NAU publications by CHER
Faculty & staff publications
NAU faculty and staff have the opportunity to publish their findings and knowledge as authors. CHER has many researchers that have been cited multiple times in major publications for their great work. The Center for Health Equity Research has accumulated all faculty publications into one, easy to navigate database.
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Dickerson, Daniel; Baldwin, Julie A; Belcourt, Annie; Belone, Lorenda; Gittelsohn, Joel; Kaholokula, Joseph Keawe'aimoku; Lowe, John; Patten, Christi A; Wallerstein, Nina Encompassing cultural contexts within scientific research methodologies in the development of health promotion interventions Journal Article Prevention Science, 2018. @article{Dickerson2018, title = {Encompassing cultural contexts within scientific research methodologies in the development of health promotion interventions}, author = {Daniel Dickerson and Julie A Baldwin and Annie Belcourt and Lorenda Belone and Joel Gittelsohn and Joseph Keawe'aimoku Kaholokula and John Lowe and Christi A Patten and Nina Wallerstein}, url = {https://link.springer.com/article/10.1007%2Fs11121-018-0926-1}, doi = {10.1007/s11121-018-0926-1}, year = {2018}, date = {2018-06-29}, journal = {Prevention Science}, abstract = {American Indians/Alaska Natives/Native Hawaiians (AI/AN/NHs) disproportionately experience higher rates of various health conditions. Developing culturally centered interventions targeting health conditions is a strategy to decrease the burden of health conditions among this population. This study analyzes characteristics from 21 studies currently funded under the Interventions for Health Promotion and Disease Prevention in Native American (NA) Populations program among investigators currently funded under this grant mechanism. Four broad challenges were revealed as critical to address when scientifically establishing culturally centered interventions for Native populations. These challenges were (a) their ability to harness culture-centered knowledge and perspectives from communities; (b) their utilization of Indigenous-based theories and knowledge systems with Western-based intervention paradigms and theories; (c) their use of Western-based methodologies; and (d) their cultural adaptation, if based on an evidence-based treatment. Findings revealed that qualitative methodologies and community-based participatory research (CBPR) approaches were very commonly used to finalize the development of interventions. Various Indigenous-based theories and knowledge systems and Western-based theories were used in the methodologies employed. Cultural adaptations were made that often used formative mixed qualitative and quantitative methods. Illustrative examples of strategies used and suggestions for future research are provided. Findings underscored the importance of CBPR methods to improve the efficacy of interventions for AI/AN/NH communities by integrating Indigenous-based theories and knowledge systems with Western science approaches to improve health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indians/Alaska Natives/Native Hawaiians (AI/AN/NHs) disproportionately experience higher rates of various health conditions. Developing culturally centered interventions targeting health conditions is a strategy to decrease the burden of health conditions among this population. This study analyzes characteristics from 21 studies currently funded under the Interventions for Health Promotion and Disease Prevention in Native American (NA) Populations program among investigators currently funded under this grant mechanism. Four broad challenges were revealed as critical to address when scientifically establishing culturally centered interventions for Native populations. These challenges were (a) their ability to harness culture-centered knowledge and perspectives from communities; (b) their utilization of Indigenous-based theories and knowledge systems with Western-based intervention paradigms and theories; (c) their use of Western-based methodologies; and (d) their cultural adaptation, if based on an evidence-based treatment. Findings revealed that qualitative methodologies and community-based participatory research (CBPR) approaches were very commonly used to finalize the development of interventions. Various Indigenous-based theories and knowledge systems and Western-based theories were used in the methodologies employed. Cultural adaptations were made that often used formative mixed qualitative and quantitative methods. Illustrative examples of strategies used and suggestions for future research are provided. Findings underscored the importance of CBPR methods to improve the efficacy of interventions for AI/AN/NH communities by integrating Indigenous-based theories and knowledge systems with Western science approaches to improve health. |
