Culture and Community in Research with American Indian and Alaska Native Infants, Toddlers, and Families

ERIC Educational Resources Information Center

Spicer, Paul; Sarche, Michelle

2007-01-01

In this brief essay the authors reflect on the value of community participation and cultural adaptation in their evolving research on American Indian and Alaska Native (AI/AN) infant and toddler development. They describe three concerns identified by their AI/AN community partners in adapting established research methodologies to work in AI/AN…

Honoring children, mending the circle: cultural adaptation of trauma-focused cognitive-behavioral therapy for American Indian and Alaska native children.

PubMed

BigFoot, Dolores Subia; Schmidt, Susan R

2010-08-01

American Indians and Alaska Natives are vulnerable populations with significant levels of trauma exposure. The Indian Country Child Trauma Center developed an American Indian and Alaska Native (AI/AN) adaptation of the evidence-based child trauma treatment, trauma-focused cognitive-behavioral therapy. Honoring Children, Mending the Circle (HC-MC) guides the therapeutic process through a blending of AI/AN traditional teachings with cognitive-behavioral methods. The authors introduced the HC-MC treatment and illustrated its therapeutic tools by way of a case illustration.

Streptococcus pneumoniae non-susceptibility and outpatient antimicrobial prescribing rates at the Alaska Native Medical Center

PubMed Central

Stevens, Ryan W.; Wenger, Jay; Bulkow, Lisa; Bruce, Michael G.

2013-01-01

Background American Indian/Alaska Native (AI/AN) people suffer substantially higher rates of invasive pneumococcal disease (IPD) than the general US population. We evaluated antimicrobial prescribing data and their association with non-susceptibility in Streptococcus pneumoniae causing IPD in AI/AN people between 1992 and 2009. Methods Antimicrobial use data were gathered from the electronic patient management system and included all prescriptions dispensed to Alaska Native patients aged 5 years and older from outpatient pharmacies at the Alaska Native Medical Center (ANMC). Antimicrobial susceptibility data were gathered from pneumococcal isolates causing IPD among Anchorage Service Unit AI/AN residents aged 5 years and older. Data were restricted to serotypes not contained in the pneumococcal vaccine (PCV7). Results Over the study period, overall antimicrobial prescribing increased 59% (285/1,000 persons/year in 1992 to 454/1,000 persons per year in 2009, p<0.001). Trimethoprim/sulfamethoxazole prescribing increased (43/1,000 persons/year in 1992 to 108/1,000 persons/year in 2009, p<0.001) and non-susceptibility to trimethoprim/sulfamethoxazole in AI/AN patients ≥5 years of age increased in non-PCV7 serotypes (0–12%, p<0.05). Similarly, prescribing rates increased for macrolide antibiotics (46/1,000 persons/year in 1992 to 84/1,000 persons/year in 2009, p<0.05). We observed no statistically significant change over time in erythromycin non-susceptibility among non-PCV7 serotypes in AI/AN patients aged 5 years or greater (0–7%, p=0.087). Conclusion Antimicrobial prescribing patterns of some antibiotics in the AI/AN population corresponded to increased antimicrobial resistance in clinical isolates. This study highlights the on-going threat of antimicrobial resistance, the critical importance of judicious prescribing of antibiotics and the potential utility of prescribing data for addressing this issue. PMID:24358456

Creating a Culturally Appropriate Web-Based Behavioral Intervention for American Indian/Alaska Native Women in Southern California: The Healthy Women Healthy Native Nation Study

ERIC Educational Resources Information Center

Gorman, Jessica R.; Clapp, John D.; Calac, Daniel; Kolander, Chelsea; Nyquist, Corinna; Chambers, Christina D.

2013-01-01

Health disparities in fetal alcohol spectrum disorders (FASD) are of high importance to American Indian/Alaska Native (AI/AN) communities. We conducted focus groups and interviews with 21 AI/AN women and key informants in Southern California to modify a brief, Web-based program for screening and prevention of prenatal alcohol use. This process…

Disparities in Infectious Disease Hospitalizations for American Indian/Alaska Native People

PubMed Central

Holman, Robert C.; Folkema, Arianne M.; Singleton, Rosalyn J.; Redd, John T.; Christensen, Krista Y.; Steiner, Claudia A.; Schonberger, Lawrence B.; Hennessy, Thomas W.; Cheek, James E.

2011-01-01

Objectives We described disparities in infectious disease (ID) hospitalizations for American Indian/Alaska Native (AI/AN) people. Methods We analyzed hospitalizations with an ID listed as the first discharge diagnosis in 1998–2006 for AI/AN people from the Indian Health Service National Patient Information Reporting System and compared them with records for the general U.S. population from the Nationwide Inpatient Survey. Results The ID hospitalization rate for AI/AN people declined during the study period. The 2004–2006 mean annual age-adjusted ID hospitalization rate for AI/AN people (1,708 per 100,000 populiation) was slightly higher than that for the U.S. population (1,610 per 100,000 population). The rate for AI/AN people was highest in the Southwest (2,314 per 100,000 population), Alaska (2,063 per 100,000 population), and Northern Plains West (1,957 per 100,000 population) regions, and among infants (9,315 per 100,000 population). ID hospitalizations accounted for approximately 22% of all AI/AN hospitalizations. Lower-respiratory--tract infections accounted for the largest proportion of ID hospitalizations among AI/AN people (35%) followed by skin and soft tissue infections (19%), and infections of the kidney, urinary tract, and bladder (11%). Conclusions Although the ID hospitalization rate for AI/AN people has declined, it remains higher than that for the U.S. general population, and is highest in the Southwest, Northern Plains West, and Alaska regions. Lower-respiratory-tract infections; skin and soft tissue infections; and kidney, urinary tract, and bladder infections contributed most to these health disparities. Future prevention strategies should focus on high-risk regions and age groups, along with illnesses contributing to health disparities. PMID:21800745

78 FR 63494 - Meeting of the National Coordination Committee on the AI/AN SANE-SART Initiative

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-24

.../ Alaska Native (AI/AN) Sexual Assault Nurse Examiner (SANE)--Sexual Assault Response Team (SART...) Sexual Assault Nurse Examiner (SANE)- Sexual Assault Response Team (SART) Initiative (``National...

Providing culturally competent services for American Indian and Alaska Native veterans to reduce health care disparities.

PubMed

Noe, Timothy D; Kaufman, Carol E; Kaufmann, L Jeanne; Brooks, Elizabeth; Shore, Jay H

2014-09-01

We conducted an exploratory study to determine what organizational characteristics predict the provision of culturally competent services for American Indian and Alaska Native (AI/AN) veterans in Department of Veterans Affairs (VA) health facilities. In 2011 to 2012, we adapted the Organizational Readiness to Change Assessment (ORCA) for a survey of 27 VA facilities in the Western Region to assess organizational readiness and capacity to adopt and implement native-specific services and to profile the availability of AI/AN veteran programs and interest in and resources for such programs. Several ORCA subscales (Program Needs, Leader's Practices, and Communication) statistically significantly predicted whether VA staff perceived that their facilities were meeting the needs of AI/AN veterans. However, none predicted greater implementation of native-specific services. Our findings may aid in developing strategies for adopting and implementing promising native-specific programs and services for AI/AN veterans, and may be generalizable for other veteran groups.

Providing Culturally Competent Services for American Indian and Alaska Native Veterans to Reduce Health Care Disparities

PubMed Central

Kaufman, Carol E.; Kaufmann, L. Jeanne; Brooks, Elizabeth; Shore, Jay H.

2014-01-01

Objectives. We conducted an exploratory study to determine what organizational characteristics predict the provision of culturally competent services for American Indian and Alaska Native (AI/AN) veterans in Department of Veterans Affairs (VA) health facilities. Methods. In 2011 to 2012, we adapted the Organizational Readiness to Change Assessment (ORCA) for a survey of 27 VA facilities in the Western Region to assess organizational readiness and capacity to adopt and implement native-specific services and to profile the availability of AI/AN veteran programs and interest in and resources for such programs. Results. Several ORCA subscales (Program Needs, Leader’s Practices, and Communication) statistically significantly predicted whether VA staff perceived that their facilities were meeting the needs of AI/AN veterans. However, none predicted greater implementation of native-specific services. Conclusions. Our findings may aid in developing strategies for adopting and implementing promising native-specific programs and services for AI/AN veterans, and may be generalizable for other veteran groups. PMID:25100420

Breast Cancer Mortality Among American Indian and Alaska Native Women, 1990–2009

PubMed Central

White, Arica; Richardson, Lisa C.; Li, Chunyu; Ekwueme, Donatus U.; Kaur, Judith S.

2014-01-01

Objectives. We compared breast cancer death rates and mortality trends among American Indian/Alaska Native (AI/AN) and White women using data for which racial misclassification was minimized. Methods. We used breast cancer deaths and cases linked to Indian Health Service (IHS) data to calculate age-adjusted rates and 95% confidence intervals (CIs) by IHS-designated regions from 1990 to 2009 for AI/AN and White women; Hispanics were excluded. Mortality-to-incidence ratios (MIR) were calculated for 1999 to 2009 as a proxy for prognosis after diagnosis. Results. Overall, the breast cancer death rate was lower in AI/AN women (21.6 per 100 000) than in White women (26.5). However, rates in AI/ANs were higher than rates in Whites for ages 40 to 49 years in the Alaska region, and ages 65 years and older in the Southern Plains region. White death rates significantly decreased (annual percent change [APC] = −2.1; 95% CI = −2.3, −2.0), but regional and overall AI/AN rates were unchanged (APC = 0.9; 95% CI = 0.1, 1.7). AI/AN women had higher MIRs than White women. Conclusions. There has been no improvement in death rates among AI/AN women. Targeted screening and timely, high-quality treatment are needed to reduce mortality from breast cancer in AI/AN women. PMID:24754658

Assessment for American Indian and Alaska Native Learners. ERIC Digest.

ERIC Educational Resources Information Center

Bordeaux, Roger

This digest examines the use of standardized, nationally normed testing in assessing the progress of American Indian and Alaska Native (AI/AN) students and describes alternative forms of assessment. For years, researchers have criticized the overuse of standardized, nationally normed tests to assess learner and school success. Problems with such…

Understanding Disabilities in American Indian and Alaska Native Communities. Toolkit Guide.

ERIC Educational Resources Information Center

National Council on Disability, Washington, DC.

This "toolkit" document is intended to provide a culturally appropriate set of resources to address the unique political and legal concerns of people with disabilities in American Indian/Alaska Native (AI/AN) communities. It provides information on education, health, vocational rehabilitation (VR), independent living, model approaches, and…

Trends and Disparities in Stroke Mortality by Region for American Indians and Alaska Natives

PubMed Central

Ayala, Carma; Valderrama, Amy L.; Veazie, Mark A.

2014-01-01

Objectives. We evaluated trends and disparities in stroke death rates for American Indians and Alaska Natives (AI/ANs) and White people by Indian Health Service region. Methods. We identified stroke deaths among AI/AN persons and Whites (adults aged 35 years or older) using National Vital Statistics System data for 1990 to 2009. We used linkages with Indian Health Service patient registration data to adjust for misclassification of race for AI/AN persons. Analyses excluded Hispanics and focused on Contract Health Service Delivery Area (CHSDA) counties. Results. Stroke death rates among AI/AN individuals were higher than among Whites for both men and women in CHSDA counties and were highest in the youngest age groups. Rates and AI/AN:White rate ratios varied by region, with the highest in Alaska and the lowest in the Southwest. Stroke death rates among AI/AN persons decreased in all regions beginning in 2001. Conclusions. Although stroke death rates among AI/AN populations have decreased over time, rates are still higher for AI/AN persons than for Whites. Interventions that address reducing stroke risk factors, increasing awareness of stroke symptoms, and increasing access to specialty care for stroke may be more successful at reducing disparities in stroke death rates. PMID:24754653

Unintentional Injury Mortality Among American Indians and Alaska Natives in the United States, 1990–2009

PubMed Central

Pokhrel, Pallavi; Worthington, Anne; Billie, Holly; Sewell, Mack; Bill, Nancy

2014-01-01

Objectives. We describe the burden of unintentional injury (UI) deaths among American Indian and Alaska Native (AI/AN) populations in the United States. Methods. National Death Index records for 1990 to 2009 were linked with Indian Health Service registration records to identify AI/AN deaths misclassified as non-AI/AN deaths. Most analyses were restricted to Contract Health Service Delivery Area counties in 6 geographic regions of the United States. We compared age-adjusted death rates for AI/AN persons with those for Whites; Hispanics were excluded. Results. From 2005 to 2009, the UI death rate for AI/AN people was 2.4 times higher than for Whites. Death rates for the 3 leading causes of UI death—motor vehicle traffic crashes, poisoning, and falls—were 1.4 to 3 times higher among AI/AN persons than among Whites. UI death rates were higher among AI/AN males than among females and highest among AI/AN persons in Alaska, the Northern Plains, and the Southwest. Conclusions. AI/AN persons had consistently higher UI death rates than did Whites. This disparity in overall rates coupled with recent increases in unintentional poisoning deaths requires that injury prevention be a major priority for improving health and preventing death among AI/AN populations. PMID:24754624

AMERICAN INDIAN AND ALASKA NATIVE BOYS: EARLY CHILDHOOD RISK AND RESILIENCE AMIDST CONTEXT AND CULTURE.

PubMed

Sarche, Michelle; Tafoya, Greg; Croy, Calvin D; Hill, Kyle

2017-01-01

American Indian and Alaska Native (AIAN) adolescent and adult men experience a range of health disparities relative to their non-AIAN counterparts and AIAN women. Given the relatively limited literature on early development in tribal contexts, however, indicators of risk during early childhood specific to AIAN boys are not well-known. The current article reviews sources of strength and challenge within AIAN communities for AIAN children in general, including cultural beliefs and practices that support development, and contextual challenges related to socioeconomic and health disparities and historical trauma affecting the AIAN population as a whole. The research literature on early development is reviewed, highlighting what this literature reveals about early gender differences. The article concludes with calls to action on behalf of AIAN boys that align with each of the five tiers of R. Frieden's (2010) Public Health Pyramid. © 2016 Michigan Association for Infant Mental Health.

triADD: The Risk for Alcohol Abuse, Depression, and Diabetes Multimorbidity in the American Indian and Alaska Native Population

ERIC Educational Resources Information Center

Tann, Sheila S.; Yabiku, Scott T.; Okamoto, Scott K.; Yanow, Jessica

2007-01-01

This study examined the risk for alcoholism, diabetes, and depression (triADD) in American Indian/Alaska Native (AI/AN) populations in the U.S. Using the Behavioral Risk Factor Surveillance System, a series of descriptive statistics and regression models were used to examine the interrelationships among these disorders in AI/AN populations.…

The American Indian and Alaska Native Population: 2000. Census 2000 Brief.

ERIC Educational Resources Information Center

Ogunwole, Stella U.

This brief summarizes data from Census 2000 on the American Indian and Alaska Native (AI/AN) population and discusses its distribution at national, regional, and state levels. This information is intended for all levels of government to use in implementing and evaluating programs related to education, employment, health care, job training, civil…

Responding to concerning posts on social media: Insights and solutions from American Indian and Alaska Native youth.

PubMed

Gritton, Jesse; Rushing, Stephanie Craig; Stephens, David; Ghost Dog, Thomas; Kerr, Bradley; Moreno, Megan A

2017-01-01

This study aimed to understand American Indian and Alaska Native (AI/AN) adolescents' perspectives on concerning social media posts, including those expressing suicidal intent. A purposive sample of AI/AN youth were recruited; trained facilitators conducted focus groups. Participants discussed experiences viewing concerning posts on social media. Qualitative analysis used the constant comparative method. A total of 32 AI/AN youth ages 14-22 participated. Three salient themes emerged: 1) youth typically respond alone; 2) barriers to action; 3) recommended training and support - trusted adults, anonymity, and privacy. Study findings will guide the development of resources trusted by AI/AN youth.

Effect of Race and Ethnicity Classification on Survey Estimates: Anomaly of the Weighted Totals of American Indians and Alaska Natives

ERIC Educational Resources Information Center

Lee, Sunghee; Satter, Delight E.; Ponce, Ninez A.

2009-01-01

Racial classification is a paramount concern in data collection and analysis for American Indians and Alaska Natives (AI/ANs) and has far-reaching implications in health research. We examine how different racial classifications affect survey weights and consequently change health-related indicators for the AI/AN population in California. Using a…

Residential Substance Abuse Treatment for Urban American Indians and Alaska Natives, Part II: Costs.

PubMed

McFarland, Bentson H; Walker, Dale; Silk-Walker, Patricia

2017-01-01

The present study examined costs of two residential substance abuse treatment programs designed for urban American Indians and Alaska Natives (AI/ANs). Costs for one agency were well within national norms, while costs at the other program were less than expected from nationwide data. Economies of scale accounted for much of the difference between observed and expected costs. Culturally specific residential substance abuse treatment services can be provided to urban AI/ANs within budgets typically found at mainstream programs.

Decolonizing Strategies for Mentoring American Indians and Alaska Natives in HIV and Mental Health Research

PubMed Central

Simoni, Jane M.

2009-01-01

American Indian and Alaska Native (AIAN) scholars in the fields of mental health and HIV face formidable barriers to scientific success. These include justifiable mistrust of historically oppressive educational systems, educational disparities, role burdens within academe, the devaluation and marginalization of their research interests, and outright discrimination. Research partners can work to dismantle these barriers by embracing indigenous worldviews, engaging in collaborative research partnerships, building research capacity within universities and tribal communities, changing reward systems, and developing mentoring programs. At the individual level, aspiring AIAN scholars must build coalitions, reject internalized colonial messages, and utilize indigenous ethical frames. The creation of a cadre of AIAN researchers is crucial to improving the health of AIAN peoples. PMID:19246668

Use of online health information resources by American Indians and Alaska Natives

PubMed Central

Geana, Mugur; Daley, Christine Makosky; Nazir, Niaman; Cully, Lance; Etheridge, Jesse; Bledowski, Caroline; Choi, Won S.; Greiner, K. Allen

2012-01-01

According to the Office of Minority Health, an estimated 4.9 million people living in the United States consider themselves American Indian or Alaska Native (AIAN), either alone or in combination with one or more races/ethnicities. AIAN are a racial/ethnic group experiencing serious health disparities, with very little if any improvement in health outcomes over the last several decades. This study was designed to explore use of the Internet as a health information source among American Indians in the Central Plains region of the United States. Nine hundred and ninety eight Natives in the region were recruited from May 2008 to December 2009 at pow wows, health fairs, through focus groups, career fairs and conferences, and other social and cultural events, and asked to complete a self-administered survey. Although compared with data from the general population, AIAN from our sample may seem heavier Internet users, their use of modern wireless devices is limited, and their usage of Internet to access health information is lower compared to the adult US population. Natives living in the Central Plains region face generational differences in both general and health-related use of the Internet. Inadequate availability of culturally appropriate health information websites may drive AIAN towards search engines and general information websites. PMID:22642739

Promoting Ethical Research With American Indian and Alaska Native People Living in Urban Areas

PubMed Central

Bartgis, Jami; Demers, Deirdre

2014-01-01

Most health research with American Indian and Alaska Native (AI/AN) people has focused on tribal communities on reservation lands. Few studies have been conducted with AI/AN people living in urban settings despite their documented health disparities compared with other urban populations. There are unique considerations for working with this population. Engaging key stakeholders, including urban Indian health organization leaders, tribal leaders, research scientists and administrators, and policymakers, is critical to promoting ethical research and enhancing capacity of urban AI/AN communities. Recommendations for their involvement may facilitate an open dialogue and promote the development of implementation strategies. Future collaborations are also necessary for establishing research policies aimed at improving the health of the urban AI/AN population. PMID:25211730

Hepatitis A Incidence and Hepatitis A Vaccination Among American Indians and Alaska Natives, 1990–2001

PubMed Central

Bialek, Stephanie R.; Thoroughman, Douglas A.; Hu, Diana; Simard, Edgar P.; Chattin, Jody; Cheek, Jim; Bell, Beth P.

2004-01-01

Objectives. We assessed the effect on trends in hepatitis A incidence of the 1996 recommendation for routine hepatitis A vaccination of American Indian/Alaska Native (AIAN) children. Methods. We examined trends in hepatitis A incidence among AIAN peoples during 1990–2001 and vaccination coverage levels among children on the largest American Indian reservation. Results. Hepatitis A rates among AIANs declined 20-fold during 1997–2001. Declines in hepatitis A incidence occurred among AIANs in reservation and metropolitan areas. Among 1956 children living on the Navajo Nation whose medical records were reviewed, 1508 (77.1%) had received at least one dose of hepatitis A vaccine, and 1020 (52.1%) had completed the vaccine series. Conclusions. Hepatitis A rates among AIAN peoples have declined dramatically coincident with implementation of routine hepatitis A vaccination of AIAN children. PMID:15249305

Leaving No American Indian/Alaska Native Behind: Identifying Reading Strengths and Needs

ERIC Educational Resources Information Center

Buly, Marsha Riddle

2005-01-01

American Indian/Alaska Native (AI/AN) students are often labeled as struggling readers based on the results of large-scale standardized tests yet little empirical data about specific strengths and needs exists. In the present study we looked beyond high-stakes assessment to highlight reading strengths and needs for a group of fourth grade American…

Body Mass Index and Cancer Screening in Older American Indian and Alaska Native Men

ERIC Educational Resources Information Center

Muus, Kyle J.; Baker-Demaray, Twyla; McDonald, Leander R.; Ludtke, Richard L.; Allery, Alan J.; Bogart, T. Andy; Goldberg, Jack; Ramsey, Scott D.; Buchwald, Dedra S.

2009-01-01

Context: Regular screenings are important for reducing cancer morbidity and mortality. There are several barriers to receiving timely cancer screening, including overweight/obesity. No study has examined the relationship between overweight/obesity and cancer screening among American Indian/Alaska Natives (AI/ANs). Purpose: To describe the…

Homicide Among American Indians/Alaska Natives, 1999-2009: Implications for Public Health Interventions.

PubMed

Herne, Mose A; Maschino, Alexandra C; Graham-Phillips, Anita L

2016-01-01

We determined estimates of homicide among American Indians/Alaska Natives (AI/ANs) compared with non-Hispanic white people to characterize disparities and improve AI/AN classification in incidence and mortality reporting. We linked 1999-2009 death certificate data with Indian Health Service (IHS) patient registration data to examine death rates from homicide among AI/AN and non-Hispanic white people. Our analysis focused primarily on residents of IHS Contract Health Service Delivery Area counties and excluded Hispanic people to avoid underestimation of incidence and mortality in AI/ANs and for consistency in our comparisons. We used age-adjusted death rates per 100,000 population and stratified our analyses by sex, age, and IHS region. Death rates per 100,000 population from homicide were four times higher among AI/ANs (rate = 12.1) than among white people (rate = 2.8). Homicide rates for AI/ANs were highest in the Southwest (25.6 and 6.9 for males and females, respectively) and in Alaska (17.7 and 10.3 for males and females, respectively). Disparities between AI/ANs and non-Hispanic white people were highest in the Northern Plains region among men (rate ratio [RR] = 9.8, 95% confidence interval [CI] 8.5, 11.3) and among those aged 25-44 years (RR59.0, 95% CI 7.5, 10.7) and 0-24 years (RR57.4, 95% CI 6.1, 8.9). Death rates from homicide among AI/ANs were higher than previously reported and varied by sex, age, and region. Violence prevention efforts involving a range of stakeholders are needed at the community level to address this important public health issue.

Indian Health Service Care System and Cancer Stage in American Indians and Alaska Natives.

PubMed

Burnett-Hartman, Andrea N; Adams, Scott V; Bansal, Aasthaa; McDougall, Jean A; Cohen, Stacey A; Karnopp, Andrew; Warren-Mears, Victoria; Ramsey, Scott D

2018-01-01

We aimed to determine whether the association between late-stage cancer and American Indian/Alaska Native (AI/AN) race differed by enrollment in the Indian Health Service Care System (IHSCS). We used Surveillance, Epidemiology, and End Results (SEER) data linked to Medicare files to compare the odds of late-stage breast, colorectal, lung, or prostate cancer between non-Hispanic Whites (NHWs) (n=285,993) and AI/ANs with (n=581) and without (n=543) IHSCS enrollment. For AI/ANs without IHSCS enrollment, the odds of late-stage disease were higher in AI/ANs compared with NHWs for breast (OR=3.17, 95%CI: 1.82-5.53) and for prostate (OR=2.59, 95%CI:1.55-4.32) cancer, but not for colorectal or lung cancers. Among AI/ANs with IHSCS enrollment, there was not a significant association between late-stage disease and AI/AN race for any of the four cancers evaluated. Our results suggest that enrollment in the IHSCS reduced the disparity between AI/ANs and NHWs with respect to late-stage cancer diagnoses.

Evaluating disparities in inpatient surgical cancer care among American Indian/Alaska Native patients.

PubMed

Simianu, Vlad V; Morris, Arden M; Varghese, Thomas K; Porter, Michael P; Henderson, Jeffrey A; Buchwald, Dedra S; Flum, David R; Javid, Sara H

2016-08-01

American Indian/Alaska Native (AI/AN) patients with cancer have the lowest survival rates of all racial and ethnic groups, possibly because they are less likely to receive "best practice" surgical care than patients of other races. Prospective cohort study comparing adherence with generic and cancer-specific guidelines on processes of surgical care between AI/AN and non-Hispanic white (NHW) patients in Washington State (2010 to 2014) was conducted. A total of 156 AI/AN and 6,030 NHW patients underwent operations for 10 different cancers, and had similar mean adherence to generic surgical guidelines (91.5% vs 91.9%, P = .57). AI/AN patients with breast cancer less frequently received preoperative diagnostic core needle biopsy (81% vs 94%, P = .004). AI/AN patients also less frequently received care adherent to prostate cancer-specific guidelines (74% vs 92%, P = .001). Although AI/ANs undergoing cancer operations in Washington receive similar overall best practice surgical cancer care to NHW patients, there remain important, modifiable disparities that may contribute to their lower survival. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluating Disparities in Inpatient Surgical Cancer Care Among American Indian/Alaska Native Patients

PubMed Central

Simianu, Vlad V.; Morris, Arden M.; Varghese, Thomas K.; Porter, Michael P.; Henderson, Jeffrey A.; Buchwald, Dedra S.; Flum, David R.; Javid, Sara H.

2016-01-01

Background American Indian/Alaska Native (AI/AN) patients with cancer have the lowest survival rates of all racial and ethnic groups, possibly because they are less likely to receive “best practice” surgical care than patients of other races. Methods Prospective cohort study comparing adherence to generic and cancer-specific guidelines on processes of surgical care between AI/AN and non-Hispanic white (NHW) patients in Washington State (2010–2014). Results 156 AI/AN and 6,030 NHW patients underwent operations for 10 different cancers, and had similar mean adherence to generic surgical guidelines (91.5% vs 91.9%, p=0.57). AI/AN patients with breast cancer less frequently received preoperative diagnostic core-needle biopsy (81% versus 94%, p=0.004). AI/AN patients also less frequently received care adherent to prostate cancer-specific guidelines (74% versus 92%,p=0.001). Conclusions While AI/ANs undergoing cancer operations in Washington receive similar overall best practice surgical cancer care to NHW patients, there remain important, modifiable disparities that may contribute to their lower survival. PMID:26846176

Use of Large-Scale Data Sets to Study Educational Pathways of American Indian and Alaska Native Students

ERIC Educational Resources Information Center

Faircloth, Susan C.; Alcantar, Cynthia M.; Stage, Frances K.

2014-01-01

This chapter discusses issues and challenges encountered in using large-scale data sets to study educational experiences and subsequent outcomes for American Indian and Alaska Native (AI/AN) students. In this chapter, we argue that the linguistic and cultural diversity of Native peoples, coupled with the legal and political ways in which education…

The Affordable Care Act and Implications for Health Care Services for American Indian and Alaska Native Individuals

PubMed Central

Ross, Raven E.; Garfield, Lauren D.; Brown, Derek S.; Raghavan, Ramesh

2016-01-01

American Indian and Alaska Native (AI/AN) populations report poor physical and mental health outcomes while tribal health providers and the Indian Health Service (IHS) operate in a climate of significant under funding. Understanding how the Patient Protection and Affordable Care Act (ACA) affects Native American tribes and the IHS is critical to addressing the improvement of the overall access, quality, and cost of health care within AI/AN communities. This paper summarizes the ACA provisions that directly and/or indirectly affect the service delivery of health care provided by tribes and the IHS. PMID:26548665

Prevalence of Fracture and Osteoporosis Risk Factors in American Indian and Alaska Native People

PubMed Central

Frech, Tracy; Ma, Khe-ni; Ferrucci, Elizabeth D.; Lanier, Anne P.; McFadden, Molly; Tom-Orme, Lillian; Slattery, Martha L.; Murtaugh, Maureen A.

2012-01-01

Objective Little is known about prevalence of osteoporosis risk factors among American Indians and Alaska Natives (AIAN). Methods We included AIAN people (n = 8,039) enrolled in the Education and Research Towards Health (EARTH) Study. Prevalence ratios were used to determine cross-sectional associations of risk factors with self-reported bone fractures. Results There is a high prevalence of multiple risk factors for osteoporosis in AIAN, although the factors that are associated with past fracture vary by gender and geographical area. In general, women who reported a fracture reported more risk behaviors, more than two medical conditions, and low physical activity. Men with higher BMI were less likely to report a fracture. Smoking history was associated with fracture for both genders, though not significantly in all sub-groups. Conclusion We prevent a high prevalence of risk factors for osteoporosis for AIAN. Future research for osteoporosis risk reduction and prevention in AIAN people is indicated. PMID:24212166

Culturally Based Math Education as a Way to Improve Alaska Native Students' Math Performance.

ERIC Educational Resources Information Center

Lipka, Jerry; Adams, Barbara

2004-01-01

Culturally based instruction has long been touted as a preferred approach to improving the performance of American Indian and Alaska Native (AI/AN) students? academic performance. However, there has been scant research to support this conjecture, particularly when quantitative data and quasi-experimental designs are included. The results of this…

Obesity, Diabetes, and Birth Outcomes Among American Indians and Alaska Natives.

PubMed

Anderson, Kermyt G; Spicer, Paul; Peercy, Michael T

2016-12-01

Objectives To examine the relationships between prepregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), and prepregnancy body mass index, with several adverse birth outcomes: preterm delivery (PTB), low birthweight (LBW), and macrosomia, comparing American Indians and Alaska Natives (AI/AN) with other race/ethnic groups. Methods The sample includes 5,193,386 singleton US first births from 2009-2013. Logistic regression is used to calculate adjusted odds ratios controlling for calendar year, maternal age, education, marital status, Kotelchuck prenatal care index, and child's sex. Results AI/AN have higher rates of diabetes than all other groups, and higher rates of overweight and obesity than whites or Hispanics. Neither overweight nor obesity predict PTB for AI/AN, in contrast to other groups, while diabetes predicts increased odds of PTB for all groups. Being overweight predicts reduced odds of LBW for all groups, but obesity is not predictive of LBW for AI/AN. Diabetes status also does not predict LBW for AI/AN; for other groups, LBW is more likely for women with DM or GDM. Overweight, obesity, DM, and GDM all predict higher odds of macrosomia for all race/ethnic groups. Conclusions for Practice Controlling diabetes in pregnancy, as well as prepregnancy weight gain, may help decrease preterm birth and macrosomia among AI/AN.

Excess frequent insufficient sleep in American Indians/Alaska natives.

PubMed

Chapman, Daniel P; Croft, Janet B; Liu, Yong; Perry, Geraldine S; Presley-Cantrell, Letitia R; Ford, Earl S

2013-01-01

Frequent insufficient sleep, defined as ≥14 days/past 30 days in which an adult did not get enough rest or sleep, is associated with adverse mental and physical health outcomes. Little is known about the prevalence of frequent insufficient sleep among American Indians/Alaska Natives (AI/AN). We assessed racial/ethnic differences in the prevalence of frequent insufficient sleep from the combined 2009-2010 Behavioral Risk Factor Surveillance Survey among 810,168 respondents who self-identified as non-Hispanic white (NHW, n = 671,448), non-Hispanic black (NHB, n = 67,685), Hispanic (n = 59,528), or AI/AN (n = 11,507). We found significantly higher unadjusted prevalences (95% CI) of frequent insufficient sleep among AI/AN (34.2% [32.1-36.4]) compared to NHW (27.4% [27.1-27.6]). However, the age-adjusted excess prevalence of frequent insufficient sleep in AI/AN compared to NHW was decreased but remained significant with the addition of sex, education, and employment status; this latter relationship was further attenuated by the separate additions of obesity and lifestyle indicators, but was no longer significant with the addition of frequent mental distress to the model (PR  =  1.05; 95% CI : 0.99-1.13). This is the first report of a high prevalence of frequent insufficient sleep among AI/AN. These results further suggest that investigation of sleep health interventions addressing frequent mental distress may benefit AI/AN populations.

Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999-2009.

PubMed

Jacobs-Wingo, Jasmine L; Espey, David K; Groom, Amy V; Phillips, Leslie E; Haverkamp, Donald S; Stanley, Sandte L

2016-05-01

To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999-2009 and compared those with corresponding urban White and rural AI/AN death rates. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities.

Health Promotion and Substance Abuse Prevention among American Indian and Alaska Native Communities: Issues in Cultural Competence. Cultural Competence Series 9. Special Collaborative Edition.

ERIC Educational Resources Information Center

Trimble, Joseph E., Ed.; Beauvais, Fred, Ed.

Substance abuse continues to be one of the most damaging and chronic health problems faced by Indian people. American Indian and Alaska Native (AI/AN) substance abuse prevention and treatment programs must be framed within the broader context of the widening health disparities between AI/AN communities and the general population. Successful…

Lung Cancer Deaths Among American Indians and Alaska Natives, 1990–2009

PubMed Central

Plescia, Marcus; Henley, Sarah Jane; Pate, Anne; Underwood, J. Michael; Rhodes, Kris

2014-01-01

Objectives. We examined regional differences in lung cancer among American Indians/Alaska Natives (AI/ANs) using linked data sets to minimize racial misclassification. Methods. On the basis of federal lung cancer incidence data for 1999 to 2009 and deaths for 1990 to 2009 linked with Indian Health Service (IHS) registration records, we calculated age-adjusted incidence and death rates for non-Hispanic AI/AN and White persons by IHS region, focusing on Contract Health Service Delivery Area (CHSDA) counties. We correlated death rates with cigarette smoking prevalence and calculated mortality-to-incidence ratios. Results. Lung cancer death rates among AI/AN persons in CHSDA counties varied across IHS regions, from 94.0 per 100 000 in the Northern Plains to 15.2 in the Southwest, reflecting the strong correlation between smoking and lung cancer. For every 100 lung cancers diagnosed, there were 6 more deaths among AI/AN persons than among White persons. Lung cancer death rates began to decline in 1997 among AI/AN men and are still increasing among AI/AN women. Conclusions. Comparison of regional lung cancer death rates between AI/AN and White populations indicates disparities in tobacco control and prevention interventions. Efforts should be made to ensure that AI/AN persons receive equal benefit from current and emerging lung cancer prevention and control interventions. PMID:24754613

Cultural Discontinuity between Home and School and American Indian and Alaska Native Children's Achievement

ERIC Educational Resources Information Center

Torres, D. Diego

2017-01-01

An assumption of culture-based education with respect to American Indian and Alaska Native (AI/AN) children is that discontinuity between home and school cultures is responsible for educational underachievement. Using data from the 2009 round of the National Indian Education Study, a subset of the larger National Assessment of Education Progress…

Disparities in Smoking-Related Mortality Among American Indians/Alaska Natives.

PubMed

Mowery, Paul D; Dube, Shanta R; Thorne, Stacy L; Garrett, Bridgette E; Homa, David M; Nez Henderson, Patricia

2015-11-01

Smoking-related disparities continue to be a public health problem among American Indian/Alaska Native (AI/AN) population groups and data documenting the health burden of smoking in this population are sparse. The purpose of this study was to assess mortality attributable to cigarette smoking among AI/AN adults relative to non-Hispanic white adults (whites) by calculating and comparing smoking-attributable fractions and mortality. Smoking-attributable fractions and mortality among AI/ANs (n=1.63 million AI/ANs) and whites were calculated for people living in 637 Indian Health Service Contract Health Service Delivery Area counties in the U.S., from mortality data collected during 2001-2009. Differences in smoking-attributable mortality between AI/ANs and whites for five major causes of smoking-related deaths were examined. All data analyses were carried out in 2013-2014. Overall, from 2001 to 2009, age-adjusted death rates, smoking-attributable fractions, and smoking-attributable mortality for all-cause mortality were higher among AI/ANs than among whites for adult men and women aged ≥35 years. Smoking caused 21% of ischemic heart disease, 15% of other heart disease, and 17% of stroke deaths in AI/AN men, compared with 15%, 10%, and 9%, respectively, for white men. Among AI/AN women, smoking caused 18% of ischemic heart disease deaths, 13% of other heart diseases deaths, and 20% of stroke deaths, compared with 9%, 7%, and 10%, respectively, among white women. These findings underscore the need for comprehensive tobacco control and prevention efforts that can effectively reach and impact the AI/AN population to prevent and reduce smoking. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Staying Connected: A Feasibility Study Linking American Indian and Alaska Native Trauma Survivors to their Tribal Communities

PubMed Central

Tsosie, Ursula; Nannauck, Sweetwater; Buchwald, Dedra; Russo, Joan; Geiss Trusz, Sarah; Foy, Hugh; Zatzick, Douglas

2013-01-01

The objective of this investigation was to assess the feasibility of a culturally tailored care management intervention for physically injured American Indian/Alaska Native (AI/AN) patients. The intervention was initiated at a Level I trauma center and aimed to link AI/AN patients to their distant tribal communities. Thirty AI/AN patients were randomized to the intervention or to usual care. Assessments at baseline, 3 months, and 6 months included self-reported lifetime cumulative trauma burden, Native healing requests, and symptoms of posttraumatic stress, depression, and alcohol use. Generalized estimating equations ascertained differences between groups over time. Ninety-four percent of eligible patients participated; follow-up at 3 and 6 months was 83%. Participants had high numbers of lifetime traumas (mean = 5.1, standard deviation = 2.6). No differences between the intervention and control groups were observed in posttraumatic stress symptoms, depression symptoms, or alcohol use at baseline or follow-up time points. Among intervention patients, 60% either requested or participated in traditional Native healing practices and 75% reported that the intervention was helpful. This effectiveness trial demonstrated the feasibility of recruiting and randomizing injured AI/AN patients. Future efforts could integrate evidence-based interventions and traditional Native healing into stepped collaborative care treatment programs. PMID:22168295

Food Insecurity among American Indians and Alaska Natives: A National Profile using the Current Population Survey-Food Security Supplement.

