A Narrative Interview Study. J Womens Health (Larchmt) 2022; 31:13-22. [PMID: 34747659 PMCID: PMC8785763 DOI: 10.1089/jwh.2021.0056] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: The disproportionately high prevalence of poor reproductive and sexual health outcomes among American Indian and Alaska Native (AI/AN) women is related to histories of colonization, oppression, and structural racism. Intimate partner violence (IPV) and sexual violence (SV) contribute to these health outcomes. Materials and Methods: Narrative interviews were conducted with AI/AN women from four tribal reservation communities. Interviews explored connections among sexual and reproductive health, IPV, SV, reproductive coercion (RC), and pregnancy experiences as well as women's experiences of healing and recovery. Results: Among the 56 women interviewed (aged 17-55 years, 77% were aged 40 years and younger), all described multiple exposures to violence and highlighted lack of disclosure related to sexuality, childhood abuse, SV, and historical trauma. Access to confidential reproductive health services and contraceptive education was limited. Almost half (45%) reported experiencing RC in their lifetime. Use of substances occurred in both the context of SV and for surviving after exposure to violence. Women underscored the extent to which IPV, SV, and RC are embedded in histories of colonization, racism, and ongoing oppression. Interventions that incorporate AI/AN traditions, access to culturally responsive reproductive health and advocacy services, organizations, and services that have AI/AN personnel supporting survivors, public discussion about racism, abuse, sexuality, and more accountable community responses to violence (including law enforcement) are promising pathways to healing and recovery. Conclusions: Findings may advance understanding of AI/AN women's reproductive health in the context of historical trauma and oppression. Intervention strategies that enhance resiliency of AI/AN women may promote reproductive health.
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Affiliation(s)
- Elena Giacci
- Advocate and Training Specialist (Dine), Albuquerque, New Mexico, USA
| | - Kee J.E. Straits
- Tinkuy Life Community Transformations, LLC, Albuquerque, New Mexico, USA
| | - Amanda Gelman
- Chinle Comprehensive Health Care Facility, Chinle, Arizona, USA
| | - Summer Miller-Walfish
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rosemary Iwuanyanwu
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Palimaru AI, Dong L, Brown RA, D'Amico EJ, Dickerson DL, Johnson CL, Troxel WM. Mental health, family functioning, and sleep in cultural context among American Indian/Alaska Native urban youth: A mixed methods analysis. Soc Sci Med 2022; 292:114582. [PMID: 34826766 PMCID: PMC8748395 DOI: 10.1016/j.socscimed.2021.114582] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/11/2021] [Accepted: 11/17/2021] [Indexed: 01/03/2023]
Abstract
Mental health problems contribute significantly to the global burden of disease. Driven in part by family stressors and insufficient sleep, mental health disproportionately affects low SES urban adolescents. In the United States, American Indian/Alaska Native (AI/AN) youth exhibit excessively high rates of mental health problems. Family functioning is strongly associated with adolescent mental health, and sleep problems may serve as a pathway between family functioning and mental health. Using mixed methods we examine the associations among family functioning, subjective- and actigraphy-measured sleep, mental health (depressive and anxiety symptoms), and cultural identity in a sample of urban AI/AN youth. All participants (N = 142) completed surveys; a random subsample (n = 26) completed qualitative interviews to assess family and cultural dynamics related to sleep, which informed hypothesized direct and indirect effects that were tested using survey data. Narratives identified mechanisms of family cohesion (e.g., daily interactions that build perceived family togetherness and family-centered traditional activities) and the role that family cohesion plays in sleep (e.g., ensuring stability of sleep environments). Path analysis showed direct effects of improved family functioning on fewer depressive and anxiety symptoms, and indirect effects through lower self-reported sleep disturbance (but not through greater actigraphy-measured sleep duration or efficiency). Cultural identity did not moderate effects in quantitative tests. Our findings illustrate the complex associations among family functioning, sleep, and mental health in AI/AN youth. Family-based interventions to improve adolescent mental health should address modifiable intervention targets such as sleep, and address sources of both risk and resilience relevant to urban AI/AN families, including extended family and cultural practices.
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Affiliation(s)
| | - Lu Dong
- RAND Corporation, Santa Monica, CA, USA.
| | | | | | - Daniel L Dickerson
- UCLA Integrated Substance Abuse Programs (ISAP), Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA.