King, Caroline; Atwood, Sidney; Brown, Chris; Nelson, Adrianne Katrina; Lozada, Mia; Wei, Jennie; Merino, Maricruz; Curley, Cameron; Muskett, Olivia; Sabo, Samantha; Gampa, Vikas; Orav, John; Shin, Sonya Primary Care Diabetes, 12 (3), pp. 212-217, 2018. @article{King2018, title = {Primary care and survival among American Indian patients with diabetes in the Southwest United States: Evaluation of a cohort study at Gallup Indian Medical Center, 2009-2016}, author = {Caroline King and Sidney Atwood and Chris Brown and Adrianne Katrina Nelson and Mia Lozada and Jennie Wei and Maricruz Merino and Cameron Curley and Olivia Muskett and Samantha Sabo and Vikas Gampa and John Orav and Sonya Shin}, url = {https://www.primary-care-diabetes.com/article/S1751-9918(17)30184-5/fulltext}, year = {2018}, date = {2018-06-01}, journal = {Primary Care Diabetes}, volume = {12}, number = {3}, pages = {212-217}, abstract = {Objectives To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States. Methods Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses. Results Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider. Conclusions Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objectives To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States. Methods Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses. Results Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider. Conclusions Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission. |
Teufel-Shone, Nicolette; Jiang, Luohua; Rockwell, Jennifer; Chang, Jennifer; Beals, Janette; Bullock, Ann; Manson, Spero M Food choices and distress in reservation-based American Indians and Alaska Natives with type 2 diabetes Journal Article Public Health Nutrition, pp. 1-9, 2018. @article{Teufel-Shone2018, title = {Food choices and distress in reservation-based American Indians and Alaska Natives with type 2 diabetes}, author = {Nicolette Teufel-Shone and Luohua Jiang and Jennifer Rockwell and Jennifer Chang and Janette Beals and Ann Bullock and Spero M Manson}, url = {https://doi.org/10.1017/S1368980018000897}, doi = {10.1017/S1368980018000897}, year = {2018}, date = {2018-03-12}, journal = {Public Health Nutrition}, pages = {1-9}, abstract = {Objective: To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes. Design: Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as ‘healthy’ or ‘unhealthy’ using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson’s correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes. Setting: Rural AI reservations and AN villages. Subjects: AI/AN (n 2484) with type 2 diabetes. Results: Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β = 0·078}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objective: To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes. Design: Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as ‘healthy’ or ‘unhealthy’ using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson’s correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes. Setting: Rural AI reservations and AN villages. Subjects: AI/AN (n 2484) with type 2 diabetes. Results: Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β = 0·078 |
Henson, Michele; Sabo, Samantha; Trujillo, Aurora; Teufel-Shone, Nicolette Identifying protective factors to promote health in American Indian and Alaska Native adolescents: A literature review Journal Article Journal of Primary Prevention, 38 (1-2), pp. 5-26, 2017. @article{Henson2017, title = {Identifying protective factors to promote health in American Indian and Alaska Native adolescents: A literature review}, author = {Michele Henson and Samantha Sabo and Aurora Trujillo and Nicolette Teufel-Shone}, url = {https://link.springer.com/article/10.1007/s10935-016-0455-2}, year = {2017}, date = {2017-11-08}, journal = {Journal of Primary Prevention}, volume = {38}, number = {1-2}, pages = {5-26}, abstract = {Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent’s environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent’s environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents. |