PubMed

Jernigan, Valarie Blue Bird; Huyser, Kimberly R; Valdes, Jimmy; Simonds, Vanessa Watts

2017-01-01

Food insecurity increases the risk for obesity, diabetes, hypertension, and cancer-conditions highly prevalent among American Indians and Alaska Natives (AI/ANs). Using the Current Population Survey Food Security Supplement, we analyzed the food insecurity trends of AI/ANs compared to other racial and ethnic groups in the United States from 2000 to 2010. From 2000 to 2010, 25% of AI/ANs remained consistently food insecure and AI/ANs were twice as likely to be food insecure compared to whites. Urban AI/ANs were more likely to experience food insecurity than rural AI/ANs. Our findings highlight the need for national and tribal policies that expand food assistance programs; promote and support increased access to healthy foods and community food security, in both rural and urban areas; and reduce the burden of diet-related disparities on low-income and racial/ethnic minority populations.

Cervical cancer incidence and mortality among American Indian and Alaska Native women, 1999-2009.

PubMed

Watson, Meg; Benard, Vicki; Thomas, Cheryll; Brayboy, Annie; Paisano, Roberta; Becker, Thomas

2014-06-01

We analyzed cervical cancer incidence and mortality data in American Indian and Alaska Native (AI/AN) women compared with women of other races. We improved identification of AI/AN race, cervical cancer incidence, and mortality data using Indian Health Service (IHS) patient records; our analyses focused on residents of IHS Contract Health Service Delivery Area (CHSDA) counties. Age-adjusted incidence and death rates were calculated for AI/AN and White women from 1999 to 2009. AI/AN women in CHSDA counties had a death rate from cervical cancer of 4.2, which was nearly twice the rate in White women (2.0; rate ratio [RR] = 2.11). AI/AN women also had higher incidence rates of cervical cancer compared with White women (11.0 vs 7.1; RR = 1.55) and were more often diagnosed with later-stage disease (RR = 1.84 for regional stage and RR = 1.74 for distant stage). Death rates decreased for AI/AN women from 1990 to 1993 (-25.8%/year) and remained stable thereafter. Although rates decreased over time, AI/AN women had disproportionately higher cervical cancer incidence and mortality. The persistently higher rates among AI/AN women compared with White women require continued improvements in identifying and treating cervical cancer and precancerous lesions.

Leading causes of death and all-cause mortality in American Indians and Alaska Natives.

PubMed

Espey, David K; Jim, Melissa A; Cobb, Nathaniel; Bartholomew, Michael; Becker, Tom; Haverkamp, Don; Plescia, Marcus

2014-06-01

We present regional patterns and trends in all-cause mortality and leading causes of death in American Indians and Alaska Natives (AI/ANs). US National Death Index records were linked with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN. We analyzed temporal trends for 1990 to 2009 and comparisons between non-Hispanic AI/AN and non-Hispanic White persons by geographic region for 1999 to 2009. Results focus on IHS Contract Health Service Delivery Area counties in which less race misclassification occurs. From 1990 to 2009 AI/AN persons did not experience the significant decreases in all-cause mortality seen for Whites. For 1999 to 2009 the all-cause death rate in CHSDA counties for AI/AN persons was 46% more than that for Whites. Death rates for AI/AN persons varied as much as 50% among regions. Except for heart disease and cancer, subsequent ranking of specific causes of death differed considerably between AI/AN and White persons. AI/AN populations continue to experience much higher death rates than Whites. Patterns of mortality are strongly influenced by the high incidence of diabetes, smoking prevalence, problem drinking, and social determinants. Much of the observed excess mortality can be addressed through known public health interventions.

Homicide Among American Indians/Alaska Natives, 1999–2009: Implications for Public Health Interventions

PubMed Central

Maschino, Alexandra C.; Graham-Phillips, Anita L.

2016-01-01

Objective We determined estimates of homicide among American Indians/Alaska Natives (AI/ANs) compared with non-Hispanic white people to characterize disparities and improve AI/AN classification in incidence and mortality reporting. Methods We linked 1999–2009 death certificate data with Indian Health Service (IHS) patient registration data to examine death rates from homicide among AI/AN and non-Hispanic white people. Our analysis focused primarily on residents of IHS Contract Health Service Delivery Area counties and excluded Hispanic people to avoid underestimation of incidence and mortality in AI/ANs and for consistency in our comparisons. We used age-adjusted death rates per 100,000 population and stratified our analyses by sex, age, and IHS region. Results Death rates per 100,000 population from homicide were four times higher among AI/ANs (rate = 12.1) than among white people (rate = 2.8). Homicide rates for AI/ANs were highest in the Southwest (25.6 and 6.9 for males and females, respectively) and in Alaska (17.7 and 10.3 for males and females, respectively). Disparities between AI/ANs and non-Hispanic white people were highest in the Northern Plains region among men (rate ratio [RR] = 9.8, 95% confidence interval [CI] 8.5, 11.3) and among those aged 25–44 years (RR59.0, 95% CI 7.5, 10.7) and 0–24 years (RR57.4, 95% CI 6.1, 8.9). Conclusion Death rates from homicide among AI/ANs were higher than previously reported and varied by sex, age, and region. Violence prevention efforts involving a range of stakeholders are needed at the community level to address this important public health issue. PMID:27453605

Obesity and Overweight in American Indian and Alaska Native Children, 2006-2015.

PubMed

Bullock, Ann; Sheff, Karen; Moore, Kelly; Manson, Spero

2017-09-01

To estimate obesity and overweight prevalence in American Indian and Alaska Native (AI/AN) children across genders, ages, and geographic regions in the Indian Health Service active clinical population. We obtained data from the Indian Health Service National Data Warehouse. At least 184 000 AI/AN children aged 2 to 19 years had body mass index data for each year studied, 2006 to 2015. We calculated body mass index percentiles with the 2000 Centers for Disease Control and Prevention growth charts. In 2015, the prevalence of overweight and obesity in AI/AN children aged 2 to 19 years was 18.5% and 29.7%, respectively. Boys had higher obesity prevalence than girls (31.5% vs 27.9%). Children aged 12 to 19 years had a higher prevalence of overweight and obesity than younger children. The AI/AN children in our study had a higher prevalence of obesity than US children overall in the National Health and Nutrition Examination Survey. Results for 2006 through 2014 were similar. The prevalence of overweight and obesity among AI/AN children in this population may have stabilized, while remaining higher than prevalence for US children overall.

With All My Relations: Counseling American Indians and Alaska Natives within a Familial Context

ERIC Educational Resources Information Center

Harper, Faith G.

2011-01-01

Statistics show that two thirds of American Indians and Alaska Natives (AIs/ANs) live outside of tribal areas, and 50% of those individuals who seek counseling services will not use tribal resources. There is a strong likelihood that counselors will have the opportunity to provide services to AI/AN clients. The review of the academic literature…

Drop-Out Rates among American Indian and Alaska Native Students: Beyond Cultural Discontinuity. ERIC Digest.

ERIC Educational Resources Information Center

St. Germaine, Richard

American Indian and Alaska Native (AI/AN) students regularly face obstacles during the transition to high school and have the highest dropout rate of all U.S. racial and ethnic groups. Educational theorists and researchers have various explanations for this high failure rate, each with its own prescriptions. These explanations include: (1) deficit…

Substance Use and Sexual Risk Behaviors among American Indian and Alaska Native High School Students

ERIC Educational Resources Information Center

de Ravello, Lori; Everett Jones, Sherry; Tulloch, Scott; Taylor, Melanie; Doshi, Sonal

2014-01-01

Background: We describe the prevalence of behaviors that put American Indian and Alaska Native (AI/AN) high school students at risk for teen pregnancy and sexually transmitted infections (STIs) and the relationships among race/ethnicity and these behaviors. Methods: We analyzed merged 2007 and 2009 data from the national Youth Risk Behavior…

Regular tobacco use among American Indian and Alaska native adolescents: an examination of protective mechanisms.

PubMed

Osilla, Karen Chan; Lonczak, Heather S; Mail, Patricia D; Larimer, Mary E; Marlatt, G Alan

2007-01-01

American Indian and Alaska Native (AIAN) adolescents use tobacco at earlier ages and in larger quantities compared to non-AIAN peers. Regular tobacco use was examined against five protective factors (peer networks supportive of not using drugs, college aspirations, team sports, playing music, and volunteerism). Participants consisted of 112 adolescents between the ages of 13 and 19 who participated in a study testing the efficacy of a life-skills program aimed at reducing substance-related consequences. Findings indicated that, with the exception of prosocial peer networks and volunteerism, each of the above factors was significantly associated with a reduced probability of being a regular tobacco user. Gender differences were notable. These results hold important treatment implications regarding the reduction and prevention of tobacco use among AIAN youth.

Advancing Suicide Prevention Research With Rural American Indian and Alaska Native Populations

PubMed Central

Chandler, Michael; Gone, Joseph P.; Cwik, Mary; Kirmayer, Laurence J.; LaFromboise, Teresa; Brockie, Teresa; O’Keefe, Victoria; Walkup, John; Allen, James

2015-01-01

As part of the National Action Alliance for Suicide Prevention’s American Indian and Alaska Native (AI/AN) Task Force, a multidisciplinary group of AI/AN suicide research experts convened to outline pressing issues related to this subfield of suicidology. Suicide disproportionately affects Indigenous peoples, and remote Indigenous communities can offer vital and unique insights with relevance to other rural and marginalized groups. Outcomes from this meeting include identifying the central challenges impeding progress in this subfield and a description of promising research directions to yield practical results. These proposed directions expand the alliance’s prioritized research agenda and offer pathways to advance the field of suicide research in Indigenous communities and beyond. PMID:25790403

Geographic variation in trends and characteristics of teen childbearing among American Indians and Alaska Natives, 1990-2007.

PubMed

Wingo, Phyllis A; Lesesne, Catherine A; Smith, Ruben A; de Ravello, Lori; Espey, David K; Arambula Solomon, Teshia G; Tucker, Myra; Thierry, Judith

2012-12-01

To study teen birth rates, trends, and socio-demographic and pregnancy characteristics of AI/AN across geographic regions in the US. The birth rate for US teenagers 15-19 years reached a historic low in 2009 (39.1 per 1,000) and yet remains one of the highest teen birth rates among industrialized nations. In the US, teen birth rates among Hispanic, non-Hispanic black, and American Indian/Alaska Native (AI/AN) youth are consistently two to three times the rate among non-Hispanic white teens. Birth certificate data for females younger than age 20 were used to calculate birth rates (live births per 1,000 women) and joinpoint regression to describe trends in teen birth rates by age (<15, 15-17, 18-19) and region (Aberdeen, Alaska, Bemidji, Billings, California, Nashville, Oklahoma, Portland, Southwest). Birth rates for AI/AN teens varied across geographic regions. Among 15-19-year-old AI/AN, rates ranged from 24.35 (California) to 123.24 (Aberdeen). AI/AN teen birth rates declined from the early 1990s into the 2000s for all three age groups. Among 15-17-year-olds, trends were approximately level during the early 2000s-2007 in six regions and declined in the others. Among 18-19-year-olds, trends were significantly increasing during the early 2000s-2007 in three regions, significantly decreasing in one, and were level in the remaining regions. Among AI/AN, cesarean section rates were lower in Alaska (4.1%) than in other regions (16.4-26.6%). This is the first national study to describe regional variation in AI/AN teen birth rates. These data may be used to target limited resources for teen pregnancy intervention programs and guide research.

A Program Evaluation of a Summer Research Training Institute for American Indian and Alaska Native Health Professionals

ERIC Educational Resources Information Center

Zaback, Tosha; Becker, Thomas M.; Dignan, Mark B.; Lambert, William E.

2010-01-01

In this article, the authors describe a unique summer program to train American Indian/Alaska Native (AI/AN) health professionals in a variety of health research-related skills, including epidemiology, data management, statistical analysis, program evaluation, cost-benefit analysis, community-based participatory research, grant writing, and…

Implementing Instructional Practices to Improve American Indian and Alaska Native Students' Reading Outcomes: An Exploration of Patterns across Teacher, Classroom, and School Characteristics

ERIC Educational Resources Information Center

Vincent, Claudia; Tobin, Tary; Van Ryzin, Mark

2017-01-01

The Native Community strongly recommends integrating Native language and culture (NLC) into reading instruction to improve outcomes for American Indian/Alaska Native (AI/AN) students. However, little is known about the extent to which recommended practices are used and what might facilitate their implementation. The National Indian Education Study…

Trends and Disparities in Heart Disease Mortality Among American Indians/Alaska Natives, 1990–2009

PubMed Central

Ayala, Carma; Schieb, Linda; Dai, Shifan; Henderson, Jeffrey A.; Cho, Pyone

2014-01-01

Objectives. We evaluated heart disease death rates among American Indians and Alaska Natives (AI/ANs) and Whites after improving identification of AI/AN populations. Methods. Indian Health Service (IHS) registration data were linked to the National Death Index for 1990 to 2009 to identify deaths among AI/AN persons aged 35 years and older with heart disease listed as the underlying cause of death (UCOD) or 1 of multiple causes of death (MCOD). We restricted analyses to IHS Contract Health Service Delivery Areas and to non-Hispanic populations. Results. Heart disease death rates were higher among AI/AN persons than Whites from 1999 to 2009 (1.21 times for UCOD, 1.30 times for MCOD). Disparities were highest in younger age groups and in the Northern Plains, but lowest in the East and Southwest. In AI/AN persons, MCOD rates were 84% higher than UCOD rates. From 1990 to 2009, UCOD rates declined among Whites, but only declined significantly among AI/AN persons after 2003. Conclusions. Analysis with improved race identification indicated that AI/AN populations experienced higher heart disease death rates than Whites. Better prevention and more effective care of heart disease is needed for AI/AN populations. PMID:24754556

The American Indian and Alaska Native Dentist Workforce in the United States

PubMed Central

Mertz, Elizabeth; Wides, Cynthia; Gates, Paul

2017-01-01

Objectives The purpose of this paper is to describe the American Indian/Alaska Native (AI/AN) dentist workforce, the general practice patterns of these providers, and their contributions to oral health care for AI/AN and underserved patients. Methods A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 34.0% response rate for self-reported AI/AN dentists. Data were weighted for selection and response bias to be nationally representative. Descriptive and multivariable statistics were computed to provide a workforce profile. Comparisons to Census data and published information on dental students and dentists were used to examine practice patterns. Results The AI/AN dentist workforce (weighted n=442) is very diverse with 55 reported individual tribal affiliations. Tribal heritage was provided by 96.4% of AI/AN dentists (n=426), and of these, 93.9% (n=400) reported an affiliation with only one tribe. The largest share of AI/AN dentists were born in the U.S. (98.2%, n=434), married (75.6%, n=333), and had dependent children under age 18 (52.0%, n=222). Only 0.9% (n=4) of AI/AN dentists spoke a traditional AI/AN language in patient care, while 10.6% (n=46) were raised on tribal land or reservation. Initial practice in the Indian Health Service was reported by 15.8% of AI/AN dentists while 16.2% report currently practicing in a safety-net setting, and 42.0% report working in a practice that primarily serves underserved patients. Conclusions AI/AN dentists provide a disproportionate share of care for AI/AN populations, yet the number of AI/AN dentists would need to increase 7.4 fold in order to meet population parity. PMID:27922723

The American Indian and Alaska Native dentist workforce in the United States.

PubMed

Mertz, Elizabeth; Wides, Cynthia; Gates, Paul

2017-03-01

The purpose of this article is to describe the American Indian/Alaska Native (AI/AN) dentist workforce, the general practice patterns of these providers, and their contributions to oral health care for AI/AN and underserved patients. A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 34 percent response rate for self-reported AI/AN dentists. Data were weighted for selection and response bias to be nationally representative. Descriptive and multivariable statistics were computed to provide a workforce profile. Comparisons to Census data and published information on dental students and dentists were used to examine practice patterns. The AI/AN dentist workforce (weighted n = 442) is very diverse with 55 reported individual tribal affiliations. Tribal heritage was provided by 95.7 percent of AI/AN dentists (n = 423), and of these, 93.9 percent (n = 400) reported an affiliation with only one tribe. The largest share of AI/AN dentists were born in the United States (98.2 percent, n = 434), married (75.6 percent, n = 333), and had dependent children under age 18 (52.0 percent, n = 222). Only 0.9 percent (n = 4) of AI/AN dentists spoke a traditional AI/AN language in patient care, while 10.6 percent (n = 46) were raised on tribal land or reservation. Initial practice in the Indian Health Service was reported by 15.8 percent of AI/AN dentists while 16.2 percent report currently practicing in a safety-net setting, and 42.0 percent report working in a practice that primarily serves underserved patients. AI/AN dentists provide a disproportionate share of care for AI/AN populations, yet the number of AI/AN dentists would need to increase 7.4-fold in order to meet population parity. © 2016 American Association of Public Health Dentistry.

Chronic disease risk factors among American Indian/Alaska Native women of reproductive age.

PubMed

Amparo, Pamela; Farr, Sherry L; Dietz, Patricia M

2011-11-01

The magnitude of chronic conditions and risk factors among American Indian/Alaska Native women of reproductive age is unknown. The objective of our study was to estimate this magnitude. We analyzed data for 2,821 American Indian/Alaska Native women and 105,664 non-Hispanic white women aged 18 to 44 years from the 2005 and 2007 Behavioral Risk Factor Surveillance System. We examined prevalence of high cholesterol, high blood pressure, diabetes, body mass index (kg/m(2)) ≥25.0, physical inactivity, smoking, excessive alcohol consumption, and frequent mental distress, and the cumulative number of these chronic conditions and risk factors (≥3, 2, 1, or 0). In a multivariable, multinomial logistic regression model, we examined whether American Indian/Alaska Native race was associated with the cumulative number of chronic conditions and risk factors. American Indian/Alaska Native women, compared with white women, had significantly higher rates of high blood pressure, diabetes, obesity, smoking, and frequent mental distress. Of American Indian/Alaska Native women, 41% had 3 or more chronic conditions or risk factors compared with 27% of white women (χ(2), P < .001). After adjustment for income, education, and other demographic variables, American Indian/Alaska Native race was not associated with having either 1, 2, or 3 or more chronic conditions or risk factors. Three out of every 5 American Indian/Alaska Native women aged 18 to 44 years have 3 or more chronic conditions or risk factors. Improving economic status and education for AI/AN women could help eliminate disparities in health status.

Cultural Identity Among Urban American Indian/Alaska Native Youth: Implications for Alcohol and Drug Use.

PubMed

Brown, Ryan A; Dickerson, Daniel L; D'Amico, Elizabeth J

2016-10-01

American Indian / Alaska Native (AI/AN) youth exhibit high rates of alcohol and other drug (AOD) use, which is often linked to the social and cultural upheaval experienced by AI/ANs during the colonization of North America. Urban AI/AN youth may face unique challenges, including increased acculturative stress due to lower concentrations of AI/AN populations in urban areas. Few existing studies have explored cultural identity among urban AI/AN youth and its association with AOD use. This study used systematic qualitative methods with AI/AN communities in two urban areas within California to shed light on how urban AI/AN youth construct cultural identity and how this relates to AOD use and risk behaviors. We conducted 10 focus groups with a total of 70 youth, parents, providers, and Community Advisory Board members and used team-based structured thematic analysis in the Dedoose software platform. We identified 12 themes: intergenerational stressors, cultural disconnection, AI/AN identity as protective, pan-tribal identity, mixed racial-ethnic identity, rural vs. urban environments, the importance of AI/AN institutions, stereotypes and harassment, cultural pride, developmental trajectories, risks of being AI/AN, and mainstream culture clash. Overall, youth voiced curiosity about their AI/AN roots and expressed interest in deepening their involvement in cultural activities. Adults described the myriad ways in which involvement in cultural activities provides therapeutic benefits for AI/AN youth. Interventions that provide urban AI/AN youth with an opportunity to engage in cultural activities and connect with positive and healthy constructs in AI/AN culture may provide added impact to existing interventions.

Leading Causes of Death and All-Cause Mortality in American Indians and Alaska Natives

PubMed Central

Jim, Melissa A.; Cobb, Nathaniel; Bartholomew, Michael; Becker, Tom; Haverkamp, Don; Plescia, Marcus

2014-01-01

Objectives. We present regional patterns and trends in all-cause mortality and leading causes of death in American Indians and Alaska Natives (AI/ANs). Methods. US National Death Index records were linked with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN. We analyzed temporal trends for 1990 to 2009 and comparisons between non-Hispanic AI/AN and non-Hispanic White persons by geographic region for 1999 to 2009. Results focus on IHS Contract Health Service Delivery Area counties in which less race misclassification occurs. Results. From 1990 to 2009 AI/AN persons did not experience the significant decreases in all-cause mortality seen for Whites. For 1999 to 2009 the all-cause death rate in CHSDA counties for AI/AN persons was 46% more than that for Whites. Death rates for AI/AN persons varied as much as 50% among regions. Except for heart disease and cancer, subsequent ranking of specific causes of death differed considerably between AI/AN and White persons. Conclusions. AI/AN populations continue to experience much higher death rates than Whites. Patterns of mortality are strongly influenced by the high incidence of diabetes, smoking prevalence, problem drinking, and social determinants. Much of the observed excess mortality can be addressed through known public health interventions. PMID:24754554

Patterns of clinical response to PSA elevation in American Indian/Alaska Native men: a multi-center pilot study.

PubMed

Tilburt, Jon C; Koller, Kathryn; Tiesinga, James J; Wilson, Robin T; Trinh, Anne C; Hill, Kristin; Hall, Ingrid J; Smith, Judith Lee; Ekwueme, Donatus U; Petersen, Wesley O

2013-11-01

To assess clinical treatment patterns and response times among American Indian/Alaska Native men with a newly elevated PSA. We retrospectively identified men ages 50-80 receiving care in one of three tribally-operated clinics in Northern Minnesota, one medical center in Alaska, and who had an incident PSA elevation (> 4 ng/ml) in a specified time period. A clinical response was considered timely if it was documented as occurring within 90 days of the incident PSA elevation. Among 82 AI/AN men identified from medical records with an incident PSA elevation, 49 (60%) received a timely clinical response, while 18 (22%) had no documented clinical response. One in five AI/AN men in our study had no documented clinical action following an incident PSA elevation. Although a pilot study, these findings suggest the need to improve the documentation, notification, and care following an elevated PSA at clinics serving AI/AN men.

Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

PubMed Central

Foote, Eric M.; Singleton, Rosalyn J.; Holman, Robert C.; Seeman, Sara M.; Steiner, Claudia A.; Bartholomew, Michael; Hennessy, Thomas W.

2015-01-01

Background The lower respiratory tract infection (LRTI)-associated hospitalization rate in American Indian and Alaska Native (AI/AN) children aged <5 years declined during 1998–2008, yet remained 1.6 times higher than the general US child population in 2006–2008. Purpose Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years. Methods A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009–2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998–1999 rates prior to pneumococcal conjugate vaccine introduction. Results The average annual LRTI-associated hospitalization rate declined from 1998–1999 to 2009–2011 in AI/AN (35%, p<0.01) and the general US child population (19%, SE: 4.5%, p<0.01). The 2009–2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6–14.8). The Alaska (38.9) and Southwest regions (27.3) had the highest rates. The disparity was greatest for infant (<1 year) pneumonia-associated and 2009–2010 H1N1 influenza-associated hospitalizations. Conclusions Although the LRTI-associated hospitalization rate declined, the 2009–2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children. PMID:26547082

Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.

PubMed

Foote, Eric M; Singleton, Rosalyn J; Holman, Robert C; Seeman, Sara M; Steiner, Claudia A; Bartholomew, Michael; Hennessy, Thomas W

2015-01-01

Background The lower respiratory tract infection (LRTI)-associated hospitalization rate in American Indian and Alaska Native (AI/AN) children aged <5 years declined during 1998-2008, yet remained 1.6 times higher than the general US child population in 2006-2008. Purpose Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years. Methods A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009-2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998-1999 rates prior to pneumococcal conjugate vaccine introduction. Results The average annual LRTI-associated hospitalization rate declined from 1998-1999 to 2009-2011 in AI/AN (35%, p<0.01) and the general US child population (19%, SE: 4.5%, p<0.01). The 2009-2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6-14.8). The Alaska (38.9) and Southwest regions (27.3) had the highest rates. The disparity was greatest for infant (<1 year) pneumonia-associated and 2009-2010 H1N1 influenza-associated hospitalizations. Conclusions Although the LRTI-associated hospitalization rate declined, the 2009-2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children.

Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.

PubMed

Foote, Eric M; Singleton, Rosalyn J; Holman, Robert C; Seeman, Sara M; Steiner, Claudia A; Bartholomew, Michael; Hennessy, Thomas W

2015-01-01

The lower respiratory tract infection (LRTI)-associated hospitalization rate in American Indian and Alaska Native (AI/AN) children aged <5 years declined during 1998-2008, yet remained 1.6 times higher than the general US child population in 2006-2008. Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years. A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009-2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998-1999 rates prior to pneumococcal conjugate vaccine introduction. The average annual LRTI-associated hospitalization rate declined from 1998-1999 to 2009-2011 in AI/AN (35%, p<0.01) and the general US child population (19%, SE: 4.5%, p<0.01). The 2009-2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6-14.8). The Alaska (38.9) and Southwest regions (27.3) had the highest rates. The disparity was greatest for infant (<1 year) pneumonia-associated and 2009-2010 H1N1 influenza-associated hospitalizations. Although the LRTI-associated hospitalization rate declined, the 2009-2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children.

Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999–2009

PubMed Central

Espey, David K.; Groom, Amy V.; Phillips, Leslie E.; Haverkamp, Donald S.; Stanley, Sandte L.

2016-01-01

Objectives. To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. Methods. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999–2009 and compared those with corresponding urban White and rural AI/AN death rates. Results. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Conclusions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities. PMID:26890168

Disparities in Cancer Mortality and Incidence Among American Indians and Alaska Natives in the United States

PubMed Central

Espey, David K.; Swan, Judith; Wiggins, Charles L.; Eheman, Christie; Kaur, Judith S.

2014-01-01

Objectives. We used improved data on American Indian and Alaska Native (AI/AN) ancestry to provide an updated and comprehensive description of cancer mortality and incidence among AI/AN populations from 1990 to 2009. Methods. We linked the National Death Index and central cancer registry records independently to the Indian Health Service (IHS) patient registration database to improve identification of AI/AN persons in cancer mortality and incidence data, respectively. Analyses were restricted to non-Hispanic persons residing in Contract Health Service Delivery Area counties in 6 geographic regions of the United States. We compared age-adjusted mortality and incidence rates for AI/AN populations with White populations using rate ratios and mortality-to-incidence ratios. Trends were described using joinpoint analysis. Results. Cancer mortality and incidence rates for AI/AN persons compared with Whites varied by region and type of cancer. Trends in death rates showed that greater progress in cancer control was achieved for White populations compared with AI/AN populations over the last 2 decades. Conclusions. Spatial variations in mortality and incidence by type of cancer demonstrated both persistent and emerging challenges for cancer control in AI/AN populations. PMID:24754660

Integrating motivational interviewing and traditional practices to address alcohol and drug use among urban American Indian/Alaska Native youth

PubMed Central

Dickerson, Daniel L.; Brown, Ryan A.; Johnson, Carrie L.; Schweigman, Kurt; D’Amico, Elizabeth J.

2015-01-01

American Indians/Alaska Natives (AI/AN) exhibit high levels of alcohol and drug (AOD) use and problems. Although approximately 70% of AI/ANs reside in urban areas, few culturally relevant AOD use programs targeting urban AI/AN youth exist. Furthermore, federally-funded studies focused on the integration of evidence-based treatments with AI/AN traditional practices are limited. The current study addresses a critical gap in the delivery of culturally appropriate AOD use programs for urban AI/AN youth, and outlines the development of a culturally tailored AOD program for urban AI/AN youth called Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY). We conducted focus groups among urban AI/AN youth, providers, parents, and elders in two urban communities in northern and southern California aimed at 1) identifying challenges confronting urban AI/AN youth and 2) obtaining feedback on MICUNAY program content. Qualitative data were analyzed using Dedoose, a team-based qualitative and mixed methods analysis software platform. Findings highlight various challenges, including community stressors (e.g., gangs, violence), shortage of resources, cultural identity issues, and a high prevalence of AOD use within these urban communities. Regarding MICUNAY, urban AI/AN youth liked the collaborative nature of the motivational interviewing (MI) approach, especially with regard to eliciting their opinions and expressing their thoughts. Based on feedback from the youth, three AI/AN traditional practices (beading, AI/AN cooking, and prayer/sage ceremony) were chosen for the workshops. MICUNAY is the first AOD use prevention intervention program for urban AI/AN youth that integrates evidence-based treatment with traditional practices. This program addresses an important gap in services for this underserved population. PMID:26306776

Breast cancer screening practices and correlates among American Indian and Alaska Native women in California, 2003

PubMed Central

Eberth, Jan M.; Huber, John Charles; Rene, Antonio

2010-01-01

Background Breast cancer incidence and mortality have been increasing among American Indian and Alaska Native (AI/AN) women, and their survival rate is the lowest of all racial/ethnic groups. Nevertheless, knowledge of AI/AN women’s breast cancer screening practices and their correlates is limited. Methods Using the 2003 California Health Interview Survey, we 1) compared the breast cancer screening practices of AI/AN women to other groups and 2) explored the association of several factors known or thought to influence AI/AN women’s breast cancer screening practices. Findings Compared to other races, AI/AN women had the lowest rate of mammogram screening (ever and within the past 2 years). For clinical breast exam receipt, Asian women had the lowest rate, followed by AI/AN women. Factors associated with AI/AN women’s breast cancer screening practices included older age, having a high school diploma or some college education, receipt of a Pap test within the past 3 years, and having visited a doctor within the past year. Conclusions Significant differences in breast cancer screening practices were noted between races, with AI/AN women often having significantly lower rates. Integrating these epidemiological findings into effective policy and practice requires additional applied research initiatives. PMID:20211430

Civic engagement and political participation among American Indians and Alaska natives in the US.

PubMed

Huyser, Kimberly R; Sanchez, Gabriel R; Vargas, Edward D

2017-01-01

Within the growing literature seeking to understand civic and political engagement among racial and ethnic minorities, our understanding of political behavior among American Indian and Alaska Native's (AI/AN) remains limited. We use the Current Population Survey Civic Engagement and Voting and Registration supplements (2006-2012) to compare AI/AN voter registration, voting, and overall civic engagement to other racial and ethnic groups and to assess whether factors that predict higher levels of civic engagement vary across these populations. We find a few key socio-economic status indicators that predict civic and political engagement uniquely for AI/ANs, but they are not consistently significant across all years or all types of political participation. We find marital status, age, household size, education, and veteran status to be important in predicting civic engagement for AI/ANs. However, for voting and registration, we find that family income, age, marital status, household size, and residential stability to be important contributors. Although we find AI/ANs are less likely to register and vote compared to non-Hispanic whites, we find that the difference is not statistically significant in congressional years, which may suggest that AI/ANs are engaged in local politics and vote for representatives that will represent their tribal interests in national politics.

Conceptualizing a Mentoring Program for American Indian/Alaska Native Students in the STEM Fields: A Review of the Literature

ERIC Educational Resources Information Center

Windchief, Sweeney; Brown, Blakely

2017-01-01

In order to address the disparity of American Indian/Alaska Native (AI/AN) doctorates in science, technology, engineering, and math (STEM), culturally congruent mentorship program development is needed. Because traditional Western academic paradigms are typically constrained to a non-Indigenous perspective, the authors question how American Indian…

Balancing Two Cultures: American Indian/Alaska Native Medical Students' Perceptions of Academic Medicine Careers.

PubMed

Sánchez, John Paul; Poll-Hunter, Norma; Stern, Nicole; Garcia, Andrea N; Brewster, Cheryl

2016-08-01

American Indians and Alaska Natives (AI/AN) remain underrepresented in the academic medicine workforce and little is known about cultivating AI/AN medical students' interest in academic medicine careers. Five structured focus groups were conducted including 20 medical students and 18 physicians. The discussion guide explored factors influencing AI/AN trainees' academic medicine career interest and recommended approaches to increase their pursuit of academia. Consensual qualitative research was employed to analyze transcripts. Our research revealed six facilitating factors, nine dissuading factors, and five recommendations towards cultivating AI/AN pursuit of academia. Facilitators included the opportunity to teach, serving as a role model/mentor, enhancing the AI/AN medical education pipeline, opportunities to influence institution, collegiality, and financial stability. Dissuading factors included limited information on academic career paths, politics, lack of credit for teaching and community service, isolation, self-doubt, lower salary, lack of positions in rural areas, lack of focus on clinical care for AI/AN communities, and research obligations. Recommendations included heighten career awareness, recognize the challenges in balancing AI/AN and academic cultures, collaborate with IHS on faculty recruitment strategies, identify concordant role models/mentors, and identify loan forgiveness programs. Similar to other diverse medical students', raising awareness of academic career opportunities especially regarding teaching and community scholarship, access to concordant role models/mentors, and supportive institutional climates can also foster AI/AN medical students' pursuit of academia. Unique strategies for AI/AN trainees include learning how to balance AI/AN and academic cultures, collaborating with IHS on faculty recruitment strategies, and increasing faculty opportunities in rural areas.

Cervical Cancer Incidence and Mortality Among American Indian and Alaska Native Women, 1999–2009

PubMed Central

Benard, Vicki; Thomas, Cheryll; Brayboy, Annie; Paisano, Roberta; Becker, Thomas

2014-01-01

Objectives. We analyzed cervical cancer incidence and mortality data in American Indian and Alaska Native (AI/AN) women compared with women of other races. Methods. We improved identification of AI/AN race, cervical cancer incidence, and mortality data using Indian Health Service (IHS) patient records; our analyses focused on residents of IHS Contract Health Service Delivery Area (CHSDA) counties. Age-adjusted incidence and death rates were calculated for AI/AN and White women from 1999 to 2009. Results. AI/AN women in CHSDA counties had a death rate from cervical cancer of 4.2, which was nearly twice the rate in White women (2.0; rate ratio [RR] = 2.11). AI/AN women also had higher incidence rates of cervical cancer compared with White women (11.0 vs 7.1; RR = 1.55) and were more often diagnosed with later-stage disease (RR = 1.84 for regional stage and RR = 1.74 for distant stage). Death rates decreased for AI/AN women from 1990 to 1993 (−25.8%/year) and remained stable thereafter. Conclusions. Although rates decreased over time, AI/AN women had disproportionately higher cervical cancer incidence and mortality. The persistently higher rates among AI/AN women compared with White women require continued improvements in identifying and treating cervical cancer and precancerous lesions. PMID:24754650

A Comparison of Colorectal Cancer Screening Uptake Among Average-Risk Insured American Indian/Alaska Native and White Women

PubMed Central

Perdue, David G.; Chubak, Jessica; Bogart, Andy; Dillard, Denise A.; Garroutte, Eva Marie; Buchwald, Dedra

2014-01-01

Introduction American Indian and Alaska Native (AI/AN) women have among the lowest rates of colorectal cancer (CRC) screening. Whether screening disparities persist with equal access to health care is unknown. Methods Using administrative data from 1996-2007, we compared CRC screening events for 286 AI/AN and 14,042 White women aged 50 years and older from a health maintenance organization in the Pacific Northwest of the U.S. Results The proportion of AI/AN and White women screened for CRC at age 50 was similar (13.3% vs. 14.0%, p =.74). No differences were seen in the type of screening test. Time elapsed to first screening among AI/AN women who were not screened at age 50 did not differ from White women (hazard ratio 1.0, 95% confidence interval 0.8-1.3). Conclusions Uptake for CRC screening was similar among insured AI/AN and White women, suggesting that when access to care is equal, racial disparities in screening diminish. PMID:23974386

American Indian and Alaska Native mental health: diverse perspectives on enduring disparities.

PubMed

Gone, Joseph P; Trimble, Joseph E

2012-01-01

As descendants of the indigenous peoples of the United States, American Indians and Alaska Natives (AI/ANs) have experienced a resurgence in population and prospects since the beginning of the twentieth century. Today, tribally affiliated individuals number over two million, distributed across 565 federally recognized tribal communities and countless metropolitan and nonreservation rural areas. Although relatively little evidence is available, the existing data suggest that AI/AN adults and youth suffer a disproportionate burden of mental health problems compared with other Americans. Specifically, clear disparities have emerged for AI/AN substance abuse, posttraumatic stress, violence, and suicide. The rapid expansion of mental health services to AI/AN communities has, however, frequently preceded careful consideration of a variety of questions about critical components of such care, such as the service delivery structure itself, clinical treatment processes, and preventive and rehabilitative program evaluation. As a consequence, the mental health needs of these communities have easily outpaced and overwhelmed the federally funded agency designed to serve these populations, with the Indian Health Service remaining chronically understaffed and underfunded such that elimination of AI/AN mental health disparities is only a distant dream. Although research published during the past decade has substantially improved knowledge about AI/AN mental health problems, far fewer investigations have explored treatment efficacy and outcomes among these culturally diverse peoples. In addition to routine calls for greater clinical and research resources, however, AI/AN community members themselves are increasingly advocating for culturally alternative approaches and opportunities to address their mental health needs on their own terms.

Resilience in American Indian and Alaska Native Public Health: An Underexplored Framework.

