Open Access. Powered by Scholars. Published by Universities.®

Medicine and Health Sciences Commons

Open Access. Powered by Scholars. Published by Universities.®

PDF

Theses/Dissertations

Culture

Discipline
Institution
Publication Year
Publication

Articles 1 - 30 of 112

Full-Text Articles in Medicine and Health Sciences

Playing With International Students From Asia: An Exploration Of Cultural Commonalities And Differences In Developmental Transformations (Dvt), Hazuki Okamoto May 2024

Playing With International Students From Asia: An Exploration Of Cultural Commonalities And Differences In Developmental Transformations (Dvt), Hazuki Okamoto

Expressive Therapies Capstone Theses

Asian international students in the United States face a multitude of challenges such as language barriers, differences in cultural norms and behaviors, and identity confusion while navigating a foreign landscape. Developmental Transformations (DvT), a form of drama therapy, may apply to these challenges by enabling participants to explore different identities and express themselves creatively beyond the language barrier. This community engagement project was designed for Asian international students to be seen and heard by utilizing DvT. Within an in-person workshop, five participants played with their shared stories, and explored international and cultural roles in group DvT. Key takeaways from the …


Exploring Early Language Acquisition Through English And French, Rebecca C. Aguilar May 2024

Exploring Early Language Acquisition Through English And French, Rebecca C. Aguilar

Honors Capstones

Knowing that there is no singular event that leads to learning a language, and factoring in the extent an individual’s culture can affect language learning, this study emphasizes the importance of a cross-linguistic approach to continue to broaden the scope of language acquisition research. The primary objective is to identify and analyze the critical commonalities in the initial stages of learning English and French as first languages through two major categories: speech/language and culture. This project carried out an analytical review of 24 pieces of relevant literature, in both languages, in an effort to highlight key findings. Those findings include: …


Social And Cultural Processes That Impact Physical Activity Among South Asian Americans Managing Hypertension: A Mixed Methods Study, Sugandha Gupta Sep 2023

Social And Cultural Processes That Impact Physical Activity Among South Asian Americans Managing Hypertension: A Mixed Methods Study, Sugandha Gupta

Dissertations, Theses, and Capstone Projects

Cardiovascular disease (CVD), the number one cause of death in the U.S., disproportionately affects South Asian Americans (SAAs). Physical activity is a modifiable health behavior that can reduce cardiovascular risk. Health behaviors, such as physical activity, occur within specific social and cultural contexts and are influenced by multiple factors at multiple levels of the social ecological model. This dissertation aimed to provide a rich, culturally-informed understanding of the factors at multiple levels – individual, interpersonal, and cultural –associated with physical activity among SAAs at risk for CVD. A sequential exploratory mixed methods approach was employed to examine social and cultural …


African-American Parents’ Cultural Understandings Of The Concept Of Autism And Implications For Parental Communication And Health Management, Kellie J. Fennell Aug 2023

African-American Parents’ Cultural Understandings Of The Concept Of Autism And Implications For Parental Communication And Health Management, Kellie J. Fennell

Communication & Theatre Arts Theses

In 2023 the Centers of Disease Control reported that around 1 in 36 children are diagnosed with Autism in America and that the prevalence has increased by 178% since 2000 (CDC, 2023). Despite increases in awareness and diagnosis past research finds that the discussions of ASD in African American communities is minimal (Fombonne, 2003; Yeargin Allsopp et al., 2003). This disparity is important considering that African American children receive an ASD diagnosis years later than their white counterparts and are much more likely to be misdiagnosed (Mandell et al., 2009, 2002).

Given the history of a lack of representation of …


Practices And Attitudes Towards Infant Hearing Protection At Orthodox Jewish Weddings, Rebecca Weiss Jun 2023

Practices And Attitudes Towards Infant Hearing Protection At Orthodox Jewish Weddings, Rebecca Weiss

Dissertations, Theses, and Capstone Projects

Previous research has shown that prolonged exposure to noise can cause permanent hearing loss no matter what age, including infants. The impact of noise at orthodox Jewish weddings, where infants are frequently in attendance, can reach extremely high and damaging levels of sound intensity. Because the hearing conservation behaviors and attitudes towards child hearing protection in this population are unknown, the objective of this study is to identify the attitudes and behaviors of orthodox Jewish wedding attendees toward child hearing conservation. A survey was developed and administered electronically to congregants of orthodox Jewish synagogues in the New York City area. …