Chief, Carmenlita; Sabo, Samantha; Clark, Hershel; Henderson, Patricia Nez; Yazzie, Alfred; Nahee, Jacqueline; Leischow, Scott J Tobacco Control, 25 , pp. 19-25, 2016. @article{Chief2016, title = {Breathing clean air is Są’áh Naagháí Bik'eh Hózhóó (SNBH): a culturally centered approach to understanding commercial smoke-free policy among the Diné (Navajo People)}, author = {Carmenlita Chief and Samantha Sabo and Hershel Clark and Patricia Nez Henderson and Alfred Yazzie and Jacqueline Nahee and Scott J Leischow}, url = {http://dx.doi.org/10.1136/tobaccocontrol-2016-053081}, year = {2016}, date = {2016-10-03}, journal = {Tobacco Control}, volume = {25}, pages = {19-25}, abstract = {Introduction Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide. Objective: We describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy. Methods Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy. Results Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments. Conclusions Indigenous-centered approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide. Objective: We describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy. Methods Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy. Results Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments. Conclusions Indigenous-centered approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people. |
Laurila, Kelly; Ingram, Jani C; Briehl, Margaret M; Trotter, Robert Weaving the Web: Evaluation Strategies to Help Native-American Undergraduate Research Training Programs Navigate Students to Success Journal Article CURQ on the Web, 35 (3), pp. 4-11, 2015. @article{Laurila2015, title = {Weaving the Web: Evaluation Strategies to Help Native-American Undergraduate Research Training Programs Navigate Students to Success}, author = {Kelly Laurila and Jani C Ingram and Margaret M Briehl and Robert Trotter}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671630/}, year = {2015}, date = {2015-12-07}, journal = {CURQ on the Web}, volume = {35}, number = {3}, pages = {4-11}, abstract = {Native-American cultures are characterized by strong connections to community, family, and the land. These connections are integrated into Native-American education, resulting in curricula that are different from those in Western educational systems. Differences between Native-American and Western cultures create challenges for those educated in Native-American education systems when they pursue postsecondary education in Western cultures. The under-representation of Native-Americans among those earning degrees reflects both extremely low enrollment rates and generally poor retention rates for Native-American college students (UA 2009). Obstacles for Native-American students include inadequate academic preparation, cultural differences, vague constructs of educational or vocational goals, insufficient financial aid, and social isolation (McClellan et al. 2005). Engaging Native-American students in research is one strategy for overcoming these obstacles and improving their college experience. Here we describe a research-based training program focused on Native-American undergraduates, the evaluation model and process used to evaluate this program, and the paradigm-shifting insights that emerged from the evaluation data.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Native-American cultures are characterized by strong connections to community, family, and the land. These connections are integrated into Native-American education, resulting in curricula that are different from those in Western educational systems. Differences between Native-American and Western cultures create challenges for those educated in Native-American education systems when they pursue postsecondary education in Western cultures. The under-representation of Native-Americans among those earning degrees reflects both extremely low enrollment rates and generally poor retention rates for Native-American college students (UA 2009). Obstacles for Native-American students include inadequate academic preparation, cultural differences, vague constructs of educational or vocational goals, insufficient financial aid, and social isolation (McClellan et al. 2005). Engaging Native-American students in research is one strategy for overcoming these obstacles and improving their college experience. Here we describe a research-based training program focused on Native-American undergraduates, the evaluation model and process used to evaluate this program, and the paradigm-shifting insights that emerged from the evaluation data. |
Teufel-Shone, Nicolette; Cordova-Marks, Felina; Susanyatame, Gloria; Teufel-Shone, Louis; Irwin, Sandra L Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program Journal Article Journal of Community Health, 43 (5), pp. 891-898, 2015. @article{Teufel-Shone2015, title = {Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program}, author = {Nicolette Teufel-Shone and Felina Cordova-Marks and Gloria Susanyatame and Louis Teufel-Shone and Sandra L Irwin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25791877}, doi = {10.1007/s10900-015-0009-1}, year = {2015}, date = {2015-10-01}, journal = {Journal of Community Health}, volume = {43}, number = {5}, pages = {891-898}, abstract = {Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk. |