PubMed

Teufel-Shone, Nicolette I; Tippens, Julie A; McCrary, Hilary C; Ehiri, John E; Sanderson, Priscilla R

2018-02-01

To conduct a systematic literature review to assess the conceptualization, application, and measurement of resilience in American Indian and Alaska Native (AIAN) health promotion. We searched 9 literature databases to document how resilience is discussed, fostered, and evaluated in studies of AIAN health promotion in the United States. The article had to (1) be in English; (2) peer reviewed, published from January 1, 1980, to July 31, 2015; (3) identify the target population as predominantly AIANs in the United States; (4) describe a nonclinical intervention or original research that identified resilience as an outcome or resource; and (5) discuss resilience as related to cultural, social, and/or collective strengths. Sixty full texts were retrieved and assessed for inclusion by 3 reviewers. Data were extracted by 2 reviewers and verified for relevance to inclusion criteria by the third reviewer. Attributes of resilience that appeared repeatedly in the literature were identified. Findings were categorized across the lifespan (age group of participants), divided by attributes, and further defined by specific domains within each attribute. Nine articles (8 studies) met the criteria. Currently, resilience research in AIAN populations is limited to the identification of attributes and pilot interventions focused on individual resilience. Resilience models are not used to guide health promotion programming; collective resilience is not explored. Attributes of AIAN resilience should be considered in the development of health interventions. Attention to collective resilience is recommended to leverage existing assets in AIAN communities.

Integrating Motivational Interviewing and Traditional Practices to Address Alcohol and Drug Use Among Urban American Indian/Alaska Native Youth.

PubMed

Dickerson, Daniel L; Brown, Ryan A; Johnson, Carrie L; Schweigman, Kurt; D'Amico, Elizabeth J

2016-06-01

American Indians/Alaska Natives (AI/AN) exhibit high levels of alcohol and drug (AOD) use and problems. Although approximately 70% of AI/ANs reside in urban areas, few culturally relevant AOD use programs targeting urban AI/AN youth exist. Furthermore, federally-funded studies focused on the integration of evidence-based treatments with AI/AN traditional practices are limited. The current study addresses a critical gap in the delivery of culturally appropriate AOD use programs for urban AI/AN youth, and outlines the development of a culturally tailored AOD program for urban AI/AN youth called Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY). We conducted focus groups among urban AI/AN youth, providers, parents, and elders in two urban communities in northern and southern California aimed at 1) identifying challenges confronting urban AI/AN youth and 2) obtaining feedback on MICUNAY program content. Qualitative data were analyzed using Dedoose, a team-based qualitative and mixed methods analysis software platform. Findings highlight various challenges, including community stressors (e.g., gangs, violence), shortage of resources, cultural identity issues, and a high prevalence of AOD use within these urban communities. Regarding MICUNAY, urban AI/AN youth liked the collaborative nature of the motivational interviewing (MI) approach, especially with regard to eliciting their opinions and expressing their thoughts. Based on feedback from the youth, three AI/AN traditional practices (beading, AI/AN cooking, and prayer/sage ceremony) were chosen for the workshops. To our knowledge, MICUNAY is the first AOD use prevention intervention program for urban AI/AN youth that integrates evidence-based treatment with traditional practices. This program addresses an important gap in services for this underserved population. Copyright © 2015. Published by Elsevier Inc.

American Indian and Alaska Native Infant and Pediatric Mortality, United States, 1999–2009

PubMed Central

Gachupin, Francine C.; Holman, Robert C.; MacDorman, Marian F.; Cheek, James E.; Holve, Steve; Singleton, Rosalyn J.

2014-01-01

Objectives. We described American Indian/Alaska Native (AI/AN) infant and pediatric death rates and leading causes of death. Methods. We adjusted National Vital Statistics System mortality data for AI/AN racial misclassification by linkage with Indian Health Service (IHS) registration records. We determined average annual death rates and leading causes of death for 1999 to 2009 for AI/AN versus White infants and children. We limited the analysis to IHS Contract Health Service Delivery Area counties. Results. The AI/AN infant death rate was 914 (rate ratio [RR] = 1.61; 95% confidence interval [CI] = 1.55, 1.67). Sudden infant death syndrome, unintentional injuries, and influenza or pneumonia were more common in AI/AN versus White infants. The overall AI/AN pediatric death rates were 69.6 for ages 1 to 4 years (RR = 2.56; 95% CI = 2.38, 2.75), 28.9 for ages 5 to 9 years (RR = 2.12; 95% CI = 1.92, 2.34), 37.3 for ages 10 to 14 years (RR = 2.22; 95% CI = 2.04, 2.40), and 158.4 for ages 15 to 19 years (RR = 2.71; 95% CI = 2.60, 2.82). Unintentional injuries and suicide occurred at higher rates among AI/AN youths versus White youths. Conclusions. Death rates for AI/AN infants and children were higher than for Whites, with regional disparities. Several leading causes of death in the AI/AN pediatric population are potentially preventable. PMID:24754619

The prostitution and trafficking of American Indian/Alaska Native women in Minnesota.

PubMed

Farley, Melissa; Deer, Sarah; Golding, Jacqueline M; Matthews, Nicole; Lopez, Guadalupe; Stark, Christine; Hudon, Eileen

2016-01-01

We examined social and physical violence experienced by American Indian/Alaska Native (AI/AN) women in prostitution and their impacts on the mental and physical health of 105 women (81% Anishinaabe, mean age = 35 years) recruited through service agencies in three Minnesota cities. In childhood, abuse, foster care, arrests, and prostitution were typical. Homelessness, rape, assault, racism, and pimping were common. The women's most prevalent physical symptoms included muscle pain, impaired memory or concentration, and headaches. Symptoms of post-traumatic stress disorder and dissociation were common, with more severe psychological symptoms associated with worse health. Most of the women wanted to leave prostitution and they most often identified counseling and peer support as necessary to accomplish this. Most saw colonization and prostitution of AI/AN women as connected.

Acceptability of a Web-based Community Reinforcement Approach for Substance Use Disorders with Treatment-seeking American Indians/Alaska Natives

PubMed Central

Campbell, Aimee N. C.; Turrigiano, Eva; Moore, Michelle; Miele, Gloria M.; Rieckmann, Traci; Hu, Mei-Chen; Kropp, Frankie; Ringor-Carty, Roz; Nunes, Edward V.

2014-01-01

Longstanding disparities in substance use disorders and treatment access exist among American Indian/Alaska Natives (AI/AN). Computerized, web-delivered interventions have potential to increase access to quality treatment and improve patient outcomes. Prior research supports the efficacy of a web-based version (Therapeutic Education System [TES]) of the Community Reinforcement Approach to improve outcomes among outpatients in substance abuse treatment; however, TES has not been tested among AI/AN. The results from this mixed method acceptability study among a diverse sample of urban AI/AN (N=40) show that TES was acceptable across seven indices (range=7.8 to 9.4 on 0 to 10 scales with 10 indicating highest acceptability). Qualitative interviews suggest adaptation specific to AI/AN culture could improve adoption. Additional efforts to adapt TES and conduct a larger effectiveness study are warranted. PMID:25022913

Acceptability of a web-based community reinforcement approach for substance use disorders with treatment-seeking American Indians/Alaska Natives.

PubMed

Campbell, Aimee N C; Turrigiano, Eva; Moore, Michelle; Miele, Gloria M; Rieckmann, Traci; Hu, Mei-Chen; Kropp, Frankie; Ringor-Carty, Roz; Nunes, Edward V

2015-05-01

Longstanding disparities in substance use disorders and treatment access exist among American Indians/Alaska Natives (AI/AN). Computerized, web-delivered interventions have potential to increase access to quality treatment and improve patient outcomes. Prior research supports the efficacy of a web-based version [therapeutic education system (TES)] of the community reinforcement approach to improve outcomes among outpatients in substance abuse treatment; however, TES has not been tested among AI/AN. The results from this mixed method acceptability study among a diverse sample of urban AI/AN (N = 40) show that TES was acceptable across seven indices (range 7.8-9.4 on 0-10 scales with 10 indicating highest acceptability). Qualitative interviews suggest adaptation specific to AI/AN culture could improve adoption. Additional efforts to adapt TES and conduct a larger effectiveness study are warranted.

Prevalence and Disparities in Tobacco Product Use Among American Indians/Alaska Natives - United States, 2010-2015.

PubMed

Odani, Satomi; Armour, Brian S; Graffunder, Corinne M; Garrett, Bridgette E; Agaku, Israel T

2017-12-22

An overarching goal of Healthy People 2020 is to achieve health equity, eliminate disparities, and improve health among all groups.* Although significant progress has been made in reducing overall commercial tobacco product use, † disparities persist, with American Indians or Alaska Natives (AI/ANs) having one of the highest prevalences of cigarette smoking among all racial/ethnic groups (1,2). Variations in cigarette smoking among AI/ANs have been documented by sex and geographic location (3), but not by other sociodemographic characteristics. Furthermore, few data exist on use of tobacco products other than cigarettes among AI/ANs (4). CDC analyzed self-reported current (past 30-day) use of five tobacco product types among AI/AN adults from the 2010-2015 National Survey on Drug Use and Health (NSDUH); results were compared with six other racial/ethnic groups (Hispanic; non-Hispanic white [white]; non-Hispanic black [black]; non-Hispanic Native Hawaiian or other Pacific Islander [NHOPI]; non-Hispanic Asian [Asian]; and non-Hispanic multirace [multirace]). Prevalence of current tobacco product use was significantly higher among AI/ANs than among non-AI/ANs combined for any tobacco product, cigarettes, roll-your-own tobacco, pipes, and smokeless tobacco. Among AI/ANs, prevalence of current use of any tobacco product was higher among males, persons aged 18-25 years, those with less than a high school diploma, those with annual family income <$20,000, those who lived below the federal poverty level, and those who were never married. Addressing the social determinants of health and providing evidence-based, population-level, and culturally appropriate tobacco control interventions could help reduce tobacco product use and eliminate disparities in tobacco product use among AI/ANs (1).

Cytochrome P450 Genetic Variation Associated with Tamoxifen Biotransformation in American Indian and Alaska Native People

PubMed Central

Khan, Burhan A.; Robinson, Renee; Fohner, Alison E.; Muzquiz, LeeAnna I.; Schilling, Brian D.; Beans, Julie A.; Olnes, Matthew J.; Trawicki, Laura; Frydenlund, Holly; Laukes, Cindi; Beatty, Patrick; Phillips, Brian; Nickerson, Deborah; Howlett, Kevin; Dillard, Denise A.; Thornton, Timothy A.; Thummel, Kenneth E.

2018-01-01

Abstract Despite evidence that pharmacogenetics can improve tamoxifen pharmacotherapy, there are few studies with American Indian and Alaska Native (AIAN) people. We examined variation in cytochrome P450 (CYP) genes (CYP2D6, CYP3A4, CYP3A5, and CYP2C9) and tamoxifen biotransformation in AIAN patients with breast cancer (n = 42) from the Southcentral Foundation in Alaska and the Confederated Salish and Kootenai Tribes in Montana. We tested for associations between CYP diplotypes and plasma concentrations of tamoxifen and metabolites. Only the CYP2D6 variation was significantly associated with concentrations of endoxifen (P = 0.0008) and 4‐hydroxytamoxifen (P = 0.0074), tamoxifen's principal active metabolites, as well as key metabolic ratios. The CYP2D6 was also the most significant predictor of active metabolites and metabolic ratios in a multivariate regression model, including all four genes as predictors, with minor roles for other CYP genes. In AIAN populations, CYP2D6 is the largest contributor to tamoxifen bioactivation, illustrating the importance of validating pharmacogenetic testing for therapy optimization in an understudied population. PMID:29436156

Views on electronic cigarette use in tobacco screening and cessation in an Alaska Native healthcare setting.

PubMed

Hiratsuka, Vanessa Y; Avey, Jaedon P; Trinidad, Susan B; Beans, Julie A; Robinson, Renee F

2015-01-01

American Indian (AI) and Alaska Native (AN) communities confront some of the highest rates of tobacco use and its sequelae. This formative research project sought to identify the perspectives of 41 stakeholders (community members receiving care within the healthcare system, primary care providers, and tribal healthcare system leaders) surrounding the use of pharmacogenetics toward tobacco cessation treatment in the setting of an AI/AN owned and operated health system in south central Alaska. Interviews were held with 20 adult AI/AN current and former tobacco users, 12 healthcare providers, and 9 tribal leaders. An emergent theme from data analysis was that current tobacco screening and cessation efforts lack information on electronic cigarette (e-cigarette) use. Perceptions of the use of e-cigarettes role in tobacco cessation varied. Preventive screening for tobacco use and clinical cessation counseling should address e-cigarette use. Healthcare provider tobacco cessation messaging should similarly address e-cigarettes.

Perceptions, Barriers, and Suggestions for Creation of a Tobacco and Health Website among American Indian/Alaska Native College Students

PubMed Central

Filippi, Melissa; McCloskey, Charlotte; Williams, Chandler; Bull, Julia White; Choi, Won S.; Greiner, K. Allen; Daley, Christine M.

2012-01-01

Information concerning American Indian/Alaska Native (AI/AN) Internet use and health information needs is dearth. Our research team explored Internet use among AI/AN college students to determine Internet use in relation to health information seeking behaviors. We used a tobacco site example for participants to describe what they desired in a health site designed specifically for AI/AN. Using a community-based participatory research approach, we conducted 14 focus groups with AI/AN college students (N=108), to better understand their perceptions of and attitudes toward Internet use and health information needs. Daily Internet use was reported across strata yet health topics investigated differed among groups. Participants in all strata desired a health website that was easy to navigate and interactive. Respectful representation of Native culture was a concern, yet no consensus was reached for a multi-tribal audience. Participants felt a website should use caution with cultural depictions due to the possible misinterpretation. Overall, participants agreed that recreational and traditional tobacco use should be differentiated and the variation of traditional use among tribes acknowledged. Data concerning Internet use for health information among AI/AN college students are needed to establish baseline indicators to effectively address disparities. PMID:23149568

Historical Trends and Regional Differences in All-Cause and Amenable Mortality Among American Indians and Alaska Natives Since 1950

PubMed Central

Kunitz, Stephen J.; Veazie, Mark; Henderson, Jeffrey A.

2014-01-01

American Indian and Alaska Native (AI/AN) death rates declined over most of the 20th century, even before the Public Health Service became responsible for health care in 1956. Since then, rates have declined further, although they have stagnated since the 1980s. These overall patterns obscure substantial regional differences. Most significant, rates in the Northern and Southern Plains have declined far less since 1949 to 1953 than those in the East, Southwest, or Pacific Coast. Data for Alaska are not available for the earlier period, so its trajectory of mortality cannot be ascertained. Socioeconomic measures do not adequately explain the differences and rates of change, but migration, changes in self-identification as an AI/AN person, interracial marriage, and variations in health care effectiveness all appear to be implicated. PMID:24754651

Female Sterilization and Poor Mental Health: Rates and Relatedness among American Indian and Alaska Native Women.

PubMed

Cackler, Christina J J; Shapiro, Valerie B; Lahiff, Maureen

2016-01-01

To describe the reproductive and mental health of American Indian and Alaska Native (AI/AN) women, an understudied population. Data from the 2004 Behavioral Risk Factor Surveillance System survey were analyzed to determine the 1) prevalence of female sterilization among a nationally representative sample of reproductive age AI/AN women and 2) the association of female sterilization and poor mental health among AI/AN women compared with non-Hispanic White, non-Hispanic Black, and Hispanic women. Nearly 25% of AI/AN women reported female sterilization, a prevalence higher than the comparison racial/ethnic groups (p < .005). Adjusting for sociodemographic characteristics, AI/AN women reporting female sterilization had nearly 2.5 times the odds of poor mental health compared with AI/AN women not reporting female sterilization (p = .001). The same magnitude of relationship between female sterilization and poor mental health was not found for non-Hispanic White, non-Hispanic Black, and Hispanic women. The prevalence of female sterilization is greater among AI/AN women compared with non-Hispanic White, non-Hispanic Black, and Hispanic women, and AI/AN women reporting female sterilization have higher odds of reporting poor mental health. Common cultural experiences, such as a shared ancestral history of forced sterilizations, may be relevant, and could be considered when providing reproductive and mental health services to AI/AN women. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Assessing follow-up care after prostate-specific antigen elevation in American Indian / Alaska Native Men: a partnership approach.

PubMed

Tilburt, Jon C; James, Katherine M; Koller, Kathryn; Lanier, Anne P; Hall, Ingrid J; Smith, Judith Lee; Ekwueme, Donatus U; Nicometo, Ann M; Petersen, Wesley O

2013-01-01

Although many studies conducted among American Indian and Alaska Native (AI/AN) populations may help to advance medical science and lead to improvements in health and health care, historically few have endeavored to share their findings, benefits, and/or expected outcomes with the communities in which they are conducted. This perceived lack of responsiveness has contributed to a perception in some AI/AN communities that researchers are disrespectful and may not make community needs a priority. In the context of a study assessing the care received by AI/AN men with incident elevated prostate-specific antigen (PSA) levels, this paper describes our experience building collaborative relationships, planning, conducting analyses, and disseminating findings with four AI/AN communities. We established formal partnerships with three Northern Plains AI communities and one AN tribal health organization, convened a 12-member Community Advisory Board (CAB), and obtained study approvals from all necessary tribal and institutional review bodies before implementing our study. A menu of options for study implementation was given to key collaborators at each site. CAB members and collaborating tribes contributed to each phase of the study. After data analysis, results were shared with tribal and institutional leaders. Face-to-face communication, flexibility, and adaptability, as well as clearly defined, respectful roles contributed to the success of the study on the part of both the researchers and community partners. This study demonstrates the importance and feasibility of forging collaborative relationships with AI/AN community leaders in regions of Alaska and the Northern Plains in cancer control initiatives for AI/AN men.

Ectopic pregnancy among American Indian and Alaska Native women, 2002-2009.

PubMed

de Ravello, Lori; Folkema, Arianne; Tulloch, Scott; Taylor, Melanie; Reilley, Brigg; Hoover, Karen; Holman, Robert; Creanga, Andreea

2015-04-01

To examine rates of ectopic pregnancy (EP) among American Indian and Alaska Native (AI/AN) women aged 15-44 years seeking care at Indian Health Service (IHS), Tribal, and urban Indian health facilities during 2002-2009. We used 2002-2009 inpatient and outpatient data from the IHS National Patient Information Reporting System to identify EP-associated visits and obtain the number of pregnancies among AI/AN women. Repeat visits for the same EP were determined by calculating the interval between visits; if more than 90 days between visits, the visit was considered related to a new EP. We identified 229,986 pregnancies among AI/AN women 15-44 years receiving care at IHS-affiliated facilities during 2002-2009. Of these, 2,406 (1.05 %) were coded as EPs, corresponding to an average annual rate of 10.5 per 1,000 pregnancies. The EP rate among AI/AN women was lowest in the 15-19 years age group (5.5 EPs per 1,000 pregnancies) and highest among 35-39 year olds (18.7 EPs per 1,000 pregnancies). EP rates varied by geographic region, ranging between 6.9 and 24.4 per 1,000 pregnancies in the Northern Plains East and the East region, respectively. The percentage of ectopic pregnancies found among AI/AN women is within the national 1-2 % range. We found relatively stable annual rates of EP among AI/AN women receiving care at IHS-affiliated facilities during 2002-2009, but considerable variation by age group and geographic region. Coupling timely diagnosis and management with public health interventions focused on tobacco use and sexually transmitted diseases may provide opportunities for reducing EP and EP-associated complications among AI/AN women.

National Indian Education Study. Part II: The Educational Experiences of Fourth- and Eighth-Grade American Indian and Alaska Native Students. Statistical Analysis Report. NCES 2007-454

ERIC Educational Resources Information Center

Stancavage, Frances B.; Mitchell, Julia H.; de Mello, Victor Bandeira; Gaertner, Freya E.; Spain, Angeline K.; Rahal, Michelle L.

2006-01-01

This report presents results from a national survey, conducted in 2005, that examined the educational experiences of American Indian/Alaska Native (AI/AN) students in grades 4 and 8, with particular emphasis on the integration of native language and culture into school and classroom activities. Students, teachers, and school principals all…

Education, Income, and Employment and Prevalence of Chronic Disease Among American Indian/Alaska Native Elders.

PubMed

Adamsen, Collette; Schroeder, Shawnda; LeMire, Steven; Carter, Paula

2018-03-22

Chronic disease studies have omitted analyses of the American Indian/Alaska Native (AI/AN) population, relied on small samples of AI/ANs, or focused on a single disease among AI/ANs. We measured the influence of income, employment status, and education level on the prevalence of chronic disease among 14,632 AI/AN elders from 2011 through 2014. We conducted a national survey of AI/AN elders (≥55 y) to identify health and social needs. Using these data, we computed cross-tabulations for each independent variable (annual personal income, employment status, education level), 2 covariates (age, sex), and presence of any chronic disease. We also compared differences in values and used a binary logistic regression model to control for age and sex. Most AI/AN elders (89.7%) had been diagnosed with at least one chronic disease. AI/AN elders were also more than twice as likely to have diabetes and more likely to have arthritis. AI/AN elders with middle-to-low income levels and who were unemployed were more likely to have a chronic disease than were high-income and employed AI/AN elders. Addressing disparities in chronic disease prevalence requires focus on more than access to and cost of health care. Economic development and job creation for all age cohorts in tribal communities may decrease the prevalence of long-term chronic diseases and may improve the financial status of the tribe. An opportunity exists to address health disparities through social and economic equity among tribal populations.

The Power of Protection: A Population-Based Comparison of Native and Non-Native Youth Suicide Attempters

ERIC Educational Resources Information Center

Mackin, Juliette; Perkins, Tamara; Furrer, Carrie

2012-01-01

This study provides actionable information about intervening with American Indian/Alaska Native (AI/AN) youth to prevent suicide. Statewide school survey data were used to model the impact of risk and protective factors on self-reported suicide attempts (both AI/AN and non-AI/AN). The cumulative risk and protective model worked similarly for both…

Trends in Otitis Media and Myringotomy With Tube Placement Among American Indian and Alaska Native Children and the US General Population of Children After Introduction of the 13-valent Pneumococcal Conjugate Vaccine.

PubMed

Singleton, Rosalyn; Seeman, Sara; Grinnell, Margaret; Bulkow, Lisa; Kokesh, John; Emmett, Susan; Holve, Stephen; McCollum, Jeffrey; Hennessy, Thomas

2018-01-01

American Indian/Alaska Native (AI/AN) children have experienced higher otitis media (OM) outpatient visit rates than other US children. To understand recent trends, we evaluated AI/AN OM rates before and after 13-valent pneumococcal conjugate vaccine introduction. We analyzed outpatient visits listing OM as a diagnosis among AI/AN children <5 years of age from the Indian Health Service National Patient Information Reporting System for 2010-2013. OM outpatient visits for the general US child population <5 years of age were analyzed using the National Ambulatory Medical Care and National Hospital Ambulatory Care Surveys for 2010-2011. The 2010-2011 OM-associated outpatient visit rate for AI/AN children (63.5 per 100/year) was similar to 2010-2011 rate for same-age children in the general US population (62.8) and decreased from the 2003 to 2005 AI/AN rate (91.4). Further decline in AI/AN OM visit rates was seen for 2010-2011 to 2012-2013 (P < 0.0001). The AI/AN infant OM visit rate (130.5) was 1.6-fold higher than the US infant population. For 2010-2011, the highest AI/AN OM visit rate for <5 year olds was from Alaska (135.0). AI/AN <5-year-old OM visits declined by one third from 2003-2005 to 2010-2011 to a rate similar to the US general population <5 years. However, the AI/AN infant OM rate remained higher than the US infant population. The highest AI/AN <5-year-old OM rate occurred in Alaska.

The High Burden of Cancer Among American Indians/Alaska Natives in Wisconsin.

PubMed

Foote, Mary; Strickland, Rick; Lucas-Pipkorn, Samantha; Williamson, Amy; Lamers, Lauren

2016-02-01

American Indians/Alaska Natives (AI/AN) who live in the Northern Plains, includingt Wisconsin, face disproportionate cancer disparities. This report examines cancer incidence and mortality based on residence in Contract Health Service Delivery Areas (CHSDA) to assess disparities between AIs/ANs and other racial populations in Wisconsin. To improve identification of the AI/AN race, incidence data were linked with Indian Health Service (IHS) patient records. Analysis further focused on residents of IHS CHSDA counties. Age-adjusted cancer incidence and mortality rates (2007-2011) were calculated by sex and major cancer sites. AI/AN rates were.analyzed for both statewide and CHSDA residency in comparison to statewide white rates and comparable national rates. In comparison with whites, AI/ANs in CHSDA counties had higher incidence rates of cervical (3.5 times), liver (3.2), lung (2.3), and kidney cancers (2.1), and higher mortality rates for liver (2.7), kidney (2.2) and lung (1.9) cancers. Although there were similar rates of prostate cancer incidence between the 2 populations, AI/ANs were 1.9 times more likely to die from the disease. AI/AN individuals in Wisconsin CHDSA counties experience the highest cancer incidence rate of any racial group for both genders combined and for females. This population also has the highest mortality rate among all racial groups for both males and females. To meet the Wisconsin Comprehensive Cancer Control Plan 2015-2020 and Healthy People 2020 goals of lowering cancer incidence and mortality rates, the disproportionate cancer burden among AIs.

Pre-eclampsia in American Indians/Alaska Natives and Whites: The Significance of Body Mass Index.

PubMed

Zamora-Kapoor, Anna; Nelson, Lonnie A; Buchwald, Dedra S; Walker, Leslie R; Mueller, Beth A

2016-11-01

Introduction The prevalence of pre-eclampsia, a major cause of maternal morbidity, varies by race, being greater in African Americans, and lower in Asians and Hispanics than in White women. Little is known about its prevalence in American Indians/Alaska Natives (AI/ANs). We estimated pre-eclampsia risk in AI/ANs compared to Whites, with consideration of the potential effect of obesity, a major risk factor for pre-eclampsia, and a condition disproportionately affecting AI/AN women. Methods This retrospective cohort study of linked birth-hospital discharge data from Washington State (2003-2013) included all AI/AN women and a sample of White first-time mothers with singleton deliveries. Logistic regression was used to estimate odds ratio (OR) and 95 % confidence intervals (CI) for pre-eclampsia risk in AI/ANs compared to Whites, first controlling for several important risk factors, and subsequently with additional adjustment for pre-pregnancy body mass index (BMI). Results AI/ANs had an increased risk of pre-eclampsia compared to Whites after controlling for all covariates except BMI (OR 1.17, 95 % CI 1.06-1.29). After further adjustment for BMI, the racial disparity in pre-eclampsia risk was greatly attenuated (OR 1.05, 95 % CI 0.95-1.16). Discussion This population-based study suggests that any increased risk in AI/ANs relative to Whites may be at least partly due to differences in BMI.

Pre-eclampsia in American Indians/Alaska Natives and Whites: The Significance of Body Mass Index

PubMed Central

Nelson, Lonnie A.; Buchwald, Dedra S.; Walker, Leslie R.; Mueller, Beth A.

2016-01-01

Introduction The prevalence of pre-eclampsia, a major cause of maternal morbidity, varies by race, being greater in African Americans, and lower in Asians and Hispanics than in White women. Little is known about its prevalence in American Indians/Alaska Natives (AI/ANs). We estimated pre-eclampsia risk in AI/ANs compared to Whites, with consideration of the potential effect of obesity, a major risk factor for pre-eclampsia, and a condition disproportionately affecting AI/AN women. Methods This retrospective cohort study of linked birth-hospital discharge data from Washington State (2003–2013) included all AI/AN women and a sample of White first-time mothers with singleton deliveries. Logistic regression was used to estimate odds ratio (OR) and 95 % confidence intervals (CI) for pre-eclampsia risk in AI/ANs compared to Whites, first controlling for several important risk factors, and subsequently with additional adjustment for pre-pregnancy body mass index (BMI). Results AI/ANs had an increased risk of pre-eclampsia compared to Whites after controlling for all covariates except BMI (OR 1.17, 95 % CI 1.06–1.29). After further adjustment for BMI, the racial disparity in pre-eclampsia risk was greatly attenuated (OR 1.05, 95 % CI 0.95–1.16). Discussion This population-based study suggests that any increased risk in AI/ANs relative to Whites may be at least partly due to differences in BMI. PMID:27461024

National Indian Education Study 2015: American Indian and Alaska Native Students at Grades 4 and 8. NCES 2017-161

ERIC Educational Resources Information Center

Ninneman, A. M.; Deaton, J.; Francis-Begay, K.

2017-01-01

The National Indian Education Study (NIES) is administered as part of the National Assessment of Educational Progress (NAEP) to allow more in-depth reporting on the achievement and experiences of American Indian/Alaska Native (AI/AN)1 students in grades 4 and 8. This report focuses primarily on two themes identified during the development of the…

Associations Among Body Mass Index, Waist Circumference, and Health Indicators in American Indian and Alaska Native Adults

PubMed Central

Slattery, Martha L.; Ferucci, Elizabeth D.; Murtaugh, Maureen A.; Edwards, Sandra; Ma, Khe-Ni; Etzel, Ruth A.; Tom-Orme, Lillian; Lanier, Anne P.

2010-01-01

Purpose Little is known about obesity-related health issues among American Indian and Alaska Native (AIAN) populations. Approach A large cohort of AIAN people was assembled to evaluate factors associated with health. Setting The study was conducted in Alaska and on the Navajo Nation. Participants A total of 11,293 AIAN people were included. Methods We present data for body mass index (BMI, kg/m2) and waist circumference (cm) to evaluate obesity-related health factors. Results Overall, 32.4% of the population were overweight (BMI 25–29.9 kg/m2), 47.1% were obese (BMI ≥ 30 kg/m2), and 21.4% were very obese (BMI, ≥ 35 kg/m2). A waist circumference greater than 102 cm for men and greater than 88 cm for women was observed for 41.7% of men and 78.3% of women. Obese people were more likely to perceive their health as fair/poor than nonobese participants (prevalence ratio [PR]), 1.91; 95% CI, 1.71–2.14). Participants younger than 30 years were three times more likely to perceive their health as being fair or poor when their BMI results were 35 or greater compared with those whose BMI results were less than 25 kg/m2. A larger BMI was associated with having multiple medical conditions, fewer hours of vigorous activity, and more hours of television watching. Conclusions Given the high rates of obesity in AIAN populations and the association of obesity with other health conditions, it is important to reduce obesity among AIAN people. PMID:20232606

Incidence of amyotrophic lateral sclerosis among American Indians and Alaska natives.

PubMed

Gordon, Paul H; Mehal, Jason M; Holman, Robert C; Rowland, Lewis P; Rowland, Andrew S; Cheek, James E

2013-04-01

More thorough evaluation of amyotrophic lateral sclerosis (ALS) and motor neuron disease in unique populations could provide clues to etiologies for these idiopathic conditions, and educational programs for American Indian and Alaska Native (AI/AN) people and health care professionals on reservations could improve awareness, understanding, diagnosis, and treatment. In the ongoing search for susceptibility genes, studying particular racial groups, such as AI/ANs,might facilitate the identification of new mutations. To provide better understanding of ALS and secondarily of motor neuron disease among AI/AN people by estimating the incidence and prevalence among AI/ANs served by the Indian Health Service health care system. Analysis of electronic records for AI/ANs with ALS and with motor neuron disease separately for the calendar years 2002-2009 using inpatient and outpatient visit data from the Indian Health Service, which provides health care to eligible AI/ANs nationwide. Cases were defined by at least 2 inpatient or outpatient visits with the diagnosis. Crude and age-adjusted incidence and prevalence rates were calculated. Seventy-one AI/ANs were diagnosed with ALS, yielding an average annual crude incidence rate of 0.63 cases per 100 000 and an age-adjusted incidence of 0.92. The median age at onset was 56.0 years and was higher among women than men (62.0 vs 55.0 years; P=.06). Age-specific incidence increased to 70 to 74 years. The crude and age-adjusted point prevalence rates were 2.00 and 4.12, respectively. The crude and age-adjusted incidence rates for motor neuron disease were 1.08 and 1.50, respectively. The annual rates were unchanged across the study period. The incidence of ALS among AI/ANs appears to be lower than that reported for white populations, a finding congruent with reports of other minority populations. Community-based studies are important to confirm these findings and to examine reasons for the low rate of ALS among AI/ANs.

Using Storytelling to Address Oral Health Knowledge in American Indian and Alaska Native Communities.

PubMed

Heaton, Brenda; Gebel, Christina; Crawford, Andrew; Barker, Judith C; Henshaw, Michelle; Garcia, Raul I; Riedy, Christine; Wimsatt, Maureen A

2018-05-24

We conducted a qualitative analysis to evaluate the acceptability of using storytelling as a way to communicate oral health messages regarding early childhood caries (ECC) prevention in the American Indian and Alaska Native (AIAN) population. A traditional story was developed and pilot tested among AIAN mothers residing in 3 tribal locations in northern California. Evaluations of the story content and acceptability followed a multistep process consisting of initial feedback from 4 key informants, a focus group of 7 AIAN mothers, and feedback from the Community Advisory Board. Upon story approval, 9 additional focus group sessions (N = 53 participants) were held with AIAN mothers following an oral telling of the story. Participants reported that the story was culturally appropriate and used relatable characters. Messages about oral health were considered to be valuable. Concerns arose about the oral-only delivery of the story, story content, length, story messages that conflicted with normative community values, and the intent to target audiences. Feedback by focus group participants raised some doubts about the relevance and frequency of storytelling in AIAN communities today. AIAN communities value the need for oral health messaging for community members. However, the acceptability of storytelling as a method for the messaging raises concerns, because the influence of modern technology and digital communications may weaken the acceptability of the oral tradition. Careful attention must be made to the delivery mode, content, and targeting with continual iterative feedback from community members to make these messages engaging, appropriate, relatable, and inclusive.

Ectopic Pregnancy Among American Indian and Alaska Native Women, 2002–2009

PubMed Central

Folkema, Arianne; Tulloch, Scott; Taylor, Melanie; Reilley, Brigg; Hoover, Karen; Holman, Robert; Creanga, Andreea

2015-01-01

To examine rates of ectopic pregnancy (EP) among American Indian and Alaska Native (AI/AN) women aged 15–44 years seeking care at Indian Health Service (IHS), Tribal, and urban Indian health facilities during 2002–2009. We used 2002–2009 inpatient and outpatient data from the IHS National Patient Information Reporting System to identify EP-associated visits and obtain the number of pregnancies among AI/AN women. Repeat visits for the same EP were determined by calculating the interval between visits; if more than 90 days between visits, the visit was considered related to a new EP. We identified 229,986 pregnancies among AI/AN women 15–44 years receiving care at IHS-affiliated facilities during 2002–2009. Of these, 2,406 (1.05 %) were coded as EPs, corresponding to an average annual rate of 10.5 per 1,000 pregnancies. The EP rate among AI/AN women was lowest in the 15–19 years age group (5.5 EPs per 1,000 pregnancies) and highest among 35–39 year olds (18.7 EPs per 1,000 pregnancies). EP rates varied by geographic region, ranging between 6.9 and 24.4 per 1,000 pregnancies in the Northern Plains East and the East region, respectively. The percentage of ectopic pregnancies found among AI/AN women is within the national 1–2 % range. We found relatively stable annual rates of EP among AI/AN women receiving care at IHS-affiliated facilities during 2002–2009, but considerable variation by age group and geographic region. Coupling timely diagnosis and management with public health interventions focused on tobacco use and sexually transmitted diseases may provide opportunities for reducing EP and EP-associated complications among AI/AN women. PMID:25023759

Death rates from human immunodeficiency virus and tuberculosis among American Indians/Alaska Natives in the United States, 1990-2009.

PubMed

Reilley, Brigg; Bloss, Emily; Byrd, Kathy K; Iralu, Jonathan; Neel, Lisa; Cheek, James

2014-06-01

We used race-corrected data and comprehensive diagnostic codes to better compare HIV and tuberculosis (TB) mortality from 1999 to 2009 between American Indian/Alaska Natives (AI/ANs) and Whites. National Vital Statistics Surveillance System mortality data were adjusted for AI/AN racial misclassification through linkage with Indian Health Service registration records. We compared average annual 1990 to 2009 HIV and TB death rates (per 100,000 people) for AI/AN persons with those for Whites; Hispanics were excluded. Although death rates from HIV in AI/AN persons were significantly lower than those in Whites from 1990 to 1998 (4.2 vs 7.0), they were significantly higher than those in Whites from 1999 to 2009 (3.6 vs 2.0). Death rates from TB in AI/AN persons were significantly higher than those in Whites, with a significant disparity during both 1990 to 1998 (3.3 vs 0.3) and 1999 to 2009 (1.5 vs 0.1). The decrease in death rates from HIV and TB was greater among Whites, and death rates remained significantly higher among AI/AN individuals. Public health interventions need to be prioritized to reduce the TB and HIV burden and mortality in AI/AN populations.

HIV-Related Risk Behaviors, Perceptions of Risk, HIV Testing, and Exposure to Prevention Messages and Methods among Urban American Indians and Alaska Natives

ERIC Educational Resources Information Center

Lapidus, Jodi A.; Bertolli, Jeanne; McGowan, Karen; Sullivan, Patrick

2006-01-01

The goal of this study was to describe HIV risk behaviors, perceptions, testing, and prevention exposure among urban American Indians and Alaska Natives (AI/AN). Interviewers administered a questionnaire to participants recruited through anonymous peer-referral sampling. Chi-square tests and multiple logistic regression were used to compare HIV…

Mental health burden in a national sample of American Indian and Alaska Native adults: differences between multiple-race and single-race subgroups.

