Medicine and Health Sciences Commons^™

Urban American Indian Experiences Living With Type 2 Diabetes Mellitus, Elin E. Kambuga, Yitza A. Arcelay-Rojas

Journal of Social, Behavioral, and Health Sciences

This qualitative interpretive study aimed to describe the experiences of 13 American Indians living in urban settings and their use of traditional healing and biomedical health services for type 2 diabetes. Urban American Indian adults living in the United States who used traditional healing and biomedical health services for type 2 diabetes were recruited for the study through purposive sampling, including snowball sampling. Thirteen participants completed semi-structured interviews. Participants reported positive experiences and barriers to traditional healing and Western biomedical services. They also discussed feelings of disorientation when diagnosed at a young age with type 2 diabetes but self-empowerment as …

Addressing Adolescent Sexual Health Through An Educational Toolkit For Providers In Rural Alaska, Anna M. Martin, Tracy L. Brewer, Hannah E. Warren

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Introduction. Adequately addressing an adolescent’s sexual health is essential during the child’s development yet, 33% of adolescents have health visits with no mention of sexual health. On average, primary care providers spend approximately thirty-six seconds discussing sexual health topics with adolescents despite recommendations for comprehensive education. Alaska Native youth face significant disparities regarding sexual and reproductive health care. Implementation and evaluation of a comprehensive educational toolkit regarding various sexual health topics for rural healthcare providers in Alaska revealed positive outcomes in discussing sexual health with an adolescent.

Methods. Larrabee's Model for Evidence-based Practice Change guided the development, implementation, and …

A Walk In Two Worlds: An Indigenous Health Research Mentorship Model Developed From The Experiences Of Mentors And Mentees In A Cancer Research Education Program Aimed At Increasing Representation Of American Indians/Alaska Natives In Cancer Research And Healthcare Professions, Kiana Borengasser, Aislinn C. Rookwood, Joyce C. Solheim, Maurice Godfrey, Karen Taraszka Hastings, Keyonna King, Hannah Robbins, Mariah Abney, Rudy Smith Jr., Liliana Tamayo, Regina Emily Robbins

Capstone Experience

The National Cancer Institute promotes workforce development programs that aim to increase representation of American Indian/Alaska Natives in health science and research careers. One such program, Youth Enjoy Science at the University of Nebraska Medical Center, has employed American Indian/Alaska Native youth in mentored cancer research internships from 2017 to 2022. The primary purpose of this study was to examine mentor and mentee experiences of participation in Youth Enjoy Science research education internships to learn from their stories. We conducted semi-structured interviews with current and former Youth Enjoy Science mentees (n=8) and mentors (n=8). We analyzed and collectively re-storied the …

Promoting Culturally Respectful Cancer Education Through Digital Storytelling, Melany Cueva, Regina Kuhnley, Anne Lanier, Mark Dignan, Laura Revels, Nancy E. Schoenberg, Katie Cueva

Internal Medicine Faculty Publications

Cancer is the leading cause of mortality among Alaska Native people. Over half of Alaska Native people live in rural communities where specially trained community members called Community Health Aides/Practitioners (CHA/Ps) provide health care. In response to CHA/Ps’ expressed desire to learn more about cancer, four 5-day cancer education and digital storytelling courses were provided in 2014. Throughout each course, participants explored cancer information, reflected on their personal experiences, and envisioned how they might apply their knowledge within their communities. Each course participant also created a personal and authentic digital story, a methodology increasingly embraced by Indigenous communities as a …

Infant Mortality In American Indians And Alaska Natives 1995–1999 And 2000–2004, Patrik Johansson, Weston Williams, Ayman El-Mohandes

Publications and Research

Objectives. (1) To determine the infant mortality rate (IMR) in American Indians/ Alaska Natives (AI/AN) and Whites between 1995–1999 and 2000–2004. (2) To compare the leading causes of infant mortality in AI/AN and Whites. (3) To examine differences in neonatal vs. postneonatal causes of death in Whites and AI/AN.

Methods. Using the 1995–99 and 2000–04 Centers for Disease Control and Prevention’s National Center for Health Statistics national linked birth/infant death data, we examined neonatal and postneonatal IMR among AI/AN and Whites.

Results. AI/AN experienced significantly greater overall IMR in 1995–1999 and 2000–2004 than Whites. While the reduction in …

Intergenerational Dialogue Exchange And Action: Introducing A Community-Based Participatory Approach To Connect Youth, Adults And Elders In An Alaskan Native Community, Lisa Wexler

Lisa Wexler

The broad goals of the community-based participatory research (CBPR) include community engagement, capacity building, developing practical solutions for community concerns and knowledge building. This article describes the data generation and sharing process as it relates to the goals of CBPR and health promotion in an American Indian/Alaska Native communities. The project described herein, “Investigating Inupiaq Cultural Resilience: A Pilot Study,” achieved these goals in a tribal context by fostering intergenerational dialogue through data collection. The intergenerational exchange served to collect data for a community-based participatory study and provide an opportunity for communication between Elders, adults and youth. By providing an …

Gastric Cancer Among American Indians And Alaska Natives In The United States, 1999–2004, Charles Wiggins, David G. Perdue, Jeffrey A. Henderson, Michael G. Bruce, Anne P. Lanier, Janet J. Kelly, Brenda F. Seals, David K. Espey

Public Health Resources

BACKGROUND. Gastric cancer incidence rates for American Indians and Alaska Natives (AI/ANs) historically have exceeded those for non-Hispanic whites (NHWs). Previous reports may have underestimated the true burden of gastric cancer in AI/AN populations because of misclassification of AI/AN race in cancer registries.