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Petrosky E, Mercer Kollar LM, Kearns MC, Smith SG, Betz CJ, Fowler KA, Satter DE. Homicides of American Indians/Alaska Natives - National Violent Death Reporting System, United States, 2003-2018. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2021; 70:1-19. [PMID: 34793415 PMCID: PMC8639023 DOI: 10.15585/mmwr.ss7008a1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PROBLEM/CONDITION Homicide is a leading cause of death for American Indians/Alaska Natives (AI/ANs). Intimate partner violence (IPV) contributes to many homicides, particularly among AI/AN females. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on AI/AN homicides. Results include victim and suspect sex, age group, and race/ethnicity; method of injury; type of location where the homicide occurred; precipitating circumstances (i.e., events that contributed to the homicide); and other selected characteristics. PERIOD COVERED 2003-2018. DESCRIPTION OF SYSTEM NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports and links related deaths (e.g., multiple homicides and homicide followed by suicide) into a single incident. This report includes data on AI/AN homicides that were collected from 34 states (Alabama, Alaska, Arizona, California, Colorado, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Utah, Virginia, Washington, and Wisconsin) and the District of Columbia. RESULTS NVDRS collected data on 2,226 homicides of AI/ANs in 34 states and the District of Columbia during 2003-2018. The age-adjusted AI/AN homicide rate was 8.0 per 100,000 population. The homicide rate was three times higher in AI/AN males than females (12.0 versus 3.9), and the median age of AI/AN victims was 32 years (interquartile range: 23-44 years). Approximately half of AI/AN homicide victims lived or were killed in metropolitan areas (48.2% and 52.7%, respectively). A firearm was used in nearly half (48.4%) of homicides and in a higher percentage of homicides of AI/AN males than females (51.5% versus 39.1%). More AI/AN females than males were killed in a house or apartment (61.8% versus 53.7%) or in their own home (47.7% versus 29.0%). Suspects were identified in 82.8% of AI/AN homicides. Most suspects were male (80.1%), and nearly one third (32.1%) of suspects were AI/ANs. For AI/AN male victims, the suspect was most often an acquaintance or friend (26.3%), a person known to the victim but the exact nature of the relationship was unclear (12.3%), or a relative (excluding intimate partners) (10.5%). For AI/AN female victims, the suspect was most often a current or former intimate partner (38.4%), an acquaintance or friend (11.5%), or a person known to the victim but the exact nature of the relationship was unclear (7.9%). A crime precipitated 24.6% of AI/AN homicides (i.e., the homicide occurred as the result of another serious crime). More AI/AN males were victims of homicides due to an argument or conflict than females (54.7% versus 37.3%), whereas more AI/AN females were victims of homicides due to IPV than males (45.0% versus 12.1%). For homicides related to IPV, 87.2% of AI/AN female victims were killed by a current or former intimate partner, whereas approximately half (51.5%) of AI/AN male victims were corollary victims (i.e., victims killed during an IPV-related incident who were not the intimate partners themselves). INTERPRETATION This report provides a detailed summary of NVDRS data on AI/AN homicides during 2003-2018. Interpersonal conflict was a predominant circumstance, with nearly half of all AI/AN homicides precipitated by an argument and for female victims, 45.0% precipitated by IPV. PUBLIC HEALTH ACTION NVDRS provides critical and ongoing data on AI/AN homicides that can be used to identify effective and early intervention strategies for preventing these deaths. When possible, violence prevention efforts should include community-developed, culturally relevant, and evidence-based strategies. These efforts should incorporate traditional native knowledge and solutions, implement and possibly adapt evidence-based IPV and other violence prevention strategies, and consider the influence of historical and larger societal factors that increase the likelihood of violence in AI/AN communities.
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James R, Hesketh MA, Benally TR, Johnson SS, Tanner LR, Means SV. Assessing Social Determinants of Health in a Prenatal and Perinatal Cultural Intervention for American Indians and Alaska Natives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11079. [PMID: 34769596 PMCID: PMC8583343 DOI: 10.3390/ijerph182111079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 12/03/2022]
Abstract
American Indians and Alaska Natives (AIANs) refer to cultural traditions and values to guide resilient and strength-based practices to address maternal and infant health disparities. METHODS A case study of a culturally-based educational intervention on AIAN maternal and child health. RESULTS Cultural teachings have successfully been applied in AIAN behavioral interventions using talking circles and cradleboards, but maternal and child health interventions are not well-represented in peer-reviewed literature. Zero publications included interventions centered around cradleboards and safe sleep. DISCUSSION There is a need for rigorous published research on culturally based interventions and effectiveness on health outcomes for mothers and babies. CONCLUSIONS This paper discusses how a cradleboard educational intervention incorporates national guidelines to address maternal and infant health while mediating social determinants of health.
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Affiliation(s)
- Rosalina James
- Urban Indian Health Institute, Seattle, WA 98144, USA; (M.A.H.); (T.R.B.); (S.S.J.)
