Obesity Education among American Indians: Evaluating a Culturally Appropriate Approach to Health Awareness

Gamble, Firouzeh A; Eley, Susan; Southard, Erik

doi:10.1080/26408066.2019.1639237

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…When providers fail to acknowledge the cultural identity of AI/AN patients or respect their medical preferences and knowledge, these sociocultural barriers can prevent AI/AN patients from seeking or receiving care from specialists [75][76][77] . Examples of cul-turally competent care to reduce health-care disparities have recently emerged and merit expansion 70,[78][79][80][81] .…”

Section: Sociocultural Barriersmentioning

confidence: 99%

The Unmet Need for Orthopaedic Services Among American Indian and Alaska Native Communities in the United States

Ottesen

Amick

Kapadia

et al. 2022

Journal of Bone and Joint Surgery

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:Historic and present-day marginalization has resulted in a high burden of disease and worse health outcomes for American Indian and Alaska Native (AI/AN) communities in the United States. Musculoskeletal disease is the leading cause of disability for the general population in the U.S. today. However, few have examined musculoskeletal disease burden and access to orthopaedic surgical care in the AI/AN communities. A high prevalence of hip dysplasia, arthritis, back pain, and diabetes, and a high incidence of trauma and road traffic-related mortality, suggest a disproportionately high burden of musculoskeletal pathology among the AI/AN communities and a substantial need for orthopaedic surgical services. Unfortunately, AI/AN patients face many barriers to receiving specialty care, including long travel distances and limited transportation to health facilities, inadequate staff and resources at Indian Health Service (IHS)-funded facilities, insufficient funding for referral to specialists outside of the IHS network, and sociocultural barriers that complicate health-system navigation and erode trust between patients and providers. For those who manage to access orthopaedic surgery, AI/AN patients face worse outcomes and more complications than White patients. There is an urgent need for orthopaedic surgeons to participate in improving the availability of quality orthopaedic services for AI/AN patients through training and support of local providers, volunteerism, advocating for a greater investment in the IHS Purchased/Referred Care program, expanding telemedicine capabilities, and supporting community-based participatory research activities.

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Section: Sociocultural Barriersmentioning

confidence: 99%

The Unmet Need for Orthopaedic Services Among American Indian and Alaska Native Communities in the United States

Ottesen

Amick

Kapadia

et al. 2022

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

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Association between steroid use and concussions among high school athletes: a cross-sectional analysis of the Youth Risk Behavior Surveillance System

Sherman,

Tyree,

Ford

et al. 2023

Journal of Osteopathic Medicine

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Context In 2017, there were almost 2.5 million high school students who experienced a concussion while playing a sport, raising concern for the neurologic problems that they could face. Some of these athletes may seek to gain a competitive advantage in their sport by utilizing substances like steroids. However, steroid use can cause increased aggression and body mass index (BMI), which might lead to heightened risk for concussions. Despite extensive research, we found no previous evidence linking these two factors. Objectives This analysis aims to investigate steroid use trends in high school athletes and to determine whether there is an association between steroid use and concussions in these athletes. Methods We conducted a cross-sectional analysis of the cumulative Youth Risk Behavior Surveillance System (YRBSS). Respondents were added if they participated in sports and answered the steroid and concussion prompts. Demographic variables were assessed including age, grade, BMI, gender, and race/ethnicity. Results We found that 3.7 % (n=2991) of high school athletes reported previous steroid use and that 20.7 % (n=2273) reported having sustained a concussion. There was a statistically significant difference in steroid use by race/ethnicity (p<0.001), with the highest rate of use (7.2 %) among American Indian/Alaska Natives (AI/AN). A significantly higher prevalence of steroid use occurred in athletes who were males (4.7 %) than females (2.5 %) and in athletes with a BMI>95 % (5.2 %) compared with those with a BMI between 85 and 95 % (3.9 %) and <85 % (3.5 %) (χ2=135.1, p<0.001 and χ2=16.3, p<0.001, respectively). Further, our results showed that the prevalence of steroid use among high school athletes decreased from 3.4 % in 1999 to 1.9 % in 2019, with the most drastic drop occurring between 2015 and 2019—declining 1.9 %. Whereas 19.6 % of athletes reported a concussion without steroid use, 54.6 % of steroid-utilizing athletes reported having experienced a concussion—a statistically significant finding (adjusted odds ratio [AOR]=4.3; 95 % CI: 3.2–5.9). Finally, compared with White athletes, we found that AI/AN athletes were significantly more likely to have sustained a concussion (AOR=2.3; 95 % CI=1.2–4.3). Conclusions Although our study found decreasing rates of steroid use among high school athletes from 1999 through 2019, our results also show that steroid use is significantly associated with sustaining a concussion. Additionally, the data from YRBSS also demonstrates that AI/AN high school athletes are more likely to utilize steroids and sustain a concussion. Given the long-term consequences of traumatic brain injuries, we recommend that coaches should be aware of potential steroid use among players, and that coaches, athletic trainers, and physicians should all be aware of concussion protocols and remove players from games for evaluation when a concussion is suspected.

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Obesity Education among American Indians: Evaluating a Culturally Appropriate Approach to Health Awareness

Cited by 2 publications

References 11 publications

The Unmet Need for Orthopaedic Services Among American Indian and Alaska Native Communities in the United States

The Unmet Need for Orthopaedic Services Among American Indian and Alaska Native Communities in the United States

Association between steroid use and concussions among high school athletes: a cross-sectional analysis of the Youth Risk Behavior Surveillance System

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