PubMed

Asdigian, Nancy L; Bear, Ursula Running; Beals, Janette; Manson, Spero M; Kaufman, Carol E

2018-05-01

Research on American Indian and Alaska Native (AIAN) mental health disparities is based largely on either tribal populations or national samples of adults that do not account for multiracial AIANs, even though over 40% of AIANs identify with multiple racial groups. The present investigation extends this research by assessing mental health status in a national sample of multiracial AIAN adults relative to adults who identify exclusively as either AIAN or White. 2012 BRFSS data were used to conduct multinomial logistic regression analyses comparing mental health outcomes among respondents who identified as either AIAN and one or more other races (AIAN-MR), AIAN-Single Race (AIAN-SR), or White-SR. After demographic adjustment, the AIAN-MR group reported a higher lifetime prevalence of diagnosed depressive disorder, more days of poor mental health, and more frequent mental distress compared to both the AIAN-SR and White-SR groups. AIAN-MR individuals also had higher levels of Kessler 6 (K6) non-specific psychological distress compared to White-SR individuals but not AIAN-SR adults. Differences between AIAN-SR and White-SR adults were found in days of poor mental health, frequent mental distress, and total K6 scores. These findings help gauge the magnitude of mental health disparities in the U.S. AIAN population and pinpoint AIAN subgroups for whom mental health is particularly problematic. As such, they raise concerns about restrictions that limit the identification of national survey respondents who report multiple race designations. Such restrictions will thwart efforts to understand the causal mechanisms and pathways leading to mental distress among AIAN individuals.

Mental health and substance abuse characteristics among a clinical sample of urban American Indian/Alaska native youths in a large California metropolitan area: a descriptive study.

PubMed

Dickerson, Daniel L; Johnson, Carrie L

2012-02-01

This study analyzes descriptive data among a clinical sample of American Indian/Alaska Native (AI/AN) youths receiving mental health services in a large California metropolitan area. Among 118 urban AI/AN youths, mood disorders (41.5%) and adjustment disorder (35.4%) were the most common mental health diagnoses. Alcohol (69.2%) and marijuana (50.0%) were the most commonly used substances. Witnessing domestic violence (84.2%) and living with someone who had a substance abuse problem (64.7%) were reported. The majority of patients demonstrated various behavior and emotional problems. Enhancing culturally relevant mental health and substance abuse treatment and prevention programs for urban AI/AN youth is suggested.

Death Rates From Human Immunodeficiency Virus and Tuberculosis Among American Indians/Alaska Natives in the United States, 1990–2009

PubMed Central

Bloss, Emily; Byrd, Kathy K.; Iralu, Jonathan; Neel, Lisa; Cheek, James

2014-01-01

Objectives. We used race-corrected data and comprehensive diagnostic codes to better compare HIV and tuberculosis (TB) mortality from 1999 to 2009 between American Indian/Alaska Natives (AI/ANs) and Whites. Methods. National Vital Statistics Surveillance System mortality data were adjusted for AI/AN racial misclassification through linkage with Indian Health Service registration records. We compared average annual 1990 to 2009 HIV and TB death rates (per 100 000 people) for AI/AN persons with those for Whites; Hispanics were excluded. Results. Although death rates from HIV in AI/AN persons were significantly lower than those in Whites from 1990 to 1998 (4.2 vs 7.0), they were significantly higher than those in Whites from 1999 to 2009 (3.6 vs 2.0). Death rates from TB in AI/AN persons were significantly higher than those in Whites, with a significant disparity during both 1990 to 1998 (3.3 vs 0.3) and 1999 to 2009 (1.5 vs 0.1). Conclusions. The decrease in death rates from HIV and TB was greater among Whites, and death rates remained significantly higher among AI/AN individuals. Public health interventions need to be prioritized to reduce the TB and HIV burden and mortality in AI/AN populations. PMID:24754664

Kidney Cancer Incidence and Mortality Among American Indians and Alaska Natives in the United States, 1990–2009

PubMed Central

Weir, Hannah K.; Jim, Melissa A.; King, Sallyann M.; Wilson, Reda; Master, Viraj A.

2014-01-01

Objectives. We describe rates and trends in kidney cancer incidence and mortality and identify disparities between American Indian/Alaska Native (AI/AN) and White populations. Methods. To improve identification of AI/AN race, incidence and mortality data were linked with Indian Health Service (IHS) patient records. Analysis focused on residents of IHS Contract Health Service Delivery Area counties; Hispanics were excluded. We calculated age-adjusted kidney cancer incidence (2001–2009) and death rates (1990–2009) by sex, age, and IHS region. Results. AI/AN persons have a 1.6 times higher kidney cancer incidence and a 1.9 times higher kidney cancer death rate than Whites. Despite a significant decline in kidney cancer death rates for Whites (annual percentage change [APC] = −0.3; 95% confidence interval [CI] = −0.5, 0.0), death rates for AI/AN persons remained stable (APC = 0.4; 95% CI = −0.7, 1.5). Kidney cancer incidence rates rose more rapidly for AI/AN persons (APC = 3.5; 95% CI = 1.2, 5.8) than for Whites (APC = 2.1; 95% CI = 1.4, 2.8). Conclusions. AI/AN individuals have greater risk of developing and dying of kidney cancers. Incidence rates have increased faster in AI/AN populations than in Whites. Death rates have decreased slightly in Whites but remained stable in AI/AN populations. Racial disparities in kidney cancer are widening. PMID:24754655

Using Storytelling to Address Oral Health Knowledge in American Indian and Alaska Native Communities

PubMed Central

Gebel, Christina; Crawford, Andrew; Barker, Judith C.; Henshaw, Michelle; Garcia, Raul I.; Riedy, Christine; Wimsatt, Maureen A.

2018-01-01

Introduction We conducted a qualitative analysis to evaluate the acceptability of using storytelling as a way to communicate oral health messages regarding early childhood caries (ECC) prevention in the American Indian and Alaska Native (AIAN) population. Methods A traditional story was developed and pilot tested among AIAN mothers residing in 3 tribal locations in northern California. Evaluations of the story content and acceptability followed a multistep process consisting of initial feedback from 4 key informants, a focus group of 7 AIAN mothers, and feedback from the Community Advisory Board. Upon story approval, 9 additional focus group sessions (N = 53 participants) were held with AIAN mothers following an oral telling of the story. Results Participants reported that the story was culturally appropriate and used relatable characters. Messages about oral health were considered to be valuable. Concerns arose about the oral-only delivery of the story, story content, length, story messages that conflicted with normative community values, and the intent to target audiences. Feedback by focus group participants raised some doubts about the relevance and frequency of storytelling in AIAN communities today. Conclusion AIAN communities value the need for oral health messaging for community members. However, the acceptability of storytelling as a method for the messaging raises concerns, because the influence of modern technology and digital communications may weaken the acceptability of the oral tradition. Careful attention must be made to the delivery mode, content, and targeting with continual iterative feedback from community members to make these messages engaging, appropriate, relatable, and inclusive. PMID:29806581

The Effects of Prepregnancy Body Mass Index and Gestational Weight Gain on Fetal Macrosomia Among American Indian/Alaska Native Women.

PubMed

Rockhill, Karilynn; Dorfman, Haley; Srinath, Meghna; Hogue, Carol

2015-11-01

The American Indian/Alaska Native (AI/AN) population is a high-risk group across many health indicators, including fetal macrosomia. We aimed to investigate the effects of prepregnancy body mass index (BMI) and gestational weight gain (GWG) on macrosomia and explore possible racial and geographical variations among AI/AN women. This retrospective cohort study was conducted from the Pregnancy Risk Assessment Monitoring System in eight states (2004-2011) among live, singleton, term births to AI/AN women 20 years or older. Prevalence of macrosomia (birth weight ≥ 4000 g) by select characteristics were estimated; differences were assessed with Chi-squares. Multivariable logistic regression was conducted to calculate adjusted odds ratios (aOR) for effects on macrosomia of BMI and GWG (enumerating the pounds women deviated from the Institute of Medicine guidelines for GWG) controlling for other factors in the total sample and stratified by race and state of residence. The prevalence of macrosomia was 14 %, ranging from 8 to 21 % (Utah-Alaska). Among AI/AN women, 30 % were obese prepregnancy and 50 % had excess GWG. Significant independent effects were found for macrosomia of prepregnancy overweight (aOR 1.27; 95 % Confidence Interval 1.01-1.59), obesity (aOR 1.63; 1.29-2.07), and excess GWG (aOR 1.16; 1.13-1.20 per five pounds gained beyond appropriate). Adjusted estimates varied between race and state. Prepregnancy BMI and GWG are independent factors for macrosomia among AI/AN women. Future research should prioritize development, testing, and implementation of weight management programs, which account for variations among AI/AN women, both before and during pregnancy for BMI regulation and GWG control.

Focus groups to increase the cultural acceptability of a contingency management intervention for American Indian and Alaska Native Communities.

PubMed

Hirchak, Katherine A; Leickly, Emily; Herron, Jalene; Shaw, Jennifer; Skalisky, Jordan; Dirks, Lisa G; Avey, Jaedon P; McPherson, Sterling; Nepom, Jenny; Donovan, Dennis; Buchwald, Dedra; McDonell, Michael G

2018-07-01

Many American Indian and Alaska Native (AI/AN) people seek evidence-based, cost-effective, and culturally acceptable solutions for treating alcohol use disorders. Contingency management (CM) is a feasible, low-cost approach to treating alcohol use disorders that uses "reinforcers" to promote and support alcohol abstinence. CM has not been evaluated among AI/AN communities. This study explored the cultural acceptability of CM and adapted it for use in diverse AI/AN communities. We conducted a total of nine focus groups in three AI/AN communities: a rural reservation, an urban health clinic, and a large Alaska Native healthcare system. Respondents included adults in recovery, adults with current drinking problems, service providers, and other interested community members (n = 61). Focus group questions centered on the cultural appropriateness of "reinforcers" used to incentivize abstinence and the cultural acceptability of the intervention. Focus groups were audio-recorded, transcribed, and coded independently by two study team members using both a priori and emergent codes. We then analyzed coded data. Across all three locations, focus group participants described the importance of providing both culturally specific (e.g., bead work and cultural art work supplies), as well as practical (e.g., gas cards and bus passes) reinforcers. Focus group participants underscored the importance of providing reinforcers for the children and family of intervention participants to assist with reengaging with family and rebuilding trust that may have been damaged during alcohol use. Respondents indicated that they believed CM was in alignment with AI/AN cultural values. There was consensus that Elders or a well-respected community member implementing this intervention would enhance participation. Focus group participants emphasized use of the local AI/AN language, in addition to the inclusion of appropriate cultural symbols and imagery in the delivery of the intervention. A CM

The Association Between Diabetes Mellitus Among American Indian/Alaska Native Populations with Preterm Birth in Eight US States from 2004-2011.

PubMed

Dorfman, Haley; Srinath, Meghna; Rockhill, Karilynn; Hogue, Carol

2015-11-01

Assess risk of preterm birth associated with diabetes mellitus (DM) among American Indian and Alaska Natives (AI/AN), a population with increased risk of DM and preterm birth, and examine whether this association differed by state of residence. We used surveillance data from the Pregnancy Risk Assessment Monitoring System from 12,400 AI/AN respondents with singleton births in Alaska, Minnesota, Nebraska, New Mexico, Oklahoma, Oregon, Utah, and Washington from 2004-2011. We conducted multivariable logistic regression models to estimate the odds ratio adjusted for maternal age and prepregnancy BMI with all observations and then stratified by state. DM was reported in 5.92 % of the study population and preterm birth occurred in 8.95 % of births. Women with DM had 1.92 times higher odds of having a preterm birth than women without DM [95 % confidence interval (CI) 1.21-2.78]. After stratifying on state, women with DM in Nebraska had the greatest odds of preterm birth [aOR 6.63, (95 % CI 3.80-11.6)] while women in Alaska saw a protective effect from DM [aOR 0.17, (95 % CI 0.07-0.42)] compared to women without DM. Overall, AI/AN women with DM had significantly greater odds of preterm birth compared to AI/AN women without DM across states. Substantial differences in this association between states calls for increased public health efforts in high-risk areas as well as further research to assess whether differences are attributable to diagnosis, reporting, tribal, healthcare or lifestyle factors.

National Indian Education Study 2011: The Educational Experiences of American Indian and Alaska Native Students at Grades 4 and 8. NCES 2012-466

ERIC Educational Resources Information Center

National Center for Education Statistics, 2012

2012-01-01

Since 2005, the National Indian Education Study (NIES) has provided educators, policymakers, and the public with information about the background and academic performance of fourth- and eighth-grade American Indian and Alaska Native (AI/AN) students in the United States. NIES was administered in 2005, 2007, 2009, and 2011 as part of the National…

Drum-Assisted Recovery Therapy for Native Americans (DARTNA): results from a pretest and focus groups.

PubMed

Dickerson, Daniel L; Venner, Kamilla L; Duran, Bonnie; Annon, Jeffrey J; Hale, Benjamin; Funmaker, George

2014-01-01

Drum-Assisted Recovery Therapy for Native Americans (DARTNA) is a substance abuse treatment intervention for American Indians/Alaska Natives (AI/ANs). This article provides results from 1) an initial pretest of DARTNA provided to 10 AI/AN patients with histories of substance use disorders, and 2) three subsequent focus groups conducted among AI/AN DARTNA pretest participants, substance abuse treatment providers, and the DARTNA Community Advisory Board. These research activities were conducted to finalize the DARTNA treatment manual; participants also provided helpful feedback which will assist toward this goal. Results suggest that DARTNA may be beneficial for AI/ANs with substance use problems.

Discrimination and participation in traditional healing for American Indians and Alaska Natives.

PubMed

Moghaddam, Jacquelene F; Momper, Sandra L; Fong, Timothy

2013-12-01

Contemporary American Indians and Alaska Natives (AIs/ANs) who live in urban areas today face the daunting task of navigating an urban landscape while maintaining the facets of their respective Native cultures. While AIs/ANs continue to grapple with the intergenerational trauma associated with forced assimilation, relocation movements, and boarding schools, these traumas have manifested themselves in elevated rates of psychopathology. AIs/ANs have elevated rates of domestic abuse, poverty, suicide, and substance misuse. Furthermore, AIs/ANs, like many other minority cultures often face discrimination in their everyday lives. In light of the aversive experiences they face, AI/AN people have followed the tenets of ritual and traditional healing to address imbalances in the body, mind, and spirit. For providers working with AI/AN clients, it is important to understand who is using traditional healing and why they are using alternative services. Secondary data analyses of survey data from 389 urban AIs/ANs were utilized in order to determine the relationship between experiences of discrimination and traditional healing use. Analyses indicated that experiences of discrimination in healthcare settings were significantly associated with participation in traditional healing. Analyses also indicated that nearly a quarter of the sample reported discrimination in a healthcare setting, roughly half of the sample had used traditional healing, and that the majority of those who had used traditional healing were women, and ages 35-44 (27%). This study calls attention to the socio-demographic factors implicated in traditional healing use by urban AI/AN people, in addition to the clinical and demographic characteristics of this sample.

Lessons Learned from Native C.I.R.C.L.E., a Culturally Specific Resource.

PubMed

Garcia, Andrea; Baethke, Lisa; Kaur, Judith S

2017-12-01

Cancer is now the second leading cause of death among American Indians and Alaska Natives (AIAN), and trends in cancer-related mortality over the past 2 decades show inferior control in AIAN compared to non-Hispanic Whites. The American Indian/Alaska Native Cancer Information Resource Center and Learning Exchange (Native C.I.R.C.L.E.) was developed in the year 2000 as part of a comprehensive network of partnerships to develop, maintain, and disseminate culturally appropriate cancer and other health information materials for AIAN educators and providers. Now, in its 15th year of existence, enough data has been accumulated by Native C.I.R.C.L.E. to analyze trends in the distribution of culturally relevant cancer information materials and compare access to both printed (hard copy) and online materials. The amount of culturally appropriate materials available since its creation has increased more than 10-fold. Print materials are now distributed throughout the world, and the number of materials requested from print and downloads combined are in the thousands on a monthly basis. Native C.I.R.C.L.E. is in the process of expanding its access and capabilities to target more of the lay AIAN public in order to address the digital divide.

Unpacking the Placement of American Indian and Alaska Native Students in Special Education Programs and Services in the Early Grades: School Readiness as a Predictive Variable

ERIC Educational Resources Information Center

Hibel, Jacob; Faircloth, Susan C.; Farkas, George

2008-01-01

In this article, Jacob Hibel, Susan Faircloth, and George Farkas investigate the persistent finding that American Indian and Alaska Native (AI/AN) students are overrepresented in special education. Using data from the kindergarten cohort of the Early Childhood Longitudinal Study, the authors compare the third-grade special education placement rate…

Beverage consumption in an Alaska Native village: a mixed-methods study of behaviour, attitudes and access.

PubMed

Elwan, Deena; de Schweinitz, Peter; Wojcicki, Janet M

2016-01-01

American Indians/Alaska Natives (AI/AN) have the highest prevalence of obesity for any racial/ethnic group. Previous studies examining risk factors for obesity have identified excessive sugar-sweetened beverage (SSB) and inadequate water consumption as major risk factors for this population group. The historical scarcity of water in rural Alaska may explain consumption patterns including reliance on SSBs and other packaged drinks. Our study was designed to assess SSB, water and other beverage consumption and attitudes towards consumption in Alaska Native children and adults residing in rural Alaska. During summer 2014, 2 focus groups were conducted employing community members in a small rural village more than 200 air miles west of Fairbanks, Alaska. Interviews were completed with shop owners, Early Head Start and Head Start program instructors (n=7). SSB and total beverage intakes were measured using a modified version of the BEVQ-15, (n=69). High rates of SSB consumption (defined as sweetened juice beverages, soda, sweet tea, energy drink or sports drinks) and low rates of water consumption were reported for all age groups in the village. All adolescents and 81% of children reported drinking SSBs at least once per week in the last month, and 48% of adolescents and 29% of younger children reported daily consumption. Fifty-two per cent of adults reported consuming SSBs at least once per week and 20% reported daily consumption. Twenty-five per cent of adolescents reported never drinking water in the past month, and 19% of younger children and 21% of adults did not consume water daily. Alaska Native children and adults living in the Interior Alaska consume high amounts of SSBs including energy drinks and insufficient amounts of water. Interventions targeting beverage consumption are urgently needed for the Alaska Native population in rural Alaska.

Beverage consumption in an Alaska Native village: a mixed-methods study of behaviour, attitudes and access

PubMed Central

de Schweinitz, Peter; Wojcicki, Janet M.

2016-01-01

Background American Indians/Alaska Natives (AI/AN) have the highest prevalence of obesity for any racial/ethnic group. Previous studies examining risk factors for obesity have identified excessive sugar-sweetened beverage (SSB) and inadequate water consumption as major risk factors for this population group. The historical scarcity of water in rural Alaska may explain consumption patterns including reliance on SSBs and other packaged drinks. Methods Our study was designed to assess SSB, water and other beverage consumption and attitudes towards consumption in Alaska Native children and adults residing in rural Alaska. During summer 2014, 2 focus groups were conducted employing community members in a small rural village more than 200 air miles west of Fairbanks, Alaska. Interviews were completed with shop owners, Early Head Start and Head Start program instructors (n=7). SSB and total beverage intakes were measured using a modified version of the BEVQ-15, (n=69). Results High rates of SSB consumption (defined as sweetened juice beverages, soda, sweet tea, energy drink or sports drinks) and low rates of water consumption were reported for all age groups in the village. All adolescents and 81% of children reported drinking SSBs at least once per week in the last month, and 48% of adolescents and 29% of younger children reported daily consumption. Fifty-two per cent of adults reported consuming SSBs at least once per week and 20% reported daily consumption. Twenty-five per cent of adolescents reported never drinking water in the past month, and 19% of younger children and 21% of adults did not consume water daily. Conclusion Alaska Native children and adults living in the Interior Alaska consume high amounts of SSBs including energy drinks and insufficient amounts of water. Interventions targeting beverage consumption are urgently needed for the Alaska Native population in rural Alaska. PMID:26928369

Cancer in American Indian and Alaska Native young adults (ages 20-44 years): US, 1999-2004.

PubMed

Weir, Hannah K; Jim, Melissa A; Marrett, Loraine D; Fairley, Temeika

2008-09-01

An examination of cancer incidence patterns in American Indians and Alaska Native (AI/AN) young adults may provide insight into their present and future cancer burden. To reduce racial misclassification, incidence data were linked with the Indian Health Service (IHS) patient services database. Age-adjusted cancer incidence rates per 100,000 (AAR) and corresponding rate ratios (RR) for young adults (ages 20-44 years) were compared across IHS regions and for selected cancers within Contract Health Service Delivery Area counties by race (AI/AN vs non-Hispanic whites [NHW]) and sex. The all-sites cancer incidence rate was lower for AI/ANs (AAR of 83.8) than for NHWs (AAR of 111.2) (RR of 0.75) but varied by IHS regions. Among the leading cancers in AI/AN females the risk was elevated for stomach (RR of 3.22), colorectal (RR of 1.30), uterine (RR of 1.61), and kidney (RR of 1.39) cancers and was lower for breast (RR of 0.70) and thyroid (RR of 0.71) cancers. Among AI/AN young adult males the risk was elevated for stomach (RR of 2.62), liver (RR of 1.89), and kidney (RR of 1.59) cancers and lower for testicular germ cell cancer (RR of 0.64) and lymphoma (RR of 0.60). The risk for these and other cancers varied across IHS regions. Many of the cancer patterns that characterize the AI/AN population overall are apparent among young adults. Compared with NHW young adults, the overall cancer burden among AI/AN young adults was lower but varied for selected cancers and across IHS regions. Cancer control and research strategies are needed to address the unique genetic, social, cultural, and lifestyle aspects of AI/AN young adults.

Mortality Caused by Chronic Liver Disease Among American Indians and Alaska Natives in the United States, 1999–2009

PubMed Central

Suryaprasad, Anil; Byrd, Kathy K.; Redd, John T.; Perdue, David G.; Manos, M. Michele; McMahon, Brian J.

2014-01-01

Objectives. We compared chronic liver disease (CLD) mortality from 1999 to 2009 between American Indians and Alaska Natives (AI/ANs) and Whites in the United States after improving CLD case ascertainment and AI/AN race classification. Methods. We defined CLD deaths and causes by comprehensive death certificate-based diagnostic codes. To improve race classification, we linked US mortality data to Indian Health Service enrollment records, and we restricted analyses to Contract Health Service Delivery Areas and to non-Hispanic populations. We calculated CLD death rates (per 100 000) in 6 geographic regions. We then described trends using linear modeling. Results. CLD mortality increased from 1999 to 2009 in AI/AN persons and Whites. Overall, the CLD death rate ratio (RR) of AI/AN individuals to Whites was 3.7 and varied by region. The RR was higher in women (4.7), those aged 25 to 44 years (7.4), persons residing in the Northern Plains (6.4), and persons dying of cirrhosis (4.0) versus hepatocellular carcinoma (2.5), particularly those aged 25 to 44 years (7.7). Conclusions. AI/AN persons had greater CLD mortality, particularly from premature cirrhosis, than Whites, with variable mortality by region. Comprehensive prevention and care strategies are urgently needed to stem the CLD epidemic among AI/AN individuals. PMID:24754616

Recruiting American Indian/Alaska Native Students to Medical School: A Multi-Institutional Alliance in the U.S. Southwest.

PubMed

Ballejos, Marlene P; Olsen, Polly; Price-Johnson, Tanisha; Garcia, Cindy; Parker, Tassy; Sapién, Robert E; Romero-Leggott, Valerie

2018-01-01

Despite national efforts to diversify the physician workforce, American Indian/Alaska Native (AI/AN) individuals have the least representation of all major racial and ethnic groups. Limited resources at state medical schools present institution-level recruitment challenges. Unified efforts to engage AI/AN students in premedical education activities are needed. The medical schools at the Universities of Arizona (Phoenix and Tucson), Colorado, New Mexico, and Utah identified a collective need to increase student diversity, particularly with regard to AI/AN students. The schools partnered with the Association of American Indian Physicians to support AI/AN students applying to medical school and to grow the overall AI/AN applicant pool. Each year from 2011 to 2016, these institutions hosted a two-day preadmissions workshop (PAW) to prepare participants for applying to medical school. From 2011 to 2016, 130 AI/AN students participated in the PAWs. Of these, 113 were first-time attendees, 15 participated on two separate occasions, and 1 participated on three separate occasions. Nineteen (21%) of the 90 first-time participants from 2011 to 2015 matriculated to a U.S. medical school in the past five years. Twenty-two of 23 participants (96% response rate) in 2016 responded to the postworkshop survey. Results indicated that interview preparation, individual consultation, and writing preparation ranked as the three most beneficial sessions/activities. Standardized evaluation of future PAWs will identify best practices for recruiting AI/AN students to medical school, and future initiatives will include more robust measures of success.

Alaska Native Education: Issues in the Nineties. Alaska Native Policy Papers.

ERIC Educational Resources Information Center

Kleinfeld, Judith

This booklet identifies several crucial problems in Alaska Native education, for example: (1) Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) occur in Alaska Native populations at relatively high rates and can produce mental retardation, hyperactivity, attention deficits, and learning disabilities; (2) while many Native rural school…

Evidence-Based Practices, Attitudes, and Beliefs in Substance Abuse Treatment Programs Serving American Indians and Alaska Natives: A Qualitative Study

PubMed Central

Larios, Sandra E.; Wright, Serena; Jernstrom, Amanda; Lebron, Dorothy; Sorensen, James L.

2012-01-01

Substance abuse disproportionately impacts American Indian/Alaska Native (AI/AN) communities in the United States. For the increasing numbers of AI/AN individuals who enter and receive treatment for their alcohol or other drug problem it is imperative that the service they receive be effective. This study used qualitative methodology to examine attitudes toward evidence-based practices, also known as evidence-based treatments (EBTs) in minority-serving substance abuse treatment programs in the San Francisco Bay area. Twenty-two interviews were conducted in the study, of which seven were with program directors and substance abuse counselors at two urban AI/AN focused sites. These clinics were more likely than other minority-focused programs to have experience with research and knowledge about adapting EBTs. Only in the AI/AN specific sites did an issue arise concerning visibility, that is, undercounting AI/AN people in national and state databases. Similar to other minority-focused programs, these clinics described mistrust, fear of exploitation from the research community, and negative attitudes towards EBTs. The underutilization of EBTs in substance abuse programs is prevalent and detrimental to the health of patients who would benefit from their use. Future research should explore how to use this research involvement and experience with adaptation to increase the adoption of EBTs in AI/AN serving clinics. PMID:22400469

Alaska Natives & the Land.

ERIC Educational Resources Information Center

Arnold, Robert D.; And Others

Pursuant to the Native land claims within Alaska, this compilation of background data and interpretive materials relevant to a fair resolution of the Alaska Native problem seeks to record data and information on the Native peoples; the land and resources of Alaska and their uses by the people in the past and present; land ownership; and future…

Chronic conditions, functional difficulties, and disease burden among American Indian/Alaska Native children with special health care needs, 2009-2010.

PubMed

Kenney, Mary Kay; Thierry, Judy

2014-11-01

The purpose of this study was to determine the prevalence of chronic conditions and functional difficulties of American Indian/Alaska Native (AIAN) children with special health care needs (CSHCN). We conducted bivariate and multivariable analysis of cross-sectional data on 40,202 children from the 2009-2010 National Survey of Children with Special Health Care Needs aged birth through 17 years, including 1,051 AIAN CSHCN. The prevalence of AIAN CSHCN was 15.7 %, not significantly different from the prevalence of US white CSHCN (16.3 %). As qualifiers for special needs status among AIAN children the use of or need for prescription medication was the most frequent (70 %), compared to the lower rates of need for elevated service use (44 %) and emotional, mental, or behavioral treatment/counseling (36 %). Asthma (45 %), conduct disorder (18 %), developmental delay (27 %), and migraine headaches (16 %) were significantly more common chronic conditions among AIAN CSHCN compared to white CSHCN, as were functional difficulties with respiration (52 %), communication (42 %), anxiety/depression (57 %), and behavior (54 %). AIAN CSHCN were also more likely to have 3 or more chronic conditions (39 vs. 28 %, respectively) and 3 or more functional difficulties (70 vs. 55 %, respectively) than white CSHCN. Results indicated a greater impact on the daily activities of AIAN CSHCN compared to white CSHCN (74 vs. 63 %). Significantly greater disease burden among AIAN CSHCN suggests that care must be taken to ensure an appropriate level of coordinated care in a medical home to ameliorate the severity and complexity of their conditions.

Barriers to Cancer Clinical Trial Participation Among American Indian and Alaska Native Tribal College Students

PubMed Central

Sprague, Debra; Russo, Joan; LaVallie, Donna L.; Buchwald, Dedra

2012-01-01

Purpose American Indians and Alaska Natives (AIs/ANs) have some of the highest cancer-related mortality rates of all US racial and ethnic groups, but they are underrepresented in clinical trials. We sought to identify factors that influence willingness to participate in cancer clinical trials among AI/AN tribal college students, and to compare attitudes toward clinical trial participation among these students with attitudes among older AI/AN adults. Methods Questionnaire data from 489 AI/AN tribal college students were collected and analyzed along with previously collected data from 112 older AI/AN adults. We examined 10 factors that influenced participation in the tribal college sample, and using chi-square analysis and these 10 factors, we compared attitudes toward research participation among 3 groups defined by age: students younger than 40, students 40 and older, and nonstudent adults 40 and older. Findings About 80% of students were willing to participate if the study would lead to new treatments or help others with cancer in their community, the study doctor had experience treating AI/AN patients, and they received payment. Older nonstudent adults were less likely to participate on the basis of the doctor’s expertise than were students (73% vs 84%, P = .007), or if the study was conducted 50 miles away (24% vs 41%, P = .001). Conclusions Finding high rates of willingness to participate is an important first step in increasing participation of AIs/ANs in clinical trials. More information is needed on whether these attitudes influence actual behavior when opportunities to participate become available. PMID:23289655

Assessing the Everyday Discrimination Scale Among American Indians and Alaska Natives

PubMed Central

Gonzales, Kelly L.; Noonan, Carolyn; Goins, R. Turner; Henderson, William G.; Beals, Janette; Manson, Spero M.; Acton, Kelly J.; Roubideaux, Yvette

2015-01-01

The Everyday Discrimination Scale (EDS) has been used widely as a measure of subjective experiences of discrimination. The usefulness of this measure for assessments of perceived experiences of discrimination by American Indian and Alaska Native (AI/AN) peoples has not been explored. Data derived from the Special Diabetes Program for Indians – Healthy Heart Demonstration Project (SDPI-HH), a large-scale initiative to reduce cardiovascular risk among AI/ANs with Type 2 diabetes. Participants (N=3,039) completed a self-report survey that included the EDS and measures of convergent and divergent validity. Missing data were estimated by multiple imputation techniques. Reliability estimates for the EDS were calculated, yielding a single factor with high internal consistency (α=0.92). Younger, more educated respondents reported greater perceived discrimination; retired or widowed respondents reported less. Convergent validity was evidenced by levels of distress, anger, and hostility, which increased as the level of perceived discrimination increased (all p<0.001). Divergent validity was evidenced by the absence of an association between EDS and resilient coping. Resilient coping and insulin-specific diabetes knowledge were not significantly associated with perceived discrimination (p=0.61 and 0.16, respectively). However, general diabetes-related health knowledge was significantly associated with perceived discrimination (p=0.02). The EDS is a promising measure for assessing perceived experiences of discrimination among those AI/ANs who participated in the SDPI-HH. PMID:26146948

Alaska Dental Health Aide Program.

PubMed

Shoffstall-Cone, Sarah; Williard, Mary

2013-01-01

In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities. This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.

Alaska Dental Health Aide Program

PubMed Central

Shoffstall-Cone, Sarah; Williard, Mary

2013-01-01

Background In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities. Objectives This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. Results The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Conclusions Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities. PMID:23984306

Place and sexual partnership transition among young American Indian and Alaska native women.

PubMed

Pearson, Cynthia R; Cassels, Susan

2014-08-01

Multiple challenges expose American Indian and Alaska Native (AIAN) women to high-risk sexual partnerships and increased risk for HIV/STI. Using a unique sample of sexually-active young AIAN women (n = 129), we examined characteristics of last three partners and whether transitional partnerships were associated with different risk profiles, including where partners met, lived, and had sex. Respondents were more likely to have met their previous or current secondary partner (P2) at a friend's or family setting (versus work or social setting) (AOR = 3.92; 95 % CI 1.31, 11.70). Condom use was less likely when meeting a partner at friend's or family settings (AOR = 0.17; 95 % CI 0.05, 0.59). Sexual intercourse with P2 (compared to P1) usually took place in "riskier" settings such as a car, bar, or outside (AOR = 4.15; 95 % CI 1.59, 10.68). Perceived "safe" places, e.g., friend's or family's house, were identified with risky behaviors; thus, homogeneous messaging campaigns may promote a false sense of safety.

Place and sexual partnership transition among young American Indian and Alaska Native Women

PubMed Central

Pearson, Cynthia R.; Cassels, Susan

2014-01-01

Multiple challenges expose American Indian and Alaska Native (AIAN) women to high-risk sexual partnerships and increased risk for HIV/STI. Using a unique sample of sexually-active young AIAN women (n=129), we examined characteristics of last three partners and whether transitional partnerships were associated with different risk profiles, including where partners met, lived, and had sex. Respondents were more likely to have met their previous or current secondary partner (P2) at a friend’s or family setting (versus work or social setting) (AOR=3.92; 95%CI: 1.31, 11.70). Condom use was less likely when meeting a partner at friend’s or family settings (AOR=0.17; 95%CI: 0.05, 0.59). Sexual intercourse with P2 (compared to P1) usually took place in “riskier” settings such as a car, bar, or outside (AOR=4.15; 95%CI: 1.59, 10.68). Perceived “safe” places, e.g., friend’s or family’s house, were identified with risky behaviors; thus, homogeneous messaging campaigns may promote a false sense of safety. PMID:24276791

The role of culture in substance abuse treatment programs for American Indian and Alaska Native communities.

PubMed

Legha, Rupinder Kaur; Novins, Douglas

2012-07-01

Culture figures prominently in discussions regarding the etiology of alcohol and substance abuse in American Indian and Alaska Native (AI/AN) communities, and a substantial body of literature suggests that it is critical to developing meaningful treatment interventions. However, no study has characterized how programs integrate culture into their services. Furthermore, reports regarding the associated challenges are limited. Twenty key informant interviews with administrators and 15 focus groups with clinicians were conducted in 18 alcohol and substance abuse treatment programs serving AI/AN communities. Transcripts were coded to identify relevant themes. Substance abuse treatment programs for AI/AN communities are integrating culture into their services in two discrete ways: by implementing specific cultural practices and by adapting Western treatment models. More important, however, are the fundamental principles that shape these programs and their interactions with the people and communities they serve. These foundational beliefs and values, defined in this study as the core cultural constructs that validate and incorporate AI/AN experience and world view, include an emphasis on community and family, meaningful relationships with and respect for clients, a homelike atmosphere within the program setting, and an “open door” policy for clients. The primary challenges for integrating these cultural practices include AI/AN communities' cultural diversity and limited socioeconomic resources to design and implement these practices. The prominence of foundational beliefs and values is striking and suggests a broader definition of culture when designing services. This definition of foundational beliefs and values should help other diverse communities culturally adapt their substance abuse interventions in more meaningful ways.

Culturally appropriate HIV/AIDS and substance abuse prevention programs for urban Native youth.

PubMed

Aguilera, Solis; Plasencia, Ana Vanesa

2005-09-01

This article will examine HIV/AIDS and substance abuse prevention for urban Native youth in Oakland, California. It will highlight the Native American Health Center's Youth Services programs. These programs incorporate solutions based on a traditional value system rooted in Native culture and consisting of youth empowerment, leadership training, prevention activities, traditional cultural activities and wellness and life skills education. They aim to reduce HIV/AIDS and substance abuse risk for American Indian/Alaska Native (AI/AN) youth through structured, community-based interventions. The Youth Services Program's events, such as the Seventh Native American Generation and the Gathering of Native Americans, offer effective and culturally relevant ways of teaching youth about American Indian/Alaska Native history, intergenerational trauma, and traditional Native culture. Satisfaction surveys gathered from these youth provide invaluable data on the positive effects of these prevention efforts. The need for culturally relevant and culturally appropriate HIV/AIDS and substance abuse prevention programs for urban AI/AN youth is apparent. These prevention efforts must be creatively integrated into the multidimensional and complex social structures of Native American youth.

National Indian Education Study--Part I: Performance of American Indian and Alaska Native Students at Grades 4 and 8 on NAEP 2009 Reading and Mathematics Assessments. NCES 2010-462

ERIC Educational Resources Information Center

Grigg, W.; Moran, R.; Kuang, M.

2010-01-01

The National Indian Education Study (NIES) is administered as part of the National Assessment of Educational Progress (NAEP), which was expanded to allow more in-depth reporting on the achievement and experiences of American Indian/Alaska Native (AI/AN) students. It fulfills a mandate of Executive Order 13336 issued in 2004 calling for closer…

Reproductive health and sexual violence among urban American Indian and Alaska Native young women: select findings from the National Survey of Family Growth (2002).

PubMed

Rutman, Shira; Taualii, Maile; Ned, Dena; Tetrick, Crystal

2012-12-01

Existing data on American Indians and Alaska Natives (AI/ANs) has indicated high rates of unintended pregnancy, high-risk sexual behavior, and experiences of sexual violence. This study from the first analysis to examine AI/ANs and the urban AI/AN subgroup in the National Survey of Family Growth (NSFG) reports new findings of reproductive health and sexual violence among urban AI/AN young women. We examined 2002 NSFG data on urban AI/AN women ages 15-24 years for pregnancies/births, unintended pregnancy, sexual initiation and contraceptive use. We also examined non-voluntary first sexual intercourse among urban AI/AN women ages 18-44 years. Prevalence estimates and 95 % confidence intervals were calculated. Findings include prevalence rates of risk factors among urban AI/AN women ages 15-24 years including unprotected first sex (38 %), first sex with much older partners (36 %), three or more pregnancies (13 %) and births (5 %) and unintended pregnancies (26 %). Seventeen percent of urban AI/ANs ages 18-44 years reported experiencing non-voluntary first sex. Sixty-one percent of urban AI/AN women ages 15-24 years were not using any method of contraception. Current contraceptive methods among those using a method included: injections/implants (23 %), contraceptive pills (32 %) and condoms (25 %). Findings describe reproductive health risk factors among young urban AI/AN women and highlight the need for enhanced surveillance on these issues. Those working to improve AI/AN health need these data to guide programming and identify resources for implementing and evaluating strategies that address risk factors for this overlooked population.

