Native American Health Resources

Using the interview data, we developed a model that illustrates the factors affecting patient-provider interactions. Trust emerged as the central theme in the determination of whether an interaction is considered good or bad. Trust was influenced by four higher-level themes: visit context, visit expectations, history, and time. These higher-level themes also affected the perceived barriers and facilitators to the clinical interaction, which were categorized as either actions or feelings/interpretations. Addressing and reducing barriers to positive clinical interactions on multiple levels is necessary for improving patient trust in the health care system, particularly among members of minority groups.

This is the first known study to examine racial concordance of the healthcare provider and ethnic salience of the patient in pain care. This study informs healthcare provider practice and consideration of patients’ racial/cultural attributes and possible influence on assessment bias, which may be particularly relevant among Indigenous patients. More research is needed to identify specific interventions to improve cultural awareness and sensitivity for Indigenous persons who suffer from pain.

Results revealed evidence of negative implicit attitudes toward American Indians. In addition, results showed that providers implicitly stereotype American Indians as noncompliant. This effect was moderated by self-reports of cultural competency and implicit bias training experience such that those reporting cultural competency or implicit bias training reported lower implicit stereotyping than those reporting no cultural competency or implicit bias training. Moreover, medical students reported lower implicit stereotyping than medical residents and practicing physicians.

These gaps combine to increase the breach between patient expectations and perceptions of their healthcare services. With better insight that captures what patients are looking for from a service, the potential to meet those needs increases, and patients feel that their voice is respected and valued.

Insights from PTs and PTAs on providing care for American Indians and Alaska Natives

Results identified the following important themes: Do Participants Have a Regular Provider, Personal Relationship With Provider, Feel Provider Cares, Provider Addresses Concern, and Respect for Traditional or Holistic Medicine. These findings suggest health care providers play an important role in impacting the health care experiences of Native American tribal members.

To engage tribal community members in adapting an evidence based, youth life skills curriculum for transition-age youth who have experienced multiple risk factors that prevent a healthy transition to adulthood. This exploratory, qualitative study draws on the voices of twelve critical community member (providers, parents & youth) that identified the specific cultural adaptations for the curriculum. Three primary overlapping themes emerged (1) the importance of incorporating AIAN identity and ceremony in the intervention design, (2) how the program should be integrated into current service delivery and (3) the specific curricular components to be delivered, including by whom and how they should be delivered. The inclusion of tribal members is key to building culturally relevant service delivery systems that will meet the needs of American Indian adolescents and young adults who are who are transitioning to adult hood in a American Indian community. Implications for policy and practice are offered.