Teufel-Shone, Nicolette; Gamber, Michelle; Watahomigie, Helen; Siyuja, Jr T J; Crozier, Laurie; Irwin, Sandra L Preventing Chronic Disease, 11 (E166), 2014. @article{Teufel-Shone2014, title = {Using a participatory research approach in a school-based physical activity intervention to prevent diabetes in the Hualapai Indian community, Arizona, 2002-2006}, author = {Nicolette Teufel-Shone and Michelle Gamber and Helen Watahomigie and Jr T. J. Siyuja and Laurie Crozier and Sandra L Irwin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25254984}, doi = {10.5888/pcd11.130397}, year = {2014}, date = {2014-09-25}, journal = {Preventing Chronic Disease}, volume = {11}, number = {E166}, abstract = {INTRODUCTION: In the United States, type 2 diabetes has reached epidemic proportions among indigenous people. Community-based participatory research offers American Indian communities and university partners an opportunity to integrate skills in community action and systematic inquiry to develop locally acceptable primary prevention interventions to combat diabetes risk factors. The Hualapai Tribe and the University of Arizona designed, implemented, and assessed a school-based physical activity intervention to reduce diabetes risk factors among youth. METHODS: During a 2-year period, trained community members led in-school physical activity classes 2 times per week among students in grades 3 through 8. Body mass index (BMI), fitness measures, and fasting blood glucose level were measured on 6 occasions. Descriptive statistics and t tests were used to assess change in outcome measures. RESULTS: Of the more than 100 youth who took part in the physical activity classes for 2 years, 71 youth (38 male, 33 female) participated in 3 or more data collection sessions. Over time, the percentage of youth with a high fasting blood glucose level of more than 125 mg/dL decreased concurrently with significant improvements in fitness measures. However, BMI increased in both male and female participants. The high number of youth who missed more than 3 data collection sessions was attributed to poor school attendance and tardiness. CONCLUSION: Classes led by lay physical activity leaders can affect diabetes risk factors in youth. Incongruous health and fitness outcomes suggest that one indicator does not adequately define the risk profile; BMI alone may not be sufficient as a measure of diabetes risk in youth.}, keywords = {}, pubstate = {published}, tppubtype = {article} } INTRODUCTION: In the United States, type 2 diabetes has reached epidemic proportions among indigenous people. Community-based participatory research offers American Indian communities and university partners an opportunity to integrate skills in community action and systematic inquiry to develop locally acceptable primary prevention interventions to combat diabetes risk factors. The Hualapai Tribe and the University of Arizona designed, implemented, and assessed a school-based physical activity intervention to reduce diabetes risk factors among youth. METHODS: During a 2-year period, trained community members led in-school physical activity classes 2 times per week among students in grades 3 through 8. Body mass index (BMI), fitness measures, and fasting blood glucose level were measured on 6 occasions. Descriptive statistics and t tests were used to assess change in outcome measures. RESULTS: Of the more than 100 youth who took part in the physical activity classes for 2 years, 71 youth (38 male, 33 female) participated in 3 or more data collection sessions. Over time, the percentage of youth with a high fasting blood glucose level of more than 125 mg/dL decreased concurrently with significant improvements in fitness measures. However, BMI increased in both male and female participants. The high number of youth who missed more than 3 data collection sessions was attributed to poor school attendance and tardiness. CONCLUSION: Classes led by lay physical activity leaders can affect diabetes risk factors in youth. Incongruous health and fitness outcomes suggest that one indicator does not adequately define the risk profile; BMI alone may not be sufficient as a measure of diabetes risk in youth. |
