Visioning an Effective Health Encounter: Indigenous Healthcare Experiences and Recommendations for Health Professionals
Abstract
:1. Introduction
2. Methods
2.1. Study Purpose and Research Questions
2.2. Method
2.3. Analysis
- Ineffective health encounters;
- Effective health encounters;
- Improvements needed for healthcare encounters;
- Systemic and structural barriers;
- Effective healthcare systems;
- Improvements needed for healthcare systems;
- Indigenous knowledge and beliefs.
2.4. Indigenous Research Methodology (IRM)
3. Results
3.1. Participant Demographics
3.2. Results
3.3. Free of Stigma
3.4. Quality Care
3.5. Respecting Trauma Experience
3.6. Expanded Integrated Care
3.7. Patient–Provider Relationship
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Question | Response Options |
---|---|
Introduction: We are working to create a training for all healthcare providers at (clinic) to improve the care they deliver. We are particularly interested in discussing what is needed so that healthcare providers deliver culturally sensitive care to patients (What we are not discussing how the clinic operates: issues related to wait times, and contract health services issues for example). | |
Main Question: 1. What would you like to see as part of their training to meet this goal? | Open |
Follow-up Questions 2. What would you like your healthcare providers to know about you, your family, your culture to be able to treat you effectively? | Open |
3. Do you think your providers know enough about Native American people and culture? | 1. No. If no, what more do they need to know? 2. Yes. If yes, what things do they already know that have been helpful as they care for you? |
4. Do you wish your healthcare provider would treat you/your family differently? a. Do you think you are treated differently because you are Native American? b. Different cultural/racial communication? | 1. No. If no, what do you like about how your provider treats you? 2. Yes. If yes, how would you like to be treated? |
5. Do you get the healthcare you want? | 1. No. If no, what would you like to see more/less of? 2. Yes. If yes, what do you like about it? |
Wrap-up Questions 6. Of all the topics that we discussed around your personal experiences of healthcare, what is the most important experience that came up for you? | Open |
7. Is there anything that we should have talked about but didn’t in regards to your healthcare experiences? | Open |
References
- Kisely, S.; Alichniewicz, K.K.; Black, E.B.; Siskind, D.; Spurling, G.; Toombs, M. The prevalence of depression and anxiety disorders in indigenous people of the Americas: A systematic review and meta-analysis. J. Psychiatr. Res. 2017, 84, 137–152. [Google Scholar] [CrossRef]
- Dawson, A.Z.; Walker, R.J.; Campbell, J.A.; Davidson, T.M.; Egede, L.E. Telehealth and indigenous populations around the world: A systematic review on current modalities for physical and mental health. mHealth 2020, 6, 30. [Google Scholar] [CrossRef]
- Kirmayer, L.; Simpson, C.; Cargo, M. Healing traditions: Culture, community and mental health promotion with Canadian Aboriginal Peoples. Australas. Psychiatry 2003, 11 (Suppl. 1), S15–S23. [Google Scholar] [CrossRef]
- Indian Health Service. Indian Health Service Tracking Regional Indian Health Status Objectives. 2018. Available online: https://www.ihs.gov/sites/dps/themes/responsive2017/display_objects/documents/TrackingReport2018.pdihs.gov (accessed on 12 November 2021).
- Indian Health Service. Disparities. 2018. Available online: www.ihs.gov/newsroom/index.cfm/factsheets/disparities/ (accessed on 10 November 2021).
- Espey, D.K.; Jim, M.A.; Cobb, N.; Bartholomew, M.; Becker, T.; Haverkamp, D.; Plescia, M. Leading causes of death and all-cause mortality in American Indians and Alaska Natives. Am. J. Public Health 2014, 104 (Suppl. 3), S303–S311. [Google Scholar] [CrossRef]
- Solomon, T.G.A.; Cordova, F.M.; Garcia, F. What’s Killing Our Children? Child and Infant Mortality among American Indians and Alaska Natives; NAM Perspectives; National Academy of Medicine: Washington, DC, USA, 2017; pp. 1–9. Available online: https://webcms.pima.gov/UserFiles/Servers/Server_6/File/Whats-Killing-Our-Children-Child-and-Infant-Mortality-among-American-Indians-and-Alaska-Natives.pdf (accessed on 18 August 2023).
