Suchergebnisse

Since 1998, the US Congress has funded the Special Diabetes Programs for American Indians and Alaskan Natives (SDPI). These funds are administered by the Indian Health Service (IHS) and have been awarded to more than 330 IHS, tribal, and urban Indian health programs in thirty-five states to build or enhance diabetes mellitus (DM) treatment and prevention programs. Over the past thirteen years, these community-directed programs have emerged as models of intervention creativity, innovation, and persistence, with program staff drawing on their cultural capital to design culturally acceptable and locally relevant strategies. These programs have achieved measurable change in Native peoples' knowledge of the diabetes risk factors, access to much needed DM related services, and in some cases, helped reduce rates of DM-related morbidity and mortality. Yet, perhaps their greatest influence has been in understanding and shaping the context of behavioral change and in promoting normative shifts in food choices, activity patterns, DM screening, and DM self-management. Systematic qualitative data collection has not played a prominent role in the evaluation of the SDPI programs, and subsequently the role of cultural capital and the subtle normative shifts over the course of the SDPI programs have not been documented. This article offers a review of the qualitative accomplishments of the SDPI programs and some methodological suggestions for capturing the impact of cultural capital.

Objective.To describe physical activity (PA) interventions implemented in American Indian/Alaska Native (AI/AN) populations in the United States and Canada.Data Sources.MEDLINE, PubMed, ERIC, and Sociological Abstracts were used to identify peer-reviewed journal articles. Dissertation abstracts, Web sites, and conference proceedings were searched to identify descriptions within the gray literature from 1986 to 2006.Study Inclusion and Exclusion Criteria.The target population had to be described as AI/AN, aboriginal, native Hawaiian, and/or native U.S. Samoan. PA interventions among indigenous populations of Latin America were not included.Data Extraction.Descriptions of 64 different AI/AN PA interventions (28 peer-reviewed journal articles and 36 in the gray literature) were identified.Data Synthesis.Data were synthesized by geographic region, intervention strategy, target audience, activities, and sustainability.Results.Most interventions were conducted in the southwest United States (35.4%), in reservation communities (72%), and among participants 18 years and younger (57.8%). Forty-one percent of the 27 interventions with evaluation components reported significant changes in health, behavior, or knowledge.Conclusions.Effective AI/AN PA interventions demonstrated impact on individual health and community resources. Program sustainability was linked to locally trained personnel, local leadership, and stable funding. Culturally acceptable and scientifically sound evaluation methods that can be implemented by local personnel are needed to assess the health and social impact of many long-running AI/AN PA interventions.

Community partnerships or networks of collaborating public and nonprofit organizations are an important way of addressing a wide range of problems and needs that communities face. In the academic literature, network analysis has been used to analyze and understand the structure of the relationships that make up multiorganizational partnerships. But this tool is not well‐known outside the small group of researchers who study networks, and it is seldom used as a method of assisting communities. This article briefly discusses network analysis and how community leaders can use the results generated by this tool to strengthen relationships among public and nonprofit organizations, thereby building the community's capacity to address critical needs in areas such as health, human services, social problems, and economic development.

Service learning (SL) is a form of community-centered experiential education that places emerging health professionals in community-generated service projects and provides structured opportunities for reflection on the broader social, economic, and political contexts of health.

Objective:To conduct a systematic literature review to assess the conceptualization, application, and measurement of resilience in American Indian and Alaska Native (AIAN) health promotion.Data Sources:We searched 9 literature databases to document how resilience is discussed, fostered, and evaluated in studies of AIAN health promotion in the United States.Study Inclusion and Exclusion Criteria: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.Data Extraction: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.Data Synthesis: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.Results: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.Conclusion: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.

BACKGROUND: The inclusion of protective factors ("assets") are increasingly supported in developing culturally grounded interventions for American Indian (AI) populations. This study sought to explore AI women's cultural assets, perspectives, and teachings to inform the development of a culturally grounded, intergenerational intervention to prevent substance abuse and teenage pregnancy among AI females. METHODS: Adult self-identified AI women (N = 201) who reside on the Navajo Nation completed a cross-sectional survey between May and October 2018. The 21-question survey explored health communication around the transition to womanhood, cultural assets, perceptions of mother–daughter reproductive health communication, and intervention health topics. Univariate descriptive analyses, chi squared, and fisher's exact tests were conducted. RESULTS: Respondents ranged in age from 18 to 82 years, with a mean age of 44 ± 15.5 years. Women self-identified as mothers (95; 48%), aunts (59; 30%), older sisters (55; 28%), grandmothers (37; 19%), and/or all of the aforementioned (50; 25%). 66% (N = 95) of women admired their mother/grandmother most during puberty; 29% (N = 58) of women were 10–11 years old when someone first spoke to them about menarche; and 86% (N=172) felt their culture was a source of strength. 70% (N = 139) would have liked to learn more about reproductive health when they were a teenager; 67% (N = 134) felt Diné mothers are able to provide reproductive health education; 51% (N = 101) reported having a rite of passage event, with younger women desiring an event significantly more than older women. Responses also indicate a disruption of cultural practices due to government assimilation policies, as well as the support of male relatives during puberty. CONCLUSIONS: Results informed intervention content and delivery, including target age group, expanded caregiver eligibility criteria, lesson delivery structure and format, and protective cultural teachings. Other implications include the development of a ...