Women finding the way: American Indian women leading intervention research in Native communities

Heart, Maria Brave

doi:10.5820/aian.2303.2016.24

Cited by 19 publications

(10 citation statements)

References 60 publications

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“…Disruption of culture due to government assimilation policies still has a profound impact on Diné women’s transition to womanhood [ 59 , 60 ]. Some write-in responses revealed that women were in off-reservation boarding schools during menarche and, without their mother, they confided in dorm aides, teachers, sisters, or cousins.…”

Section: Discussionmentioning

confidence: 99%

Diné (Navajo) female perspectives on mother–daughter communication and cultural assets around the transition to womanhood: a cross-sectional survey

et al. 2021

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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 complementary fatherhood and/or family-based intervention to prevent Native girls’ substance use and teen pregnancy.

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Section: Discussionmentioning

confidence: 99%

Diné (Navajo) female perspectives on mother–daughter communication and cultural assets around the transition to womanhood: a cross-sectional survey

et al. 2021

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“…This mixed-method analysis examines quantitative survey data and qualitative interview data that were collected as part of a multi-year study exploring experiences with healthcare and health insurance among American Indian Elders (age 55 and older) in two states in the Southwestern U.S. ( 26 ). Consistent with community-engaged approaches to conducting research with Indigenous peoples ( 27 , 28 ), the study was conceptualized and designed by a team of Indigenous and non-Indigenous researchers in consultation with a group of Elders and allies comprising the Seasons of Care Community Action Board (CAB). The CAB members have overseen and participated in each aspect of the research, including reviewing data collection instruments, assisting with recruitment, and strategizing efforts to promote Elder health.…”

Section: Methodsmentioning

confidence: 99%

Causes and Consequences of Not Having a Personal Healthcare Provider Among American Indian Elders: A Mixed-Method Study

Jaramillo

Sommerfeld

Haozous

et al. 2022

Front. Public Health

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Having a regular relationship with a healthcare provider contributes to better health outcomes and greater satisfaction with care for older adults. Although members of federally recognized American Indian tribes have a legal right to healthcare, American Indian Elders experience inequities in healthcare access that may compromise their ability to establish a relationship with a healthcare provider. This multi-year, community-driven, mixed-method study examines the potential causes and consequences of not having a personal healthcare provider among American Indian Elders. Quantitative surveys and qualitative interviews were conducted with 96 American Indian Elders (age 55 and over) in two states in the Southwestern United States. Quantitative and qualitative data were analyzed separately and then triangulated to identify convergences and divergences in data. Findings confirmed that having a consistent healthcare provider correlated significantly with self-rated measures of health, confidence in getting needed care, access to overall healthcare, and satisfaction with care. Lack of a regular healthcare provider was related to interconnected experiences of self-reliance, bureaucratic and contextual barriers to care, and sentiments of fear and mistrust based in previous interactions with medical care. Increasing health equity for American Indian Elders will thus require tailored outreach and system change efforts to increase continuity of care and provider longevity within health systems and build Elders' trust and confidence in healthcare providers.

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“…Health-promotion programs for AIAN communities are most effective when grounded in Indigenous cultural and community knowledge and values (Walters et al, 2020). A common approach is to tailor existing evidence-based programs to AIAN communities by integrating Tribal cultural education and traditional practices (Greenfield & Venner, 2012;Lucero, 2011), which have been effective for improving mental health (Brave Heart et al, 2016) and reducing substance use (Ivanich et al, 2020). Evidence-based programs that align with existing culture (Goodkind et al, 2015) and emphasize health promotion through cultural sources of strength and resiliency (Walker et al, 2015) are particularly successful.…”

Section: Brief Preconceptual Aep-reduction Programs Within Aian Communitiesmentioning

confidence: 99%

Where there’s a will, there’s a way? Strategies to reduce or abstain from alcohol use developed by Northern Plains American Indian women participating in a brief, alcohol‐exposed pregnancy preconceptual intervention

Deutsch

Lustfield

Hanson

2021

Alcoholism Clin & Exp Res

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Background: Alcohol-exposed pregnancy (AEP) is an ongoing concern, especially within low-resource, high-risk areas such as rural American Indian/Alaska Native (AIAN) communities. Brief, preconceptual AEP-reduction interventions are popular in such areas but have a small impact on alcohol use. Developing a strategic alcohol change plan is a key program component; however, there is little research on strategy selection, especially within contexts that positively or negatively impact selection (e.g., cultural strengths, trauma, collective efficacy within AIAN communities). This study qualitatively analyzed strategies chosen to reduce alcohol use by AIAN women participating in a culturally tailored, brief, preconceptual AEP-reduction intervention.Methods: One hundred-sixty Northern Plains AIAN women who were participating in a brief AEP-reduction program developed a plan to accomplish an alcohol reduction/ abstention goal at the first and last program sessions. The plan included choosing 1 or more strategies to (1) achieve the goal, (2) mitigate barriers, and (3) use cultural strengths. Qualitative analysis of the data involved thematic open and structured coding of all 3 strategies separately. We also examined how many different themes (different individual strategies) participants reported for each strategy component. Results:Most participants reported only 1 strategy (theme) for each of the 3 components. Common goal-achieving and barrier-mitigation strategies included positive social supports and avoiding negative or alcohol-involved social environments. Other strategies involved circular logic (e.g., the strategy to reduce drinking was to drink less). Both traditional and western cultural strengths were reported as important resources, although many participants had no cultural resource strategy. Conclusion:Programs aimed at reducing AEPs may need to provide participants more support to develop strong strategies to reduce alcohol use when implemented within areas with high levels of trauma and contextual barriers that can impact strategy selection. Such support could include ways to improve health on both interpersonal and community levels.

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Women finding the way: American Indian women leading intervention research in Native communities

Cited by 19 publications

References 60 publications

Diné (Navajo) female perspectives on mother–daughter communication and cultural assets around the transition to womanhood: a cross-sectional survey

Diné (Navajo) female perspectives on mother–daughter communication and cultural assets around the transition to womanhood: a cross-sectional survey

Causes and Consequences of Not Having a Personal Healthcare Provider Among American Indian Elders: A Mixed-Method Study

Where there’s a will, there’s a way? Strategies to reduce or abstain from alcohol use developed by Northern Plains American Indian women participating in a brief, alcohol‐exposed pregnancy preconceptual intervention

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