- Ely, D.M.; Driscoll, A.K. Infant mortality in the United States, 2018: Data from the period linked birth/infant death file. Natl. Vital Stat. Rep. 2020, 69, 1–18. [Google Scholar] [PubMed]
- Heck, J.L.; Jones, E.J.; Bohn, D.; McCage, S.; Parker, J.G.; Parker, M.; Campbell, J. Maternal mortality among American Indian/Alaska Native women: A scoping review. J. Women Health 2021, 30, 220–229. [Google Scholar] [CrossRef]
- Petersen, E.E.; Davis, N.L.; Goodman, D.; Cox, S.; Syverson, C.; Seed, K.; Barfield, W. Racial/ethnic disparities in pregnancy-related deaths—United States, 2007–2016. MMWR Morb. Mortal. Wkly. Rep. 2019, 68, 762–765. [Google Scholar] [CrossRef]
- Office of Minority Health. Health Disease and American Indians/Alaska Natives. 2021. Available online: https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=34 (accessed on 12 July 2023).
- Kaliszewski, M. Alcohol and Drug Abuse among Native Americans. 2021. Available online: https://americanaddictioncenters.org/rehab-guide/addiction-statistics/native-americans (accessed on 30 November 2021).
- Office of Minority Health. Mental and Behavioral Health—American Indians/Alaska Natives. 2021. Available online: https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=39 (accessed on 15 June 2023).
- Murphy, S.L.; Xu, J.; Kochanek, K.D.; Arias, E.; Tejada-Vera, B. Deaths: Final data for 2018. Natl. Vital Stat. Rep. 2021, 69, 1–83. [Google Scholar] [PubMed]
- Valeggia, C.R.; Snodgrass, J.J. Health of Indigenous Peoples. Annu. Rev. Anthropol. 2015, 44, 117–135. [Google Scholar] [CrossRef]
- Matthews, R. The cultural erosion of Indigenous people in health care. CMAJ Can. Med. Assoc. J. 2017, 189, E78–E79. [Google Scholar] [CrossRef]
- Kirkham, R.; Maple-Brown, L.J.; Freeman, N.; Beaton, B.; Lamilami, R.; Hausin, M.; Hughes, J.T. Incorporating indigenous knowledge in health services: A consumer partnership framework. Public Health 2019, 176, 159–162. [Google Scholar] [CrossRef] [PubMed]
- Redvers, N.; Blondin, B. Traditional Indigenous medicine in North America: A scoping review. PLoS ONE 2020, 15, e0237531. [Google Scholar] [CrossRef]
- Harris, R.; Tobias, M.; Waldegrave, K.; Jeffreys, M.; Karlsen, S.; Nazroo, J. Effects of self-reported racial discrimination and deprivation on Māori health and inequalities in New Zealand: Cross-sectional study. Lancet 2006, 367, 2005–2009. [Google Scholar] [CrossRef] [PubMed]
- Larson, A.; Gillies, M.; Howard, P.J.; Coffin, J. It’s enough to make you sick: The impact of racism on the health of Aboriginal Australians. Aust. N. Z. J. Public Health 2007, 31, 322–329. [Google Scholar] [CrossRef] [PubMed]
- Ortega, H.W.; Velden, H.V.; Lin, C.-W.; Reid, S. Ethnicity and reported pain scores among children with long-bone fractures requiring emergency care. Pediatr. Emerg. Care 2012, 28, 1146–1149. [Google Scholar] [CrossRef] [PubMed]
- Puumala, S.E.; Burgess, K.M.; Kharbanda, A.B.; Zook, H.G.; Castille, D.M.; Pickner, W.J.; Payne, N.R. The role of bias by emergency department providers in care for American Indian children. Med. Care 2016, 54, 562–569. [Google Scholar] [CrossRef]
- Zestcott, C.A.; Spece, L.; McDermott, D.; Stone, J. Health care providers’ negative implicit attitudes and stereotypes of American Indians. J. Racial Ethn. Health Disparities 2021, 8, 230–236. [Google Scholar] [CrossRef]