- Seattle Indian Health Board, Seattle, WA 98144, USA
| | - Martell A. Hesketh
- Urban Indian Health Institute, Seattle, WA 98144, USA; (M.A.H.); (T.R.B.); (S.S.J.)
- Seattle Indian Health Board, Seattle, WA 98144, USA
| | - Tia R. Benally
- Urban Indian Health Institute, Seattle, WA 98144, USA; (M.A.H.); (T.R.B.); (S.S.J.)
- School of Public Health, University of Washington, Seattle, WA 98195, USA;
| | - Selisha S. Johnson
- Urban Indian Health Institute, Seattle, WA 98144, USA; (M.A.H.); (T.R.B.); (S.S.J.)
- School of Public Health, University of Washington, Seattle, WA 98195, USA;
| | - Leah R. Tanner
- Native American Women’s Dialogue on Infant Mortality, Seattle, WA 98144, USA;
- Portland Area Consultant, Healthy Native Babies Project, Seattle, WA 98144, USA
| | - Shelley V. Means
- School of Public Health, University of Washington, Seattle, WA 98195, USA;
- Native American Women’s Dialogue on Infant Mortality, Seattle, WA 98144, USA;
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Sarmiento K, Kennedy J, Daugherty J, Peterson AB, Evans ME, Haberling DL, Billie H. Traumatic Brain Injury-Related Emergency Department Visits Among American Indian and Alaska Native Persons-National Patient Information Reporting System, 2005-2014. J Head Trauma Rehabil 2021; 35:E441-E449. [PMID: 32472829 PMCID: PMC7483258 DOI: 10.1097/htr.0000000000000570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The American Indian/Alaska Native (AI/AN) population has a disproportionately high rate of traumatic brain injuries (TBIs). However, there is little known about incidence and common mechanisms of injury among AI/AN persons who seek care in an Indian Health Service (IHS) or tribally managed facility. METHODS Using the IHS National Patient Information Reporting System, we assessed the incidence of TBI-related emergency department visits among AI/AN children and adults seen in IHS or tribally managed facilities over a 10-year period (2005-2014). RESULTS There were 44 918 TBI-related emergency department visits during the study period. Males and persons aged 18 to 34 years and 75 years and older had the highest rates of TBI-related emergency department visits. Unintentional falls and assaults contributed to the highest number and proportion of TBI-related emergency department visits. The number and age-adjusted rate of emergency department visits for TBI were highest among persons living in the Southwest and Northern Plains when compared with other IHS regions. CONCLUSION Thousands of AI/AN children and adults are seen each year in emergency departments for TBI and the numbers increased over the 10-year period examined. Evidence-based interventions to prevent TBI-related emergency department visits, such as programs to reduce the risk for older adult falls and assault, are warranted.
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Affiliation(s)
- Kelly Sarmiento
- Divisions of Injury Prevention (Ms Sarmiento and Drs Daugherty and Peterson) and Overdose Prevention (Dr Evans), National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (Mss Kennedy and Haberling); and Indian Health Service, Office of Environmental Health and Engineering, Division of Environmental Health Services, Injury Prevention Program, Washington, District of Columbia (Ms Billie)
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Cunradi CB, Ponicki WR, Caetano R, Alter HJ. Frequency of Intimate Partner Violence among an Urban Emergency Department Sample: A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E222. [PMID: 33396705 PMCID: PMC7796012 DOI: 10.3390/ijerph18010222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 11/17/2022]
Abstract
Intimate partner violence (IPV) is a pervasive public health problem. Within the U.S., urban emergency department (ED) patients have elevated prevalence of IPV, substance use, and other social problems compared to those in the general household population. Using a social-ecological framework, this cross-sectional study analyzes the extent to which individual, household, and neighborhood factors are associated with the frequency of IPV among a socially disadvantaged sample of urban ED patients. Confidential survey interviews were conducted with 1037 married/partnered study participants (46% male; 50% Hispanic; 29% African American) at a public safety-net hospital. Gender-stratified multilevel Tobit regression models were estimated for frequency of past-year physical IPV (perpetration and victimization) and frequency of severe IPV. Approximately 23% of participants reported IPV. Among men and women, impulsivity, adverse childhood experiences, substance use, and their spouse/partner's hazardous drinking were associated with IPV frequency. Additionally, household food insufficiency, being fired or laid off from their job, perceived neighborhood disorder, and neighborhood demographic characteristics were associated with IPV frequency among women. Similar patterns were observed in models of severe IPV frequency. IPV prevention strategies implemented in urban ED settings should address the individual, household, and neighborhood risk factors that are linked with partner aggression among socially disadvantaged couples.