Ots Delivering Culturally Sensitive Care For Dementia Family Caregivers From Diverse Backgrounds, Abraham Lai, Lucy Palacios Mendez, Darren Sarmiento May 2023

Ots Delivering Culturally Sensitive Care For Dementia Family Caregivers From Diverse Backgrounds, Abraham Lai, Lucy Palacios Mendez, Darren Sarmiento

Occupational Therapy | Graduate Capstone Projects

As occupational therapists, addressing key cultural barriers that may obstruct access to dementia care and education for individuals with dementia and their caregivers from diverse backgrounds is a priority for client-centered care. Stress, racial discrimination, and distrust may exacerbate symptoms and prevalence of dementia in certain populations, such as Chinese- Americans and Latinx (Quinones et al. 2020). Immigrants’ experiences of aging and health are diverse due to belonging to different socioeconomic, ethnic, cultural, and linguistic groups and having varying levels of education and work experience (R. S. 2020). There are existing cultural differences regarding caregiving and family networks, perception and …


Doing Death Better: Practical Ways For Healthcare Professionals To Care For The Dying Patient And Their Families, Andrea Wilson Jan 2023

Doing Death Better: Practical Ways For Healthcare Professionals To Care For The Dying Patient And Their Families, Andrea Wilson

Undergraduate Honors Theses

Healthcare professionals care for patients with unique personal, cultural, religious, and medical needs, but these needs are not always met in a way that ensures the patient and their families are being treated as unique individuals. This paper first provides an overview of the physiological aspects of dying and how to educate patients and their families regarding expectations in end-of-life. The impacts of the death of a child and a parent were explored, and areas in need of more resources for these individuals were identified. The beliefs and practices of Hindu, Native American, and Islamic cultures were discussed, and lessons …


Utilization Of Mental Health Services For Caregivers Of Hemophiliacs, Anna Maria Bell Jan 2023

Utilization Of Mental Health Services For Caregivers Of Hemophiliacs, Anna Maria Bell

Walden Dissertations and Doctoral Studies

The utilization of mental health services for caregivers of hemophiliacs is an underserved area. Andersen’s behavioral model of utilization was the conceptual framework in this generic qualitative study. I used surveys and semi-structured interviews to obtain 20 participants’ information for nonprobability sampling, specifically purposive sampling. Narrative analysis was used as the foundation of the coding process The study findings revealed seven themes: cultural impact/stigma of mental health services; normalizing mental health services in the hemophilia community (national impact); inconsistencies in hemophilia treatment centers’ (HTCs’) service delivery; clarity of the role of the HTC social worker; member organizations emphasis on mental …


Distinctiveness In Hospital Safety And Security, Jimmy Reid Rollins Jr. Jan 2023

Distinctiveness In Hospital Safety And Security, Jimmy Reid Rollins Jr.

Doctor of Education Dissertations

The purpose of this research was to understand leadership and how these ideas feed into a professional dynamic of employee behavior, organizational leadership, motivation, and workplace culture, and how there is a real human interest as employees excel, grow, mature, and become better individuals.

Participants in this study were employees of a regional health organization and employed with the job title of public safety officer, public safety supervisor, or public safety administrator. This research used a mixed methodology approach in an explanatory design. A survey was completed followed by one on one interviews.

Conducting research into the safety and security …


Cultural Perspectives In Pain And Palliative Care, Loan Lagué Jan 2023

Cultural Perspectives In Pain And Palliative Care, Loan Lagué

Master's Projects

Culturally and linguistically diverse (CALD) patients are constantly challenged by the different levels on which lack of cultural competency or bias occurs in healthcare. This literature review focuses on the healthcare providers’ experiences when providing pain and palliative care to CALD populations and explores the challenges that may result in health inequalities. A review of current literature was conducted using PubMed, CINHAL, Sage Journals, Ovid, and Science Direct electronic databases. Sixteen published articles between 2015-2023 were reviewed. Findings from this review identified factors that induce poor quality palliative, pain, and end-of-life (EOL) care among culturally diverse groups. Improving quality of …


Contextual Factors And Sti/Hiv Sexual Risk Behaviors Among Hispanic Youths Aged 13 To 24 Years, Mariam Taiwo May 2022

