Recent studies have demonstrated that the most successful
interventions for Native American women’s health have taken community
partnering into consideration. This makes sense considering that most
Native American cultures focus on the betterment of the community rather
than on a single individual [2]. Partnering with Native American
communities allows for more culturally sensitive approaches[3]—an
important aspect because many surveyed native women claim that more
cultural awareness and professionalism is required by doctors, nurses,
and implementers of health interventions [8]. Therefore, by involving
the community as a whole intervention programs take a step towards
health improvement and cultural reclamation. Below are some successful
examples of health interventions in populations of Native American women
that involve community partnership.
(1) Physical Activity
There are higher rates of obesity, diabetes, and heart disease in Native American women compared to non-Hispanic white women [1]. Furthermore, rates of physical activity are lower among Native American women than among non-Hispanic white women. However, social environmental factors such as community interaction are significantly associated with rate of physical activity. Research interventions to increase physical activity in Native American suggest that “results emphasize importance of support from family, friends, and communities” [4]. Other suggested interventions for increasing physical activity in native women include: providing exercise facilities, improving existing programs and facilities, developing exercise programs/classes specifically for women, and improving community security. Overall though, increasing social support via the community correlates with the greatest increases in physical activity [4].
(2) Breast Cancer Awareness
Native American women have lower breast cancer screening and 5-year survival rates than non-Hispanic white women in the US. Native women have themselves recommended interventions such as the “buddy system,” a system of partnering community members together to provide mentorship and motivation [8]. An organization called the Circle of Sisters, which is a breast cancer education initiative and offers free mammography for Native American women, has found its most promising results in community partnerships. The organization conducted a small audit of its intervention community-based programs and found that they increased native women’s understanding of: (1) chances of being diagnosed with breast cancer, (2) association of breast cancer with pregnancy complications, and (3) that breast cancer can be detected early. Furthermore, the percent of women intending to get a mammogram after the intervention had increased [6].
(3) Alcohol Consumption
Research to reduce alcohol consumption and dependency in Native American women and to prevent fetal alcohol spectrum disorders have associated community involvement with successful interventions. According to a review of evidence based approaches for reducing alcohol consumption in native women by The American Journal of Drug and Alcohol Use, “Studies presently reviewed suggest that to create a successful prevention/treatment program, it is important to incorporate community members in all aspects of project design and implementation” [7]. More studies are required but it is clear that respect for community and social identity is necessary to implement successful health interventions [7].
(4) Reproductive Health and Sexual violence
A Native Teen Voices study conducted in Minnesota asked urban native youth for recommendations to reduce health and sexual violence. Many of their answers included involving knowledgeable, trusted family and community leaders in addition to more comprehensive sex education in schools and increased access to contraceptive resources [9]. Other studies have demonstrated success in community based youth development programs for reducing sexual violence and increasing reproductive health [9,10]. Furthermore, the National Institute of Justice was mandated by The Violence Against Women Act of 2005 to conduct a national baseline study on violence against Native American women living on tribal lands. They found that barriers to helping victims of sexual violence included: “fear of being blamed, fear of prejudice, geographic isolation, lack of services available, conflict between Western approaches to intervention and American Indian values,” etc. [11]. At this time they are currently conducting research on intervention methods but have emphasized the importance of involving women of the community in creation of prevention and intervention methods [11].
As one can see from these examples, community based research [12] and intervention is an effective approach to health issues of Native American women [2, 3]. Thus, community involvement should be considered in any health intervention being applied to native women. Despite forced cultural, religious, and economic assimilation of Native American people which has shaped cultural practices and social structure, Native American women are a strong, persevering, and influential social group. Next week, we will discuss how native women have and continue to be the forefront of advocacy and implementation of health resources and services[1].
