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Advances in Indigenous and American Indian and Alaska Native Health and Wellness

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 11016

Special Issue Editors


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Guest Editor
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
Interests: American Indian and Alaska Native health disparities; opioid and substance use disorders; American Indian youth prevention and intervention programming; evaluation

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Guest Editor
Department of Pediatrics, Keck School of Medicine, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA 90027, USA
Interests: community-based participatory intervention research; culturally-grounded intervention development; Native American youth; pediatric mood and anxiety disorders

Special Issue Information

Dear Colleagues,

Indigenous populations have poorer health outcomes and a gap in life expectancy of approximately 10 years compared to non-Indigenous populations. The focus of this Special Issue includes Indigenous populations from Australia (Australian Aboriginals), Canada (First Nations), the United States (American Indian and Alaska Natives) and New Zealand (Maoris). Even though there are differences in the Indigenous health among these four countries, the experience of colonization and the long-term effects of being colonized has impacted the physical, social, emotional and mental health and wellbeing of Indigenous populations. These inequities exist and have led to poor social determinants of health. Significant advancements have been made to improve health outcomes and reduce health disparities among unique and diverse Indigenous communities. Papers focusing on new research, reviews, case reports, and conference papers to address Indigenous-specific mental health, the burden of communicable and non-communicable diseases, nutrition, disability, community resilience and social determinants of health inequities are invited.

Dr. Claradina Soto
Prof. Dr. Amy E. West
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • behavioral and mental health
  • health promotion
  • pediatric health
  • injury prevention
  • school health
  • communicable diseases
  • non-communicable diseases
  • environmental health
  • physical, mental, emotional, and spiritual health

Published Papers (7 papers)