Contextual Factors And Sti/Hiv Sexual Risk Behaviors Among Hispanic Youths Aged 13 To 24 Years, Mariam Taiwo

Theses & Dissertations

Despite the growing population of Hispanics and several efforts to combat the high STI/HIV rates among Hispanic youths aged 13 to 24 years in the United States, this population continues to experience stark disparities in STI/HIV and is underrepresented in STI/HIV research relative to their White peers. This dissertation consists of three distinct studies designed to identify and understand the contextual factors of STI/HIV sexual risk behaviors across the social-ecological model that are pertinent to Hispanic youths.

Results from the first study showed that STI/HIV sexual risk behavior varied by Hispanic youths’ acculturation types and moderated by gender. We found …


A Mixed Methods Study Of Cultural Competence Among Nursing Students In Kenya, Sylvia Waweru May 2022

A Mixed Methods Study Of Cultural Competence Among Nursing Students In Kenya, Sylvia Waweru

Nursing Theses and Dissertations

Significance and Background: Kenya has been experiencing an increase in cultural and ethnic diversity. As a result of cultural differences, health disparities among ethnic groups in Kenya are increasing. A component of patient centered care involves the incorporation of cultural aspects of health and illness in the delivery of nursing care. Understanding cultural competence of nursing students will provide guidance on educational needs related to cultural competence.

Purpose:. The purpose of this study was to assess nursing students’ cultural competence (CC) in the areas of cultural awareness, knowledge, sensitivity, skills, encounters and desire. Nursing students’ views on caring for …


Is Health Literacy A Defined Risk Factor? A Literature Review Of Health Literacy As It Relates To Immigrant Populations In The U.S., Kelly Zdanuczyk May 2022

Is Health Literacy A Defined Risk Factor? A Literature Review Of Health Literacy As It Relates To Immigrant Populations In The U.S., Kelly Zdanuczyk

Sustainability and Social Justice

Throughout its lifespan the definition of health literacy in the United States has been ambiguous and disagreeable. This discrepancy has created disparity among health outcomes for vulnerable populations who are classified with lower degrees of health literacy and thus have a harder time interacting with the healthcare system. This paper will review published peer-reviewed literature on the topic of health literacy as it relates to immigrant populations in the United States and explore the ways in which low health literacy results in negative health outcomes. The literature review finds the discrepancies among health literacy, as it pertains to immigrant communities …


The Role Of Socio-Cultural Perspectives And Vaccine Misinformation On The Intention To Receive Covid-19 Vaccination In A Selected Sample Of Georgia Southern Students, Alyssa G. Love-Archey Apr 2022

The Role Of Socio-Cultural Perspectives And Vaccine Misinformation On The Intention To Receive Covid-19 Vaccination In A Selected Sample Of Georgia Southern Students, Alyssa G. Love-Archey

Honors College Theses

The purpose of the study was to explore sociocultural influences on the intention to receive the Covid-19 vaccination and to measure which sociocultural factor had the greater influence: misinformation about the vaccine or specific cultural beliefs (religion and/or cultural practices) on vaccine intent in Georgia Southern students. An anonymous, exploratory survey was utilized to collect information on these constructs in two selected groups of students: those who had been vaccinated prior to taking the survey and those who had not been vaccinated prior to taking the survey. Subjects of the study were undergraduate, master’s degree, and doctoral students of the …


When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores Apr 2022

When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores

Dissertations

In healthcare, workgroup mistreatment is a pervasive problem that begins during medical education (medical and nursing school) and becomes embedded in the “hidden curriculum of professionalism,” which dissuades and even punishes learners for talking about abuse they witness. Furthermore, the mistreatment of healthcare providers (HCPs) pervades all disciplines in the healthcare delivery chain due to a combination of cultural factors, systemic pressures, dysfunctional hierarchies, and leadership’s tolerance of intimidating and disruptive behaviors. Not surprisingly, 18% of U.S. HCPs have left the medical field since the start of the COVID-19 pandemic, and burnout, stress, anxiety, and increased workloads have been identified …


The Importance Of Learning Deaf Culture Through A Black Deaf Perspective In The Field Of Communication Sciences And Disorders, Lindsay Lee Apr 2022