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Affiliation(s)
- Carol B. Cunradi
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704, USA; (W.R.P.); (R.C.)
| | - William R. Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704, USA; (W.R.P.); (R.C.)
| | - Raul Caetano
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704, USA; (W.R.P.); (R.C.)
| | - Harrison J. Alter
- Andrew Levitt Center for Social Emergency Medicine, Berkeley, CA 94703, USA;
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Crowder J, Burnett C, Laughon K, Dreisbach C. Elder Abuse in American Indian Communities: An Integrative Review. JOURNAL OF FORENSIC NURSING 2019; 15:250-258. [PMID: 31764529 DOI: 10.1097/jfn.0000000000000259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND American Indian elders have one of the lowest life expectancies in the United States. Disproportionate disease burden, socioeconomic disparities, and higher rates of violence across the lifespan are thought to contribute to higher rates of elder abuse. Elder abuse and higher rates of trauma exposure are linked with adverse outcomes. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the methodology and assessment of the literature on elder abuse among American Indians. RESULTS Of the nine studies published in the last 30 years, rates of elder abuse varied by study, location, and tribal affiliation from 4.3% to 45.9%. Large studies with comparison populations found higher rates for American Indians. There was a consensus for three risk factors: substance abuse, mental health problems, and caregiving issues. Importance of tribal norms, the notion of respect conferred to elders, and the concept of acculturation were major culturally relevant themes. Perceived tribal norms and strengths, for example, respect for elders, were at odds with abuse experiences, particularly financial exploitation and neglect. Historical trauma, shame, and fear impacted reporting. There was little consistency in study designs, most were qualitative or mixed methods, samples were small, there was no common measurement tool or time frame for abuse, and there was only one intervention study. IMPLICATIONS High rates of abuse suggest healthcare providers should be encouraged to screen and intervene despite the lack of empirical evidence. Providers should not assume that traditional culturally ascribed strengths, such as honor and respect for elders, provide any degree of protection against elder abuse.
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Montag AC, Brodine SK, Alcaraz JE, Clapp JD, Allison MA, Calac DJ, Hull AD, Gorman JR, Jones KL, Chambers CD. Effect of Depression on Risky Drinking and Response to a Screening, Brief Intervention, and Referral to Treatment Intervention. Am J Public Health 2015; 105:1572-6. [PMID: 26066915 DOI: 10.2105/ajph.2015.302688] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We assessed alcohol consumption and depression in 234 American Indian/Alaska Native women (aged 18-45 years) in Southern California. Women were randomized to intervention or assessment alone and followed for 6 months (2011-2013). Depression was associated with risk factors for alcohol-exposed pregnancy (AEP). Both treatment groups reduced drinking (P < .001). Depressed, but not nondepressed, women reduced drinking in response to SBIRT above the reduction in response to assessment alone. Screening for depression may assist in allocating women to specific AEP prevention interventions.
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Affiliation(s)
- Annika C Montag
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
| | - Stephanie K Brodine
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
| | - John E Alcaraz
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
| | - John D Clapp
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
| | - Matthew A Allison
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
| | - Dan J Calac
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
| | - Andrew D Hull
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
| | - Jessica R Gorman
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
| | - Kenneth Lyons Jones
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
| | - Christina D Chambers
- Annika C. Montag, Jessica R. Gorman, Kenneth Lyons Jones, and Christina D. Chambers are with the Department of Pediatrics, University of California, San Diego. Stephanie K. Brodine and John E. Alcaraz are with the Graduate School of Public Health, San Diego State University, San Diego. John D. Clapp is with the School of Social Work, Ohio State University, Columbus. Matthew A. Allison is with the Department of Family and Preventive Medicine, University of California, San Diego. Dan J. Calac is with the Southern California Tribal Health Clinic. Andrew D. Hull is with the Department of Reproductive Medicine, University of California, San Diego
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Abstract
Advances in injury epidemiology and prevention are among the landmark achievements in epidemiology and public health in the past century. Despite remarkable success and growth, the field of injury epidemiology did not have its own publication outlet until now. This commentary marks the debut of the new academic journal Injury Epidemiology and introduces the reader to the first batch of peer-reviewed manuscripts accepted for publication in this new journal.
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Affiliation(s)
- Guohua Li
- Center for Injury Epidemiology and Prevention, Columbia University Medical Center, 622 West 168th St, PH5-505, New York, NY, 10032, USA.
| | - Charles J DiMaggio
- Center for Injury Epidemiology and Prevention, Columbia University Medical Center, 622 West 168th St, PH5-505, New York, NY, 10032, USA
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