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

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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 21117

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Special Issue Editors

Dr. Claradina Soto

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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

Prof. Dr. Amy E. West

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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

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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

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Published Papers (10 papers)

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Research

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16 pages, 322 KiB

Open AccessArticle

Use of Cognitive Interviews in the Development of a Survey Assessing American Indian and Alaska Native Adult Perspectives on Genetics and Biological Specimens

by Vanessa Y. Hiratsuka, Julie A. Beans, Christie Byars, Joseph Yracheta and Paul G. Spicer

Int. J. Environ. Res. Public Health 2024, 21(9), 1144; https://doi.org/10.3390/ijerph21091144 - 29 Aug 2024

Viewed by 1017

Abstract

The cognitive interview process is a method to validate a survey instrument’s face validity and enhance confidence in item interpretation, as well as a method to engage communities in the research process. Trained American Indian and Alaska Native (AIAN) interviewers conducted retrospective cognitive interviews at three AIAN communities to assess the item quality of a 131-item survey item that measures AIAN knowledge and attitudes on genetics and biological specimens. A cognitive interview process was used to assess cultural consonance, thought processes used when considering survey instructions, items and responses, and language preference of survey items in the development of a survey to assess public knowledge and attitudes on genetics. Content analysis was used to analyze interview data. Survey instructions, items and scales generated no cognitive difficulties. The participants noted being unfamiliar with terminology used to describe genetic and biological specimens. In several cases, the participants’ written response in the survey and verbal response in the interview did not align. A resultant 52-item survey for use in AIAN communities was finalized. Cognitive interviewing is resource-intensive; however, ignoring community engagement during survey development results in inappropriate interpretations about culturally diverse populations such as AIAN peoples. Full article

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

10 pages, 558 KiB

Open AccessArticle

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 1559

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 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

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

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10 pages, 268 KiB

Open AccessArticle

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 1827

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 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

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

19 pages, 680 KiB

Open AccessArticle

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

Cited by 1 | Viewed by 2691

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 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

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

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10 pages, 502 KiB

Open AccessArticle

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

Cited by 1 | Viewed by 1915

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 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

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

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18 pages, 392 KiB

Open AccessArticle

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

Cited by 1 | Viewed by 2386

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 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

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

10 pages, 356 KiB

Open AccessArticle

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

Cited by 1 | Viewed by 2099

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, 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

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

Review

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19 pages, 647 KiB

Open AccessReview

Examining Indigenous Identity as a Protective Factor in Mental Well-Being Research in the United States: A Scoping Review

by William Oyenque Carson, Caleigh Curley, Renée Goldtooth-Halwood, Deborah Jean McClelland, Stephanie Russo Carroll, Nicole P. Yuan, Scott Carvajal and Felina M. Cordova-Marks

Int. J. Environ. Res. Public Health 2024, 21(11), 1404; https://doi.org/10.3390/ijerph21111404 - 24 Oct 2024

Viewed by 1107

Abstract

Due to historical and ongoing structural racism and settler colonialism, Indigenous Peoples and communities in the United States are at a higher risk for a variety of diseases, elevated stress, and negative mental health outcomes. In addition, the United States federal government and the public encourage a view that Indigenous Peoples are primarily a racial group. Federally-, state-, and un-recognized Indigenous Peoples have a collective right to self-determination and sovereignty, and individuals of these Peoples understand this. The goals of this scoping review were to examine what research on identity and mental well-being is currently being conducted with Indigenous populations in the United States, synthesize the results, and determine if researchers are utilizing toolsets and theories that reinforce the sovereignty of Indigenous Peoples, communities, and the individual. The scoping review followed guidelines from the Joanna Briggs Institute guide for Scoping Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). Four databases and over six thousand articles were searched for this review, with twenty-four that had data extracted and analyzed. Current research on the relationship between Indigenous identity and mental well-being shows mixed results. The findings of this scoping review highlight a need for Indigenous-specific tools for measuring identity in place of tools used for other ethnic and racial groups. More research must be conducted to create tools that specifically examine the phenomena of United States-based Indigenous identity. Full article

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

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13 pages, 1404 KiB

Open AccessReview

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 1872

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 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

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

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14 pages, 346 KiB

Open AccessPerspective

Revisiting One of the Oldest Orphanages, Asylums, and Indigenous Residential Boarding Schools: The Thomas Indian School at Seneca Nation

by Hayden Haynes, Theresa McCarthy, Corinne Abrams, Melissa E. Lewis and Rodney C. Haring

Int. J. Environ. Res. Public Health 2024, 21(9), 1120; https://doi.org/10.3390/ijerph21091120 - 25 Aug 2024

Viewed by 2499

Abstract

For Indigenous populations, one of the most recognized acts of historical trauma has come from boarding schools. These institutions were established by federal and state governments to forcibly assimilate Indigenous children into foreign cultures through spiritual, physical, and sexual abuse and through the destruction of critical connections to land, family, and tribal community. This literature review focuses on the impact of one of the oldest orphanages, asylums, and Indigenous residential boarding schools in the United States. The paper shares perspectives on national and international parallels of residential schools, land, truth and reconciliation, social justice, and the reconnection of resiliency-based Indigenous Knowledge towards ancestral strength, reclamation, survivorship, and cultural continuance. Full article

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

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