The Importance Of Learning Deaf Culture Through A Black Deaf Perspective In The Field Of Communication Sciences And Disorders, Lindsay Lee

Honors College Theses

As the diversity in the demographics of clinical populations increases in the United States, clinicians must also be accountable for learning the culture of their patients. The Deaf community, specifically individuals who identify with Deaf culture and Black Deaf culture, is a multifaceted, cultural group that has been marginalized within various settings including social, political, and employment settings, including academic and clinical research. This review will examine the historical developments within Deaf History in the United States, the injustices related to Deaf culture, and more specifically Black Deaf culture, and discuss the critical need for Deaf research and tools that …


Improving Patients' Engagement And Retention In Intensive Outpatient Substance Abuse Treatment, Leo W. Lavender Jan 2022

Improving Patients' Engagement And Retention In Intensive Outpatient Substance Abuse Treatment, Leo W. Lavender

Walden Dissertations and Doctoral Studies

Substance use disorder continues to be a major health crisis in the United States. Thousands of people die yearly due to substance use and related criminal activity. Substance abuse treatment is a remedy to the disorder and treatment centers admit thousands of patients yearly to address the dilemma. Throughout the years retention has been an ongoing barrier to successful treatment. This study explored significant obstacles to retention: motivation and engagement. The Baldrige Excellence Framework was utilized to assess the training, supervision, procedures, and leadership roles at an intensive outpatient substance abuse treatment center. This study utilized a qualitative approach case …


It’S Hapi Hour: An Action Plan On Preventing Hospital-Acquired Pressure Injuries, Emira Maureen A. Romero Dec 2021

It’S Hapi Hour: An Action Plan On Preventing Hospital-Acquired Pressure Injuries, Emira Maureen A. Romero

Master's Projects and Capstones

Hospital-Acquired Pressure Injuries (HAPIs) are detrimental to both the hospital and the patient as they are costly, painful, and can lead to further infection and an increased length of stay. Although this problem is seen across the country, this action plan focuses on a microsystem (i.e. medical-surgical telemetry unit) in Hospital A in the San Francisco Bay Area. The target population includes medical-surgical telemetry patients at high risk for HAPIs (i.e. Braden score <18, moisture/mobility scores <2, patients with devices at risk for device-related pressure injuries). The proposed intervention is an evidence-based HAPI prevention bundle that includes utilization of wound care champions and turn teams, increasing attendance of daily huddles, implementing a standardized algorithm for escalation and documentation, and reinforcement of evidence-based HAPI prevention measures. Effectiveness of this bundle will be measured through chart audits, nursing questionnaires, and staff interviews. These measures will be conducted 12 months post-implementation and findings will be compared to the baseline data in order to investigate whether there is a reduction in HAPI incidence. Since this project is currently in the Study phase of the proposed Plan, Do, Study, Act (PDSA) cycle, this action plan concludes with recommendations of how the team can continue to move forward in addressing the project’s specific aim.


The Debate On Physician-Assisted Death In The United States: A Narrative Analysis Of Formula Stories, Rebecca Blackwell Nov 2021

The Debate On Physician-Assisted Death In The United States: A Narrative Analysis Of Formula Stories, Rebecca Blackwell

USF Tampa Graduate Theses and Dissertations

Public policy discussions can be viewed as empirical windows into broadly shared culturalvalues and emotions of the social contexts in which the policy discussions take place. This project is a narrative analysis of the public debate on physician-assisted death (PAD), drawing from three data sources: newspaper articles, the websites of social movement organizations, and testimonies from a state legislative hearing. This analysis explores ways in which social actors deploy personal stories that contribute to shape the policy-making process by appealing to cultural beliefs and broadly shared emotions. The findings of this project constitute a contribution to the study of emotions …


Improved Psychological Services For American Indian Communities, Grace Anna Hofer Aug 2021

Improved Psychological Services For American Indian Communities, Grace Anna Hofer

Honors Thesis

The importance of mental health care is growing. Inadequate psychological aid in underserved areas creates an environment for health disparities. There is a needed emphasis for outreach in rural and ethnically diverse communities with a lack of healthcare professionals to service those afflicted by mental illness. One such group is the American Indian communities of indigent populations that experience multifactorial inequalities. The treatment and reception of mental health care continue to face many challenges such as access to care, lack of education, and stereotypes. To provide effective mental health services to the American Indian population, a collaboration in designing interventions …