Sanderson, Priscilla R; Weinstein, Neil; Teufel-Shone, Nicolette; Martínez, María Elena Assessing colorectal cancer screening knowledge at tribal fairs Journal Article Preventing Chronic Disease, 8 (1), pp. 1-10, 2011. @article{Sanderson2011, title = {Assessing colorectal cancer screening knowledge at tribal fairs}, author = {Priscilla R Sanderson and Neil Weinstein and Nicolette Teufel-Shone and María Elena Martínez}, url = {https://www.ncbi.nlm.nih.gov/pubmed/21159228}, year = {2011}, date = {2011-01-01}, journal = {Preventing Chronic Disease}, volume = {8}, number = {1}, pages = {1-10}, abstract = {INTRODUCTION: Increasing public awareness and knowledge about the need for colorectal cancer (CRC) screening among American Indians is key to reducing health disparities. The objective of this study was to assess Navajo adults' knowledge of CRC risk factors and prevention, CRC screening, and self-reported experience with CRC screening. METHODS: We collected data generated by a self-administered survey given to Navajo adults, most of whom lived on the reservation. Data were collected at 2 annual tribal fairs in 2006. Fair attendees who visited an exhibit booth completed a CRC knowledge survey. The study design was nonrandomized. RESULTS: Of the 285 Navajo adults who participated, most were bilingual (74%) and female (80%). Of the respondents aged 50 years or older, 77% had heard of CRC screening and 28% reported being screened for colon or colorectal cancer. Knowledge was high (mean, 5.78 [standard deviation (SD), 1.28]) (8.0 was the highest possible knowledge score). Respondents with little or no formal schooling had lower scores (mean, 5.4), indicating less knowledge of CRC and associated screening tests than did those with more education (mean, 6.0). CONCLUSION: Among a sample of Navajo adults aged 50 years or older, participants with more education were more likely to be knowledgeable about CRC and to have received screening. This survey, led by a Navajo investigator with Navajo surveyors, revealed a high awareness of CRC and screening, but overall CRC screening was low. CRC education for Navajo adults who have little or no formal schooling should be improved.}, keywords = {}, pubstate = {published}, tppubtype = {article} } INTRODUCTION: Increasing public awareness and knowledge about the need for colorectal cancer (CRC) screening among American Indians is key to reducing health disparities. The objective of this study was to assess Navajo adults' knowledge of CRC risk factors and prevention, CRC screening, and self-reported experience with CRC screening. METHODS: We collected data generated by a self-administered survey given to Navajo adults, most of whom lived on the reservation. Data were collected at 2 annual tribal fairs in 2006. Fair attendees who visited an exhibit booth completed a CRC knowledge survey. The study design was nonrandomized. RESULTS: Of the 285 Navajo adults who participated, most were bilingual (74%) and female (80%). Of the respondents aged 50 years or older, 77% had heard of CRC screening and 28% reported being screened for colon or colorectal cancer. Knowledge was high (mean, 5.78 [standard deviation (SD), 1.28]) (8.0 was the highest possible knowledge score). Respondents with little or no formal schooling had lower scores (mean, 5.4), indicating less knowledge of CRC and associated screening tests than did those with more education (mean, 6.0). CONCLUSION: Among a sample of Navajo adults aged 50 years or older, participants with more education were more likely to be knowledgeable about CRC and to have received screening. This survey, led by a Navajo investigator with Navajo surveyors, revealed a high awareness of CRC and screening, but overall CRC screening was low. CRC education for Navajo adults who have little or no formal schooling should be improved. |
Sanderson, Priscilla R; Teufel-Shone, Nicolette; Baldwin, Julie A; Sandoval, Nellie; Robinson, Frances Breast cancer education for Navajo women: a pilot study evaluating a culturally relevant video Journal Article Journal of Cancer Education, 25 (2), pp. 217-223, 2010. @article{Sanderson2010, title = {Breast cancer education for Navajo women: a pilot study evaluating a culturally relevant video}, author = {Priscilla R Sanderson and Nicolette Teufel-Shone and Julie A Baldwin and Nellie Sandoval and Frances Robinson}, url = {https://www.ncbi.nlm.nih.gov/pubmed/20111913}, doi = {10.1007/s13187-009-0036-7}, year = {2010}, date = {2010-06-01}, journal = {Journal of Cancer Education}, volume = {25}, number = {2}, pages = {217-223}, abstract = {This pilot study evaluated a culturally specific video designed to teach Navajo women about breast cancer treatment options. Fourteen Navajo women diagnosed with breast cancer and 26 healthcare providers participated in a mixed-method evaluation that documented their perceptions immediately and 6 months after viewing the video. After initial viewing, women reported reduced anxiety about treatment and interest in support groups. Six months later, women said the video prompted them to seek more information from printed sources and their provider. Younger Navajo women who were 44 to 51 years old were more likely to attend support groups than women who were 55-67 years. Providers corroborated the positive effects of the video. The providers believed the video encouraged patients to seek information about breast cancer and to ask questions about treatment plans and side effects. A culturally relevant video for Navajo women can be an effective teaching tool and can enhance patient-provider communication.