- Wylie, L.; McConkey, S. Insiders’ insight: Discrimination against Indigenous Peoples through the eyes of health care professionals. J. Racial Ethn. Health Disparities 2018, 6, 37–45. [Google Scholar] [CrossRef]
- Goodman, A.; Fleming, K.; Markwick, N.; Morrison, T.; Lagimodiere, L.; Kerr, T. “They treated me like crap and I know it was because I was Native”: The healthcare experiences of Aboriginal peoples living in Vancouver’s inner city. Soc. Sci. Med. 2017, 178, 87–94. [Google Scholar] [CrossRef]
- Findling, M.G.; Casey, L.S.; Fryberg, S.A.; Hafner, S.; Blendon, R.J.; Benson, J.M.; Miller, C. Discrimination in the United States: Experiences of Native Americans. Health Serv. Res. 2019, 54 (Suppl. 2), 1431–1441. [Google Scholar] [CrossRef]
- Kitching, G.T.; Firestone, M.; Schei, B.; Wolfe, S.; Bourgeois, C.; O’Campo, P.; Smylie, J. Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada. Can. J. Public Health Rev. Can. Santé Publique 2020, 111, 40–49. [Google Scholar] [CrossRef] [PubMed]
- Gonzales, K.L.; Harding, A.K.; Lambert, W.E.; Fu, R.; Henderson, W.G. Perceived experiences of discrimination in health care: A barrier for cancer screening among American Indian women with type 2 diabetes. Women’s Health Issues 2013, 23, e61–e67. [Google Scholar] [CrossRef] [PubMed]
- Walensky, R.P. Racism and Health: Director’s Commentary. 2021. Available online: https://www.cdc.gov/healthequity/racism-disparities/director-commentary.html (accessed on 30 November 2021).
- University of Huddersfield. What is Template Analysis. 2021. Available online: https://research.hud.ac.uk/research-subjects/human-health/template-analysis/what-is-template-analysis/ (accessed on 30 November 2021).
- Shotton, H.J.; Tachine, A.R.; Nelson, C.A.; Minthorn, R.Z.-t.-h.-a.; Waterman, S.J. Living our research through Indigenous scholar sisterhood practices. Qual. Inq. 2017, 24, 636–645. [Google Scholar] [CrossRef]
- Rincón, A.M. Practicing cultural humility. In Foundations for Community Health Workers; Berthold, T., Miller, J., Avila-Esparza, A., Eds.; Jossey-Bass: San Francisco, CA, USA, 2009; pp. 135–154. [Google Scholar]
- Tervalon, M.; Murray-García, J. Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. J. Health Care Poor Underserved 1998, 9, 117–125. [Google Scholar] [CrossRef]
- Mincin, J. Addiction and stigmas: Overcoming labels, empowering people. In New Directions in Treatment, Education, and Outreach for Mental Health and Addiction; Springer International Publishing: Cham, Switzerland, 2018; pp. 125–131. [Google Scholar]
- Rivas Velarde, M.C. Addressing double layers of discrimination as barriers to health care: Indigenous peoples with disabilities. ab-Original 2017, 1, 269–278. [Google Scholar] [CrossRef]
- Baba, J.T.; Brolan, C.E.; Hill, P.S. Aboriginal medical services cure more than illness: A qualitative study of how Indigenous services address the health impacts of discrimination in Brisbane communities. Int. J. Equity Health 2014, 13, 56. [Google Scholar] [CrossRef]
- Agency for Healthcare Research and Quality. Six Domains of Health Care Quality. 2018. Available online: https://www.ahrq.gov/talkingquality/measures/six-domains.html (accessed on 10 November 2021).
