Search Results (5)

Indigenous wellness has been defined in varying contexts by diverse Indigenous Peoples. The existing indicators used to measure wellness are often defined from a Western perspective. Despite the rich conceptualizations of Indigenous wellness, there exists a notable gap in how it can be measured in contemporary contexts through an Indigenous lens. A scoping review methodology with the aim of identifying measures of wellness developed through Indigenous partnerships was carried out. We completed a systematic search in the following electronic databases: PubMed, CINAHL, Psych Info Academic Search Complete, SocIndex, and the Native Health Database. We then carried out a two-stage article screening process to identify eighteen relevant papers. Content analysis was then used to identify (1) the major categories for the partnership contexts utilized in the process for measuring Indigenous wellness and (2) the kinds of measures developed. Five main categories were characterized, including the following: (1) building relationships that uphold Indigenous worldviews is important, (2) a call for co-development protocols that weave multiple worldviews, (3) the need to increase awareness of the limitations in measuring Indigenous wellness, (4) community-specific context is important, and (5) a call for strengths-based indicators. Governments, organizations, and research partners are called upon to support the co-development of meaningful engagement protocols that privilege and reflect Indigenous voices and perspectives when measuring Indigenous wellness. Full article

Suicide is the second leading cause of death for American Indian youth, far surpassing the rates of suicide experienced by other races. The White Mountain Apache Tribe has made significant impacts on suicide risk by implementing a robust suicide prevention program which includes a community-led database and case management follow-ups. Due to the success of the program in preventing suicides, the White Mountain Apache team has worked with other tribal communities to adapt the program. We wanted to understand the factors that are most important to implementing and sustaining this model and how these factors compare with existing implementation science frameworks. We employed an adapted nominal group technique to compile facilitators and barriers to implementation of the suicide prevention model across settings with five partner teams. Two researchers independently coded the resulting list of facilitators and barriers using the Consolidated Framework for Implementation Research (version 1.0) codebook. The final list of cross-site prioritized facilitators and barriers included 41 factors. Some factors did not match easily with the framework’s constructs. The White Mountain Apache suicide prevention team noted that seven of the top prioritized factors are considerations they most try to emphasize to new communities working in suicide prevention. The factors fall into two key themes: staffing and tribal engagement. This finding affirms their focus when they conduct suicide prevention trainings with new communities and provides an opportunity for more structure and in-depth training in those two areas. Several factors could not be easily coded to the framework, especially around the sociocultural characteristics of suicide prevention work in Native communities. This contributes to the larger discussion in implementation science concerning the ways in which Indigenous approaches to public health differ from Western models. Full article

Indigenous and American Indian Alaskan Native (AI/AN) community members are systematically underrepresented in clinical trial research. This paper focuses on exploratory steps to partner with Native Nations of Arizona to engage Community Health Representatives (CHR) as a trusted source for building COVID-19 clinical trial research, including vaccine trials awareness. CHRs are frontline public health workers who apply a unique understanding of the experience, language, and culture of the population served. This workforce has entered the spotlight as essential to the prevention and control of COVID-19. Methods: Three Tribal CHR programs were engaged to develop and refine culturally centered educational materials and a pre-post survey using a consensus-based decision-making approach. CHRs used these materials in brief education sessions during regular client home visits and community events. Results: At 30 days post CHR intervention, participants (N = 165) demonstrated significantly increased awareness about and ability to enroll in COVID-19 treatment and vaccine trials. Participants also described a significant increase in trust in researchers, decreased perceived barriers related to cost for participation in a clinical trial, and improved belief that participation in a COVID-19 clinical trial for treatment was considered a benefit to American Indian and Alaskan Native people. Conclusion: CHRs as trusted sources of information, coupled with culturally centered education materials designed by CHRs for CHR clients, demonstrated a promising approach to improved awareness of clinical trial research generally and COVID-19 trials specifically among Indigenous and American Indian community members of Arizona. Full article

The goal of this study was to establish effective, culturally appropriate strategies to enhance participation of American Indian/Alaska Native (AI/AN) communities in prevention and treatment of COVID-19, including vaccine uptake. Thirteen Community Health Representatives (CHRs) from three Arizona Native nations tailored education materials to each community. CHRs delivered the intervention to over 160 community members and administered a pre-posttest to assess trusted sources of information, knowledge, and self-efficacy and intention regarding COVID-19 vaccines. Based on pre-posttest results, doctors/healthcare providers and CHRs were the most trusted health messengers for COVID-19 information; contacts on social media, the state and federal governments, and mainstream news were among the least trusted. Almost two-thirds of respondents felt the education session was relevant to their community and culture, and more than half reported using the education materials to talk to a family member or friend about getting vaccinated. About 67% trusted the COVID-19 information provided and 74% trusted the CHR providing the information. Culturally and locally relevant COVID-19 vaccine information was welcomed and used by community members to advocate for vaccination. The materials and education provided by CHRs were viewed as helpful and emphasized the trust and influence CHRs have in their communities. Full article

Among American Indian nations, the White Mountain Apache Tribe has been at the forefront of a struggle to control natural resource management within reservation boundaries. In 1952, they developed the first comprehensive tribal natural resource management program, the White Mountain Recreational Enterprise (WMRE), which became a cornerstone for fighting legal battles over the tribe’s right to manage cultural and natural resources on the reservation for the benefit of the tribal community rather than outside interests. This article examines how White Mountain Apaches used the WMRE, while embracing both Euro-American and Apache traditions, as an institutional foundation for resistance and exchange with Euro-American society so as to reassert control over tribal eco-cultural resources in east-central Arizona. Full article