}, keywords = {}, pubstate = {published}, tppubtype = {article} } This pilot study evaluated a culturally specific video designed to teach Navajo women about breast cancer treatment options. Fourteen Navajo women diagnosed with breast cancer and 26 healthcare providers participated in a mixed-method evaluation that documented their perceptions immediately and 6 months after viewing the video. After initial viewing, women reported reduced anxiety about treatment and interest in support groups. Six months later, women said the video prompted them to seek more information from printed sources and their provider. Younger Navajo women who were 44 to 51 years old were more likely to attend support groups than women who were 55-67 years. Providers corroborated the positive effects of the video. The providers believed the video encouraged patients to seek information about breast cancer and to ask questions about treatment plans and side effects. A culturally relevant video for Navajo women can be an effective teaching tool and can enhance patient-provider communication. |
Henson, Michele; Sabo, Samantha; Trujillo, Aurora; Teufel-Shone, Nicolette Identifying Protective Factors to Promote Health in American Indian and Alaska Native Adolescents: A Literature Review Journal Article The Journal of Primary Prevention, 38 (1), pp. 5-26, 2010. @article{Henson2010, title = {Identifying Protective Factors to Promote Health in American Indian and Alaska Native Adolescents: A Literature Review}, author = {Michele Henson and Samantha Sabo and Aurora Trujillo and Nicolette Teufel-Shone}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27826690}, doi = {10.1007/s10935-016-0455-2}, year = {2010}, date = {2010-03-01}, journal = {The Journal of Primary Prevention}, volume = {38}, number = {1}, pages = {5-26}, abstract = {Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent's environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent's environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents. |
Johnson, Jeannette; Baldwin, Julie A; Gryczynski, Jan; Wiechelt, Shelly A; Haring, Rodney C The Native American experience: From displacement and cultural trauma to resilience Book Chapter Multiethnicity and Multiethnic Families: Development, Identity, and Resilience, Chapter 14, pp. 277-302, Xlibris Corporation, 2010, ISBN: 9781450003407. @inbook{Johnson2010, title = {The Native American experience: From displacement and cultural trauma to resilience}, author = {Jeannette Johnson and Julie A Baldwin and Jan Gryczynski and Shelly A Wiechelt and Rodney C Haring}, url = {https://books.google.com/books?hl=en&lr=&id=VidnMGRDFdwC&oi=fnd&pg=PR2&dq=Multiethnicity+and+Multiethnic+Families:+Development,+Identity,+and+Resilience,+Chapter+14&ots=Z610xp1ePw&sig=8M8O6UAUJvfcnTvZO92e4atv-6c#v=onepage&q=Multiethnicity%20and%20Multiethnic%20Families%3A%20Development%2C%20Identity%2C%20and%20Resilience%2C%20Chapter%2014&f=false}, isbn = {9781450003407}, year = {2010}, date = {2010-01-01}, booktitle = {Multiethnicity and Multiethnic Families: Development, Identity, and Resilience}, pages = {277-302}, publisher = {Xlibris Corporation}, chapter = {14}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } |
Harris, Kelly A; Trotter, Robert Community Health Status Assessment Navajo County, Arizona Journal Article 2010. @article{Harris2010, title = {Community Health Status Assessment Navajo County, Arizona}, author = {Kelly A Harris and Robert Trotter}, url = {https://repository.asu.edu/items/23700}, year = {2010}, date = {2010-01-01}, abstract = {The CHSA focuses on 11 health status indicators which include: demographic characteristics, socioeconomic characteristics, health resource availability, quality of life, behavioral risk factors, environmental health, social and mental health, maternal and child health, death, illness and injury, communicable disease, and sentinel events.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The CHSA focuses on 11 health status indicators which include: demographic characteristics, socioeconomic characteristics, health resource availability, quality of life, behavioral risk factors, environmental health, social and mental health, maternal and child health, death, illness and injury, communicable disease, and sentinel events. |