- Tawfik, D.S.; Scheid, A.; Profit, J.; Shanafelt, T.; Trockel, M.; Adair, K.C.; Ioannidis, J.P.A. Evidence relating health care provider burnout and quality of care: A systematic review and meta-analysis. Ann. Intern. Med. 2019, 171, 555–567. [Google Scholar] [CrossRef]
- Kelly, L.; Brown, J.B. Listening to native patients. Changes in physicians’ understanding and behaviour. Can. Fam. Physician 2002, 48, 1645–1652. [Google Scholar]
- Durie, M. Whaiora: Māori Health Development; Oxford University Press: London, UK, 1994. [Google Scholar]
- Lacey, C.; Huria, T.; Beckert, L.; Gilles, M.; Pitama, S. The Hui Process: A framework to enhance the doctor–patient relationship with Māori. N. Z. Med. J. 2011, 124, 72–78. [Google Scholar]
- Thunderbird Partnership Foundation. First Nations Mental Wellness Continuum Framework. 2021. Available online: https://thunderbirdpf.org/first-nations-mental-wellness-continuum-framework/ (accessed on 15 December 2021).
- Rasmus, S.M.; Trickett, E.; Charles, B.; John, S.; Allen, J. The Qasgiq model as an indigenous intervention: Using the cultural logic of contexts to build protective factors for Alaska Native suicide and alcohol misuse prevention. Cult. Divers. Ethn. Minor. Psychol. 2019, 25, 44–54. [Google Scholar] [CrossRef]
- Kahn-John Diné, M.; Koithan, M. Living in health, harmony, and beauty: The diné (navajo) hózhó wellness philosophy. Glob. Adv. Health Med. 2015, 4, 24–30. [Google Scholar] [CrossRef] [PubMed]
- Oshiro, K.H. Social determinants of health. In 2015 Native Hawaiian Health Fact Sheet; Office of Hawaiian Affairs: Honolulu, HI, USA, 2015; Volume 3, Available online: https://www.oha.org/wp-content/uploads/Volume-III-Social-Determinants-of-Health-FINAL.pdf (accessed on 15 December 2021).
- National Council for the Social Studies. Toward Responsibility: Social Studies Education that Respects and Affirms Indigenous Peoples and Nations. Soc. Educ. 2018, 82, 167–173. [Google Scholar]
- U.S. Department of Housing and Urban Development. HUD Study Shows More Than One in Four Native American Renters Face Discrimination. HUD Archives: News Releases. 2003. Available online: https://archives.hud.gov/news/2003/pr03-126.cfm (accessed on 15 December 2021).
- Datz, T. Poll Finds More Than One-Third of Native Americans Report Slurs, Violence, Harassment, and Being Discriminated against in the Workplace. 2017. Available online: https://www.hsph.harvard.edu/news/press-releases/poll-native-americans-discrimination/ (accessed on 15 December 2021).
- Warne, D.; Wescott, S. Social Determinants of American Indian Nutritional Health. Curr. Dev. Nutr. 2019, 3, 12–18. [Google Scholar] [CrossRef]
- Alliance for Healthier Communities. Rx: Community—Social Prescribing in Ontario. 2021. Available online: https://www.allianceon.org/Social-Prescribing (accessed on 15 November 2021).