Right in our backyard, there are thousands of women at risk for diabetes, cancer, alcoholism, substance abuse, domestic abuse, heart disease, obesity, etc. However, as members of sovereign yet domestically dependent nations, they are often forgotten. The plight of these Native American women can teach us about the health and social effects of external pressures on women of once independent cultures. In other words, Native American women have experienced war, death, acculturation, racism, loss of land, sustenance shortage, and the “give and take” of sovereignty.
Overall, these obstacles have forced many Native Americans away from their traditional beliefs/practices and into a cycle of health and social inequalities. However, there is hope for the health of Native American women. A recent study of health-risk behavior in the Cheyenne River Sioux tribe by Han 1994 “found that women who were more traditionally engaged in terms of lifestyle and language fluency were healthier than less traditional women” [1]. Thus, the healing journey for many Native American women entails reclaiming native heritage, identity, and spirituality while also addressing historical trauma (i.e. harmful psycho-social legacy of boarding schools) [3].
Citations:
[1] Joe, Jennie Rose., and Francine C. Gachupin. Health and Social Issues of Native American Women. Santa Barbara: Praeger, 2012. Print.
[2] Hobfoll, Stevan E., Anita Jackson, Ivonne Hobfoll, Charles A. Pierce, and Sara Young. “The Impact of Communal-Mastery Versus Self-Mastery on Emotional Outcomes During Stressful Conditions: A Prospective Study of Native American Women.” American Journal of Community Psychology 30.6 (2002): 853-71. Springer.com. Web. 27 Feb. 2014.
[3] Gone, Joseph P. “A Community-based Treatment for Native American Historical Trauma: Prospects for Evidence-based Practice.” Spirituality in Clinical Practice 1.S (2013): 78-94. 2013. Web.
[4] Thompson, J. “Personal, Social, and Environmental Correlates of Physical Activity in Native American Women.” American Journal of Preventive Medicine 25.3 (2003): 53-60.Elsevier Inc. 2003. Web.
[5] Kitayama, S., Markus, H. R., Matsumoto, H., & Norasakkunkit, V. (1997). Individual and collective processes in the construction of the self: Self-enhancement in the United States and self-criticism in Japan. Journal of Personality and Social Psychology, 72, 1245–1267.
[6] Chilton, Janice A., Cheryl Downing, Melissa Lofton, Mike Hernandez, Beth W. Allen, Richard A. Hajek, and Beverly Gor. “Circle of Sisters: Raising Awareness of Native American Women to Breast Cancer.” Journal of Health Care for the Poor and Underserved 24.3 (2013): 1167-179. 3 Aug. 2013. Web.
[7] Montag, Annika, John D. Clapp, Dan Calac, Jessica Gorman, and Christina Chambers. “A Review of Evidence-Based Approaches for Reduction of Alcohol Consumption in Native Women Who Are Pregnant or of Reproductive Age.” The American Journal of Drug and Alcohol Abuse 38.5 (2012): 436-43. 2012. Web.
[8] Ndikum-Moffor, Florence M., Stacy Braiuca, Christine Makosky Daley, Byron J. Gajewski, and Kimberly K. Engelman. “Assessment of Mammography Experiences and Satisfaction Among American Indian/Alaska Native Women.” Women’s Health Issues 23.6 (2013): E395-402. 2013. Web.
[9] Rutman, Shira, Maile Taualii, Dena Ned, and Crystal Tetrick. “Reproductive Health and Sexual Violence Among Urban American Indian and Alaska Native Young Women: Select Findings from the National Survey of Family Growth (2002).” Maternal and Child Health Journal 16.S2 (2012): 347-52. Springer Science+Business Media. 19 Aug. 2012. Web.
[10] Smith, M. U., Rushing, S. C., & Native STAND Curriculum Development Group. (2011). Native STAND (students together against negative decisions): Evaluating a school-based sexual risk reduction intervention in Indian boarding schools. The Health Education Monograph, 28(2), 67–74. Available from: http://www.indiana.edu/*aids/
[11] Crossland, C., J. Palmer, and A. Brooks. “NIJ’s Program of Research on Violence Against American Indian and Alaska Native Women.” Violence Against Women 19.6 (2013): 771-90. 2013. Web.