Exploring And Understanding The Culture Of Young Adults Who Vape: A Focused Ethnography, Beth Tremblay Aug 2021

Exploring And Understanding The Culture Of Young Adults Who Vape: A Focused Ethnography, Beth Tremblay

Electronic Theses and Dissertations

Introduction: Vaping, the act of inhaling an aerosolized liquid, is associated with health risks. The 18- to 25-year-old age group has the highest rate of vaping among adults. Understanding culturally held values, beliefs, and experiences associated with the behavior of vaping in young adults may uncover the social mechanisms that underpin vaping initiation and influence continued use. The purpose of this study was to explore and understand the cultural values and beliefs about vaping among young adults. Method: The method used for this study was a focused ethnography. Young adults who currently vape nicotine (N=24) were recruited via snowball method …


Attitudes Toward Mindfulness And Adherence In Chronic Pain Management, Sarah Johnson Jun 2021

Attitudes Toward Mindfulness And Adherence In Chronic Pain Management, Sarah Johnson

Global Honors Theses

Chronic pain is a global public health problem, affecting 10-25% of the population. Mindfulness is an effective treatment but requires consistency. Because of its benefit, it is important to examine obstacles to mindfulness practice. In order to determine if negative attitudes toward mindfulness are related to non-adherence, 748 adults with chronic pain were recruited to fill out a series of questionnaires assessing treatment adherence and attitudes toward mindfulness. We found that positive attitudes toward mindfulness predicted reduced adherence. However, those who had more positive feelings toward mindfulness made more attempts at the therapy. Upper and middle-class participants had more positive …


Female Infertility In The United States And India: An Analysis Of Treatment Barriers And Coping Strategies, Devneet Singh Jun 2021

Female Infertility In The United States And India: An Analysis Of Treatment Barriers And Coping Strategies, Devneet Singh

Honors Theses

This research studies barriers to accessing fertility treatment in the United States (U.S.) and India, as well as the coping strategies infertile women use. Barriers include reproductive health knowledge, cost, and politics, while coping is affected by cultural stigma, family, and religion. These two countries were chosen for their different cultural contexts, healthcare systems, and political infrastructure. Ten fertility specialists across both countries were interviewed as expert informants. Reproductive health knowledge was the most important barrier to accessing care in both countries, with similar gaps in understanding when and what type of care to utilize, though social media can educate …


Ohiohealth Mayo Well-Being Collaborative: Driving Associate Culture, Resilience, And Efficacy Of Practice, Bethany Gwinn Jun 2021

Ohiohealth Mayo Well-Being Collaborative: Driving Associate Culture, Resilience, And Efficacy Of Practice, Bethany Gwinn

Masters Theses/Capstone Projects

The Mayo Well-Being Index is a validated nine-question self-assessment tool that enables individuals to better understand their overall wellbeing. The Mayo Well-Being Index is 100% anonymous, and provides individualized feedback with access to local and national resources through the tool at any time. Additionally, three process improvement questions are asked at the end of each assessment, allowing the users to share their feedback on topics such as the drivers of stress in the workplace, additional resources desired, etc. OhioHealth utilizes both qualitative and quantitative data from the Mayo Well-Being Index to identify teams in high distress as well as opportunities …


The Effects Of Sociodemographic Characteristics, Caregiving Practice Patterns, Coping Mechanisms, And Social Support On The Health Of Asian American Ethnic Groups And Asian American Caregivers, Suryadewi Edi Nugraheni May 2021

The Effects Of Sociodemographic Characteristics, Caregiving Practice Patterns, Coping Mechanisms, And Social Support On The Health Of Asian American Ethnic Groups And Asian American Caregivers, Suryadewi Edi Nugraheni

Legacy Theses & Dissertations (2009 - 2024)

Background: Asian American family caregivers came from various ethnic groups with different sociodemographic characteristics and culturally specific values. However, cultural practices were often overlooked because researchers often combined all Asian Americans under one umbrella. Objective: The purpose of the study was two-fold. First, the study investigated the study sample of Asian Americans participating in the California Health Interview Survey (CHIS) 2009 comprised of multiple Asian American ethnic groups. By utilizing the study sample, the research aimed to investigate 1) the associations between caregiving and self-rated health (SRH) and hypertension and 2) the associations between heterogeneity of Asian American ethnic groups …