- Lewis, M.E.; Myhra, L.L. Integrated care with Indigenous populations: A systematic review of the literature. Am. Indian Alsk. Native Ment. Health Res. J. Natl. Cent. 2017, 24, 88–110. [Google Scholar] [CrossRef] [PubMed]
- Vasquez Guzman, C.; Lewis, M.; Yancey, D.; Empey, A.; Metoxen, M.; Frutos, R.; Brodt, E. The time is now: Transforming recruitment and retention of American Indian and Alaska Native medical students using the Medicine Wheel Model. J. Health Sci. Educ. 2020, 4, 198. [Google Scholar]
- Grimes, C.; Dankovchik, J.; Cahn, M.; Warren-Mears, V. American Indian and Alaska Native Cancer Patients’ Perceptions of a Culturally Specific Patient Navigator Program. J. Prim. Prev. 2017, 38, 121–135. [Google Scholar] [CrossRef]
- Sayal, A.; Richardson, L.; Crawford, A. Six ways to get a grip on teaching medical trainees on the convergence of Indigenous knowledges and biomedicine, within a culturally-safe Indigenous health curriculum. Can. Med. Educ. J. 2021, 12, e88–e93. [Google Scholar] [CrossRef]
- The Leaders in Indigenous Medical Education (LIME) Network. Pedagogical Principles & Approach. 2016. Available online: https://www.limenetwork.net.au/resources-lime-publications/curriculum-framework/pedagogical-principles-approach/ (accessed on 10 November 2021).
- Royal College of Physicians and Surgeons of Canada. Indigenous Health: What You Should Know about Being a Culturally Safe Physician. 2021. Available online: https://www.royalcollege.ca/rcsite/health-policy/indigenous-health-e (accessed on 15 November 2021).
- American Association of Biological Anthropologists. Executive Summary: AAPA Statement on Race and Racism. 2019. Available online: https://physanth.org/about/position-statements/aapa-statement-race-and-racism-2019/ (accessed on 12 November 2021).
Domain | Definition | Exemplar Quotes |
---|---|---|
1. Free of stigma | Participants noted the difference between care that is free of stigma and care in which they are stigmatized for their race, their illness, or the intersection of them. Care that is free of stigma is quality care that effectively assesses and treats the patient to improve the illness without bias affecting the care that is given. Stigma for illness and race reduce the ability of care systems to provide quality care. | When I was going to the doctor before I came here, I wanted to get help and it was very hard. As soon as they find out that you’re needing help, you’re no longer a client, you’re an addict. Every place I went before they would say, ‘no it’s a waiting list’ and they don’t give medicine to help people to help them to withdraw. Here the same day I got medicine and they brought me in and made sure I was comfortable, I was really in bad shape. They [providers] really took personal time to help. We’re not drug addicts, alcoholics, we’re regular people we just can’t help it. |
2. Quality care | Participants shared that an effective health encounter included a proper and thorough assessment, correct diagnosis, effective treatment with an explanation of the treatment plan, and proper follow-up care. For many participants, they have rarely received this kind of care. | When I come to my appointments they do the whole, the whole rundown, you know, the blood pressure, weight and all that stuff. When they’re working with my lab stuff everything’s gone over with me. Medications are explained what they [U] to prescribe them to me and making sure that I understand. |
3. Respecting trauma experience | Indigenous patients experience disparate rates of trauma, both historical and through the lifespan. These experiences relate to negative health outcomes and, therefore, should be properly assessed and treated by the healthcare provider. | And the last few times I’ve had two different people that worked on my dental and they were very open and understanding. But even the second time she literally put it (i.e., patient trauma story and needs) all in the notes so that I don’t have to continue to explain myself. So that is a major plus, and that’s when I’m also bringing that it’s important that they’re trained in historical trauma. You don’t know what keeps us from coming to the dentist or what’s gonna happen or what will be triggered. |
4. Expanded integrated care | Participants expressed a preference for expanded integrated care to include care in the areas of medical, dental, behavioral health, substance abuse treatment, social needs, family needs, community needs, and cultural needs. | I finally started taking care of my health, you know, trying to look at the health, dental, primary care. |