Baldwin, Julie A; Johnson, Jeannette L; Benally, Christine C Building partnerships between indigenous communities and universities: lessons learned in HIV/AIDS and substance abuse prevention research Journal Article American Journal of Public health, 99 (S1), pp. S77-S82, 2009. @article{Baldwin2009, title = {Building partnerships between indigenous communities and universities: lessons learned in HIV/AIDS and substance abuse prevention research}, author = {Julie A Baldwin and Jeannette L Johnson and Christine C Benally}, url = {https://www.ncbi.nlm.nih.gov/pubmed/19246672}, doi = {10.2105/AJPH.2008.134585}, year = {2009}, date = {2009-04-01}, journal = {American Journal of Public health}, volume = {99}, number = {S1}, pages = {S77-S82}, abstract = {Many HIV/AIDS and substance abuse prevention studies in American Indian and Alaska Native communities have been directed by academic researchers with little community input. We examined the challenges in conducting HIV/AIDS-related research in American Indian and Alaska Native communities and the benefits of changing the research paradigm to a community-based participatory model. The lessons we learned illustrate that the research process should be a cyclical one with continual involvement by community members. Steps in the process include (1) building and sustaining collaborative relationships, (2) planning the program together, (3) implementing and evaluating the program in culturally acceptable ways, and (4) disseminating research findings from a tribal perspective. These steps can enhance the long-term capacity of the community to conduct HIV/AIDS and substance abuse prevention research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Many HIV/AIDS and substance abuse prevention studies in American Indian and Alaska Native communities have been directed by academic researchers with little community input. We examined the challenges in conducting HIV/AIDS-related research in American Indian and Alaska Native communities and the benefits of changing the research paradigm to a community-based participatory model. The lessons we learned illustrate that the research process should be a cyclical one with continual involvement by community members. Steps in the process include (1) building and sustaining collaborative relationships, (2) planning the program together, (3) implementing and evaluating the program in culturally acceptable ways, and (4) disseminating research findings from a tribal perspective. These steps can enhance the long-term capacity of the community to conduct HIV/AIDS and substance abuse prevention research. |
Mmari, Kristin N; Blum, Robert Wm.; Teufel-Shone, Nicolette What Increases Risk and Protection for Delinquent Behaviors Among American Indian Youth? Findings from Three Tribal Communities Journal Article Youth and Society, 41 (3), pp. 382-413, 2009. @article{Mmari2009, title = {What Increases Risk and Protection for Delinquent Behaviors Among American Indian Youth? Findings from Three Tribal Communities}, author = {Kristin N Mmari and Robert Wm. Blum and Nicolette Teufel-Shone}, url = {http://journals.sagepub.com/doi/pdf/10.1177/0044118X09333645}, doi = {10.1177/0044118X09333645}, year = {2009}, date = {2009-03-24}, journal = {Youth and Society}, volume = {41}, number = {3}, pages = {382-413}, abstract = {The primary purpose of this study was to compare the risk and protective factors for delinquent behaviors among American Indian youth in three distinct tribal communities. Focus group discussions were used to gather data from elders, parents, youth workers, and youth in each tribal community. Findings showed that the key source for increasing risk and protection for delinquent behaviors among American Indian youth is the family. In particular is the protective presence of a parent and having a parent available for discussing problems. Participants also revealed how many parents lack the knowledge and confidence to discipline their children. These findings suggest a need for programs that strengthen parent-adolescent communication, parenting skills, and offer cultural teachings and sensitivity training for school personnel. Interventions also need to be specific to the cultural context and cannot assume the same risk and protective factors will apply to all American Indian youth.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The primary purpose of this study was to compare the risk and protective factors for delinquent behaviors among American Indian youth in three distinct tribal communities. Focus group discussions were used to gather data from elders, parents, youth workers, and youth in each tribal community. Findings showed that the key source for increasing risk and protection for delinquent behaviors among American Indian youth is the family. In particular is the protective presence of a parent and having a parent available for discussing problems. Participants also revealed how many parents lack the knowledge and confidence to discipline their children. These findings suggest a need for programs that strengthen parent-adolescent communication, parenting skills, and offer cultural teachings and sensitivity training for school personnel. Interventions also need to be specific to the cultural context and cannot assume the same risk and protective factors will apply to all American Indian youth. |