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Research

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10 pages, 558 KiB  
Article
Clinical Outcomes from the Alaska Native Tribal Health Consortium Colorectal Cancer Control Program: 2009–2015
by Sarah H. Nash, Elizabeth Verhage, Christie Flanagan, Donald Haverkamp, Elena Roik, Garrett Zimpelman and Diana Redwood
Int. J. Environ. Res. Public Health 2024, 21(5), 552; https://doi.org/10.3390/ijerph21050552 - 26 Apr 2024
Viewed by 547
Abstract
The Alaska Native Tribal Health Consortium (ANTHC) participated in the United States Centers for Disease Control and Prevention Colorectal Cancer Control Program (CRCCP) from 2009 to 2015. We conducted a descriptive evaluation of ANTHC CRCCP demographics, quality measures, and clinical outcomes, including screening [...] Read more.
The Alaska Native Tribal Health Consortium (ANTHC) participated in the United States Centers for Disease Control and Prevention Colorectal Cancer Control Program (CRCCP) from 2009 to 2015. We conducted a descriptive evaluation of ANTHC CRCCP demographics, quality measures, and clinical outcomes, including screening methods employed within the program and screening outcomes. There were 6981 program screenings completed, with the majority (81.3%) of people screened in the 50–75 year age group. Colonoscopy was the primary screening test used, accounting for 6704 (96.9%) of the screening tests. Quality of colonoscopy was high: adequate bowel preparation was reported in 98.2% of colonoscopies, cecal intubation rate was 98.9%, and the adenoma detection rate was 38.9%. A high proportion (58.9%) of colonoscopies had an initial finding of polyps or lesions suspicious for cancer; 41.2% of all colonoscopies had histological confirmation of either adenomatous polyps (40.6%) or cancer (0.5%). The ANTHC CRCCP successfully increased CRC screening among American Indian and Alaska Native peoples living in Alaska; this was achieved primarily through high-quality colonoscopy metrics. These data support a continued focus by the Alaska Native Tribal Health Consortium and its tribal health partners on increasing CRC screening and reducing cancer mortality among Alaska Native peoples. Full article
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10 pages, 268 KiB  
Article
Reach, Acceptability, and Sustainability of the Native Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (CHOICES) Intervention: A Qualitative Evaluation of an Alcohol-Exposed Pregnancy Prevention Program
by Sara M. London, Jessica D. Hanson, Michelle Sarche, Kyra Oziel and Dedra Buchwald
Int. J. Environ. Res. Public Health 2024, 21(3), 266; https://doi.org/10.3390/ijerph21030266 - 26 Feb 2024
Viewed by 1247
Abstract
American Indian (AI) women are at risk of alcohol-exposed pregnancy (AEP) due to the higher prevalence of alcohol use disorders (AUDs) and risky drinking. The Native Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (Native CHOICES) was implemented in partnership with a [...] Read more.
American Indian (AI) women are at risk of alcohol-exposed pregnancy (AEP) due to the higher prevalence of alcohol use disorders (AUDs) and risky drinking. The Native Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (Native CHOICES) was implemented in partnership with a Northern Plains Tribal community to address the effectiveness of a brief, motivational interviewing-based intervention to reduce AEP risk among adult AI women. A subgroup of the participants shared their perspectives in a qualitative interview conducted following the completion of the six-month post-baseline data collection. These interviews solicited participant perspectives on the Native CHOICES intervention and its satisfaction, reach, acceptability, and sustainability. The participants were delighted with Native CHOICES, felt the intervention helped them learn about AEP prevention and goal setting, learned valuable lessons, and believed Native CHOICES would be well-received by other women in their community and should be continued. The participants also shared how the COVID-19 pandemic affected their choices about drinking and birth control. The findings showed the receptivity to and acceptance of Native CHOICES among AI women. The interview findings offered a glimpse into the effectiveness of Native CHOICES and how it contributed to participants making healthier choices surrounding drinking and sexual health. Full article
19 pages, 680 KiB  
Article
Indigenous Voices Against Suicide: A Meta-Synthesis Advancing Prevention Strategies
by Meenakshi Richardson and Sara F. Waters
Int. J. Environ. Res. Public Health 2023, 20(22), 7064; https://doi.org/10.3390/ijerph20227064 - 15 Nov 2023
Viewed by 1838
Abstract
Rates of suicidality amongst Indigenous Peoples are linked to historical and ongoing settler-colonialism including land seizures, spiritual oppression, cultural disconnection, forced enculturation, and societal alienation. Consistent with decolonial practices, Indigenous voices and perspectives must be centered in the development and evaluation of suicide [...] Read more.
Rates of suicidality amongst Indigenous Peoples are linked to historical and ongoing settler-colonialism including land seizures, spiritual oppression, cultural disconnection, forced enculturation, and societal alienation. Consistent with decolonial practices, Indigenous voices and perspectives must be centered in the development and evaluation of suicide prevention programs for Indigenous Peoples in the United States to ensure efficacy. The current study is a meta-synthesis of qualitative research on suicide prevention among Indigenous populations in the United States. Findings reveal little evidence for the centering of participant voices within existing suicide prevention programs. Applied thematic analysis of synthesis memos developed for each article in the final sample surfaced four primary themes: (1) support preferences; (2) challenges to suicide prevention; (3) integration of culture as prevention; and (4) grounding relationships in prevention. The need for culturally centered programming and the inadequacy of ‘pan-Indian’ approaches are highlighted. Sub-themes with respect to resiliency, kinship connection, and safe spaces to share cultural knowledge also emerge. Implications of this work to further the decolonization of suicide prevention and aid in the promotion of culturally grounded prevention science strategies are discussed. Full article
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10 pages, 502 KiB  
Article
A Qualitative Study on Parenting Practices to Sustain Adolescent Health Behaviors in American Indian Families
by Christine Hodgson, Dylan Decker, Teresia M. O’Connor, Melanie Hingle and Francine C. Gachupin
Int. J. Environ. Res. Public Health 2023, 20(21), 7015; https://doi.org/10.3390/ijerph20217015 - 3 Nov 2023
Viewed by 1425
Abstract
American Indian (AI) adolescents who practice healthy behaviors of sleep, nutrition, physical activity, and limited screen time can lower their lifetime risk of diet-sensitive disease. Little is known about how AI parenting practices influence the health behaviors of youth. The objective of this [...] Read more.
American Indian (AI) adolescents who practice healthy behaviors of sleep, nutrition, physical activity, and limited screen time can lower their lifetime risk of diet-sensitive disease. Little is known about how AI parenting practices influence the health behaviors of youth. The objective of this qualitative study was to explore how a group of AI parents of youths at risk of disease influenced their youth’s health behaviors after a family intervention. A secondary objective was to understand the role of AI parents in supporting and sustaining health behavior change in their youths following the intervention. Semi-structured in-depth interviews were conducted with AI parents (n = 11) and their young adolescents, 10–15 years old (n = 6). Parents reported facilitators to how they enacted healthy lifestyle behaviors, including family togetherness, routines, youth inclusion in cooking, and motivation due to a health condition in the family. Barriers to enacting healthy behaviors included a lack of time, a lack of access to health resources, negative role modeling, and the pervasiveness of screen media. Three major themes about the role of AI parenting emerged inductively from the interview data: “Parenting in nontraditional families”, “Living in the American grab-and-go culture”, and “Being there and teaching responsibility”. The importance of culture in raising youths was emphasized. These findings inform strategies to promote long-term adherence to behavior changes within the intervention. This study contributes to public health conversations regarding approaches for AI youths and families, who are not well represented in previous health behavior research. Full article
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18 pages, 392 KiB  
Article
Visioning an Effective Health Encounter: Indigenous Healthcare Experiences and Recommendations for Health Professionals
by Melissa E. Lewis, Sky Wildcat and Amber Anderson
Int. J. Environ. Res. Public Health 2023, 20(20), 6917; https://doi.org/10.3390/ijerph20206917 - 13 Oct 2023
Viewed by 1686
Abstract
Purpose: Indigenous patients experience challenges while accessing and utilizing healthcare services that relate to worsened health experiences. Bias towards Indigenous patients is prevalent in healthcare settings and leads to poor health outcomes. The purpose of this study was to learn about the healthcare [...] Read more.
Purpose: Indigenous patients experience challenges while accessing and utilizing healthcare services that relate to worsened health experiences. Bias towards Indigenous patients is prevalent in healthcare settings and leads to poor health outcomes. The purpose of this study was to learn about the healthcare experiences, both positive and negative, of Indigenous patients and solicit subsequent recommendations to improve care delivered to this population. Methods: This study sampled Indigenous patients (n = 20) from an Indigenous-serving health clinic to discuss participants’ health experiences and elicit recommendations for improved care. Four focus groups were conducted, and template analysis was employed to analyze the data. Results: A total of 15 themes were developed under the category of an effective health encounter. Highlighted themes include healthcare that is free of stigma, quality care, respecting trauma experiences, expanded integrated care and the patient–provider relationship. Based on participant recommendations, a checklist was created for healthcare professionals to improve care delivery to Indigenous patients. Results indicated that bias in healthcare settings may masquerade as poor clinical care but is really founded in biased beliefs and healthcare delivery. Alternatively, when patients received good quality care, their healthcare outcomes improved. Further, effective healthcare incorporates culture, family, tribe, and community and addresses these aspects of health in both clinical and systemic settings. Conclusions: With some of the largest proportions of health disparities and bias experiences in the US, it is critical that healthcare delivered to Indigenous patients incorporate culturally safe care to regain dignity and improve health outcomes for this population. Full article
10 pages, 356 KiB  
Article
Sleep Time, Physical Activity, and Screen Time among Montana American Indian Youth
by Vernon Grant and Francine C. Gachupin
Int. J. Environ. Res. Public Health 2023, 20(17), 6658; https://doi.org/10.3390/ijerph20176658 - 26 Aug 2023
Viewed by 1408
Abstract
The purpose of this study is to describe sleep, PA, and screen time behaviors among rural American Indian (AI) youth, stratified by sex and grade, to better understand how to address these health behaviors in AI youth. Body composition, a screen time survey, [...] Read more.
The purpose of this study is to describe sleep, PA, and screen time behaviors among rural American Indian (AI) youth, stratified by sex and grade, to better understand how to address these health behaviors in AI youth. Body composition, a screen time survey, and demographic information were collected from 65 AI youth. Accelerometers were worn for 7 days. Sixty percent were overweight or obese. Sleep did not differ by sex or grade, with an actigraphy-based total sleep time (aTST) of 7.8 h per night. Boys had significantly more light PA (p = 0.002) and vigorous PA (p = 0.01) compared to girls. Screen time did differ by sex but not by grade, with girls in the sixth and seventh grades reporting more screen time than boys, but boys in the eighth grade reporting more screen time than girls. Despite sex differences in screen time, high levels of screen time and obesity and low levels of PA and sleep are a concern in this population. Full article