5. Patient–provider relationship | Participants shared that a positive relationship with their provider is important to them and included feeling listened to and cared for. A positive relationship also hinged on the provider’s relationship with their family and the community. | Having a provider who’s sensitive with some compassion would be really great. |
6. Traditional Indigenous Medicine (TIM) | a. Participants expressed wanting providers to be more aware of traditional healing methods, such as traditional medicine, ceremony, providing food, holistic theory and care, female-based care, and smudging. b. Participants appreciated having TIM services. An elder in residence is a staff member who is familiar with Traditional Indigenous Medicine and provides services to patients, supports healthcare providers, and can be a member of the treatment team. | a. I wish there was an option for that (traditional Indigenous medicine) instead of regular medicine. There’s just so many people hooked on stuff like Opiates now because of that. I wish they’d offer more traditional medicine before they start pushing the pills on you. b. Like cedar tea. I’ve never drank that before until I came to (this state). (Elder-in-residence) even told us that when we’re really having a hard time to take a bath in it. I did that once and it just felt so good, very healing. |
7. Patient agency | a. Participant control over their own body and being an active decision maker in their healthcare plan improved patient satisfaction, adherence to treatment plan, and culturally relevant care. b. A patient’s ability to have control over their own healthcare treatment was described in terms of the cultural barriers that exist in activating agency and resources to help attain it. | a. So I’m gonna continue to come to see my primary care (doctor) here. My diabetes levels-my sugar levels would have been still high, so I take my medications now like she prescribes and it’s starting to work for me now. I felt good about it, you know, and that’s what worked for me anyways. b. I really like that they have [name] here, like the Elder in Residence, because you can always talk to her and she can be like the advocate. I think they should have that at every clinic cause just even her presence is really powerful. Because there are a lot of cultural barriers. |
8. Gender preference for provider | a. Indigenous women reported a preference for female providers, especially around health issues including pregnancy, childbirth, menopause, moontime (menstruation), sex, sexual abuse. Participants reported that these topics have specific cultural values that are tied to gender-specific knowledge and practice. b. Cultural practices involve rules and protocols around gender and should be respected in healthcare settings, including what gender should discuss and treat certain illnesses. For example, part of culturally relevant care is knowing that an Indigenous woman might request a female provider and respecting that, which can include having a female Native patient navigator if there are only male doctors. | a. A lot of us, we have traditions revolving when we’re menstruating we call on our moon. So, I wouldn’t feel comfortable talking to a male, in particular a non-native male that’s not going to understand that. So, if we could have an option of a female for those kinds of visits. Like sometimes there’s issues that are sexual that we have to deal with where again I wouldn’t be comfortable with a man again especially where there’s a particular background so to speak. b. If there was an option to have a female native, pretty much any native woman, I definitely be more comfortable with something like that. You know going through a pap smear or things like that involve women issues, menopause, menstruation, that kind of stuff. I mean if they offered native medicine instead of trying to push a pill because they don’t help anything just mask it. So, I’d much rather use a native traditional man rather than have one with modern medicine. |
9. Native American-serving clinic | Given the lack of good care and culturally relevant care, Native people prefer to seek care at a clinic that has a mission to work with Native people, hires Native people, is in a Native community, and has providers trained to work with this population. | Natives want to go to somewhere that’s culturally involved...people that understand that our people, our ways. It’s a good feeling going to a Native clinic. |
10. Appropriate billing practices | Participants shared experiences in which they have been refused service due to their socioeconomic status or their assumed socioeconomic status by their race. | I took my son over there and I gave them my tribal card and they looked at me and said they would not see my son unless I had the cash or a credit card to hand to them. [Specific clinic] will bill you later and they will see your children and they will see you and they will bill you later. |