Exploring The Mental Health Experiences Of African, Caribbean, And Black Youth In London, Ontario, Lily Yosieph Mar 2021

Exploring The Mental Health Experiences Of African, Caribbean, And Black Youth In London, Ontario, Lily Yosieph

Electronic Thesis and Dissertation Repository

This qualitative study explores the mental health experiences of African, Caribbean, and Black (ACB) youth in London, Ontario, investigating how the factors of race, gender, culture, and place have shaped their perceptions and experiences of mental health. The data collection and analysis were conducted using a phenomenological approach and a critical lens informed by feminist, intersectionality, and critical race theories. These data illuminate the ways in which these young people’s attitudes toward mental health and help-seeking strategies are impacted by broader social constructs and community expectations, which they navigate and often resist in their everyday lives. Their insights can provide …


Exploring The Influences Of Culture On Hand-Hygiene Beliefs Of Foreign-Born Healthcare Workers, Sheila Blanche Davis Jan 2021

Exploring The Influences Of Culture On Hand-Hygiene Beliefs Of Foreign-Born Healthcare Workers, Sheila Blanche Davis

Walden Dissertations and Doctoral Studies

AbstractThe hand-hygiene practices of nonadherent health care workers (HCWs) are a major threat to patient safety and thus continue to be a concern for healthcare leaders and administrators worldwide. Healthcare-associated infections (HAIs), which are linked to HCWs' unclean hands, are prevalent throughout global healthcare settings. Global migration in the nursing profession and intercontinental travel among direct patient care providers make it challenging for healthcare leaders to sustain HCWs' adherence to hand-hygiene practices. The purpose of this grounded study was to explore the influence of the cultural beliefs about hand-hygiene practices of foreign-born HCWs. The theory of planned behavior was used …


Improving Staff Knowledge Of Cultural Competence, Sherry Denise Akins Jan 2021

Improving Staff Knowledge Of Cultural Competence, Sherry Denise Akins

Walden Dissertations and Doctoral Studies

Professional nurses must demonstrate sensitivity to and understanding of a variety of cultures within United States (US) healthcare systems. Such skillsets are needed for the provision of high-quality nursing care across the entire spectrum of healthcare. Nurses are challenged to provide holistic care that is congruent with each patient’s beliefs, practices, and culture. Guidelines from the constructs of pioneer Madeline Leininger’s Transcultural Theory was used as the conceptual framework for the proposal. The purpose of this project was to validate an evidence-based orientation module to educate nurses and nursing staff within an acute healthcare setting regarding cultural competence during hospital …


Exploring Ethnic And New Orleans Cultural Influences On Health Behaviors Of African American Women, Keneitra Brown-Mayfield Jan 2021

Exploring Ethnic And New Orleans Cultural Influences On Health Behaviors Of African American Women, Keneitra Brown-Mayfield

Walden Dissertations and Doctoral Studies

In the United States (U.S.), African American women suffer disproportionately due to obesity and chronic diseases. Many studies have examined the culture of African Americans and its influence on their health behaviors in order to gain knowledge to inform obesity and chronic disease prevention interventions. However, a geographical segment of the U.S. African American population shares a unique culture that had yet to be studied. This qualitative study used in-depth interviews to understand the perceptions of overweight and obese African American women living in the Greater New Orleans region about their culture’s role in the prevalence of obesity and obesity-related …


The Critical Need For A Culturally Sensitive Suicide Risk Assessment Instrument For American Indian And Alaska Native Youth, Courtney E. Shaw Jan 2021

The Critical Need For A Culturally Sensitive Suicide Risk Assessment Instrument For American Indian And Alaska Native Youth, Courtney E. Shaw

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: This systematic literature review was conducted to better understand why there has been a significant increase in America Indian/Alaska Native (AI/AN) youth suicides in tribes across the United States today. The intent of this review is to understand key issues surrounding the increasing numbers of AI/AN youth with suicide ideation, plans, and attempt in order to be able to answer the following clinical question: Is there a valid and reliable culturally sensitive assessment tool designed to recognize at-risk AI/AN youth presenting for primary care? If not, what are key aspects to consider for developing an instrument that could …