Gaps in Survey Data on Cancer in American Indian and Alaska Native Populations: Examination of US Population Surveys, 1960–2010

PubMed Central

Duran, Tinka; Stimpson, Jim P.; Smith, Corey

2013-01-01

Introduction Population-based data are essential for quantifying the problems and measuring the progress made by comprehensive cancer control programs. However, cancer information specific to the American Indian/Alaska Native (AI/AN) population is not readily available. We identified major population-based surveys conducted in the United States that contain questions related to cancer, documented the AI/AN sample size in these surveys, and identified gaps in the types of cancer-related information these surveys collect. Methods We conducted an Internet query of US Department of Health and Human Services agency websites and a Medline search to identify population-based surveys conducted in the United States from 1960 through 2010 that contained information about cancer. We used a data extraction form to collect information about the purpose, sample size, data collection methods, and type of information covered in the surveys. Results Seventeen survey sources met the inclusion criteria. Information on access to and use of cancer treatment, follow-up care, and barriers to receiving timely and quality care was not consistently collected. Estimates specific to the AI/AN population were often lacking because of inadequate AI/AN sample size. For example, 9 national surveys reviewed reported an AI/AN sample size smaller than 500, and 10 had an AI/AN sample percentage less than 1.5%. Conclusion Continued efforts are needed to increase the overall number of AI/AN participants in these surveys, improve the quality of information on racial/ethnic background, and collect more information on treatment and survivorship. PMID:23517582

Infant mortality trends and differences between American Indian/Alaska Native infants and white infants in the United States, 1989-1991 and 1998-2000.

PubMed

Tomashek, Kay M; Qin, Cheng; Hsia, Jason; Iyasu, Solomon; Barfield, Wanda D; Flowers, Lisa M

2006-12-01

To describe changes in infant mortality rates, including birthweight-specific rates and rates by age at death and cause. We analyzed US linked birth/infant-death data for 1989-1991 and 1998-2000 for American Indians/Alaska Native (AIAN) and White singleton infants at > or =20 weeks' gestation born to US residents. We calculated birthweight-specific infant mortality rates (deaths in each birthweight category per 1000 live births in that category), and overall and cause-specific infant mortality rates (deaths per 100000 live births) in infancy (0-364 days) and in the neonatal (0-27 days) and postneonatal (28-364 days) periods. Birthweight-specific infant mortality rates declined among AIAN and White infants across all birthweight categories, but AIAN infants generally had higher birthweight-specific infant mortality rates. Infant mortality rates declined for both groups, yet in 1998-2000, AIAN infants were still 1.7 times more likely to die than White infants. Most of the disparity was because of elevated post-neonatal mortality, especially from sudden infant death syndrome, accidents, and pneumonia and influenza. Although birthweight-specific infant mortality rates and infant mortality rates declined among both AIAN and White infants, disparities in infant mortality persist. Preventable causes of infant mortality identified in this analysis should be targeted to reduce excess deaths among AIAN communities.

Vaccine-preventable, hospitalizations among American Indian/Alaska Native children using the 2012 Kid's Inpatient Database.

PubMed

Nickel, Amanda J; Puumala, Susan E; Kharbanda, Anupam B

2018-02-08

Our aim was to assess the odds of hospitalization for a vaccine-preventable, infectious disease (VP-ID) in American Indian/Alaska Native (AI/AN) children compared to other racial and ethnic groups using the 2012 Kid's Inpatient Database (KID) The KID is a nationally representative sample, which allows for evaluation of VP-ID in a non-federal, non-Indian Health Service setting. In a cross-sectional analysis, we evaluated the association of race/ethnicity and a composite outcome of hospitalization due to vaccine-preventable infection using multivariate logistic regression. AI/AN children were more likely (OR=1.81, 95% CI=1.34, 2.45) to be admitted to the hospital in 2012 for a VP-ID compared to Non-Hispanic white children after adjusting for age, sex, chronic disease status, metropolitan location, and median household income. This disparity highlights the necessity for a more comprehensive understanding of immunization and infectious disease exposure among American Indian children, especially those not covered or evaluated by Indian Health Service. Copyright © 2017 Elsevier Ltd. All rights reserved.

Systematic Review of Health Disparities for Cardiovascular Diseases and Associated Factors among American Indian and Alaska Native Populations

PubMed Central

Hutchinson, Rebecca Newlin; Shin, Sonya

2014-01-01

Background American Indians and Alaska Native (AI/AN) populations experience significant health disparities compared to non-Hispanic white populations. Cardiovascular disease and related risk factors are increasingly recognized as growing indicators of global health disparities. However, comparative reports on disparities among this constellation of diseases for AI/AN populations have not been systematically reviewed. Objectives We performed a literature review on the prevalence of diabetes, metabolic syndrome, dyslipidemia, obesity, hypertension, and cardiovascular disease; and associated morbidity and mortality among AI/AN. Data sources A total of 203 articles were reviewed, of which 31 met study criteria for inclusion. Searches were performed on PUBMED, MEDLINE, the CDC MMWR, and the Indian Health Services. Study eligibility criteria Published literature that were published within the last fifteen years and provided direct comparisons between AI/AN to non-AI/AN populations were included. Study appraisal and synthesis methods We abstracted data on study design, data source, AI/AN population, comparison group, and. outcome measures. A descriptive synthesis of primary findings is included. Results Rates of obesity, diabetes, cardiovascular disease, and metabolic syndrome are clearly higher for AI/AN populations. Hypertension and hyperlipidemia differences are more equivocal. Our analysis also revealed that there are likely regional and gender differences in the degree of disparities observed. Limitations Studies using BRFSS telephone surveys administered in English may underestimate disparities. Many AI/AN do not have telephones and/or speak English. Regional variability makes national surveys difficult to interpret. Finally, studies using self-reported data may not be accurate. Conclusions and implications of key findings Profound health disparities in cardiovascular diseases and associated risk factors for AI/AN populations persist, perhaps due to low

Infant Mortality Trends and Differences Between American Indian/Alaska Native Infants and White Infants in the United States, 1989–1991 and 1998–2000

PubMed Central

Tomashek, Kay M.; Qin, Cheng; Hsia, Jason; Iyasu, Solomon; Barfield, Wanda D.; Flowers, Lisa M.

2006-01-01

Objectives. To describe changes in infant mortality rates, including birthweight-specific rates and rates by age at death and cause. Methods. We analyzed US linked birth/infant-death data for 1989–1991 and 1998–2000 for American Indians/Alaska Native (AIAN) and White singleton infants at ≥20 weeks’ gestation born to US residents. We calculated birthweight-specific infant mortality rates (deaths in each birthweight category per 1000 live births in that category), and overall and cause-specific infant mortality rates (deaths per 100000 live births) in infancy (0–364 days) and in the neonatal (0–27 days) and postneonatal (28–364 days) periods. Results. Birthweight-specific infant mortality rates declined among AIAN and White infants across all birthweight categories, but AIAN infants generally had higher birthweight-specific infant mortality rates. Infant mortality rates declined for both groups, yet in 1998–2000, AIAN infants were still 1.7 times more likely to die than White infants. Most of the disparity was because of elevated post-neonatal mortality, especially from sudden infant death syndrome, accidents, and pneumonia and influenza. Conclusions. Although birthweight-specific infant mortality rates and infant mortality rates declined among both AIAN and White infants, disparities in infant mortality persist. Preventable causes of infant mortality identified in this analysis should be targeted to reduce excess deaths among AIAN communities. PMID:17077400

Speaking out about physical harms from tobacco use: response to graphic warning labels among American Indian/Alaska Native communities

PubMed Central

Patterson Silver Wolf, David A; Tovar, Molly; Thompson, Kellie; Ishcomer, Jamie; Kreuter, Matthew W; Caburnay, Charlene; Boyum, Sonia

2016-01-01

Objective This study is the first to explore the impact of graphic cigarette labels with physical harm images on members of American Indian/Alaska Native (AI/AN) communities. The aim of this article is to investigate how AI/AN respond to particular graphic warning labels. Methods The parent study recruited smokers, at-risk smokers and non-smokers from three different age groups (youths aged 13–17 years, young adults aged 18–24 years and adults aged 25+ years) and five population subgroups with high smoking prevalence or smoking risk. Using nine graphic labels, this study collected participant data in the field via an iPad-administered survey and card sorting of graphic warning labels. This paper reports on findings for AI/AN participants. Results After viewing graphic warning labels, participants rated their likelihood of talking about smoking risks to friends, parents and siblings higher than their likelihood of talking to teachers and doctors. Further, this study found that certain labels (eg, the label of the toddler in the smoke cloud) made them think about their friends and family who smoke. Conclusions Given the influence of community social networks on health beliefs and attitudes, health communication using graphic warning labels could effect change in the smoking habits of AI/AN community members. Study findings suggest that graphic labels could serve as stimuli for conversations about the risks of smoking among AI/AN community members, and could be an important element of a peer-to-peer smoking cessation effort. PMID:27009143

Initial Exploration of a Construct Representing Native Language and Culture (NLC) in Elementary and Middle School Instruction

ERIC Educational Resources Information Center

Van Ryzin, Mark J.; Vincent, Claudia G.; Hoover, Joseph

2016-01-01

Students from American Indian/Alaska Native (AI/AN) backgrounds have typically experienced poor academic and behavioral outcomes. In response, the educational community has recommended that teachers integrate Native Language and Culture (NLC) into instruction to create a welcoming and culturally relevant classroom environment. However, translating…

Assessment of Mammography Experiences and Satisfaction among American Indian/Alaska Native Women

PubMed Central

Ndikum-Moffor, Florence M.; Braiuca, Stacy; Daley, Christine Makosky; Gajewski, Byron J.; Engelman, Kimberly K.

2013-01-01

BACKGROUND American Indian/Alaska Native (AI/AN) women have lower breast cancer (BCA) screening and 5-year survival rates than non-Hispanic Whites. Understanding reasons for low screening rates is important to combat later stage diagnoses. The purpose of this study was to assess mammography experiences and satisfaction among AI/AN women. METHODS Nine focus groups were held with rural (N=15) and urban (N=38) AI/AN women 40 years and older in Kansas and Kansas City, Missouri, living both near and far from Indian Health Service (IHS) and tribal facilities, to examine experiences and satisfaction with mammography. Transcripts were coded and themes identified using a community-based participatory research approach. FINDINGS Themes were classified under knowledge, communication, and awareness of breast cancer, barriers to mammography, mammogram facility size, impressions of mammogram technologist, motivations to getting a mammogram, and how to improve the mammogram experience. Participants had knowledge of prevention, but described cultural reasons for not discussing it and described better experiences in smaller facilities. Participants indicated having a mammogram technologist who was friendly, knowledgeable, respectful, competent, and explained the test was a determining factor in satisfaction. Other factors included family history, physician recommendation, and financial incentives. Barriers included transportation, cost, perceptions of prejudice, and time constraints. Participants on reservations or near IHS facilities preferred IHS over mainstream providers. Suggestions for improvement included caring technologists, better machines with less discomfort, and education. CONCLUSIONS Interventions to enhance the professionalism, empathy, and cultural awareness of mammogram technologists, reduce barriers, and provide positive expectations and incentives could improve satisfaction and compliance with screening mammography. PMID:24183414

Tailoring an Alcohol Intervention for American Indian Alaska Native Women of Childbearing Age: Listening to the Community.

PubMed

Montag, Annika C; Dusek, Marlené L; Ortega, Marina L; Camp-Mazzetti, Alexandrea; Calac, Dan J; Chambers, Christina D

2017-11-01

Reduction of risky drinking in women of childbearing age is 1 strategy that may be employed to prevent fetal alcohol spectrum disorder, a sequela of prenatal alcohol exposure. Communities differ in risk and protective factors, necessitating culturally informed interventions for maximal efficacy. This article describes the modification of an existing web-based screening, brief intervention, and referral to treatment intervention to reduce risky drinking among American Indian Alaska Native (AIAN) women of childbearing age in Southern California into a peer-to-peer-based intervention using motivational interviewing (MI). The modification process was iterative and included various community focus groups, interviews, and a final review. Intervention modification was required for cultural congruence. Components of the peer-to-peer intervention designed by this project included a flip chart used to guide the motivational interviewing, charts of the financial and physical costs of alcohol consumption, revised baseline and follow-up questionnaires, and guidance regarding the application of MI techniques. This study may inform the modification of future interventions among AIAN communities. Copyright © 2017 by the Research Society on Alcoholism.

Cardiovascular Disease Among Alaska Native Peoples.

PubMed

Jolly, Stacey E; Howard, Barbara V; Umans, Jason G

2013-12-01

Although Alaska Native peoples were thought to be protected from cardiovascular disease (CVD), data now show that this is not the case, despite traditional lifestyles and high omega-3 fatty acid intake. In this article, the current understanding of CVD and its risk factors among Alaska Native peoples, particularly among the Yupik and Inupiat populations, will be discussed, using data from three major studies funded by the National Institutes of Health: Genetics of Coronary Artery Disease among Alaska Natives (GOCADAN), Center for Native Health Research (CANHR), and Education and Research Towards Health (EARTH). Data from these epidemiologic studies have focused concern on CVD and its risk factors among Alaska Native peoples. This review will summarize the findings of these three principal studies and will suggest future directions for research and clinical practice.

A Review of the Experience, Epidemiology, and Management of Pain among American Indian, Alaska Native, and Aboriginal Canadian Peoples

PubMed Central

Jimenez, Nathalia; Garroutte, Eva; Kundu, Anjana; Morales, Leo; Buchwald, Dedra

2011-01-01

Substantial literature suggests that diverse biological, psychological, and sociocultural mechanisms account for differences by race and ethnicity in the experience, epidemiology, and management of pain. Many studies have examined differences between Whites and minority populations, but American Indians (AIs), Alaska Natives (ANs), and Aboriginal peoples of Canada have been neglected both in studies of pain and in efforts to understand its bio-psychosocial and cultural determinants. This article reviews the epidemiology of pain and identifies factors that may affect clinical assessment and treatment in these populations. We searched for peer-reviewed articles focused on pain in these populations, using PubMed, CINAHL, Cochrane, and the University of New Mexico Native Health Database. We identified 28 articles published 1990-2009 in 3 topic areas: epidemiology of pain, pain assessment and treatment, and healthcare utilization. A key finding is that AI/ANs have a higher prevalence of pain symptoms and painful conditions than the U.S. general population. We also found evidence for problems in provider-patient interactions that affect clinical assessment of pain, as well as indications that AI/AN patients frequently use alternative modalities to manage pain. Future research should focus on pain and comorbid conditions and develop conceptual frameworks for understanding and treating pain in these populations. Perspective We reviewed the literature on pain in AI/ANs and found a high prevalence of pain and painful conditions, along with evidence of poor patient-provider communication. We recommend further investigation of pain and comorbid conditions and development of conceptual frameworks for understanding and treating pain in this population. PMID:21330217

Speaking out about physical harms from tobacco use: response to graphic warning labels among American Indian/Alaska Native communities.

PubMed

Patterson Silver Wolf, David A; Tovar, Molly; Thompson, Kellie; Ishcomer, Jamie; Kreuter, Matthew W; Caburnay, Charlene; Boyum, Sonia

2016-03-23

This study is the first to explore the impact of graphic cigarette labels with physical harm images on members of American Indian/Alaska Native (AI/AN) communities. The aim of this article is to investigate how AI/AN respond to particular graphic warning labels. The parent study recruited smokers, at-risk smokers and non-smokers from three different age groups (youths aged 13-17 years, young adults aged 18-24 years and adults aged 25+ years) and five population subgroups with high smoking prevalence or smoking risk. Using nine graphic labels, this study collected participant data in the field via an iPad-administered survey and card sorting of graphic warning labels. This paper reports on findings for AI/AN participants. After viewing graphic warning labels, participants rated their likelihood of talking about smoking risks to friends, parents and siblings higher than their likelihood of talking to teachers and doctors. Further, this study found that certain labels (eg, the label of the toddler in the smoke cloud) made them think about their friends and family who smoke. Given the influence of community social networks on health beliefs and attitudes, health communication using graphic warning labels could effect change in the smoking habits of AI/AN community members. Study findings suggest that graphic labels could serve as stimuli for conversations about the risks of smoking among AI/AN community members, and could be an important element of a peer-to-peer smoking cessation effort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Association Between Lifetime Posttraumatic Stress Disorder and Past Year Alcohol Use Disorder Among American Indians/Alaska Natives and Non-Hispanic Whites.

PubMed

Emerson, Marc A; Moore, Roland S; Caetano, Raul

2017-03-01

Posttraumatic stress disorder (PTSD) and alcohol use disorder disproportionately impact certain populations including American Indians/Alaska Natives (AIAN). While PTSD and alcohol use disorder have been studied both separately and in tandem, less is known about the association in AIAN. The objective was to examine the association between lifetime PTSD and past year alcohol use disorder among AIAN and non-Hispanic Whites (NHW). Data come from the 2012 to 2013 U.S. National Epidemiologic Survey on Alcohol and Related Conditions-III. We used logistic regression to estimate odds of AUD among adults with and without PTSD by race. A total of 19,705 participants, of whom 511 were AIAN and 19,194 were NHW, were included in this study. The percentage of PTSD among AIAN was 22.9% (n = 117) compared to 11.7% (n = 2,251) in NHW (p-value <0.0001). The percentage of past year alcohol use disorder among AIAN was 20.2% (n = 103) compared to 14.2% (n = 2,725) in NHW (p-value <0.0001). The percentage of comorbid past year alcohol use disorder with lifetime PTSD among AIAN was 6.5% (n = 33) compared to 2.4% (n = 457) in NHW (p-value <0.0001). Regarding the joint distribution of PTSD and AUD, AIAN men have greater than 3 times the percentage compared to NHW men (9.5% vs. 3.1%). When stratifying by race (after adjusting for age, sex, depression, and education), among AIAN, the odds of past year alcohol use disorder with (vs. without) lifetime PTSD were 1.76 (95% CI 1.07, 2.90) and among NHW, the odds were 1.59 (95% CI 1.41, 1.80). PTSD is significantly associated with alcohol use disorder in the study populations. Despite a lack of pre-PTSD measures of alcohol use disorder, these findings show a trend indicating that AIAN exposed to PTSD are more burdened with alcohol use disorder compared to NHW in the general U.S. Copyright © 2017 by the Research Society on Alcoholism.

'I've had unsafe sex so many times why bother being safe now?': the role of cognitions in sexual risk among American Indian/Alaska Native men who have sex with men.

PubMed

Nelson, Kimberly M; Simoni, Jane M; Pearson, Cynthia R; Walters, Karina L

2011-12-01

American Indian/Alaska Native (AI/AN) men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV) acquisition and transmission. This study aimed to investigate a potential area of focus for HIV prevention interventions by assessing the impact of sexual risk cognitions on sexual risk-taking among AI/AN MSM. AI/AN MSM (N = 173) from a national cross-sectional survey were analyzed. Reporting more frequent sexual risk cognitions overall (high sexual risk cognitions) was associated with multiple HIV risk factors including unprotected anal intercourse and serodiscordant unprotected anal intercourse. Participants with high sexual risk cognitions had a 2.3 (95% Confidence Interval: 1.1, 4.7) times greater odds of engaging in unprotected anal intercourse regardless of childhood sexual abuse, depression, and alcohol dependence. Most individual sexual risk cognitions were associated with unprotected anal intercourse, serodiscordant unprotected anal intercourse, or both. Results suggest that sexual risk cognitions may be a productive area for further work on HIV prevention among AI/AN MSM.

Capacity building from the inside out: development and evaluation of a CITI ethics certification training module for American Indian and Alaska Native community researchers.

PubMed

Pearson, Cynthia R; Parker, Myra; Fisher, Celia B; Moreno, Claudia

2014-02-01

Current human subject research training modules fail to capture ethically relevant cultural aspects of research involving American Indian and Alaska Native (AI/AN) community members. Applying a Community Engaged Research (CEnR) approach, we adapted the Collaborative IRB Training Initiative training module "assessing risk and benefits." In a two-arm randomized controlled trial, followed by debriefing interviews, we evaluated module acceptability and understandability (test scores) among 40 reservation-based community members. Participants who took the adapted module, compared to those who took the standard module, reported higher scores on relevance of the material overall satisfaction, module quiz scores, and a trend toward higher self-efficacy. Implications of the efficacy of this approach for enhancing ethics training and community participation in research within AI/AN and other cultural populations within and outside the United States are discussed.

Civic engagement and political participation among American Indians and Alaska natives in the US†

PubMed Central

Huyser, Kimberly R.; Sanchez, Gabriel R.; Vargas, Edward D.

2016-01-01

Within the growing literature seeking to understand civic and political engagement among racial and ethnic minorities, our understanding of political behavior among American Indian and Alaska Native’s (AI/AN) remains limited. We use the Current Population Survey Civic Engagement and Voting and Registration supplements (2006-2012) to compare AI/AN voter registration, voting, and overall civic engagement to other racial and ethnic groups and to assess whether factors that predict higher levels of civic engagement vary across these populations. We find a few key socio-economic status indicators that predict civic and political engagement uniquely for AI/ANs, but they are not consistently significant across all years or all types of political participation. We find marital status, age, household size, education, and veteran status to be important in predicting civic engagement for AI/ANs. However, for voting and registration, we find that family income, age, marital status, household size, and residential stability to be important contributors. Although we find AI/ANs are less likely to register and vote compared to non-Hispanic whites, we find that the difference is not statistically significant in congressional years, which may suggest that AI/ANs are engaged in local politics and vote for representatives that will represent their tribal interests in national politics. PMID:29226016

Alaska Natives assessing the health of their environment.

PubMed

Garza, D

2001-11-01

The changes in Alaska's ecosystems caused by pollution, contaminants and global climate change are negatively impacting Alaska Natives and rural residents who rely on natural resources for food, culture and community identity. While Alaska commerce has contributed little to these global changes and impacts, Alaska and its resources are nonetheless affected by the changes. While Alaska Natives have historically relied on Alaska's land, water and animals for survival and cultural identity, today their faith in the safety and quality of these resources has decreased. Alaska Natives no longer believe that these wild resources are the best and many are turning to alternative store-bought foods. Such a change in diet and activity may be contributing to a decline in traditional activities and a decline in general health. Contaminants are showing up in the animals, fish and waters that Alaska Natives use. Efforts need to be expanded to empower Alaska Native Tribes to collect and analyze local wild foods for various contaminants. In addition existing information on contaminants and pollution should be made readily available to Alaska residents. Armed with this type of information Alaska Native residents will be better prepared to make informed decisions on using wild foods and materials.

Native timber harvests in southeast Alaska.

Treesearch

G. Knapp

1992-01-01

The Alaska Native Claims Settlement Act established 13 Native corporations in southeast Alaska. There are 12 "village" corporations and 1 "regional" corporation (Sealaska Corporation). The Native corporations were entitled to select about 540,000 acres of land out of the Tongass National Forest; about 95 percent have been conveyed. This study...

Use of Native Language and Culture (NLC) in Elementary and Middle School Instruction as a Predictor of Mathematics Achievement

ERIC Educational Resources Information Center

Van Ryzin, Mark J.; Vincent, Claudia G.

2017-01-01

Because students from American Indian/Alaska Native (AI/AN) backgrounds tend to lag behind their peers in academic achievement, researchers have recommended integrating Native Language and Culture (NLC) into instruction. However, existing evidence from large-scale studies finds a "negative" effect of the use of NLC on achievement,…

Launching Native Health Leaders: Reducing Mistrust of Research Through Student Peer Mentorship

PubMed Central

McGlone West, Kathleen; Madrid, Teresa M.

2013-01-01

Objectives. We assessed the impact of Launching Native Health Leaders (LNHL), a peer-mentoring and networking program that introduced American Indian/Alaska Native (AI/AN) undergraduates to health and research careers and concepts of community-based participatory research (CBPR). Methods. We conducted 15 interviews and 1 focus group with students who had attended 1 or more LNHL meetings, which took place during 9 professional health research conferences in 2006 to 2009. We completed data collection in 2010, within 1 to 4 years of LNHL participant engagement in program activities. Results. Participants described identity and cultural challenges they encountered in academic institutions and how their views shifted from perceiving research as an enterprise conducted by community outsiders who were not to be trusted toward an understanding of CBPR as contributing to AI/AN health. Conclusions. LNHL provided a safe environment for AI/AN students to openly explore their place in the health and research arenas. Programs such as LNHL support AI/AN student development as leaders in building trust for academic–tribal partnerships. PMID:24134376

Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities.

PubMed

Novins, Douglas K; Croy, Calvin D; Moore, Laurie A; Rieckmann, Traci

2016-04-01

Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes toward, and use of EBTs in substance abuse treatment programs serving AI/AN communities. Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes toward, and use of 9 psychosocial and 3 medication EBTs. Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively). EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Alaska Natives In Higher Education.

ERIC Educational Resources Information Center

Kohout, Karen; Kleinfeld, Judith

This study examines changes in the entrance and success rates of Native students in Alaska colleges from 1963 to 1972, a time when special college recruitment and assistance programs were being developed. Information is based on the college records of those Natives who entered college for the first time at the University of Alaska at Fairbanks…

Alaska Native Languages: Past, Present, and Future. Alaska Native Language Center Research Papers No. 4.

ERIC Educational Resources Information Center

Krauss, Michael E.

Three papers (1978-80) written for the non-linguistic public about Alaska Native languages are combined here. The first is an introduction to the prehistory, history, present status, and future prospects of all Alaska Native languages, both Eskimo-Aleut and Athabaskan Indian. The second and third, presented as appendixes to the first, deal in…

Use of Media Technologies by Native American Teens and Young Adults: Evaluating Their Utility for Designing Culturally-Appropriate Sexual Health Interventions Targeting Native Youth in the Pacific Northwest

ERIC Educational Resources Information Center

Craig Rushing, Stephanie Nicole

2010-01-01

American Indian and Alaska Native (AI/AN) youth are disproportionally burdened by high rates of sexually transmitted infections and teen pregnancy, heightening their need for sexual health interventions that are aligned to their unique culture and social context. Media technologies, including the Internet, cell phones, and video games, offer new…

Internet-Based Delivery of Evidence-Based Health Promotion Programs Among American Indian and Alaska Native Youth: A Case Study

PubMed Central

Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross

2016-01-01

Background American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. Objective We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet’s potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. Methods This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths’ perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using

Utilizing drumming for American Indians/Alaska Natives with substance use disorders: a focus group study.

PubMed

Dickerson, Daniel; Robichaud, Francis; Teruya, Cheryl; Nagaran, Kathleen; Hser, Yih-Ing

2012-09-01

Drumming has been utilized among American Indian/Alaska Native (AI/AN) tribes for centuries to promote healing and self-expression. Drum-Assisted Recovery Therapy for Native Americans (DARTNA), currently under development, is a substance abuse treatment utilizing drumming as a core component. Focus groups were conducted to assist in the development of the DARTNA protocol. Feedback obtained from these focus groups will inform a subsequent pretest of DARTNA and an empirical study analyzing its effectiveness. Three focus groups were conducted among AIs/ANs with substance use disorders (n = 6), substance abuse treatment providers (n = 8), and a community advisory board (n = 4) to solicit feedback prior to a pretest of the DARTNA protocol. Overall, participants indicated that DARTNA could be beneficial for AIs/ANs with substance use disorders. Four overarching conceptual themes emerged across the focus groups: (1) benefits of drumming, (2) importance of a culture-based focus, (3) addressing gender roles in drumming activities, and (4) providing a foundation of common AI/AN traditions. The DARTNA protocol is a potentially beneficial and culturally appropriate substance abuse treatment strategy for AIs/ANs. In order to optimize the potential benefits of a substance abuse treatment protocol utilizing drumming for AIs/ANs, adequate attention to tribal diversity and gender roles is needed. Due to the shortage of substance abuse treatments utilizing traditional healing activities for AIs/ANs, including drumming, results from this study provide an opportunity to develop an intervention that may meet the unique treatment needs of AIs/ANs.

Diabetes care and outcomes for American Indians and Alaska natives in commercial integrated delivery systems: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) Study.

PubMed

Schmittdiel, Julie A; Steiner, John F; Adams, Alyce S; Dyer, Wendy; Beals, Janette; Henderson, William G; Desai, Jay; Morales, Leo S; Nichols, Gregory A; Lawrence, Jean M; Waitzfelder, Beth; Butler, Melissa G; Pathak, Ram D; Hamman, Richard F; Manson, Spero M

2014-01-01

To compare cardiovascular disease risk factor testing rates and intermediate outcomes of care between American Indian/Alaska Native (AI/AN) patients with diabetes and non-Hispanic Caucasians enrolled in nine commercial integrated delivery systems in the USA. We used modified Poisson regression models to compare the annual testing rates and risk factor control levels for glycated haemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), and systolic blood pressure (SBP); number of unique diabetes drug classes; insulin use; and oral diabetes drug medication adherence between insured AI/AN and non-Hispanic white adults with diabetes aged ≥18 in 2011. 5831 AI/AN patients (1.8% of the cohort) met inclusion criteria. After adjusting for age, gender, comorbidities, insulin use, and geocoded socioeconomic status, AI/AN patients had similar rates of annual HbA1c, LDL-C, and SBP testing, and LDL-C and SBP control, compared with non-Hispanic Caucasians. However, AI/AN patients were significantly more likely to have HbA1c >9% (>74.9 mmol/mol; RR=1.47, 95% CI 1.38 to 1.58), and significantly less likely to adhere to their oral diabetes medications (RR=0.90, 95% CI 0.88 to 0.93) compared with non-Hispanic Caucasians. AI/AN patients in commercial integrated delivery systems have similar blood pressure and cholesterol testing and control, but significantly lower rates of HbA1c control and diabetes medication adherence, compared with non-Hispanic Caucasians. As more AI/ANs move to urban and suburban settings, clinicians and health plans should focus on addressing disparities in diabetes care and outcomes in this population.

Ethics and Community Involvement in Syntheses Concerning American Indian, Alaska Native, or Native Hawaiian Health: A Systematic Review

PubMed Central

Around Him, Deana M.

2014-01-01

Background The objective of the research was to review reporting of ethical concerns and community involvement in peer-reviewed systematic reviews or meta-analyses concerning American Indian, Alaska Native, or Native Hawaiian (AI/AN/NH) health. Methods Text words and indexed vocabulary terms were used to query PubMed, Embase, Cochrane Library, and the Native Health Database for systematic reviews or meta-analyses concerning AI/AN/NH health published in peer-reviewed journals, followed by a search through reference lists. Each article was abstracted by two independent reviewers; results were discussed until consensus was reached. Results We identified 107 papers published from 1986–2012 that were primarily about AI/AN/NH health or presented findings separately for AI/AN/NH communities. Two reported seeking indigenous reviewer feedback; none reported seeking input from tribes and communities. Approximately 7% reported on institutional review board (IRB) approval of included studies, 5% reported on tribal approval, and 4% referenced the sovereignty of AI/AN tribes. Approximately 63% used evidence from more than one AI/AN/NH population study, and 28% discussed potential benefits to communities from the synthesis research. Conclusions Reporting of ethics and community involvement are not prominent. Systematic reviews and meta-analyses making community-level inferences may pose risks to communities. Future systematic reviews and meta-analyses should consider ethical and participatory dimensions of research. PMID:25089283

Alaska Native Water Rights as Affected by the Alaska Native Claims Settlement Act

ERIC Educational Resources Information Center

Stoebner, Kerry; And Others

1978-01-01

A strong legal claim exists for retained Native water rights on Alaska Native-selected lands which are paramount to subsequent competing users. Water rights are critical to the maintenance of Native subsistence economies and continued commercial developments. These water rights can and must be asserted and secured now. (Author/JC)

Psychosocial Predictors of Weight Loss among American Indian and Alaska Native Participants in a Diabetes Prevention Translational Project

PubMed Central

Dill, Edward J.; Manson, Spero M.; Jiang, Luohua; Pratte, Katherine A.; Gutilla, Margaret J.; Knepper, Stephanie L.; Beals, Janette; Roubideaux, Yvette; Special Diabetes Program for Indians Diabetes Prevention Demonstration Project

2016-01-01

The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality) with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs) in a diabetes prevention translational project was investigated. Participants (n = 3,135) were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components. PMID:26649314

Five Steps to Community Assessment for American Indian/Alaskan Native Head Start Programs

ERIC Educational Resources Information Center

Academy for Educational Development, 2006

2006-01-01

The Community Assessment (CA) is the collection and analysis of information on the characteristics and needs of American Indian/Alaska Native (AIAN) Head Start/Early Head Start (HS/EHS) eligible children and families in the grantee service area and the resources available to meet those needs. The primary purpose of conducting a Community…

Through the Lens of TEK - Building GeoScience Pathways for American Indian/Alaska Native Students

NASA Astrophysics Data System (ADS)

Thomas, W. J.; van Cooten, S.; Wrege, B.; Wildcat, D.

2017-12-01

Native American or American Indian/Alaska Native (AI/AN) students come from diverse communities with indigenous knowledges, perspectives and worldviews. These communities and the students they send into our nation's education systems have cultural connectivity to oral histories, documents, and artwork that details climate cycles and weather events prior to colonization through eras of forced relocation and assimilation. Today, these students are the trailblazers as tribal governments exercise their ownership rights to natural resources and the welfare of their citizens as sovereign nations. In universities, especially tribal colleges, our nation's indigenous students are bridge builders. Through the lens of Traditional Ecological Knowledge (TEK), these students have a unique yet overlooked perspective to merge mainstream research with indigenous knowledge systems to develop practical sustainable solutions for local, regional and international resource management issues. The panel will discuss barriers, such as underdeveloped geophysical science curricula at tribal colleges, that limit the pool of indigenous geoscience graduates and examine possible strategies such as entry point opportunities and partnerships, mentoring, and community relevant research experiences, to eliminate barriers that limit the influx of TEK in resiliency planning.

Diabetes care and outcomes for American Indians and Alaska natives in commercial integrated delivery systems: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) Study

PubMed Central

Schmittdiel, Julie A; Steiner, John F; Adams, Alyce S; Dyer, Wendy; Beals, Janette; Henderson, William G; Desai, Jay; Morales, Leo S; Nichols, Gregory A; Lawrence, Jean M; Waitzfelder, Beth; Butler, Melissa G; Pathak, Ram D; Hamman, Richard F; Manson, Spero M

2014-01-01

Objective To compare cardiovascular disease risk factor testing rates and intermediate outcomes of care between American Indian/Alaska Native (AI/AN) patients with diabetes and non-Hispanic Caucasians enrolled in nine commercial integrated delivery systems in the USA. Research design and methods We used modified Poisson regression models to compare the annual testing rates and risk factor control levels for glycated haemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), and systolic blood pressure (SBP); number of unique diabetes drug classes; insulin use; and oral diabetes drug medication adherence between insured AI/AN and non-Hispanic white adults with diabetes aged ≥18 in 2011. Results 5831 AI/AN patients (1.8% of the cohort) met inclusion criteria. After adjusting for age, gender, comorbidities, insulin use, and geocoded socioeconomic status, AI/AN patients had similar rates of annual HbA1c, LDL-C, and SBP testing, and LDL-C and SBP control, compared with non-Hispanic Caucasians. However, AI/AN patients were significantly more likely to have HbA1c >9% (>74.9 mmol/mol; RR=1.47, 95% CI 1.38 to 1.58), and significantly less likely to adhere to their oral diabetes medications (RR=0.90, 95% CI 0.88 to 0.93) compared with non-Hispanic Caucasians. Conclusions AI/AN patients in commercial integrated delivery systems have similar blood pressure and cholesterol testing and control, but significantly lower rates of HbA1c control and diabetes medication adherence, compared with non-Hispanic Caucasians. As more AI/ANs move to urban and suburban settings, clinicians and health plans should focus on addressing disparities in diabetes care and outcomes in this population. PMID:25452877

Internet-Based Delivery of Evidence-Based Health Promotion Programs Among American Indian and Alaska Native Youth: A Case Study.

PubMed

Markham, Christine M; Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross

2016-11-21

American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet's potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths' perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using previously established measures. Sites

Recruitment and retention of Alaska natives into nursing (RRANN).

PubMed

DeLapp, Tina; Hautman, Mary Ann; Anderson, Mary Sue

2008-07-01

In recognition of the severe underrepresentation of Alaska Natives in the Alaska RN workforce, the University of Alaska Anchorage School of Nursing implemented Project RRANN (Recruitment and Retention of Alaska Natives into Nursing) to recruit Alaska Natives into a nursing career and to facilitate their success in the nursing programs. Activities that created connections and facilitated student success were implemented. Connection-creating activities included establishing community partnerships, sponsoring a dormitory wing, hosting social and professionally related events, and offering stipends. Success facilitation activities included intensive academic advising, tutoring, and mentoring. The effectiveness of Project RRANN is evident in the 66 Alaska Native/American Indian students admitted to the clinical major since 1998, when Project RRANN was initiated; of those, 70% have completed the major and become licensed, and 23% continue to pursue program completion.

Expanding Job Opportunities for Alaska Natives. (Interim Report).

ERIC Educational Resources Information Center

McDiarmid, G. Williamson; Goldsmith, Scott; Killorin, Mary; Sharp, Suzanne; Hild, Carl

A majority of adults in most Alaska Native villages were without jobs in 1990, and the situation was probably not substantially better in 1998. This report summarizes current Alaska Native employment data and employment trends, provides information on public and private programs that target Native hire, and describes promising approaches for…

Occurrence of Endocrine and Thyroid Cancers Among Alaska Native People, 1969-2013.