Review

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13 pages, 1404 KiB  
Review
Indigenous Health Research Mentorship within Post-Secondary Institutions in Canada, the United States, Australia, and New Zealand: A Scoping Review
by Anita Manshadi and Krista Stelkia
Int. J. Environ. Res. Public Health 2023, 20(21), 6973; https://doi.org/10.3390/ijerph20216973 - 25 Oct 2023
Viewed by 1421
Abstract
Indigenous peoples have been engaged in research since time immemorial, and have always acknowledged the power of their own knowledge systems, ways of being, and approaches. However, Indigenous peoples continue to be underrepresented in health research within academic institutions. There is an increased [...] Read more.
Indigenous peoples have been engaged in research since time immemorial, and have always acknowledged the power of their own knowledge systems, ways of being, and approaches. However, Indigenous peoples continue to be underrepresented in health research within academic institutions. There is an increased need for Indigenous leadership in health research, including greater Indigenous autonomy, mentorship, and self-determination in health research. This scoping review aims to explore Indigenous mentorship within Indigenous health research in post-secondary institutions in Canada, the US, New Zealand, and Australia. A review of empirical studies, case studies, reviews, commentaries, and grey literature was conducted. Four databases were used: Web of Science, PubMed, Native Health, and Google Scholar. Out of 1594 articles, 11 articles met the inclusion criteria. Four overarching themes were identified: (1) reciprocity: giving back to community; (2) supporting the development of research skills to build research capacity; (3) fostering a sense of belonging; and (4) building student ownership and confidence. The findings suggest that Indigenous mentorship is vital to creating supportive research environments for Indigenous students in the area of health sciences. Indigenous mentorship holds promise to address challenges faced by Indigenous scholars within post-secondary institutions, including intellectual, social, and cultural isolation, and can help to foster greater integration of Indigenous worldviews in Western-dominated academic settings and research systems. Future research should examine place-based mentorship opportunities for Indigenous students in community-based health research environments. Fostering Indigenous mentorship in health sciences is essential for advancing the health and wellbeing of Indigenous peoples and communities. Full article
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