11. Continuity of care | Relationality is a key component of Indigeneity; therefore, the state of the relationship between patient–provider is a critical component of care with Indigenous populations. Participants expressed the importance of having a consistent provider that is familiar with their needs. Participants reported it was helpful to not have to repeat illness or trauma stories, long-standing relationships and knowing their family members, and this led to (increased satisfaction and adherence to treatment plans) | She acts because she cares. She’s easy to talk to and you know I feel very satisfied and happy with the treatment plan. With everybody, the therapist she’s always calling, it’s been great. |
12. Intergenerational care | Family centered care was an important part of preferred care delivery: Participants reported going to visits with family members, sharing providers with family members, talking about family members who were also patients of their provider during appointments, and answered questions about care needs with family members in mind. | I think it’s important, especially in developing that relationship and knowing that they actually genuinely care about my family. |
12. Native healthcare providers | Participants expressed a desire for providers who are from their community to understand their needs and challenges. | Natives want to go to somewhere that’s culturally involved and people that understand that our people, our ways. |
13. Community familiarity | Participants appreciated providers being familiar and from the community they were serving. | Keep treating the community that they treat because they’re in the community, so they know the people that they’re servicing |
14. Timely and convenient | From scheduling an appointment to receiving medication, participants expressed satisfaction with care when it is timely and accessible. | You can always come, you’ll get seen. With dental, or medical even with a drop in, you will be seen. Like on the reservation if you want to see the dentist appointments will be like 2 months out but if you come here you get in right away you and be seen. Like you said, I have come all the way from [a different state] because they have all these events going on for natives and different kinds of medical and treatment approaches, the staff are always welcoming and friendly, the surroundings are comfortable, plus it’s easy access. |
15. Spending time with patient | Patients expressed that it takes time to get to know a patient and that was important to them and that this resulted in improved health outcomes. | She just took the time to, to really listen to what I was talking about and then she came back with everything I needed, and it was good. |
n | % | |
---|---|---|
Age, mean (sd) | 46.25 | 12.65 |
Income, mean (sd) | $11,709.60 | 9746 |
Gender | ||
Female | 16 | 80% |
Male | 3 | 15% |
Gender-Neutral | 1 | 5% |
Tribal group | ||
Anishinaabe | 20 | 75% |
Lakota | 5 | 25% |
Reported Physical Illness | ||
0 | 6 | 30% |
1 | 10 | 50% |
2 | 3 | 15% |
4 | 1 | 5% |
Reported Emotional Illness | ||
0 | 6 | 30% |
1 | 9 | 45% |
2 | 3 | 15% |
3 | 2 | 10% |
Reported Substance Use Disorder | ||
0 | 10 | 50% |
1 | 6 | 30% |
2 | 3 | 15% |
3 | 1 | 5% |
First Language (n = 19) | ||
English | 16 | 84% |
Indigenous (Anishinaabe or Lakota) | 3 | 16% |
Language currently spoken (n = 19) | ||
English only | 16 | 84% |
English and Spanish | 2 | 10% |
English and Indigenous (Anishinaabe or Lakota) | 1 | 1% |
Clinical care delivery |
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Lewis, M.E.; Wildcat, S.; Anderson, A. Visioning an Effective Health Encounter: Indigenous Healthcare Experiences and Recommendations for Health Professionals. Int. J. Environ. Res. Public Health 2023, 20, 6917. https://doi.org/10.3390/ijerph20206917
Lewis ME, Wildcat S, Anderson A. Visioning an Effective Health Encounter: Indigenous Healthcare Experiences and Recommendations for Health Professionals. International Journal of Environmental Research and Public Health. 2023; 20(20):6917. https://doi.org/10.3390/ijerph20206917
Chicago/Turabian StyleLewis, Melissa E., Sky Wildcat, and Amber Anderson. 2023. "Visioning an Effective Health Encounter: Indigenous Healthcare Experiences and Recommendations for Health Professionals" International Journal of Environmental Research and Public Health 20, no. 20: 6917. https://doi.org/10.3390/ijerph20206917