PubMed

Nash, Sarah H; Lanier, Anne P; Southworth, Molly B

2018-04-01

Nationwide, the incidence of thyroid cancer is lower among American Indian/Alaska Native (AI/AN) people than among U.S. whites (USW). However, little is known about the incidence of thyroid or other endocrine cancers specifically among Alaska Native (AN) people. Data were examined from the National Cancer Institute's Surveillance, Epidemiology, and End Results Alaska Native Tumor Registry on endocrine cancers diagnosed among AN people from 1969-2013, with a specific focus on thyroid cancers. Frequencies of endocrine cancers by site and also of thyroid cancers by histology, size, and stage at diagnosis were evaluated. Distributions were compared to USW (Surveillance, Epidemiology, and End Results 9 Registries) using the chi-square test. Five-year average annual age-adjusted incidence rates of thyroid cancers were calculated, stratified by histology, age, and five-year period of diagnosis, and compared to those observed among USW. Five-year cause-specific survival was evaluated using cause of death data from the National Death Index Plus from the National Center for Health Statistics. During the 45-year period (1969-2013), 224 endocrine cancers were diagnosed among AN people, of which 210 (94%) were thyroid cancers. Compared to USW, AN people were diagnosed at a slightly younger age, had a higher proportion of thyroid cancers diagnosed with a size of 20-40 mm, and a larger proportion of patients with regional metastases. More than 85% of AN thyroid cancers were of papillary histology. The incidence of thyroid cancers was similar between AN people and USW, and appeared to increase among AN people over the period of surveillance. Finally, five-year cause-specific survival rate was 100% for papillary carcinoma patients and 86.3% [confidence interval 54.7-96.5] for follicular thyroid cancer patients. This study is the first report of endocrine cancers and the first detailed examination of thyroid cancer among AN people. The incidence of thyroid cancer was similar among

Alaska Native Land Claims. [Textbook].

ERIC Educational Resources Information Center

Arnold, Robert D.; And Others

Written for students at the secondary level, this textbook on Alaska Native land claims includes nine chapters, eight appendices, photographs, maps, graphs, bibliography, and an index. Chapters are titled as follows: (1) Earliest Times (Alaska's first settlers, eighteenth century territories, and other claimants); (2) American Indians and Their…

Satisfaction with cancer care among American Indian and Alaska Natives in Oregon and Washington State: a qualitative study of survivor and caregiver perspectives.

PubMed

Hohl, Sarah; Molina, Yamile; Koepl, Lisel; Lopez, Kerri; Vinson, Eric; Linden, Hannah; Ramsey, Scott

2016-06-01

To better understand satisfaction with care among American Indian and Alaska Native (AI/AN) persons with cancer, we explored dimensions of the provider relationship that contributed to satisfaction among caregivers and survivors who received cancer treatment in Oregon and Washington State. Between November 2011 and April 2013, the project team interviewed 11 caregivers and 71 AI/AN cancer survivors residing in Oregon and Washington State. Interview questions aimed to elicit participant experiences with care providers and factors associated with cancer care satisfaction. Interviews were analyzed using an inductive content analysis approach in which concepts were identified and themes derived from interview data. Three overarching themes, each with two sub-themes, emerged from the data: (1) universal factors: bolstering understanding, involvement, and empathy in care; (2) minority-specific factors: incorporating culture and community into care; and (3) AI/AN-unique factors: interacting with Indian health clinics and Indian Health Service (IHS). The results of our study suggest that satisfaction with care among survivors and their caregivers must be examined within the context of culture and community, particularly among minority patients. Our study demonstrates providers' critical role in ensuring AI/AN patients emerge satisfied with cancer treatment by honoring their AI/AN-specific needs, such as respect for integration of traditional healing modalities and navigation of specialty care coordination.

Satisfaction with cancer care among American Indian and Alaska Natives in Oregon and Washington State: a qualitative study of survivor and caregiver perspectives

PubMed Central

Molina, Yamile; Koepl, Lisel; Lopez, Kerri; Vinson, Eric; Linden, Hannah; Ramsey, Scott

2016-01-01

Purpose To better understand satisfaction with care among American Indian and Alaska Native (AI/AN) persons with cancer, we explored dimensions of the provider relationship that contributed to satisfaction among caregivers and survivors who received cancer treatment in Oregon and Washington State. Methods Between November 2011 and April 2013, the project team interviewed 11 caregivers and 71 AI/AN cancer survivors residing in Oregon and Washington State. Interview questions aimed to elicit participant experiences with care providers and factors associated with cancer care satisfaction. Interviews were analyzed using an inductive content analysis approach in which concepts were identified and themes derived from interview data. Results Three overarching themes, each with two sub-themes, emerged from the data: (1) universal factors: bolstering understanding, involvement, and empathy in care; (2) minority-specific factors: incorporating culture and community into care; and (3) AI/AN-unique factors: interacting with Indian health clinics and Indian Health Service (IHS). Conclusions The results of our study suggest that satisfaction with care among survivors and their caregivers must be examined within the context of culture and community, particularly among minority patients. Our study demonstrates providers’ critical role in ensuring AI/AN patients emerge satisfied with cancer treatment by honoring their AI/AN-specific needs, such as respect for integration of traditional healing modalities and navigation of specialty care coordination. PMID:26638004

College Persistence of Alaska Native Students: An Assessment of the Rural Alaska Honors Institute, 1983-88.

ERIC Educational Resources Information Center

Gaylord, Thomas A.; Kaul, Gitanjali

Despite efforts by educators, full participation by Alaska native students in the state's colleges and universities has not yet been achieved. Alaska Natives are the state's only racial group that is underrepresented in enrollments at the University of Alaska (UA). This report examines the contribution of the Rural Alaska Honors Institute (RAHI)…

Growing our own: building a native research team.

PubMed

Gray, Jacqueline S; Carter, Paula M

2012-01-01

In 2006, American Indian/Alaska Natives (AI/AN) made up less than 1% of the science, engineering and health doctorates in the U.S. Early introduction of AI/AN students to research and continued opportunities are necessary to develop successful AI/AN researchers who can better serve their communities. This team was developed to form a cohort of American Indian students, staff and faculty interested in research and becoming researchers. Since implementation, the program grew from one student to over 20 AI students ranging from freshmen just entering college to doctoral students working to complete their dissertations. This article highlights the team growth, increasing structure, student needs and the faculty and staff involved. It further addresses the support and educational aspects of growing an ongoing, multidisciplinary research team committed to ethical research in Native communities. The team addresses substance use prevalence, the relationship of substance abuse to other mental health diagnoses, and treatment issues. The team includes weekly team meetings, a Blackboard site on the Internet that is populated with resources and focused on sharing materials and information, a weekly journal club discussion of research articles, and collaborative discussions on each project and the barriers and challenges that need to be addressed to move forward.

78 FR 70956 - 30-Day Notice of Proposed Information Collection: Assessment of Native American, Alaska Native...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-27

... Information Collection: Assessment of Native American, Alaska Native and Native Hawaiian Housing Needs AGENCY... subcontractors, NORC, Econometrica and SSI. The project is a housing needs assessment that will produce national.... Overview of Information Collection Title of Information Collection: Assessment of Native American, Alaska...

Challenges of hepatitis C treatment in Native Americans in two North Dakota medical facilities.

PubMed

Hossain, S; Jalil, S; Guerrero, D M; Sahmoun, A E

2014-01-01

The prevalence of chronic liver disease (CLD) in the Aboriginal North American population is disproportionately higher than that of the non-indigenous population. Hepatitis C virus (HCV) is the second leading cause of CLD in American Indians or Alaska Natives (AIANs). This study described the experience of two teaching community medical centers in North Dakota in treating HCV infection among AIANs and compared treatment outcomes to a cohort of Caucasian patients. The retrospective study described the characteristics and proportion of AIAN patients with HCV who received treatment. Documented reasons for not receiving treatment were analyzed. For those AIAN patients treated for HCV infection, responses to treatment, including rapid, early and sustained virological responses (SVRs), were compared with those of Caucasians. Only 22 (18%) of 124 AIANs with HCV infection received treatment. Common reasons for not receiving treatment include lack of access to specialists, concomitant or decompensated liver disease, alcohol and drug abuse and cost. There were no significant differences in the baseline characteristics and key predictors of SVR in AIANs compared to Caucasian controls. Most AIAN patients with HCV infection do not receive treatment despite comparable treatment response rates to Caucasians. Further population-based studies, addressing access to specialized hepatitis C treatment and public health concerns are warranted, as it is crucial to treat chronic HCV infection to decrease the burden of disease in the AIAN community.

Alaska Native Villages and Rural Communities Water Grant Program

EPA Pesticide Factsheets

Significant human health and water quality problems exist in Alaska Native Village and other rural communities in the state due to lack of sanitation. To address these issues, EPA created the Alaska Rural and Native Villages Grant Program.

Cultural Identity among Urban American Indian/Native Alaskan Youth: Implications for Alcohol and Drug Use

PubMed Central

Brown, Ryan A.; Dickerson, Daniel L.; D’Amico, Elizabeth J.

2016-01-01

American Indian and Alaska Native (AI/AN) youth exhibit high rates of alcohol and other drug (AOD) use, which is often linked to the social and cultural upheaval experienced by AI/ANs during the colonization of North America. Urban AI/AN youth may face unique challenges, including increased acculturative stress due to lower concentrations of AI/AN populations in urban areas. Few existing studies have explored cultural identity among urban AI/AN youth and its association with AOD use. Objectives This study used systematic qualitative methods with AI/AN communities in two urban areas within California to shed light on how urban AI/AN youth construct cultural identity and how this relates to AOD use and risk behaviors. Methods We conducted 10 focus groups with a total of 70 youth, parents, providers, and Community Advisory Board members and used team-based structured thematic analysis in the Dedoose software platform. Results We identified 12 themes: intergenerational stressors, cultural disconnection, AI/AN identity as protective, pan-tribal identity, mixed racial-ethnic identity, rural vs. urban environments, the importance of AI/AN institutions, stereotypes and harassment, cultural pride, developmental trajectories, risks of being AI/AN, and mainstream culture clash. Overall, youth voiced curiosity about their AI/AN roots and expressed interest in deepening their involvement in cultural activities. Adults described the myriad ways in which involvement in cultural activities provides therapeutic benefits for AI/AN youth. Conclusions Interventions that provide urban AI/AN youth with an opportunity to engage in cultural activities and connect with positive and healthy constructs in AI/AN culture may provide added impact to existing interventions. PMID:27450682

American Indian/Alaska Native Elders: A Growing Demographic that Is Changing How We View Aging.

PubMed

Lewis, Jordan P

2016-01-01

Today, AIAN Elders are more actively engaged in their families and communities, encouraging the development of intergenerational programs, language and cultural revitalization, being stewards in research conducted in their communities, as well passing on their knowledge and experiences on how to live as healthy Native people. Elders have traditionally been quiet and observant of their environment, but the current and future cohorts of Elders are advocates, leaders, and culture bearers for their families and communities and they are now in positions of leadership. Western society acknowledges the value of traditional knowledge and AIAN Elders are viewed as exemplars of healthy aging and their lessons and experiences can be attributed to our own lives. This commentary highlights the paradigm shift in how society views older adults, specifically AIAN Elders and their role in health and wellbeing.

Building Alaska's Science and Engineering Pipeline: Evaluation of the Alaska Native Science & Engineering Program

ERIC Educational Resources Information Center

Bernstein, Hamutal; Martin, Carlos; Eyster, Lauren; Anderson, Theresa; Owen, Stephanie; Martin-Caughey, Amanda

2015-01-01

The Urban Institute conducted an implementation and participant-outcomes evaluation of the Alaska Native Science & Engineering Program (ANSEP). ANSEP is a multi-stage initiative designed to prepare and support Alaska Native students from middle school through graduate school to succeed in science, technology, engineering, and math (STEM)…

Yesterday Still Lives...Our Native People Remember Alaska.

ERIC Educational Resources Information Center

DeMarco, Pat, Ed.; And Others

In the summer of 1978, seven teenagers and several staff members from the Fairbanks Native Association-Johnson O'Malley program set out to record some of Alaska's past by interviewing a number of older Alaska Natives and writing their biographical sketches. Some of the students spent a week along the Yukon River taping and photographing people;…

75 FR 33589 - Office of Postsecondary Education; Overview Information; Alaska Native-Serving and Native...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... facilitate the transition between high school and college or career pathways programs that integrate basic... under this notice. At the time of application, an Alaska Native-Serving institution must have an enrollment of undergraduate students that is at least twenty percent (20%) Alaska Native. At the time of...

Potentially violent disagreements and parenting stress among American Indian/Alaska Native families: analysis across seven states.

PubMed

Probst, Janice C; Wang, Jong-Yi; Martin, Amy B; Moore, Charity G; Paul, Barbara Morningstar; Samuels, Michael E

2008-07-01

We examined the prevalence and correlates of potentially violent disagreements among AI/AN families with children. We conducted a cross-sectional examination of data from the 2003 National Survey of Children's Health, limited to seven states for which AI/AN race/ethnicity was available in public use files (Alaska, Arizona, Montana, New Mexico, North Dakota, Oklahoma, and South Dakota). Disagreements were classified based on how the family deals with conflict. If disagreements involved actual (hitting) or symbolic (throwing) violence, even rarely, the household was categorized as having "potentially violent disagreements," with heated argument and shouting being classified as "heated disagreement." Parenting stress and demographic characteristics were included as potential correlates. Potentially violent disagreements were reported by 8.4% of AI/AN and 8.4% of white families. The odds for potentially violent disagreements were markedly higher among parents reporting high parenting stress, in both AI/AN (OR 7.20; CI 3.45-15.00) and white (3.59, CI 2.71-4.75) families. High parenting stress had similar effects on the odds for heated discussion. Having a child with special health care needs was associated with parenting stress. Questions about disagreement style may be useful as potential screens for domestic violence.

Advocacy for Native American Indian and Alaska Native Clients and Counselees.

ERIC Educational Resources Information Center

Herring, Roger

Helping professionals need to be more informed and more active advocates for proactive counseling strategies with Native American Indian and Alaska Native peoples. The paper discusses the major advocacy needs of these populations. The negative impact of historical and contemporary discriminatory policies and practices on Native peoples has…

36 CFR 219.15 - Interaction with American Indian tribes and Alaska Natives.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Indian tribes and Alaska Natives. 219.15 Section 219.15 Parks, Forests, and Public Property FOREST... Collaborative Planning for Sustainability § 219.15 Interaction with American Indian tribes and Alaska Natives... recognized American Indian tribes and Alaska Natives. (b) During planning, the responsible official must...

Native Alaska's Floating Factoryship--She Plies the Pacific Ocean for Native Alaska.

ERIC Educational Resources Information Center

Wassaja, The Indian Historian, 1980

1980-01-01

Describes the history of the Al-Ind-Esk-A Sea, a floating fish processing factory representing a major hope for the economic independence of Alaska Natives residing outside the state. Discusses employment practices in effect on the ship. Notes interesting facts about the ship's engines and fittings. (SB)

Alaska Native Participation in the Civilian Conservation Corps. Alaska Historical Commission Studies in History No. 206.

ERIC Educational Resources Information Center

Sorensen, Connor; And Others

The report is a finding aid to the sources which document the 1937 federal policy decision mandating that 50% of the enrollees in the Civilian Conservation Corps (CCC) in Alaska must be Alaska Natives and provides a list of the Native CCC projects in Alaska. The finding aid section is organized according to the location of the collections and…

Tobacco cessation intervention during pregnancy among Alaska Native women.

PubMed

Patten, Christi A

2012-04-01

This paper describes a community-based participatory research program with Alaska Native people addressing a community need to reduce tobacco use among pregnant women and children. Tobacco use during pregnancy among Alaska Native women is described along with development of a community partnership, findings from a pilot tobacco cessation intervention, current work, and future directions. Among Alaska Native women residing in the Yukon Kuskokwim Delta region of western Alaska, the prevalence of tobacco use (cigarette smoking and/or use of smokeless tobacco) during pregnancy is 79%. Results from a pilot intervention study targeting pregnant women indicated low rates of participation and less than optimal tobacco abstinence outcomes. Developing alternative strategies to reach pregnant women and to enhance the efficacy of interventions is a community priority, and future directions are offered.

Tobacco Cessation Intervention During Pregnancy Among Alaska Native Women

PubMed Central

2014-01-01

This paper describes a community-based participatory research program with Alaska Native people addressing a community need to reduce tobacco use among pregnant women and children. Tobacco use during pregnancy among Alaska Native women is described along with development of a community partnership, findings from a pilot tobacco cessation intervention, current work, and future directions. Among Alaska Native women residing in the Yukon Kuskokwim Delta region of western Alaska, the prevalence of tobacco use (cigarette smoking and/or use of smokeless tobacco) during pregnancy is 79%. Results from a pilot intervention study targeting pregnant women indicated low rates of participation and less than optimal tobacco abstinence outcomes. Developing alternative strategies to reach pregnant women and to enhance the efficacy of interventions is a community priority, and future directions are offered. PMID:22311690

Use of Media Technologies by Native American Teens and Young Adults in the Pacific Northwest: Exploring Their Utility for Designing Culturally Appropriate Technology-Based Health Interventions

ERIC Educational Resources Information Center

Rushing, Stephanie Craig; Stephens, David

2011-01-01

American Indian and Alaska Native (AI/AN) youth are disproportionally burdened by many common adolescent health issues, including drug and alcohol use, injury and violence, sexually transmitted infections, and teen pregnancy. Media technologies, including the Internet, cell phones, and video games, offer new avenues for reaching adolescents on a…

Address to Yukon-Kuskokwim Delta Regional Summit on Native Education (Bethel, Alaska, April 24, 2002).

ERIC Educational Resources Information Center

Ongtooguk, Paul

Remarks of Alaska Native researcher and educator Paul Ongtooguk are presented. Alaska Native students perform worse on exit exams than any other population in the state. In the past, formal education was offered to Alaska Natives only if they gave up being Alaska Natives. The current system is not designed to solve the problems of Alaska Native…

26 CFR 1.1502-81T - Alaska Native Corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 12 2010-04-01 2010-04-01 false Alaska Native Corporations. 1.1502-81T Section... Corporations. (a) General Rule. The application of section 60(b)(5) of the Tax Reform Act of 1984 and section 1804(e)(4) of the Tax Reform Act of 1986 (relating to Native Corporations established under the Alaska...

Metabolic syndrome: prevalence among American Indian and Alaska native people living in the southwestern United States and in Alaska.

PubMed

Schumacher, Catherine; Ferucci, Elizabeth D; Lanier, Anne P; Slattery, Martha L; Schraer, Cynthia D; Raymer, Terry W; Dillard, Denise; Murtaugh, Maureen A; Tom-Orme, Lillian

2008-12-01

Metabolic syndrome occurs commonly in the United States. The purpose of this study was to measure the prevalence of metabolic syndrome among American Indian and Alaska Native people. We measured the prevalence rates of metabolic syndrome, as defined by the National Cholesterol Education Program, among four groups of American Indian and Alaska Native people aged 20 years and older. One group was from the southwestern United States (Navajo Nation), and three groups resided within Alaska. Prevalence rates were age-adjusted to the U.S. adult 2000 population and compared to rates for U.S. whites (National Health and Nutrition Examination Survey [NHANES] 1988-1994). Among participants from the southwestern United States, metabolic syndrome was found among 43.2% of men and 47.3% of women. Among Alaska Native people, metabolic syndrome was found among 26.5% of men and 31.2% of women. In Alaska, the prevalence rate varied by region, ranging among men from 18.9% (western Alaska) to 35.1% (southeast), and among women from 22.0% (western Alaska) to 38.4 % (southeast). Compared to U.S. whites, American Indian/Alaska Native men and women from all regions except western Alaska were more likely to have metabolic syndrome; men in western Alaska were less likely to have metabolic syndrome than U.S. whites, and the prevalence among women in western Alaska was similar to that of U.S. whites. The prevalence rate of metabolic syndrome varies widely among different American Indian and Alaska Native populations. Differences paralleled differences in the prevalence rates of diabetes.

MRSA USA300 at Alaska Native Medical Center, Anchorage, Alaska, USA, 2000–2006

PubMed Central

Rudolph, Karen M.; Hennessy, Thomas W.; Zychowski, Diana L.; Asthi, Karthik; Boyle-Vavra, Susan; Daum, Robert S.

2012-01-01

To determine whether methicillin-resistant Staphylococcus aureus (MRSA) USA300 commonly caused infections among Alaska Natives, we examined clinical MRSA isolates from the Alaska Native Medical Center, Anchorage, during 2000–2006. Among Anchorage-region residents, USA300 was a minor constituent among MRSA isolates in 2000–2003 (11/68, 16%); by 2006, USA300 was the exclusive genotype identified (10/10). PMID:22264651

33 CFR 203.16 - Federally recognized Indian Tribes and the Alaska Native Corporations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Tribes and the Alaska Native Corporations. 203.16 Section 203.16 Navigation and Navigable Waters CORPS OF..., NATURAL DISASTER PROCEDURES Introduction § 203.16 Federally recognized Indian Tribes and the Alaska Native... recognized Indian Tribe or Alaska Native Corporation, or through the appropriate regional representative of...

33 CFR 203.16 - Federally recognized Indian Tribes and the Alaska Native Corporations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Tribes and the Alaska Native Corporations. 203.16 Section 203.16 Navigation and Navigable Waters CORPS OF..., NATURAL DISASTER PROCEDURES Introduction § 203.16 Federally recognized Indian Tribes and the Alaska Native... recognized Indian Tribe or Alaska Native Corporation, or through the appropriate regional representative of...

33 CFR 203.16 - Federally recognized Indian Tribes and the Alaska Native Corporations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Tribes and the Alaska Native Corporations. 203.16 Section 203.16 Navigation and Navigable Waters CORPS OF..., NATURAL DISASTER PROCEDURES Introduction § 203.16 Federally recognized Indian Tribes and the Alaska Native... recognized Indian Tribe or Alaska Native Corporation, or through the appropriate regional representative of...

33 CFR 203.16 - Federally recognized Indian Tribes and the Alaska Native Corporations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Tribes and the Alaska Native Corporations. 203.16 Section 203.16 Navigation and Navigable Waters CORPS OF..., NATURAL DISASTER PROCEDURES Introduction § 203.16 Federally recognized Indian Tribes and the Alaska Native... recognized Indian Tribe or Alaska Native Corporation, or through the appropriate regional representative of...

Smoking-related knowledge, attitudes, and behaviors among Alaska Native people: a population-based study.

PubMed

Rohde, Kristen; Boles, Myde; Bushore, Chris J; Pizacani, Barbara A; Maher, Julie E; Peterson, Erin

2013-01-01

Several studies have shown that Alaska Native people have higher smoking prevalence than non-Natives. However, no population-based studies have explored whether smoking-related knowledge, attitudes, and behaviors also differ among Alaska Native people and non-Natives. We compared current smoking prevalence and smoking-related knowledge, attitudes, and behavior of Alaska Native adults living in the state of Alaska with non-Natives. We used Alaska Behavioral Risk Factor Surveillance System data for 1996 to 2010 to compare smoking prevalence, consumption, and cessation- and second-hand smoke-related knowledge, attitudes, and behaviors among self-identified Alaska Native people and non-Natives. Current smoking prevalence was 41% (95% CI: 37.9%-44.4%) among Alaska Native people compared with 17.1% (95% CI: 15.9%-18.4%) among non-Natives. Among current every day smokers, Alaska Natives were much more likely to smoke less than 10 cigarettes per day (OR = 5.0, 95% CI: 2.6-9.6) than non-Natives. Compared with non-Native smokers, Alaska Native smokers were as likely to have made a past year quit attempt (OR = 1.4, 95% CI: 0.9-2.1), but the attempt was less likely to be successful (OR = 0.5, 95% CI: 0.2-0.9). Among current smokers, Alaska Natives were more likely to believe second-hand smoke (SHS) was very harmful (OR = 4.5, 95% CI: 2.8-7.2), to believe that smoking should not be allowed in indoor work areas (OR = 1.9, 95% CI: 1.1-3.1) or in restaurants (OR = 4.2, 95% CI: 2.5-6.9), to have a home smoking ban (OR = 2.5, 95% CI: 1.6-3.9), and to have no home exposure to SHS in the past 30 days (OR = 2.3, 95% CI: 1.5-3.6) than non-Natives. Although a disparity in current smoking exists, Alaska Native people have smoking-related knowledge, attitudes, and behaviors that are encouraging for reducing the burden of smoking in this population. Programs should support efforts to promote cessation, prevent relapse, and establish smoke-free environments.

Promoting healing and restoring trust: policy recommendations for improving behavioral health care for American Indian/Alaska Native adolescents.

PubMed

Goodkind, Jessica R; Ross-Toledo, Kimberly; John, Susie; Hall, Janie Lee; Ross, Lucille; Freeland, Lance; Coletta, Ernest; Becenti-Fundark, Twila; Poola, Charlene; Begay-Roanhorse, Regina; Lee, Christopher

2010-12-01

American Indian/Alaska Native youth represent the strength and continued survival of many Nations and Tribes. However, they currently experience numerous health disparities and challenges, including the highest rate of suicide among 15-24 year-olds in the United States. Our comprehensive review of the literature on the mental health of AI/AN youth highlighted seven focal causes of behavioral health disparities: (1) high levels of violence and trauma exposure and traumatic loss, (2) past and current oppression, racism, and discrimination, (3) underfunded systems of care, (4) disregard for effective indigenous practices in service provision, policy, and funding, (5) overreliance on evidence-based practices, (6) lack of cultural competence among systems of care and providers, and (7) barriers to care. Seven policy recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and that seek to foster transformation of individuals, families, communities, behavioral health service systems of care, and social structures are presented, supported, and discussed.

PROMOTING HEALING AND RESTORING TRUST:POLICY RECOMMENDATIONS FOR IMPROVING BEHAVIORAL HEALTH CARE FOR AMERICAN INDIAN/ALASKA NATIVE ADOLESCENTS

PubMed Central

Goodkind, Jessica R.; Ross-Toledo, Kimberly; John, Susie; Hall, Janie Lee; Ross, Lucille; Freeland, Lance; Coletta, Ernest; Becenti-Fundark, Twila; Poola, Charlene; Begay-Roanhorse, Regina; Lee, Christopher

2011-01-01

American Indian/Alaska Native youth represent the strength and continued survival of many Nations and Tribes. However, they currently experience numerous health disparities and challenges, including the highest rate of suicide among 15 to 24 year-olds in the United States. Our comprehensive review of the literature on the mental health of AI/AN youth highlighted seven focal causes of behavioral health disparities: 1) high levels of violence and trauma exposure and traumatic loss, 2) past and current oppression, racism, and discrimination, 3) underfunded systems of care, 4) disregard for effective indigenous practices in service provision, policy, and funding, 5) overreliance on evidence-based practices, 6) lack of cultural competence among systems of care and providers, and 7) barriers to care. Seven policy recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and that seek to foster transformation of individuals, families, communities, behavioral health service systems of care, and social structures are presented, supported, and discussed. PMID:20857331

77 FR 19020 - Tribal Consultation Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-29

... each of the nine geographic regions of Head Start where American Indian and Alaska Native (AI/AN... the statutory purposes of Head Start Tribal Consultations related to meeting the needs of AI/AN...

77 FR 23265 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... utilization of Medicare services by American Indian and Alaska Native (AI/AN) beneficiaries, to identify and... evaluated previously by any agency or individual, so data on the extent of transportation barriers for rural AI/AN beneficiaries to Medicare services by AI/AN Medicare beneficiaries are not available except...

Blood politics, ethnic identity, and racial misclassification among American Indians and Alaska Natives.

PubMed

Haozous, Emily A; Strickland, Carolyn J; Palacios, Janelle F; Solomon, Teshia G Arambula

2014-01-01

Misclassification of race in medical and mortality records has long been documented as an issue in American Indian/Alaska Native data. Yet, little has been shared in a cohesive narrative which outlines why misclassification of American Indian/Alaska Native identity occurs. The purpose of this paper is to provide a summary of the current state of the science in racial misclassification among American Indians and Alaska Natives. We also provide a historical context on the importance of this problem and describe the ongoing political processes that both affect racial misclassification and contribute to the context of American Indian and Alaska Native identity.

Pilot test of a cervical cancer prevention video developed for Alaska Native women.

PubMed Central

Stillwater, B; Echavarria, V A; Lanier, A P

1995-01-01

Cancer of the cervix is twice as likely to occur among Alaska Native women than among Caucasian women in the United State. To understand some of the factors associated with this high incidence, a random sample of 528 Alaska Native women were surveyed about their knowledge, attitudes, and behavior regarding cervical cancer and its risk factors. From the results of the Alaska Native Women's Health Project study, the need for more public education related to cervical cancer prevention was identified. A review of existing educational resources revealed that no culturally appropriate materials related to cervical cancer had been developed for Alaska Native women. To increase Native women's knowledge about cervical cancer and to motivate them to obtain annual Papanicolaou tests, a 12-minute videotape presentation was developed specifically for this population. The videotape portrayed Alaska Native women as role models from the community discussing cervical cancer and Papanicolaou tests and engaging in healthy lifestyles. The videotape was pilot tested with several groups of Alaska Native women. The women were surveyed before and after watching the video and were asked to rate the tape and make comments about it. The results of the posttest demonstrated a significant increase in the knowledge level of the participants. The videotape was well received because of its cultural sensitivity and appropriateness. On the basis of this study, the development of additional culturally appropriate educational materials related to cancer prevention of Alaska Native women is recommended. Images p213-a PMID:7631000

Alcohol/Drug Exposure, HIV-Related Sexual Risk among Urban American Indian and Alaska Native Youth: Evidence from a National Survey

ERIC Educational Resources Information Center

Ramisetty-Mikler, Suhasini; Ebama, Malembe S.

2011-01-01

Background: Migration of the native populations from reservations to the urban areas has resulted in mixed ethnicities of American Indian/Alaskan Native (AIAN) children. Minority youth require special attention and services in urban schools as they disproportionately experience poverty, low educational attainment, unemployment, and single-parent…

Racial discrimination's influence on smoking rates among American Indian Alaska Native two-spirit individuals: does pain play a role?

PubMed

Johnson-Jennings, Michelle D; Belcourt, Annie; Town, Matthew; Walls, Melissa L; Walters, Karina L

2014-11-01

High rates of racial discrimination and non-ceremonial tobacco smoking exist among American Indian/Alaska Native (AIAN) Two-Spirit/LGBT (Lesbian, Gay, Bisexual, Transgender) populations. The authors examined whether or not pain mediates between racial discrimination and smoking among Two-Spirits. Two-Spirit adults (n=447) from seven urban U.S. locations were surveyed during the HONOR project. The Indigenist stress coping model was used as framework in which to conduct descriptive, bivariate and regression analyses. A majority of the participants reported smoking (45.2%) and pain (57%). Pain was found to mediate the association between racial discrimination and smoking. Racial discrimination appears to be a significant factor influencing tobacco smoking and health behaviors within Two-Spirit populations. Effective tobacco cessation and/or prevention planning for Two-Spirits and others who experience frequent racial discrimination, stress, and trauma should also consider the influence of pain. Pain may serve as the embodiment of discrimination, and this possibility requires future research

Blood Politics, Ethnic Identity, and Racial Misclassification among American Indians and Alaska Natives

PubMed Central

Haozous, Emily A.; Strickland, Carolyn J.; Palacios, Janelle F.; Solomon, Teshia G. Arambula

2014-01-01

Misclassification of race in medical and mortality records has long been documented as an issue in American Indian/Alaska Native data. Yet, little has been shared in a cohesive narrative which outlines why misclassification of American Indian/Alaska Native identity occurs. The purpose of this paper is to provide a summary of the current state of the science in racial misclassification among American Indians and Alaska Natives. We also provide a historical context on the importance of this problem and describe the ongoing political processes that both affect racial misclassification and contribute to the context of American Indian and Alaska Native identity. PMID:24669226

76 FR 45805 - Calculation of Annual Federal Medical Assistance Percentages for Indian Tribes for Use in the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-01

... tribes may submit plans to operate such programs at any time in the future. Indian tribes not operating... lands identifying themselves as American Indian or Alaska Native (AI/AN) was available for 143. For the... for the AI/AN population specifically. The data established that, using AI/AN data when it is...

A Summary of Changes in the Status of Alaska Natives.

ERIC Educational Resources Information Center

Alaska Univ., Anchorage. Inst. of Social and Economic Research.

Replication of 78 tables from the 1973 2(c) Report by the Secretary of the Interior using 1980 census information provided data to document the social and economic changes in the status of Alaska Natives since the passage of the Alaska Native Claims Settlement Act. Comparison of 1970 and 1980 data showed an average 2.4% growth rate in the Native…

Profiles of Native American and/or Alaska Native English Learners (ELs). Fast Facts

ERIC Educational Resources Information Center

Office of English Language Acquisition, US Department of Education, 2015

2015-01-01

The Office of English Language Acquisition (OELA) has synthesized key data on English learners (ELs) into two-page PDF sheets, by topic, with graphics, plus key contacts. The topics for this report on profiles of Native American and/or Alaska Native English Learners (ELs) include: (1) Largest Percentage of ELs Who Were Native American and/or…

Evaluation of the Alaska Native Science & Engineering Program (ANSEP). Research Report

ERIC Educational Resources Information Center

Bernstein, Hamutal; Martin, Carlos; Eyster, Lauren; Anderson, Theresa; Owen, Stephanie; Martin-Caughey, Amanda

2015-01-01

The Urban Institute conducted an implementation and participant-outcomes evaluation of the Alaska Native Science & Engineering Program (ANSEP). ANSEP is a multi-stage initiative designed to prepare and support Alaska Native students from middle school through graduate school to succeed in science, technology, engineering, and math (STEM)…

25 CFR 163.40 - Indian and Alaska Native forestry education assistance.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... 163.40 Section 163.40 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER..., professional Indians and Alaska Natives in the management of Indian and Alaska Native forest land. In keeping... forestry-related field which could include courses on indigenous culture; and (iii) To create an...

Alaska Native Land Claims. Workbook to Accompany Textbook.

ERIC Educational Resources Information Center

Hays, Lydia L.

Written as a companion to the secondary textbook, "Alaska Native Land Claims", this student workbook is organized via 9 units and 39 chapters which parallel the text's organizational format. Each unit presents unit goals and has anywhere from three to five subsections or chapters. Each titled chapter (e.g., Alaska's First Settlers)…

Alaska Native Rural Development: The NANA Experience. Occasional Paper No. 2.

ERIC Educational Resources Information Center

Gaffney, Michael J.

Faced with the need to build new social and economic institutions following the 1971 Alaska Native Claims Settlement Act, Alaska Natives formed 12 regional non-profit making corporations. One of these, Northwest Arctic Inupiat (NANA), is bringing a human resources development approach to the area in an effort to develop enduring economic and…

78 FR 75365 - 30-Day Notice of Proposed Information Collection: Assessment of Native American, Alaska Native...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

... Information Collection: Assessment of Native American, Alaska Native and Native Hawaiian Housing Needs AGENCY... its subcontractors, NORC, Econometrica and SSI. The project is a housing needs assessment that will... below. A. Overview of Information Collection Title of Information Collection: Assessment of Native...

A qualitative study of motivation in Alaska Native Science and Engineering Program (ANSEP) precollege students

NASA Astrophysics Data System (ADS)

Yatchmeneff, Michele

The dramatic underrepresentation of Alaska Natives in science, technology, engineering and mathematics (STEM) degrees and professions calls for rigorous research in how students access these fields. Research has shown that students who complete advanced mathematics and science courses while in high school are more academically prepared to pursue and succeed in STEM degree programs and professions. There is limited research on what motivates precollege students to become more academically prepared before they graduate from high school. In Alaska, Alaska Native precollege students regularly underperform on required State of Alaska mathematics and science exams when compared to non-Alaska Native students. Research also suggests that different things may motivate Alaska Native students than racial majority students. Therefore there is a need to better understand what motivates Alaska Native students to take and successfully complete advanced mathematics and science courses while in high school so that they are academically prepared to pursue and succeed in STEM degrees and professions. The Alaska Native Science & Engineering Program (ANSEP) is a longitudinal STEM educational enrichment program that works with Alaska Native students starting in middle school through doctoral degrees and further professional endeavors. Research suggests that Alaska Native students participating in ANSEP are completing STEM degrees at higher rates than before the program was available. ANSEP appears to be unique due to its longitudinal approach and the large numbers of Alaska Native precollege, university, and graduate students it supports. ANSEP provides precollege students with opportunities to take advanced high school and college-level mathematics and science courses and complete STEM related projects. Students work and live together on campus during the program components. Student outcome data suggests that ANSEP has been successful at motivating precollege participants to

Recruitment and retention of Alaska natives into nursing: elements enabling educational success.

PubMed

Rearden, Annette K

2012-01-01

In response to the underrepresentation of Alaska Native/American Indian nurses, nursing programs have implemented recruitment and retention efforts to support undergraduate Alaska Native/American Indian nursing students. The objective of this project was to provide graduates from the Recruitment and Retention of Alaska Natives into Nursing (RRANN) program the opportunity to identify program elements important to achieving academic success, levels of satisfaction, and make recommendations for future program direction. Findings suggest RRANN graduates viewed the program as vital to academic success. Recommendations include utilizing former graduates in recruitment and retention efforts, as mentors, and extending the program to benefit graduate students.

77 FR 19267 - Applications for New Awards; Alaska Native and Native Hawaiian-Serving Institutions (ANNH) Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... DEPARTMENT OF EDUCATION Applications for New Awards; Alaska Native and Native Hawaiian- Serving Institutions (ANNH) Program AGENCY: Office of Postsecondary Education, Department of Education. [[Page 19268

26 CFR 1.1502-81T - Alaska Native Corporations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 12 2012-04-01 2012-04-01 false Alaska Native Corporations. 1.1502-81T Section... Native Corporations. (a) General Rule. The application of section 60(b)(5) of the Tax Reform Act of 1984 and section 1804(e)(4) of the Tax Reform Act of 1986 (relating to Native Corporations established...

26 CFR 1.1502-81T - Alaska Native Corporations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 12 2014-04-01 2014-04-01 false Alaska Native Corporations. 1.1502-81T Section... Native Corporations. (a) General Rule. The application of section 60(b)(5) of the Tax Reform Act of 1984 and section 1804(e)(4) of the Tax Reform Act of 1986 (relating to Native Corporations established...