METHODS. Population-based cancer registry data from 1999 through 2004 were used to describe gastric cancer incidence in AI/ANs and NHWs in the US. To address misclassification of race, registry data were linked with Indian Health Service administrative records, and analyses were restricted to residents of Contract Health Service Delivery Areas (CHSDA). Disease patterns were assessed …

Lung Cancer Incidence Among American Indians And Alaska Natives In The United States, 1999–2004, Anne Bliss, Nathaniel Cobb, Teshia Solomon, Kym Cravatt, Melissa A. Jim, Latisha Marshall, Janis Campbell

Public Health Resources

BACKGROUND. Lung cancer incidence rates among American Indians and Alaska Natives (AI/ANs) in the United States have not been described well, primarily because of race misclassification and, until the 1990s, incomplete coverage of their population by cancer registries. Smoking, the predominant cause of lung cancer, is particularly prevalent among this population.

METHODS. Data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age adjusted incidence rates of lung cancer during 1999 through 2004. Cases were linked to Indian Health Service (IHS) registration databases to identify AI/ANs whose race …

Methods For Improving Cancer Surveillance Data In American Indian And Alaska Native Populations, David K. Espey, Charles Wiggins, Melissa A. Jim, Barry A. Miller, Christopher J. Johnson, Tom M. Becker

Public Health Resources

BACKGROUND. The misclassification of race decreases the accuracy of cancer incidence data for American Indians and Alaska Natives (AI/ANs) in some central cancer registries. This article describes the data sources and methods that were used to address this misclassification and to produce the cancer statistics used by most of the articles in this supplement.

METHODS. Records from United States cancer registries were linked with Indian Health Service (IHS) records to identify AI/AN cases that were misclassified as non-AI/AN. Data were available from 47 registries that linked their data with IHS, met quality criteria, and agreed to participate. Analyses …

Prostate Cancer Incidence Among American Indian And Alaska Native Men, Us, 1999–2004, Jeffrey A. Henderson, David K. Espey, Melissa Jim, Robert R. German, Kate M. Shaw, Richard M. Hoffman

Public Health Resources

BACKGROUND. American Indian and Alaska Native (AI/AN) men experience lower incidence of prostate cancer than other race/ethnic populations in the US, but racial misclassification of AI/AN men threatens the validity of these estimates. To the authors’ knowledge, little is known concerning prostate-specific antigen (PSA) testing in AI/AN men.

METHODS. The authors linked cancer registry data with Indian Health Service enrollment records to improve race classification. Analyses comparing cancer incidence rates and stage at diagnosis for AI/AN and non-Hispanic white (NHW) men for 6 geographic regions focused on counties known to have less race misclassification. The authors also used …

Primary Liver Cancer Incidence Among American Indians And Alaska Natives, Us, 1999–2004, Melissa Jim, David G. Perdue, Lisa C. Richardson, David K. Espey, John T. Redd, Howard J. Martin, Sandy L. Kwong, Janet J. Kelly, Jeffrey A. Henderson, Faruque Ahmed

Public Health Resources

BACKGROUND. American Indians and Alaska Natives (AI/AN) experience higher morbidity and mortality from primary liver cancer than other United States (US) populations, but racial misclassification in medical records results in underestimates of disease burden.

METHODS. To reduce misclassification, National Program of Cancer Registries and Surveillance, Epidemiology, and End Results data were linked with Indian Health Service (IHS) enrollment records to compare primary liver cancer incidence and stage at diagnosis between AI/AN and non-Hispanic whites (NHW) living within the regionalized IHS Contract Health Service Delivery Area counties. Incidence rates are expressed per 100,000 persons and age-adjusted by 19 age …

Cancer Among American Indians And Alaska Natives In The United States, 1999–2004, Charles Wiggins, David K. Espey, Phyllis A. Wingo, Judith S. Kaur, Robin Taylor Wilson, Judith Swan, Barry A. Miller, Melissa Jim, Janet J. Kelly, Anne P. Lanier

Public Health Resources

BACKGROUND. Cancer incidence rates vary among American Indian and Alaska Native (AI/AN) populations and often differ from rates among non-Hispanic whites (NHWs). However, the misclassification of race for AI/AN cancer cases in central cancer registries may have led to underestimates of the AI/AN cancer burden in previous reports.

METHODS. Cases diagnosed during 1999 through 2004 were identified from population- based cancer registries in the United States. Age-adjusted rates were calculated for the 25 most common sites for AI/ANs and NHWs. To minimize the misclassification of race, cancer registry records were linked with patient registration files from the Indian …

Annual Report To The Nation On The Status Of Cancer, 1975–2004, Featuring Cancer In American Indians And Alaska Natives, David K. Espey, Xiao-Cheng Wu, Judith Swan, Charles Wiggins, Melissa A. Jim, Elizabeth Ward, Phyllis A. Wingo, Holly L. Howe, Lynn A. G. Ries, Barry A. Miller, Ahmedin Jemal, Faruque Ahmed, Nathaniel Cobb, Judith S. Kaur, Brenda K. Edwards

Public Health Resources

BACKGROUND. The American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries collaborate annually to provide updated information on cancer occurrence and trends in the U.S. The 2007 report features a comprehensive compilation of cancer information for American Indians and Alaska Natives (AI/AN).

METHODS. Cancer incidence data were available for up to 82% of the U.S. population. Cancer deaths were available for the entire U.S. population. Long-term (1975 through 2004) and fixed-interval (1995 through 2004) incidence and mortality trends were evaluated by annual percent change …

Grandparent Care In The American Indian/ Alaska Native Population, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to provide information on American Indian/Alaska Native (hereafter, Native American) grandparent caregivers in the United States. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household. We use the census information to identify grandparents who are caring for grandchildren in two different types of households: …