Johnson, Jeannette L; Baldwin, Julie A; Haring, Rodney C; Wiechelt, Shelly A; Roth, Susan; Gryczynski, Jan; Lozano, Henry Essential information for disaster management and trauma specialists working with American Indians Book Chapter Marsella, A; Johnson, J; Watson, P; Gryczynski, J (Ed.): Ethnocultural Perspectives on Disaster and Trauma: Foundations, Issues, and Applications, Chapter 4, pp. 73-113, 2008, ISBN: 978-0-387-73285-5. @inbook{Johnson2008, title = {Essential information for disaster management and trauma specialists working with American Indians}, author = {Jeannette L Johnson and Julie A Baldwin and Rodney C Haring and Shelly A Wiechelt and Susan Roth and Jan Gryczynski and Henry Lozano}, editor = {A Marsella and J Johnson and P Watson and J Gryczynski}, url = {http://www.springer.com/us/book/9780387732848}, isbn = {978-0-387-73285-5}, year = {2008}, date = {2008-01-01}, booktitle = {Ethnocultural Perspectives on Disaster and Trauma: Foundations, Issues, and Applications}, pages = {73-113}, chapter = {4}, abstract = {In this pioneering volume, experts on individual and collective trauma experience, posttraumatic stress and related syndromes, and emergency and crisis intervention – share knowledge and insights on the cultural context of working with ethnic and racial minority communities during disasters. In each chapter, emotional, psychological, and social needs as well as communal strengths and coping skills that arise in disasters are documented for major minority groups in the United States including specific chapters on African Americans, Native Americans, Arab Americans, Asian Indians, Chinese Americans, Caribbean Americans, Latin Americans, Native Hawaiians, and Vietnamese Americans. Each chapter features information on: Demographics, major historical events, and core values of each population Important cultural insights, including communication styles, culture-specific disorders, and valid assessment instruments Therapeutic and healing traditions versus conventional medicine and therapy Perspectives specific to the population’s experience with disaster and trauma Authors’ recommendations for improving services to the population Practical appendices for readers new to the field This unique volume is a cultural competency compendium that will increase to the effectiveness of all who respond to disasters. It will also be of interest and value to scholars, policy makers, and health professionals working in the areas of disaster management, crisis intervention, and trauma. Ethnocultural Perspectives on Disaster and Trauma points readers to what the editors call the path "beyond simple assistance to healing and the restoration of hope and meaning."}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } In this pioneering volume, experts on individual and collective trauma experience, posttraumatic stress and related syndromes, and emergency and crisis intervention – share knowledge and insights on the cultural context of working with ethnic and racial minority communities during disasters. In each chapter, emotional, psychological, and social needs as well as communal strengths and coping skills that arise in disasters are documented for major minority groups in the United States including specific chapters on African Americans, Native Americans, Arab Americans, Asian Indians, Chinese Americans, Caribbean Americans, Latin Americans, Native Hawaiians, and Vietnamese Americans. Each chapter features information on: Demographics, major historical events, and core values of each population Important cultural insights, including communication styles, culture-specific disorders, and valid assessment instruments Therapeutic and healing traditions versus conventional medicine and therapy Perspectives specific to the population’s experience with disaster and trauma Authors’ recommendations for improving services to the population Practical appendices for readers new to the field This unique volume is a cultural competency compendium that will increase to the effectiveness of all who respond to disasters. It will also be of interest and value to scholars, policy makers, and health professionals working in the areas of disaster management, crisis intervention, and trauma. Ethnocultural Perspectives on Disaster and Trauma points readers to what the editors call the path "beyond simple assistance to healing and the restoration of hope and meaning." |
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