26 CFR 1.1502-81T - Alaska Native Corporations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 12 2013-04-01 2013-04-01 false Alaska Native Corporations. 1.1502-81T Section... Native Corporations. (a) General Rule. The application of section 60(b)(5) of the Tax Reform Act of 1984 and section 1804(e)(4) of the Tax Reform Act of 1986 (relating to Native Corporations established...

26 CFR 1.1502-81T - Alaska Native Corporations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 12 2011-04-01 2011-04-01 false Alaska Native Corporations. 1.1502-81T Section... Native Corporations. (a) General Rule. The application of section 60(b)(5) of the Tax Reform Act of 1984 and section 1804(e)(4) of the Tax Reform Act of 1986 (relating to Native Corporations established...

36 CFR 219.15 - Interaction with American Indian tribes and Alaska Natives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Interaction with American Indian tribes and Alaska Natives. 219.15 Section 219.15 Parks, Forests, and Public Property FOREST... Indian tribes and Alaska Natives to participate in the planning process to assist in: (1) The early...

Cancer Education Resources for American Indians and Alaska Natives. Supplement to Native American Monograph No. 1: Documentation of the Cancer Research Needs of American Indians and Alaska Natives.

ERIC Educational Resources Information Center

Burhansstipanov, Linda, Comp.; Barry, Kathleen Cooleen, Comp.

This directory provides information on cancer education materials that have been developed specifically for American Indians and Alaska Natives. The goal is to develop and implement culturally appropriate cancer prevention and control programs for Native Americans. The directory includes a matrix of cancer education materials that identifies…

Tobacco Industry Promotional Strategies Targeting American Indians/Alaska Natives and Exploiting Tribal Sovereignty.

PubMed

Lempert, Lauren K; Glantz, Stanton A

2018-03-12

American Indians/Alaska Natives have the highest commercial tobacco use in the United States, resulting in higher tobacco-caused deaths and diseases than the general population. Some American Indians/Alaska Natives use commercial tobacco for ceremonial as well as recreational uses. Because federally-recognized Tribal lands are sovereign, they are not subject to state cigarette taxes and smokefree laws. This study analyzes tobacco industry promotional efforts specifically targeting American Indians/Alaska Natives and exploiting Tribal lands to understand appropriate policy responses in light of American Indians'/Alaska Natives' unique sovereign status and culture. We analyzed previously secret tobacco industry documents available at the Truth Tobacco Documents Library (https://industrydocuments.library.ucsf.edu/tobacco/). Tobacco companies used promotional strategies targeting American Indians/Alaska Natives and exploiting Tribal lands that leveraged the federally-recognized Tribes' unique sovereign status exempting them from state cigarette taxes and smokefree laws, and exploited some Tribes' existing traditional uses of ceremonial tobacco and poverty. Tactics included price reductions, coupons, giveaways, gaming promotions, charitable contributions and sponsorships. Additionally, tobacco companies built alliances with Tribal leaders to help improve their corporate image, advance ineffective "youth smoking prevention" programs, and defeat tobacco control policies. The industry's promotional tactics likely contribute to disparities in smoking prevalence and smoking-related diseases among American Indians//Alaska Natives. Proven policy interventions to address these disparities including tobacco price increases, cigarette taxes, comprehensive smokefree laws, and industry denormalization campaigns to reduce smoking prevalence and smoking-related disease could be considered by Tribal communities. The sovereign status of federally-recognized Tribes does not prevent them

75 FR 53331 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14867-B; LLAK964000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. [[Page 53332

Arthritis Prevalence and Associations in American Indian and Alaska Native People

PubMed Central

Ferucci, Elizabeth D.; Schumacher, M. Catherine; Lanier, Anne P.; Murtaugh, Maureen A.; Edwards, Sandra; Helzer, Laurie J.; Tom-Orme, Lillian; Slattery, Martha L.

2010-01-01

Objective To investigate the prevalence of arthritis and associations with arthritis in American Indian and Alaska Native populations. Methods Data on self-reported, doctor-diagnosed arthritis from the baseline visit of 9,968 American Indian and Alaska Native adults from Alaska and the Southwest US were included. The prevalence of arthritis and univariate and multivariate associations between arthritis and demographic characteristics, health-related factors, and treatment are described. Results The prevalence of self-reported arthritis increased with age. The age-sex adjusted prevalence was high in Alaska (26.1%) and low in the Southwest US (16.5%) as compared with the US population (21.5%). In both centers, arthritis was associated with age, lack of employment, chronic medical conditions, and poorer self-reported overall health. Arthritis was associated with female sex in Alaska only, whereas education, marital status, and urban residency were associated with arthritis in the Southwest US. In both centers, self-reported physical health measured by the Short Form 12 Health Survey was lower in people with arthritis, and mental health was not associated with arthritis. More frequent use of antiinflammatory medications was reported with arthritis in both centers, but increased use of traditional medicine and healers were associated with arthritis only in Alaska. Conclusion Compared with US rates, the prevalence of self-reported arthritis was higher among Alaska Native people and lower in a Southwest American Indian population. Some factors associated with arthritis differ between the 2 populations. PMID:18668615

A Comparison of American Indian and Non-American Indian Parental Involvement in the IEP Process: Perceived Needs for Involvement and Training. Final Report.

ERIC Educational Resources Information Center

Gajar, Anna; Matuszny, Rose Marie

This final report discusses the activities and outcomes of a study that investigated the involvement of American Indian/Alaska Native (AI/AN) and non-American Indian/Alaska Native parents of children with disabilities in the general educational and Individualized Education Program (IEP) processes, and the specific needs of parents that would…

Institutional innovation in less than ideal conditions: management of commons by an Alaska Native village corporation

Treesearch

Dixie Dayo; Gary Kofinas

2010-01-01

Alaska Natives have experienced less than ideal conditions for engaging in management of their homeland commons. During the first 100 years after the Treaty of Cession of 1867, Alaska Natives received limited recognition by the United States. The Alaska Native Claims Settlement Act of 1971 (ANCSA) was signed into law by President Richard Nixon after tedious...

Feasibility of a tobacco cessation intervention for pregnant Alaska Native women

PubMed Central

Windsor, Richard A.; Renner, Caroline C.; Enoch, Carrie; Hochreiter, Angela; Nevak, Caroline; Smith, Christina A.; Decker, Paul A.; Bonnema, Sarah; Hughes, Christine A.; Brockman, Tabetha

2010-01-01

Background: Among Alaska Native women residing in the Yukon-Kuskokwim (Y-K) Delta region of Western Alaska, about 79% smoke cigarettes or use smokeless tobacco during pregnancy. Treatment methods developed and evaluated among Alaska Native pregnant tobacco users do not exist. This pilot study used a randomized two-group design to assess the feasibility and acceptability of a targeted cessation intervention for Alaska Native pregnant women. Methods: Recruitment occurred over an 8-month period. Enrolled participants were randomly assigned to the control group (n = 18; brief face-to-face counseling at the first visit and written materials) or to the intervention group (n = 17) consisting of face-to-face counseling at the first visit, four telephone calls, a video highlighting personal stories, and a cessation guide. Interview-based assessments were conducted at baseline and follow-up during pregnancy (≥60 days postrandomization). Feasibility was determined by the recruitment and retention rates. Results: The participation rate was very low with only 12% of eligible women (35/293) enrolled. Among enrolled participants, the study retention rates were high in both the intervention (71%) and control (94%) groups. The biochemically confirmed abstinence rates at follow-up were 0% and 6% for the intervention and control groups, respectively. Discussion: The low enrollment rate suggests that the program was not feasible or acceptable. Alternative approaches are needed to improve the reach and efficacy of cessation interventions for Alaska Native women. PMID:20018946

75 FR 13297 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... for 118.47 acres, located southeast of the Native village of Hughes, Alaska. Notice of the decision...: The Bureau of Land Management by phone at 907-271-5960, or by e-mail at ak[email protected]ak.blm.gov...

Sleep Duration and Diabetes Risk in American Indian and Alaska Native Participants of a Lifestyle Intervention Project.

PubMed

Nuyujukian, Daniel S; Beals, Janette; Huang, Haixiao; Johnson, Ann; Bullock, Ann; Manson, Spero M; Jiang, Luohua

2016-11-01

We examine the association between self-reported sleep duration and diabetes incidence in a national sample of American Indians/ Alaska Natives (AI/ANs) with prediabetes. Data were derived from the Special Diabetes Program for Indians Diabetes Prevention demonstration project. This longitudinal analysis included 1,899 participants with prediabetes recruited between January 1, 2006 and July 31, 2009 who reported sleep duration and completed all 16 classes of the lifestyle intervention consisting of diet, exercise, and behavior modification sessions to promote weight loss. Three years of follow-up data were included to fit Cox regression models to compute hazard ratios (HRs) for diabetes incidence across sleep duration categories. The crude diabetes incidence rate was 4.6 per 100 person-years among short sleepers (≤ 6 h per night) compared to 3.2 among those sleeping 7 h and 3.3 among those sleeping 8 h or more. After adjustment for age and sex, short sleep (≤ 6 h vs. others) was associated with increased diabetes risk (HR 1.55 [95% confidence interval 1.11-2.17]); risk remained significantly elevated after controlling for socioeconomic characteristics, health behaviors, and health status. When adjusting for body mass index and percent weight loss, the short sleep-diabetes relationship was attenuated (HR 1.32 [95% confidence interval 0.92-1.89]). No significant long sleep-diabetes association was found. Further, short sleepers lost significantly less weight than others (3.7% vs. 4.3%, P = 0.003). Short sleep duration, but not long duration, was significantly associated with increased diabetes risk and less weight loss among AI/ANs in a lifestyle intervention. Further exploration of the complex factors underlying short sleep duration is warranted. © 2016 Associated Professional Sleep Societies, LLC.

76 FR 44045 - Establishment of the SANE/SART AI/AN Initiative Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

... SANE/SART AI/AN Initiative Committee AGENCY: Office for Victims of Crime, Justice. ACTION: Notice of...) Initiative (``SANE/SART AI/AN Initiative Committee'' or ``Committee'') is being established in accordance... SANE/SART AI/AN Initiative Committee will provide the Office for Victims of Crime, a component of the U...

Project h[schwa]li?dx[superscript w]/Healthy Hearts across Generations: Development and Evaluation Design of a Tribally Based Cardiovascular Disease Prevention Intervention for American Indian Families

ERIC Educational Resources Information Center

Walters, Karina L.; LaMarr, June; Levy, Rona L.; Pearson, Cynthia; Maresca, Teresa; Mohammed, Selina A.; Simoni, Jane M.; Evans-Campbell, Teresa; Fredriksen-Goldsen, Karen; Fryberg, Sheryl; Jobe, Jared B.

2012-01-01

American Indian and Alaska Native (AIAN) populations are disproportionately at risk for cardiovascular disease (CVD), diabetes, and obesity, compared with the general US population. This article describes the h[schwa]li?dx[superscript w]/Healthy Hearts Across Generations project, an AIAN-run, tribally based randomized controlled trial (January…

Meeting the needs of regional minority groups: the University of Washington's programs to increase the American Indian and Alaskan native physician workforce.

PubMed

Acosta, David; Olsen, Polly

2006-10-01

Minority populations in the United States are growing rapidly, but physician workforce diversity has not kept pace with the needs of underserved communities. Minorities comprised 26.4% of the population in 1995; by 2050, these groups will comprise nearly half. Medical schools must enlist greater numbers of minority physicians and train all physicians to provide culturally responsive care. The University of Washington School of Medicine (UWSOM) is the nation's only medical school that serves a five-state region (Washington, Wyoming, Alaska, Montana, and Idaho). Its mission addresses the need to serve the region, rectify primary care shortages, and meet increasing regional demands for underserved populations. The UWSOM Native American Center of Excellence (NACOE) was established as one important way to respond to this charge. The authors describe pipeline and minority recruitment programs at UWSOM, focusing on the NACOE and other activities to recruit American Indian/Alaskan Native (AI/AN) applicants to medical schools. These programs have increased the numbers of AI/AN medical students; developed the Indian Health Pathway; worked to prepare students to provide culturally responsive care for AI/AN communities; researched health disparities specific to AI/AN populations; provided retention programs and services to ensure successful completion of medical training; developed mentorship networks; and provided faculty-development programs to increase entry of AI/AN physicians into academia. Challenges lie ahead. Barriers to the pipeline will continue to plague students, and inadequate federal funding will have a significant and negative impact on achieving needed physician-workforce diversity. Medical schools must play a larger role in resolving these, and continue to provide pipeline programs, retention programs, and minority faculty development that can make a difference.

43 CFR 2091.9-1 - Alaska Native selections.

Code of Federal Regulations, 2011 CFR

2011-10-01

... MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) SPECIAL LAWS AND RULES Segregation and Opening of Lands § 2091.9-1 Alaska Native selections. The segregation and opening of lands authorized for...

Enhancing Cancer Education through the Arts: Building Connections with Alaska Native People, Cultures and Communities

ERIC Educational Resources Information Center

Cueva, Melany; Kuhnley, Regina; Cueva, Katie

2012-01-01

Building upon the dynamic traditions of Alaska Native people, which include the arts as a viable way of knowing, the expressive arts were woven into a five-day cancer education course for Alaska village-based Community Health Workers (CHWs). Cancer is the leading cause of mortality for Alaska Native people. Course learning modalities included…

Education Is Associated with Physical Activity among American Indian Elders

ERIC Educational Resources Information Center

Sawchuk, Craig N.; Bogart, Andy; Charles, Steve; Goldberg, Jack; Forquera, Ralph; Roy-Byrne, Peter; Buchwald, Dedra

2008-01-01

Although educational attainment and physical activity levels tend to be positively associated in majority populations, this relationship has not been investigated in American Indian and Alaska Native (AI/AN) elders. This study examined the association between education and physical activity among AI/AN elders (N = 107) using self-report and…

76 FR 45272 - Office of Direct Service and Contracting Tribes Funding Opportunity

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... address the potential and actual impact of CMS programs on American Indian/Alaska Native (AI/AN... programs (program) carry out health program objectives in the AI/AN community in the interest of improving... further IHS and CMS missions and goals related to providing quality health care to the AI/ AN community...

75 FR 60780 - Announcement of Funding Awards for Fiscal Year 2010 Alaska Native/Native Hawaiian Institutions...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-01

... to be used to assist Alaska Native/Native Hawaiian institutions of higher education to expand their role and effectiveness in addressing community development needs in their localities, including... ongoing grant programs to institutions of higher education as well as creates initiatives through which...

77 FR 72832 - Applications for New Awards; Native American and Alaska Native Children in School Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... School Program AGENCY: Office of English Language Acquisition, Department of Education. Overview... participation in language instruction educational programs. Projects funded under the Native American and Alaska... Act of 1965, as amended (ESEA), may support the teaching and studying of Native American languages...

Marine Science Training Program for Alaska Native Students

DTIC Science & Technology

1991-08-01

Seward Marine Center or Kasitsna Bay. In 1989 we decided that a more intensive internship with direct faculty involvement would be more effective ...at UAF provides orientation activities for prospective Native students from the states rural high schools. In addition RSS provides the Alaska Native...opportunity to explore the effects of science upon their daily lives will attract student to careers into oceanic and related sciences and further

76 FR 23834 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-19155-10; LLAK964000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of modified... to include reservation of an easement and to reject a State selection. Notice of the modified...

75 FR 80838 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-11908, AA-11915, AA-11916, AA-11917, AA-11909, AA-11913, AA-11914; LLAK-962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As...

76 FR 55415 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-9428, AA-9752, AA-11237, AA-9755, AA-9837, AA-10075, AA-11467; LLAK-965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As...

College Pride, Native Pride: A Portrait of a Culturally Grounded Precollege Access Program for American Indian, Alaska Native, and Native Hawaiian Students

ERIC Educational Resources Information Center

Keene, Adrienne J.

2016-01-01

In this article Adrienne J. Keene employs the portraiture methodology to explore the story of College Horizons. She examines this precollege access program for American Indian, Alaska Native, and Native Hawaiian students to understand how a program rooted in Native cultures and identities can not only provide a space to create knowledge…

77 FR 2998 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-20

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14866-A; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

78 FR 7807 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14900-A; LLAK940000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

76 FR 22414 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-19155-1-LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 8375 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-14

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-12467, AA-8104-02; LLAK962000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

75 FR 8105 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14931-B; LLAK964000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

76 FR 53151 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14924-A; LLAK965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 55414 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14948-A (2651), F-14948-A2 (2651); LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d...

78 FR 49763 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-15

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6691-I; LLAK940000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

77 FR 20046 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-03

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-14015; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

75 FR 57493 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6661-F; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 38678 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-01

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-12418, AA-12419; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

76 FR 53151 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-19155-11; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

75 FR 41511 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-35320-1; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 53150 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-8103-05; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

78 FR 8581 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14936-A; LLAK944000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

76 FR 53150 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-10169, AA-10170; LLAK-965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

76 FR 81524 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-28

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-40206, F-40207; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

76 FR 22414 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-8103-05; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

75 FR 53332 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-11144; LLAK-962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

77 FR 72383 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-05

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-9660, AA-9662; LLAK-944000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

75 FR 28816 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-24

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-22588, F-22603; LLAK-962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

75 FR 69457 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-19155-08; LLAK964000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 57759 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14908-B; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 23834 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-11015, AA-12590; LLAK-962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

77 FR 5048 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-01

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14951-A; LLAK965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 5395 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-12252, AA-12250, AA-12280, AA-12291, AA-12292, AA-12293; LLAK- 962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43...

77 FR 4057 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-8103-05; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

75 FR 38537 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-19155-22; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

75 FR 65644 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-10668; LLAK-962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 61736 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-05

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-10233, AA-11482; LLAK-965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

76 FR 61737 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-05

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-22300; LLAK-965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 45604 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-29

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-9373; LLAK-965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

78 FR 64002 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14860-A; LLAK940000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

75 FR 8106 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-12124; LLAK-962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

75 FR 6694 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-10

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-21905-51; LLAK964000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

75 FR 26785 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-12

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-19155-9; LLAK964000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

77 FR 72383 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-05

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-10282, AA-10291, AA-10292, AA-10369; LLAK-944000-L14100000-HY0000- P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d...

76 FR 13428 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6666-B; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

76 FR 55414 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14838-A; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

77 FR 33231 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14901-A; LLAK965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

76 FR 14684 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-22014; LLAK-962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

75 FR 53331 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-40300, F-40313; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

75 FR 80838 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-19155-07; LLAK964000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

76 FR 22413 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6694-A; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

76 FR 75899 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-9915, AA-9916, AA-9921, AA-9936, AA-9937, AA-9965; LLAK-965000- L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43...

Traditional and western healing practices for alcoholism in American Indians and Alaska Natives.

PubMed

Abbott, P J

1998-11-01

The American Indian and Alaska Native population is a culturally diverse population with a current census of 1,959,000. Prior to White contact, there was historically little use of alcoholic beverages except for American Indians in the Southwest. After White contact, use and misuse of alcohol escalated rapidly; however, the prevalence, patterns, and problems of drinking alcoholic beverages vary enormously even in tribes closely linked geographically. American Indians and Alaska Natives have preserved and revitalized a number of traditional healing practices and applied these to the treatment of alcohol-related problems. These healing practices include the following: nativistic movements, sacred dances, sweat lodges, talking circle, four circles, and cultural enhancement programs. Additionally, Western treatment approaches have been applied in the treatment of problems related to alcohol, such as medication for detoxification, disulfiram (Antabuse), Alcoholics Anonymous, and behavioral interventions. Several investigators have completed a small number of naturalistic follow-up studies, but no one has undertaken a randomized controlled trial looking at specific methods of alcohol treatment in American Indians or Alaska Natives. American Indian and Alaska Native communities have adapted and integrated both Traditional and Western approaches to fit their own unique sociocultural needs.

Access to Specialty Health Care for Rural American Indians in Two States

ERIC Educational Resources Information Center

Baldwin, Laura-Mae; Hollow, Walter B.; Casey, Susan; Hart, L. Gary; Larson, Eric H.; Moore, Kelly; Lewis, Ervin; Andrilla, C. Holly A.; Grossman, David C.

2008-01-01

Context: The Indian Health Service (IHS), whose per capita expenditure for American Indian and Alaska Native (AI/AN) health services is about half that of the US civilian population, is the only source of health care funding for many rural AI/ANs. Specialty services, largely funded through contracts with outside practitioners, may be limited by…

Reframing Diabetes in American Indian Communities: A Social Determinants of Health Perspective

ERIC Educational Resources Information Center

Mitchell, Felicia M.

2012-01-01

American Indians and Alaska Natives (AI/ANs) experience some of the greatest health inequities of any group within the United States. AI/ANs are diagnosed with diabetes more than twice as often as non-Hispanic white Americans. Diabetes is a chronic preventable disease often associated with individual risk factors and behaviors that indicate what…

76 FR 16804 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-25

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-8102-05, AA-8102-08, AA-8102-10, AA-8102-25, AA-8102-28, AA-8102- 37, AA-8102-47; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for...

78 FR 53158 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14866-A, F-14866-A2; LLAK940000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

77 FR 72383 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-05

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14933-A, F-14933-A2; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

78 FR 27991 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-13

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14879-A, F-14879-A2; LLAK940000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

76 FR 13428 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6690-A2; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that the...

77 FR 21802 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14839-A, F-14839-A2; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

75 FR 43198 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6648-A, AA-6648-Q; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

78 FR 35047 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14860-A2; LLAK940000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

78 FR 42543 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14900-A2; LLAK940000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given that an...

78 FR 62656 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6648-A, AA-6648-C, AA-6648-O; LLAK944000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is...

76 FR 73657 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-29

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14862-A, F-14862-A2; LLAK965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

78 FR 65354 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6683-G, AA-6683-A2; LLAK940000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

76 FR 54787 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-02

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-19148-16, F-19148-35; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

77 FR 35998 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14864-A and F-14864-A2; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is...

76 FR 43340 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14920-A; F-14920-A2; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

76 FR 34248 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-13

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14936-A, F-14936-A2; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

78 FR 57411 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14885-A, F-14885-A2; LLAK940000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

77 FR 24217 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14879-A, F-14879-A2; LLAK962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

78 FR 76174 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-9014-A, AA-9014-A2; LLAK940000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

78 FR 7807 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14908-A, F-14908-B; LLAK944000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

75 FR 65644 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-11937, AA-11938, AA-11939, AA-11940, AA-11944, AA-11943, AA-11941, AA-11936, AA-11933, AA-11928, AA-11929, AA-11931, AA-11932; LLAK- 962000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION...

75 FR 8105 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14842-I, F-14842-J, F-14842-K, F-14851-I; LLAK-964000-L14100000- HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7...

77 FR 5047 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-01

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14871-A, F-14871-A2; LLAK965000-L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

75 FR 9427 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-8103-63, AA-8103-65, F-21902-06, F-21903-54, F-21903-55, F-21903- 56; LLAK-96400-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY...

75 FR 13297 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-8448-A; AA-8448-B; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

76 FR 43340 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6682-B, AA-6682-D, AA-6682-E, AA-6682-G, AA-6682-H, AA-6682-I, AA- 6682-A2; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance...

77 FR 24218 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14849-A, F-14849-A2; LLAK965 000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is hereby given...

75 FR 43199 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14837-G2, F-14837-H2, F-14837-I2; LLAK964000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d...

75 FR 55344 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-10

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14828-L, F-14935-J, F-14877-B, F-14877-E and F-14877-F, LLAK962000- L14100000-HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43...

76 FR 47234 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6705-E, AA-6705-K, AA-6705-A2, LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is...

75 FR 27359 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6647-B, AA-6647-C, AA-6647-A2; LLAK964000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is...

76 FR 3156 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-19

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6691-F, AA-6691-I, AA-6691-A2; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d), notice is...

75 FR 13296 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6679-B, AA-6679-C, AA-6679-F, AA-6679-G, AA-6679-K, AA-6679-M, AA- 6679-A2, LLAK964000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance...

75 FR 21033 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-6670-F, AA-6670-L, AA-6670-M, AA-6670-A2; LLAK964000-L14100000- HY0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As required by 43 CFR 2650.7(d...

The Dropout/Graduation Crisis among American Indian and Alaska Native Students: Failure to Respond Places the Future of Native Peoples at Risk

ERIC Educational Resources Information Center

Faircloth, Susan C.; Tippeconnic, John W., III

2010-01-01

This paper examines the graduation/dropout crisis among American Indian and Alaska Native students using data from the National Center for Education Statistics. Data from 2005 is drawn from the seven states with the highest percentage of American Indian and Alaska Native students as well as five states in the Pacific and Northwestern regions of…

Early Care and Education in Tribal Communities: Research to Policy Resources

ERIC Educational Resources Information Center

Grate, Sheree; Stephens, Samuel A.

2016-01-01

There are approximately 390,000 children age nine and under who are identified by their parents as being of American Indian or Alaska Native (AIAN) heritage alone, while more than 400,000 other children in the same age range share this heritage with that of other race and ethnic groups. The large majority--about 80 percent--of AIAN individuals…

75 FR 30051 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-14989-B, F-14989-C, F-14989-E2, F-14989-G2, F-14989-K2, F-14989-L2; LLAK965000-L14100000-KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of decision approving lands for conveyance. SUMMARY: As...

77 FR 59220 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-26

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [F-19525-A, F-19525-C, F-19525-A2, F-19525-B2; LLAK965000-L14100000- KC0000-P] Alaska Native Claims Selection AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Decision Approving Lands for Conveyance. SUMMARY: As required by 43 CFR 2650.7(d...

75 FR 26784 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-12

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-11973, AA-11993, AA-11968, AA-11972, AA-12018, AA-12013, AA-12014, AA-12015, AA-12016, AA-12017, AA-11984, AA-11994, AA-11995, AA-11996, AA-12003, AA-12012, AA-11967, AA-12020, AA-12021; LLAK-962000- L14100000-HY0000-P] Alaska Native Claims...

Dental caries in rural Alaska Native children--Alaska, 2008.

PubMed

2011-09-23

In April 2008, the Arctic Investigations Program (AIP) of CDC was informed by the Alaska Department of Health and Social Services (DHSS) of a large number of Alaska Native (AN) children living in a remote region of Alaska who required full mouth dental rehabilitations (FMDRs), including extractions and/or restorations of multiple carious teeth performed under general anesthesia. In this remote region, approximately 400 FMDRs were performed in AN children aged <6 years in 2007; the region has approximately 600 births per year. Dental caries can cause pain, which can affect children's normal growth and development. AIP and Alaska DHSS conducted an investigation of dental caries and associated risk factors among children in the remote region. A convenience sample of children aged 4-15 years in five villages (two with fluoridated water and three without) was examined to estimate dental caries prevalence and severity. Risk factor information was obtained by interviewing parents. Among children aged 4-5 years and 12-15 years who were evaluated, 87% and 91%, respectively, had dental caries, compared with 35% and 51% of U.S. children in those age groups. Among children from the Alaska villages, those aged 4-5 years had a mean of 7.3 dental caries, and those aged 12-15 years had a mean of 5.0, compared with 1.6 and 1.8 dental caries in same-aged U.S. children. Of the multiple factors assessed, lack of water fluoridation and soda pop consumption were significantly associated with dental caries severity. Collaborations between tribal, state, and federal agencies to provide effective preventive interventions, such as water fluoridation of villages with suitable water systems and provision of fluoride varnishes, should be encouraged.

Correlates of Alaska Native Fatal and Nonfatal Suicidal Behaviors 1990-2001

ERIC Educational Resources Information Center

Wexler, Lisa; Hill, Ryan; Bertone-Johnson, Elizabeth; Fenaughty, Andrea

2008-01-01

Factors correlated with suicidal behavior in a predominately Alaska Native region of Alaska are described, and the correlates relating to fatal and nonfatal suicide behaviors in this indigenous population are distinguished. Suicide data from the region (1990-2001) were aggregated and compared to 2000 U.S. Census Data using chi-squared tests.…

Focus Groups of Alaska Native Adolescent Tobacco Users: Preferences for Tobacco Cessation Interventions and Barriers to Participation

ERIC Educational Resources Information Center

Patten, Christi A.; Enoch, Carrie; Renner, Caroline C.; Offord, Kenneth P.; Nevak, Caroline; Kelley, Stacy F.; Thomas, Janet; Decker, Paul A.; Hurt, Richard D.; Lanier, Anne; Kaur, Judith S.

2009-01-01

Tobacco cessation interventions developed for Alaska Native adolescents do not exist. This study employed focus group methodology to explore preferences for tobacco cessation interventions and barriers to participation among 49 Alaska Natives (61% female) with a mean age of 14.6 (SD = 1.6) who resided in western Alaska. Using content analysis,…

Poverty and Health Disparities for American Indian and Alaska Native Children: Current Knowledge and Future Prospects

PubMed Central

Sarche, Michelle; Spicer, Paul

2008-01-01

This report explores the current state of knowledge regarding inequalities and their effect on American Indian and Alaska Native children, underscoring gaps in our current knowledge and the opportunities for early intervention to begin to address persistent challenges in young American Indian and Alaska Native children’s development. This overview documents demographic, social, health, and health care disparities as they affect American Indian and Alaska Native children, the persistent cultural strengths that must form the basis for any conscientious intervention effort, and the exciting possibilities for early childhood interventions. PMID:18579879

A comparison of self-reported physical health and health conditions of American Indian/Alaskan Natives to other college students.

PubMed

Patterson-Silver Wolf, David A; VanZile-Tamsen, Carol; Black, Jessica; Billiot, Shanondora M; Tovar, Molly

2013-12-01

American Indian/Alaska Natives comprise a small portion of the general college student population, but often have the poorest health and wellness, as well as the highest dropout rates compared to any other race or ethnicity. Despite the well-documented issues this group faces in higher education, they are often ignored in studies due to their status as the minority within the minority, comprising only 0.8% of all college students in the US. This study examines the differences in college students' overall ratings of health across racial and ethnic groups, focusing specifically on the health and wellness of AI/AN students compared to their counterparts. This paper also investigates the physical health issues students experienced in the past 12 months and the health issues' impact on their academic achievement. Results showed that AI/AN students reported the lowest overall health ratings and the most health issues in the past year.

We Have the Power to Prevent Diabetes: Tips for American Indians & Alaska Natives

MedlinePlus

... for Asian Americans & Pacific Islanders) We Have the Power to Prevent Diabetes: Tips for American Indians & Alaska ... Indians and Alaska Natives, and we have the power to prevent type 2 diabetes. Science has proven ...

Bridging the Great Divide: Connecting Alaska Native Learners and Leaders via "High Touch-High Tech" Distance Learning.

ERIC Educational Resources Information Center

Berkshire, Steven; Smith, Gary

The Rural Alaska Native Adult program of Alaska Pacific University is specifically designed for adult Native learners. Courses in business administration, human services, and teacher education are offered to rural Native adult students via an interactive Internet-based format after an initial 1-week residency. The Internet component is facilitated…

The Common Core Initiative, Education Outcomes, and American Indian/Alaska Native Students: Observations and Recommendations

ERIC Educational Resources Information Center

Nelson-Barber, Sharon; Trumbull, Elise

2015-01-01

This monograph explores the ways in which large-scale school reform efforts play out in American Indian/Alaska Native communities and schools, starting from a historical and cultural perspective, and focusing on the translation of research into concrete steps leading to American Indian/Alaska Native student academic success and personal well-being.

American Indian & Alaska Native Sources of Health Materials.

ERIC Educational Resources Information Center

Office of Minority Health (PHS/DHHS), Washington, DC.

This brief directory lists 28 agencies providing culturally sensitive printed health materials for American Indians and Alaska Natives. Each entry provides the agency's address; telephone number; fax number; and annotated titles available, with price. Many materials are free. There is also a subject index with these categories: adolescent…

Gaps in Data for American Indians and Alaska Natives in the National Healthcare Disparities Report

ERIC Educational Resources Information Center

Moy, Ernest; Smith, Colleen Ryan; Johansson, Patrik; Andrews, Roxanne

2006-01-01

The aim of this study was to identify and quantify gaps in health care data for American Indians and Alaska Natives. Findings indicate that only 42% of measures of health care quality and access tracked in the National Healthcare Disparities Report could be used to assess disparities among American Indians and Alaska Natives. Patient safety data…

A macro-level fetal alcohol syndrome prevention program for Native Americans and Alaska Natives: description and evaluation.

PubMed

May, P A; Hymbaugh, K J

1989-11-01

Presented here are a detailed description and outcome evaluation of a comprehensive, macro-level Fetal Alcohol Syndrome prevention program for Native Americans and Alaska Natives. The program was designed to provide native communities throughout the United States with the knowledge, skills and strategies to initiate primary, secondary and tertiary prevention measures on their own. The key to the program was the training of a cadre of trainers/advocates in all local Native American and Alaska Native communities served by the Indian Health Service. These people were then supported and assisted in their efforts through a variety of means. Evaluation results of knowledge gained indicate that the local trainers had substantial success in imparting FAS information to a variety of audiences (prenatal groups, school children and community groups). Further, the evaluation samples also indicate that the knowledge was retained by the groups over time (2-4 months) and that there may have been some general diffusion of knowledge among peers in local communities. This program is presented in the hope that it will be replicated and improved upon by similar programs using this model as a base.

American Indian and Alaska native aboriginal use of alcohol in the United States.

PubMed

Abbott, P J

1996-01-01

Alcohol beverages prior to White contact originated with the Mayan and the Aztec Nations and spread to the American Indians of the Southwest. Surprisingly, there are a number of accounts of alcohol use among other American Indians and Alaska Natives. Beverages were limited to wine and beer, and included: balche, pulque, and "haren a pitahaya" wines, tulpi beer and other beverages. White contact brought dramatic shifts in the use and function of alcoholic beverages in American Indian and Alaska Native societies.

Obesity and sexual abuse in American Indians and Alaska Natives.

PubMed

Levine, James A; McCrady-Spitzer, Shelly K; Bighorse, William

2016-08-01

Mainstream American culture frequently minimizes the prevalence and significance of sexual abuse. Unfortunately, this denial of extensive victimization of women is also present in many underserved populations. In June 2007, Amnesty International released its report on sexual abuse in indigenous women, which states that, "One in three Native American or Alaska Native women will be raped at some point in their lives. Most do not seek justice because they know they will be met with inaction or indifference." This report highlighted an infrequently discussed issue namely, very high levels of sexual abuse in Native American and Alaska Native women. The relationship between sexual abuse and obesity has been delineated in several studies; overall about one quarter to one half of women with high levels of obesity have been sexually abused and it has been postulated that weight-gain serves as an adaptive response for many survivors of sexual abuse. It is also well known in Native American and Alaskan Native women that there is a high prevalence of obesity (about 40% greater than the population average) and that this obesity is associated with a many-fold greater risk of diabetes and increased risks of hypertension, cancer and cardiovascular disease. The link between the concomitantly high rates of sexual abuse and obesity in this population may or may not be partial causality but the issue is nonetheless important. If approaches are to succeed in reversing the trend of increasing levels of obesity in Native American and Alaskan Native women, the high prevalence of sexual abuse will need to be specifically and comprehensively addressed.

Future Land Use Planning Alternatives for Alaska: One of a Series of Articles on the Native Land Claims.

ERIC Educational Resources Information Center

Parker, Walter B.

As one in a series of eight articles written by different professionals concerned with Alaska Native land claims, this article focuses on land use planning alternatives after December of 1976 when the configuration of Alaska lands will have been largely finalized under the Alaska Native Claims Settlement Act of 1972. While this particular booklet…

Cancer Incidence, Survival, and Mortality among American Indians and Alaska Natives.

ERIC Educational Resources Information Center

Horm, John W.; Burhansstipanov, Linda

1992-01-01

Overall cancer incidence among southwestern American Indians is less than half that of U.S. whites; Alaska Native and white rates are similar. However, both native groups have elevated rates for specific cancers (stomach, liver, and gallbladder), and Indians have low five-year survival rates. Data tables outline incidence, mortality, and survival…

Committee opinion no. 515: Health care for urban American Indian and Alaska Native women.

PubMed

2012-01-01

Sixty percent of American Indian and Alaska Native women live in metropolitan areas. Most are not eligible for health care provided by the federal Indian Health Service (IHS). The IHS partly funds 34 Urban Indian Health Organizations, which vary in size and services. Some are small informational and referral sites that are limited even in the scope of outpatient services provided. Compared with other urban populations, urban American Indian and Alaska Native women have higher rates of teenaged pregnancy, late or no prenatal care, and alcohol and tobacco use in pregnancy. Their infants have higher rates of preterm birth, mortality, and sudden infant death syndrome than infants in the general population. Barriers to care experienced by American Indian and Alaska Native women should be addressed. The American College of Obstetricians and Gynecologists encourages Fellows to be aware of the risk profile of their urban American Indian and Alaska Native patients and understand that they often are not eligible for IHS coverage and may need assistance in gaining access to other forms of coverage. The American College of Obstetricians and Gynecologists also recommends that Fellows encourage their federal legislators to support adequate funding for the Indian Health Care Improvement Act, permanently authorized as part of the Patient Protection and Affordable Care Act.

Alcohol Problems in Alaska Natives: Lessons from the Inuit

ERIC Educational Resources Information Center

Seale, J. Paul; Shellenberger, Sylvia; Spence, John

2006-01-01

In this Alaska Native study, cultural "insiders" analyzed problems associated with increased alcohol availability, factors which have reduced alcohol-related problems, and ideas for improving treatment in an Inuit community. Participants described frequent bingeing, blackouts, family violence, suicide, loss of child custody, and feelings…

Cancer Prevention and Control in American Indians/Alaska Natives.

ERIC Educational Resources Information Center

Hampton, James W.

1992-01-01

Examines differences among American Indian tribes and Alaska Natives with regard to incidence and mortality rates for various types of cancer, particularly lung, cervix, breast, biliary, gastric, colorectal, prostate, and primary hepatic cancer. Discusses the influence of genetic and environmental factors, smoking, and inadequate medical…

Strategies for Successful Retention of Alaska Native and American Indian Study Participants

ERIC Educational Resources Information Center

Redwood, Diana; Leston, Jessica; Asay, Elvin; Ferucci, Elizabeth; Etzel, Ruth; Lanier, Anne P.

2011-01-01

This paper reports the strategies used to track and follow 3,828 Alaska Native and American Indian study participants in the city of Anchorage and more rural areas of Alaska and provides characteristics of respondents and non-respondents. Over 88% were successfully followed-up, with 49% of respondents completed in three or fewer attempts.…

2016 American Indian/Alaska Native/Native Hawaiian Areas (AIANNH) Michigan, Minnesota, and Wisconsin

EPA Pesticide Factsheets

The TIGER/Line shapefiles and related database files (.dbf) are an extract of selected geographic and cartographic information from the U.S. Census Bureau's Master Address File / Topologically Integrated Geographic Encoding and Referencing (MAF/TIGER) Database (MTDB). The MTDB represents a seamless national file with no overlaps or gaps between parts, however, each TIGER/Line shapefile is designed to stand alone as an independent data set, or they can be combined to cover the entire nation. The American Indian/Alaska Native/Native Hawaiian (AIANNH) Areas Shapefile includes the following legal entities: federally recognized American Indian reservations and off-reservation trust land areas, state-recognized American Indian reservations, and Hawaiian home lands (HHLs). The statistical entities included are Alaska Native village statistical areas (ANVSAs), Oklahoma tribal statistical areas (OTSAs), tribal designated statistical areas (TDSAs), and state designated tribal statistical areas (SDTSAs). Joint use areas are also included in this shapefile refer to areas that are administered jointly and/or claimed by two or more American Indian tribes. The Census Bureau designates both legal and statistical joint use areas as unique geographic entities for the purpose of presenting statistical data. The Bureau of Indian Affairs (BIA) within the U.S. Department of the Interior (DOI) provides the list of federally recognized tribes and only provides legal boundary infor

Addressing Cancer Disparities Among American Indian and Alaska Native Populations

Cancer.gov

Cancer disparities and health equity research is a critical part of NCI’s research portfolio. The three researchers featured in this video receive funding from NCI to conduct research among American Indian and Alaska Native populations.

78 FR 10636 - Task Force on Research on Violence Against American Indian and Alaska Native Women; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-14

... DEPARTMENT OF JUSTICE Task Force on Research on Violence Against American Indian and Alaska Native Women; Meeting AGENCY: Office on Violence Against Women, United States Department of Justice. ACTION... public meeting of the Task Force on Research on Violence Against American Indian and Alaska Native Women...

Obesity and sexual abuse in American Indians and Alaska Natives

PubMed Central

Levine, James A; McCrady-Spitzer, Shelly K; Bighorse, William

2016-01-01

Mainstream American culture frequently minimizes the prevalence and significance of sexual abuse. Unfortunately, this denial of extensive victimization of women is also present in many underserved populations. In June 2007, Amnesty International released its report on sexual abuse in indigenous women, which states that, “One in three Native American or Alaska Native women will be raped at some point in their lives. Most do not seek justice because they know they will be met with inaction or indifference.” This report highlighted an infrequently discussed issue namely, very high levels of sexual abuse in Native American and Alaska Native women. The relationship between sexual abuse and obesity has been delineated in several studies; overall about one quarter to one half of women with high levels of obesity have been sexually abused and it has been postulated that weight-gain serves as an adaptive response for many survivors of sexual abuse. It is also well known in Native American and Alaskan Native women that there is a high prevalence of obesity (about 40% greater than the population average) and that this obesity is associated with a many-fold greater risk of diabetes and increased risks of hypertension, cancer and cardiovascular disease. The link between the concomitantly high rates of sexual abuse and obesity in this population may or may not be partial causality but the issue is nonetheless important. If approaches are to succeed in reversing the trend of increasing levels of obesity in Native American and Alaskan Native women, the high prevalence of sexual abuse will need to be specifically and comprehensively addressed. PMID:28529823

76 FR 5358 - Alaska Native Education; Notice Inviting Applications for New Awards for Fiscal Year (FY) 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... Description Purpose of Program: The purpose of the Alaska Native Education (ANE) program is to support... Elementary and Secondary Education Act of 1965, as amended (ESEA). Note: The construction of facilities that support the operation of Alaska Native education programs will be a permissible activity only if Congress...

Redeeming Hollow Promises: The Case for Mandatory Spending on Health Care for American Indians and Alaska Natives

PubMed Central

Westmoreland, Timothy M.; Watson, Kathryn R.

2006-01-01

The reliance on discretionary spending for American Indian/ Alaska Native health care has produced a system that is insufficient and unreliable and is associated with ongoing health disparities. Moreover, the gap between mandatory spending on a Medicare beneficiary and discretionary spending on an American Indian/Alaska Native beneficiary has grown dramatically, thus compounding the problem. The budget classification for American Indian/Alaska Native health services should be changed, and health care delivery to this population should be designated as mandatory spending. If a correct structure is in place, mandatory spending is more likely to provide adequate funding that keeps pace with changes in costs and need. PMID:16507732

Summer Internship Program for American Indian & Native Alaska College Students

ScienceCinema

None

2017-12-09

Argonne National Laboratory's Summer Internship Program for American Indian & Native Alaska College Students. Supported by the Office of Indian Energy and Economic Development (IEED) in partnership with the Council of Energy Resource Tribes (CERT) and the U.S. Department of Energy.

Tobacco use and preferences for wellness programs among health aides and other employees of an Alaska Native Health Corporation in Western Alaska.

PubMed

Patten, Christi A; Bronars, Carrie A; Scott, Matthew; Boyer, Rahnia; Lando, Harry; Clark, Matthew M; Resnicow, Kenneth; Decker, Paul A; Brockman, Tabetha A; Roland, Agnes; Hanza, Marcelo

2017-06-01

This study assessed health behaviors and preferences for wellness programs among employees of a worksite serving Alaska Native-people. Village-based Community Health Aides/Practitioners (CHA/Ps) were compared with all other employees on health indicators and program preferences. Using a cross-sectional design, all 1290 employees at the Yukon Kuskokwim Health Corporation (YKHC) in Western Alaska were invited in 2015 to participate in a 30-item online survey. Items assessed health behaviors, perceived stress, resiliency, and preferences for wellness topics and program delivery formats. Respondents (n = 429) were 77% female and 57% Alaska Natives. CHA/Ps (n = 46) were more likely than all other employees (n = 383) to currently use tobacco (59% vs. 36%; p = 0.003). After adjusting for covariates, greater stress levels were associated (p = 0.013) with increased likelihood of tobacco use. Employees reported lower than recommended levels of physical activity; 74% had a Body Mass Index (BMI) indicating overweight or obese. Top preferences for wellness topics were for eating healthy (55%), physical activity (50%), weight loss (49%), reducing stress (49%), and better sleep (41%). CHA/Ps reported greater interest in tobacco cessation than did other employees (37% vs. 21%; p = 0.016). Preferred program delivery format among employees was in-person (51%). The findings are important because tailored wellness programs have not been previously evaluated among employees of worksites serving Alaska Native people. Promoting healthy lifestyles among CHAP/s and other YKHC employees could ultimately have downstream effects on the health of Alaska Native patients and communities.

Unpacking Race, Culture, and Class in Rural Alaska: Native and Non-Native Multidisciplinary Professionals' Perceptions of Child Sexual Abuse

ERIC Educational Resources Information Center

Bubar, Roe; Bundy-Fazioli, Kimberly

2011-01-01

The purpose of this study was to unpack notions of class, culture, and race as they relate to multidisciplinary team (MDT) professionals and their perceptions of prevalence in child sexual abuse cases in Native and non-Native rural Alaska communities. Power and privilege within professional settings is significant for all social work professionals…

Prevalence of diabetic retinopathy and diabetic macular edema in a primary care-based teleophthalmology program for American Indians and Alaskan Natives.

PubMed

Bursell, Sven-Erik; Fonda, Stephanie J; Lewis, Drew G; Horton, Mark B

2018-01-01

Diabetes and its complications are more common in American Indians and Alaska Natives (AI/AN) than other US racial/ethnic populations. Prior reports of diabetic retinopathy (DR) prevalence in AI/AN are dated, and research on diabetic macular edema (DME) is limited. This study characterizes the recent prevalence of DR and DME in AI/AN using primary care-based teleophthalmology surveillance. This is a multi-site, clinic-based, cross-sectional study of DR and DME. The sample is composed of AI /AN patients with diabetes (n = 53,998), served by the nationally distributed Indian Health Service-Joslin Vision Network Teleophthalmology Program (IHS-JVN) in primary care clinics of US Indian Health Service (IHS), Tribal, and Urban Indian health care facilities (I/T/U) from 1 November 2011 to 31 October 2016. Patients were recruited opportunistically for a retinal examination using the IHS-JVN during their regular diabetes care. The IHS-JVN used clinically validated, non-mydriatic, retinal imaging and retinopathy assessment protocols to identify the severity levels of non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), DME, and sight threatening retinopathy (STR; a composite measure). Key social-demographic (age, gender, IHS area), diabetes-related health (diabetes therapy, duration of diabetes, A1c), and imaging technology variables were examined. The analysis calculated frequencies and percentages of severity levels of disease. Prevalence of any NPDR, PDR, DME, and STR among AI/AN patients undergoing DR teleophthalmology surveillance by IHS-JVN was 17.7%, 2.3%, 2.3%, and 4.2%, respectively. Prevalence was lowest in Alaska and highest among patients with A1c >/ = 8%, duration of diabetes > 10 years, or using insulin. Prevalence of DR in this cohort was approximately half that in previous reports for AI/AN, and prevalence of DME was less than that reported in non-AI/AN populations. A similar reduction in diabetes related end-stage renal

Cultural Competency Perceptions: American Indian/Alaskan Native College Students and Academic Advisors

ERIC Educational Resources Information Center

Wesberry, Leslie C.

2017-01-01

This qualitative case study examined the perceptions of American Indian/Alaskan Native (AI/AN) undergraduate students. Specifically, the study researched if AI/AN college students attending Southeastern Oklahoma State University (SOSU) perceived academic advising as more useful if they were engaged by culturally competent academic advisors as…

Work of the Bureau of Education for the Natives of Alaska. Bulletin, 1925, No. 16

ERIC Educational Resources Information Center

Hamilton, William

1925-01-01

This bulletin documents the work of the Alaska division of the Bureau of Education. It reports advance sheets for the biennial survey of education, 1922-1924. The Alaska division is required to make provision for the education of the natives of Alaska, extend to them all possible medical relief, train them to self-support, and, so far as possible,…

Comprehensive Health Care Program for American Indians & Alaska Natives.

ERIC Educational Resources Information Center

Indian Health Service (PHS/HSA), Rockville, MD.

This booklet summarizes programs of the Indian Health Service (IHS). The IHS was created in 1954 as part of the Public Health Service when responsibility for American Indian and Alaska Native health care was transferred from the Department of the Interior's Bureau of Indian Affairs to the Department of Health, Education, and Welfare. The goal of…

Resource Guide of American Indian and Alaska Native Women, 1980.

ERIC Educational Resources Information Center

Anderson, Owanah P., Comp.; Verble, Sedelta D., Comp.

A resource listing of 678 prominent American Indian and Alaska Native women representing 159 tribes throughout the United States provides the following information: name, address, date and place of birth, tribal membership, field of interest, current occupation, Indian activities, women's advocacy, educational background and professional interest.…

78 FR 15026 - Solicitation for Comments Regarding Current Procedures To Request Emergency and Major Disaster...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... well as actions to reduce losses from future disasters (44 CFR 201.7). For States that do not have a... government level, as well as the impact on American Indian/Alaska Native (AI/AN) Indian tribal government...

Focus groups of Alaska Native adolescent tobacco users: preferences for tobacco cessation interventions and barriers to participation.

PubMed

Patten, Christi A; Enoch, Carrie; Renner, Caroline C; Offord, Kenneth P; Nevak, Caroline; Kelley, Stacy F; Thomas, Janet; Decker, Paul A; Hurt, Richard D; Lanier, Anne; Kaur, Judith S

2009-08-01

Tobacco cessation interventions developed for Alaska Native adolescents do not exist. This study employed focus group methodology to explore preferences for tobacco cessation interventions and barriers to participation among 49 Alaska Natives (61% female) with a mean age of 14.6 (SD = 1.6) who resided in western Alaska. Using content analysis, themes from the 12 focus groups were found to be consistent across village, gender, and age groups. Program location or site (e.g., away from the village, hunting, fishing), a group-based format, and inclusion of medication and personal stories were reported to be important attributes of cessation programs. Motivators to quit tobacco were the perceived adverse health effects of tobacco, improved self-image and appearance, and the potential to be a future role model as a non-tobacco user for family and friends. Parents were perceived as potentially supportive to the adolescent in quitting tobacco. The findings will be used to develop tobacco cessation programs for Alaska Native youth.

The changing epidemiology and aetiology of hepatocellular carcinoma from 1969 through 2013 in Alaska Native people.

PubMed

Connelly, Marc; Bruce, Michael G; Bulkow, Lisa; Snowball, Mary; McMahon, Brian J

2016-12-01

Alaska Native people have an increased rate of hepatocellular carcinoma compared to the United States population. Viral hepatitis is a risk factor for malignancy and the leading cause of hepatocellular carcinoma in Alaska. With the introduction of hepatitis B immunization in 1982, as well as the emergence of hepatitis C virus in this population, the epidemiology and aetiology of hepatocellular carcinoma in Alaska have changed. Using the Alaska Native Tumor Registry, all cases of viral and non-viral hepatocellular carcinoma occurring from 1969 through 2013 were identified and reviewed. Incidence rates per 100 000 population were calculated for hepatocellular carcinoma overall and by aetiological category. One hundred and fifty-two cases of hepatocellular carcinoma were identified in 148 Alaska Native persons. Overall tumour rate was 3.82 per 100 000 and did not change significantly over the study period. Hepatitis B-associated cases decreased significantly over the study period (P = 0.048) and were eliminated in persons under the age of 20. Hepatitis C-associated cases increased significantly (P < 0.001). Undetermined hepatocellular carcinoma rates also decreased (P = 0.034). Overall hepatocellular carcinoma rates in Alaska Native people remained stable over the study period, but the epidemiology and aetiology are changing. Two decades after routine hepatitis B immunization, the hepatocellular carcinoma age distribution has shifted to cases presenting later in life. This is consistent with an ageing hepatitis B-infected population with no new infected young persons' coming into the population, as well as the emergence of hepatitis C in adults. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Use of the evidence base in substance abuse treatment programs for American Indians and Alaska Natives: pursuing quality in the crucible of practice and policy.

PubMed

Novins, Douglas K; Aarons, Gregory A; Conti, Sarah G; Dahlke, Dennis; Daw, Raymond; Fickenscher, Alexandra; Fleming, Candace; Love, Craig; Masis, Kathleen; Spicer, Paul

2011-06-16

A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions. We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status. Broadening this conversation beyond its primary focus on the use of evidence-based treatments to other

Use of the evidence base in substance abuse treatment programs for American Indians and Alaska natives: pursuing quality in the crucible of practice and policy

PubMed Central

2011-01-01

Background A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions. Discussion We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status. Summary Broadening this conversation beyond its primary focus on the use of evidence

Umyuangcaryaraq "Reflecting": multidimensional assessment of reflective processes on the consequences of alcohol use among rural Yup'ik Alaska Native youth.

PubMed

Allen, James; Fok, Carlotta Ching Ting; Henry, David; Skewes, Monica

2012-09-01

Concerns in some settings regarding the accuracy and ethics of employing direct questions about alcohol use suggest need for alternative assessment approaches with youth. Umyuangcaryaraq is a Yup'ik Alaska Native word meaning "Reflecting." The Reflective Processes Scale was developed as a youth measure tapping awareness and thinking over potential negative consequences of alcohol misuse as a protective factor that includes cultural elements often shared by many other Alaska Native and American Indian cultures. This study assessed multidimensional structure, item functioning, and validity. Responses from 284 rural Alaska Native youth allowed bifactor analysis to assess structure, estimates of location and discrimination parameters, and convergent and discriminant validity. A bifactor model of the scale items with three content factors provided excellent fit to observed data. Item response theory analysis suggested a binary response format as optimal. Evidence of convergent and discriminant validity was established. The measure provides an assessment of reflective processes about alcohol that Alaska Native youth engage in when thinking about reasons not to drink. The concept of reflective processes has potential to extend understandings of cultural variation in mindfulness, alcohol expectancies research, and culturally mediated protective factors in Alaska Native and American Indian youth.

Summer Internship Program for American Indian and Native Alaska College Students

ScienceCinema

None

2017-12-11

Argonne National Laboratory's Summer Internship Program for American Indian & Native Alaska College Students. Supported by the Office of Indian Energy and Economic Development (IEED) in partnership with the Council of Energy Resource Tribes (CERT) and the U.S. Department of Energy.

Summer Internship Program for American Indian and Native Alaska College Students

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2010-01-01

Argonne National Laboratory's Summer Internship Program for American Indian & Native Alaska College Students. Supported by the Office of Indian Energy and Economic Development (IEED) in partnership with the Council of Energy Resource Tribes (CERT) and the U.S. Department of Energy.

The American Indian and Alaska Native Higher Education Funding Guide. A Financial Guide to Undergraduate and Graduate Sources of Funding for American Indians and Alaska Natives.

ERIC Educational Resources Information Center

Frazier, Gregory W.

This book provides American Indian and Alaska Native students with sources for securing financial aid for higher education. The first section covers sources of funding and grants for individuals who are pursuing undergraduate degrees. This financial support includes scholarships with state residency requirements, general undergraduate…

U.S. Geological Survey Activities Related to American Indians and Alaska Natives: Fiscal Year 2005

USGS Publications Warehouse

Marcus, Susan M.

2007-01-01

Introduction This report describes the activities that the U.S. Geological Survey (USGS) conducted with American Indian and Alaska Native governments, educational institutions, and individuals during Federal fiscal year (FY) 2005. Most of these USGS activities were collaborations with Tribes, Tribal organizations, or professional societies. Others were conducted cooperatively with the Bureau of Indian Affairs (BIA) or other Federal entities. The USGS is the earth and natural science bureau within the U.S. Department of the Interior (DOI). The USGS does not have regulatory or land management responsibilities. As described in this report, there are many USGS activities that are directly relevant to American Indians, Alaska Natives, and to Native lands. A USGS website, dedicated to making USGS more accessible to American Indians, Alaska Natives, their governments, and institutions, is available at www.usgs.gov/indian. This website includes information on how to contact USGS American Indian/Alaska Native Liaisons, training opportunities, and links to other information resources. This report and previous editions are also available through the website. The USGS realizes that Native knowledge and cultural traditions of living in harmony with nature result in unique Native perspectives that enrich USGS studies. USGS seeks to increase the sensitivity and openness of its scientists to the breadth of Native knowledge, expanding the information on which their research is based. USGS scientific studies include data collection, mapping, natural resource modeling, and research projects. These projects typically last 2 or 3 years, although some are parts of longer-term activities. Some projects are funded cooperatively, with USGS funds matched or supplemented by individual Tribal governments, or by the BIA. These projects may also receive funding from the U.S. Environmental Protection Agency (USEPA), the Indian Health Service (part of the Department of Health and Human Services

Alaska Native Weatherization Training and Jobs Program First Steps Toward Tribal Weatherization – Human Capacity Development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiita, Joanne

The Alaska Native Weatherization Training and Jobs Project expanded weatherization services for tribal members’ homes in southeast Alaska while providing weatherization training and on the job training (OJT) for tribal citizens that lead to jobs and most probably careers in weatherization-related occupations. The program resulted in; (a) 80 Alaska Native citizens provided with skills training in five weatherization training units that were delivered in cooperation with University of Alaska Southeast, in accordance with the U.S. Department of Energy Core Competencies for Weatherization Training that prepared participants for employment in three weatherizationrelated occupations: Installer, Crew Chief, and Auditor; (b) 25 paidmore » OJT training opportunities for trainees who successfully completed the training course; and (c) employed trained personnel that have begun to rehab on over 1,000 housing units for weatherization.« less

Relationships between the health of Alaska Native communities and our environment -- phase 1, exploring and communicating

USGS Publications Warehouse

Smith, Durelle

2013-01-01

Alaska Natives depend on local natural resources for nutritional and, for many, spiritual health. As a result, public health in Alaska is strongly influenced by the relationship between people and their surrounding physical, chemical, and biological environments. Alaska is vast with diverse wildlife and plant communities that are valued as subsistence foods (fig. 1). These resources are supported by equally diverse ecosystems and their underpinning landforms and geologies. The U.S. Geological Survey (USGS) is attempting to integrate physical, chemical, and biological information to better describe current (2013) environments and project scenarios for the future. Integrating ecological data into the public health dialogue is challenging for the more than 280 rural communities of Alaska. This fact sheet reviews a recent USGS effort, the Geographic Information System (GIS) Native Health Project, to better incorporate scientific information into such dialogue.

Cultural Diversity and the Experiences of Alaska Native Nursing Students

ERIC Educational Resources Information Center

Gilmon, Margaret E.

2012-01-01

The purpose of this ethnonursing research study was to discover, describe, and systematically analyze the care expressions, practices, and patterns of Alaska Native nurses within the context of their nursing school experience. The goals of this study were to identify generic and professional care factors that promote the academic success of Alaska…

HIV/AIDS among American Indians/Alaska Natives Living in Montana: A Descriptive Study

ERIC Educational Resources Information Center

Sondag, K. Ann; Strike, Carrie

2011-01-01

This study examined the epidemiology of HIV among AI/ANs in Montana. Barriers to HIV testing and motivations to test also were explored. Analysis of data revealed that there were no significant changes in regard to HIV/AIDS case rates, demographic characteristics, or risk behaviors of AI/ANs infected with HIV/AIDS since reporting began in 1985.…

Intimate Partner Violence in American Indian and/or Alaska Native Communities: A Social Ecological Framework of Determinants and Interventions

ERIC Educational Resources Information Center

Oetzel, John; Duran, Bonnie

2004-01-01

This essay synthesizes the research on intimate partner violence (IPV) in American Indian and/or Alaska Native communities using a social ecological framework. The review of literature demonstrates that American Indian and/or Alaska Native women are at an elevated risk for IPV compared to non-American Indian women and thus this essay describes…

Prevention of type 2 diabetes in urban American Indian/Alaskan Native communities: The Life in BALANCE pilot study

PubMed Central

Benyshek, Daniel C.; Chino, Michelle; Dodge-Francis, Carolee; Begay, Toricellas O.; Jin, Hongbin; Giordano, Celeste

2014-01-01

Objective The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years; BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) < 6.4 percent (46 mmol/mol) participated in the program between April and December, 2011. Study participants completed a 16 week intensive lifestyle coaching intervention. In addition to obtaining qualitative data regarding opportunities and challenges of applying the lifestyle intervention for AI/AN participants in an urban setting, clinical data, including BMI, waist circumference, blood pressure, fasting blood glucose, and blood lipids (HDL, LDL and Triglycerides), were collected. Results Only 12 of the 22 participants remained in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was observed in blood pressure or fasting blood glucose. Conclusions LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies. PMID:24634801

78 FR 77009 - Section 306D Water Systems for Rural and Native Villages in Alaska

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... ``establish a program designed to provide safe water and hygienic disposal facilities in the State of Alaska... treatment facilities and wastewater treatment and collection facilities. Drinking water was hauled from... CFR Part 1784 RIN 0572-AC28 Section 306D Water Systems for Rural and Native Villages in Alaska AGENCY...

Teaching American Indian and Alaska Native Languages in the Schools: What Has Been Learned. ERIC Digest.

ERIC Educational Resources Information Center

Peacock, Thomas D.; Day, Donald R.

This digest considers issues, possible solutions, and successful efforts in dealing with Native language loss, maintenance, and restoration in American Indian and Alaska Native communities and schools. The preservation and maintenance of the remaining 210 tribal languages is a major cultural and education concern in Native communities. The problem…

77 FR 15740 - Application for New Awards; Alaska Native Education Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... Description Purpose of Program: The purpose of the Alaska Native Education (ANE) program is to support... increasing the number or percentage of teachers or principals who are effective or reducing the number or... systems; and reforming compensation and advancement systems. For the purposes of this priority, teacher...

Community and federal collaboration to assess pregnancy outcomes in Alaska Native women, 1997-2005.

PubMed

Kim, Shin Y; England, Lucinda J; Shapiro-Mendoza, Carrie K; Wilson, Hoyt G; Klejka, Joseph; Tucker, Myra; Lewis, Claire; Kendrick, Juliette S

2014-04-01

The objectives are to report the estimated prevalence of pregnancy complications and adverse pregnancy outcomes in a defined population of Alaska Native women and also examine factors contributing to an intensive and successful collaboration between a tribal health center and the Centers for Disease Control and Prevention. Investigators abstracted medical record data from a random sample of singleton deliveries to residents of the study region occurring between 1997 and 2005. We used descriptive statistics to estimate the prevalence and 95% confidence intervals of selected pregnancy complications and adverse pregnancy outcomes. Records were examined for 505 pregnancies ending in a singleton delivery to 469 women. Pregnancy complication rates were 5.9% (95% CI 4.0, 8.4) for gestational diabetes mellitus, 6.1% (95% CI 4.2, 8.6%) for maternal chronic hypertension and 11.5% (95% CI 8.8, 14.6) for pregnancy associated hypertension, and 22.9% (95% CI 19.2-26.5 %) for anemia. The cesarean section rate was 5.5% (95% CI 3.5, 7.5) and 3.8% (95% CI 2.3, 5.8) of newborns weighed >4,500 g. Few previous studies reported pregnancy outcomes among Alaska Native women in a specific geographic region of Alaska and regarding the health needs in this population. We highlight components of our collaboration that contributed to the success of the study. Studies focusing on special populations such as Alaska Native women are feasible and can provide important information on health indicators at the local level.

Native Cultures and Language: Challenges for Land Managers in Alaska

Treesearch

Thomas J. Gallagher

1992-01-01

Many of the Aleuts, Inuits, and Indians of Alaska continue to live a traditional lifestyle. Eighty-eight percent of the land they use for subsistence activities, however, is managed by federal or state agencies. Clear communication across cultures is essential if Native people are to be represented in agency land management decisions. Problems in communication relate...

U.S. Geological Survey activities related to American Indians and Alaska Natives: Fiscal year 2004

USGS Publications Warehouse

,; Brunstein, F. Craig

2006-01-01

The USGS works in cooperation with American Indian and Alaska Native governments to conduct research on (1) water, energy, and mineral resources, (2) animals and plants that are important for traditional lifeways or have environmental or economic significance, and (3) natural hazards. This report describes most of the activities that the USGS conducted with American Indian and Alaska Native governments, educational institutions, and individuals during Federal fiscal year (FY) 2004. Most of these USGS activities were collaborations with Tribes, Tribal organizations, or professional societies. Other activities were conducted cooperatively with the U.S. Bureau of Indian Affairs (BIA) or other Federal entities.

First Nations Approaches to Childhood Obesity: Healthy Lifestyles in Canada Compared with Alternatives for Alaska Native Communities

PubMed Central

de Schweinitz, Peter A.; Wojcicki, Janet M.

2017-01-01

Alaska Native and American Indian children have among the highest prevalence of obesity in the United States. Canadian Aboriginal populations including First Nations also have high rates of obesity but obesity rates among children are noticeably lower. We highlight some of the important differences between American and Canadian approaches to healthy lifestyles and Aboriginal/Native health, including diet and physical activity, which may in part explain the differences in obesity prevalence. Specifically, the Canadian government provides a food subsidy program to bring perishable fruits and vegetable to remote, rural Canadian areas and secondly supports the use of traditional foods and harvesting/gathering through a number of government supported programs. Lastly, there may be a better sense of community and overall life satisfaction for Aboriginals compared with Alaska Natives, in part because of the incorporation of healthcare and other services within the larger overall community, as opposed to separate services as is the case for Alaska Natives. This perspective provides insight into some of these potential differences. PMID:28492517

Learning and Study Practices of Postsecondary American Indian/Alaska Native Students

ERIC Educational Resources Information Center

Aragon, Steven R.

2004-01-01

This study examined the learning and study practices of postsecondary American Indian/Alaska Native students attending community colleges in the southwest. Using a survey design, students completed the Kagan Matching Familiar Figures Test, the Schmeck, Ribich, and Ramanaiah Inventory of Learning Processes, and the Weinstein, Palmer, and Schulte…

“Our Culture Is Medicine”: Perspectives of Native Healers on Posttrauma Recovery Among American Indian and Alaska Native Patients

PubMed Central

Bassett, Deborah; Tsosie, Ursula; Nannauck, Sweetwater

2012-01-01

American Indian and Alaska Native (Native) people experience more traumatic events and are at higher risk for developing posttraumatic stress disorder compared with the general population. We conducted in-depth interviews with six Native healers about their perspectives on traumatic injury and healing. We analyzed the interviews using an inductive approach to identify common themes. We categorized these themes into four categories: causes and consequences of traumatic injury, risk factors, protective factors, and barriers to care. The implications of our study include a need for improving cultural competence among health care and social services personnel working with Native trauma patients. Additional cumulative analyses of Native healers and trauma patients would contribute to a much-needed body of knowledge on improving recovery and promoting healing among Native trauma patients. PMID:22529755

Being a Native and Becoming a Teacher in the Alaska Rural Teacher Training Corps.

ERIC Educational Resources Information Center

Barnhardt, Ray

The program known as the Alaska Rural Teacher Training Corps (ARTTC) was established in 1970 as a 4-year experimental program to train Native elementary school teachers for rural Alaskan native communities or for any school in the country where an Alaskan teaching certificate is acceptable. The beginning group included an even distribution of…

American Indian/Alaskan Native Grandparents Raising Grandchildren: Findings from the Census 2000 Supplementary Survey

ERIC Educational Resources Information Center

Fuller-Thomson, Esme; Minkler, Meredith

2005-01-01

This article documents the prevalence and national profile of American Indian/Alaskan Native (AI/AN) grandparents who are raising their grandchildren, based on data from the American Community Survey/Census 2000 Supplementary Survey. In 2000 there were estimated to be nearly 53,000 AI/AN grandparent caregivers age 45 and older in the United…

Urban American Indian/Alaskan Natives Compared to Non-Indians in Out-of-Home Care

ERIC Educational Resources Information Center

Carter, Vernon B.

2011-01-01

Historically, American Indian/Alaskan Native (AI/AN) children have been disproportionately represented in the foster care system. In this study, nationally representative child welfare data from October 1999 was used to compare urban AI/AN children to non-Indian children placed into out-of-home care. Compared to non-Indian children, urban AI/AN…

33 CFR 203.16 - Federally recognized Indian Tribes and the Alaska Native Corporations.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., NATURAL DISASTER PROCEDURES Introduction § 203.16 Federally recognized Indian Tribes and the Alaska Native Corporations. Requests for Public Law 84-99 assistance on tribal lands held in trust by the United States, or...

Unemployment, Drug Use, and HIV Risk among American Indian and Alaska Native Drug Users.

ERIC Educational Resources Information Center

Reynolds, Grace L.; Fisher, Dennis G.; Estrada, Antonio L.; Trotter, Robert

2000-01-01

Study and 6-month followup of 3,622 drug users in Tucson, Flagstaff, and Anchorage found that American Indian and Alaska Native drug users were younger, less educated, and less likely to be employed than non-Native subjects. Individuals employed at intake or followup had lower levels of HIV risk factors: injection drug use and needle sharing.…

76 FR 35462 - Proposed Renewal of Information Collection; Source Directory of American Indian and Alaska Native...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

... Native artists and craftspeople, cooperatives, tribal arts and crafts enterprises, businesses privately... enterprise, or nonprofit organization. operated business. Copy of the business owner's tribal To determine...; Source Directory of American Indian and Alaska Native Owned and Operated Arts and Crafts Businesses...

Implementing Participatory Research with an Urban American Indian Community: Lessons Learned

ERIC Educational Resources Information Center

Roberts, Erica B.; Jette, Shannon L.

2016-01-01

Objective: Participatory research has proven an effective method for improving health equity among American Indians/Alaska Natives (AI/ANs) by addressing power imbalances between communities and researchers, incorporating community knowledge and theory, ensuring mutual benefit and improving community capacity and programme sustainability. However,…

75 FR 34752 - Proposed Office of State, Tribal, Local and Territorial Support (OSTLTS)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... health needs in American Indian/Alaska Native (AI/AN) communities, and discuss collaborative approaches... Director (OD), other OD Offices and National Center leadership shall actively participate in TCAC meetings... presentations from various CDC senior leadership on activities and areas identified by TCAC members and other...

Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake.

PubMed

Chi, Donald L

2013-01-01

Tooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown. To conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB) intake among Alaska Native children. Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, the terms "Alaska Native", "children" and "oral health" were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970-2012) for relevant clinical trials and evaluation studies. Eighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children. Few oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions are promising approaches to improve the oral and systemic health of Alaska Native

Mashkiki: Old Medicine Nourishing the New. American Indians and Alaska Natives in Biomedical Research Careers--II. Proceedings of the Conference (Duluth, Minnesota, 1988).

ERIC Educational Resources Information Center

Haller, Edwin W., Ed.; Aitken, Larry P., Ed.

This book consists of papers and panel discussions presented at a conference that focused on encouraging American Indian and Alaska Native students to enter the field of biomedical research. Research and treatment of diseases among Native populations can best be carried out by American Indian and Alaska Native researchers who have a background in…

Work of the Bureau of Education for the Natives of Alaska. Bulletin, 1929, No. 12

ERIC Educational Resources Information Center

Hamilton, William

1929-01-01

In addition to maintaining schools for the native children of Alaska, the United States Bureau of Education aids entire communities by extending medical aid, by relieving destitution, by fostering commercial enterprises, by supervising the reindeer industry, and by promoting generally the interests of the natives. The organization of the Alaska…

Prevalence and predictors of cancer screening among American Indian and Alaska native people: the EARTH study

PubMed Central

Schumacher, Mary Catherine; Slattery, Martha L.; Lanier, Anne P.; Ma, Khe-Ni; Edwards, Sandra; Ferucci, Elizabeth D.; Tom-Orme, Lillian

2008-01-01

Purpose The purpose of this study was to examine the prevalence rates for cervical, breast, and colorectal cancer screening among American Indian and Alaska Native people living in Alaska and in the Southwest US, and to investigate predictive factors associated with receiving each of the cancer screening tests. Methods We used the Education and Research Towards Health (EARTH) Study to measure self-reported cancer screening prevalence rates among 11,358 study participants enrolled in 2004–2007. We used prevalence odds ratios to examine demographic, lifestyle and medical factors associated with receiving age- and sex-appropriate cancer screening tests. Results The prevalence rates of all the screening tests were higher in Alaska than in the Southwest. Pap test in the past 3 years was reported by 75.1% of women in Alaska and 64.6% of women in the Southwest. Mammography in the past 2 years was reported by 64.6% of women aged 40 years and older in Alaska and 44.0% of those in the Southwest. Colonoscopy or sigmoidoscopy in the past 5 years was reported by 41.1% of study participants aged 50 years and older in Alaska and by 11.7% of those in the Southwest US. Multivariate analysis found that location (Alaska versus the Southwest), higher educational status, income and the presence of one or more chronic medical condition predicted each of the three screening tests. Additional predictors of Pap test were age (women aged 25–39 years more likely to be screened than older or younger women), marital status (ever married more likely to be screened), and language spoken at home (speakers of American Indian Alaska Native language only less likely to be screened). Additional predictors of mammography were age (women aged 50 years and older were more likely to be screened than those aged 40–49 years), positive family history of breast cancer, use of smokeless tobacco (never users more likely to be screened), and urban/rural residency (urban residents more likely to be

American Indian/Alaska Native Students' Use of a University Student Support Office

ERIC Educational Resources Information Center

Yang, Raymond K.; Byers, Steven R.; Fenton, Beverly

2006-01-01

American Indian/Alaska Native college students responded to two surveys: one assessing their overall psychological status; the other, their current commitment to the traditions they learned as children. Students described their psychological status in reliable, yet diverse ways: displaced and lost; comfortable and naturally embedded; sick,…

Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake

PubMed Central

Chi, Donald L.

2013-01-01

Background Tooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown. Objective To conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB) intake among Alaska Native children. Design Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, the terms “Alaska Native”, “children” and “oral health” were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970–2012) for relevant clinical trials and evaluation studies. Results Eighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children. Conclusions Few oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions are promising

A Prospective Cohort of American Indian and Alaska Native People: Study Design, Methods, and Implementation

PubMed Central

Slattery, M. L.; Schumacher, M. C.; Lanier, A. P.; Edwards, S.; Edwards, R.; Murtaugh, M. A.; Sandidge, J.; Day, G. E.; Kaufman, D.; Kanekar, S.; Tom-Orme, L.; Henderson, J. A.

2008-01-01

In 2001, the National Cancer Institute funded three centers to test the feasibility of establishing a cohort of American Indian and Alaska Native people. Participating tribal organizations named the study EARTH (Education and Research Towards Health). This paper describes the study methods. A computerized data collection and tracking system was developed using audio computer-assisted survey methodology with touch screens. Data were collected on diet, physical activity, lifestyle and cultural practices, medical and reproductive history, and family history of heart disease, diabetes, and cancer. In addition, a small panel of medical measurements was obtained, including height, weight, waist and hip circumferences, blood pressure, and a lipid panel plus glucose. At the completion of the enrollment visit, data were used to provide immediate health feedback to study participants. During the initial funding period, the authors anticipate enrolling 16,000 American Indian and Alaska Native participants. The age distribution of the study population was similar to that reported in the 2000 US Census for the relevant populations. A component critical to the success of the EARTH Study has been the partnerships with tribal members. The study has focused on involvement of American Indian and Alaska Native communities in development and implementation and on provision of feedback to participants and communities. PMID:17586578

Exploring the Potential for Technology-Based Nutrition Education Among WIC Recipients in Remote Alaska Native Communities.