[12] Holkup, Patricia A., PhD, RN, Toni Tripp-Reimer, PhD, RN, RAAN, Emily Matt Salois, MSW, ACSW, and Clarann Weinert, SC, PhD, RN, FAAN. “Community-based Participatory Research: An Approach to Intervention Research With a Native American Community.” Advances in Nursing Science 27.3 (2004): 162-75. NCBI. Web.
(1) Physical Activity
There are higher rates of obesity, diabetes, and heart disease in Native American women compared to non-Hispanic white women [1]. Furthermore, rates of physical activity are lower among Native American women than among non-Hispanic white women. However, social environmental factors such as community interaction are significantly associated with rate of physical activity. Research interventions to increase physical activity in Native American suggest that “results emphasize importance of support from family, friends, and communities” [4]. Other suggested interventions for increasing physical activity in native women include: providing exercise facilities, improving existing programs and facilities, developing exercise programs/classes specifically for women, and improving community security. Overall though, increasing social support via the community correlates with the greatest increases in physical activity [4].
(2) Breast Cancer Awareness
Native American women have lower breast cancer screening and 5-year survival rates than non-Hispanic white women in the US. Native women have themselves recommended interventions such as the “buddy system,” a system of partnering community members together to provide mentorship and motivation [8]. An organization called the Circle of Sisters, which is a breast cancer education initiative and offers free mammography for Native American women, has found its most promising results in community partnerships. The organization conducted a small audit of its intervention community-based programs and found that they increased native women’s understanding of: (1) chances of being diagnosed with breast cancer, (2) association of breast cancer with pregnancy complications, and (3) that breast cancer can be detected early. Furthermore, the percent of women intending to get a mammogram after the intervention had increased [6].
(3) Alcohol Consumption
Research to reduce alcohol consumption and dependency in Native American women and to prevent fetal alcohol spectrum disorders have associated community involvement with successful interventions. According to a review of evidence based approaches for reducing alcohol consumption in native women by The American Journal of Drug and Alcohol Use, “Studies presently reviewed suggest that to create a successful prevention/treatment program, it is important to incorporate community members in all aspects of project design and implementation” [7]. More studies are required but it is clear that respect for community and social identity is necessary to implement successful health interventions [7].
(4) Reproductive Health and Sexual violence
A Native Teen Voices study conducted in Minnesota asked urban native youth for recommendations to reduce health and sexual violence. Many of their answers included involving knowledgeable, trusted family and community leaders in addition to more comprehensive sex education in schools and increased access to contraceptive resources [9]. Other studies have demonstrated success in community based youth development programs for reducing sexual violence and increasing reproductive health [9,10]. Furthermore, the National Institute of Justice was mandated by The Violence Against Women Act of 2005 to conduct a national baseline study on violence against Native American women living on tribal lands. They found that barriers to helping victims of sexual violence included: “fear of being blamed, fear of prejudice, geographic isolation, lack of services available, conflict between Western approaches to intervention and American Indian values,” etc. [11]. At this time they are currently conducting research on intervention methods but have emphasized the importance of involving women of the community in creation of prevention and intervention methods [11].
As one can see from these examples, community based research [12] and intervention is an effective approach to health issues of Native American women [2, 3]. Thus, community involvement should be considered in any health intervention being applied to native women. Despite forced cultural, religious, and economic assimilation of Native American people which has shaped cultural practices and social structure, Native American women are a strong, persevering, and influential social group. Next week, we will discuss how native women have and continue to be the forefront of advocacy and implementation of health resources and services[1].
Right in our backyard, there are thousands of women at risk for diabetes, cancer, alcoholism, substance abuse, domestic abuse, heart disease, obesity, etc. However, as members of sovereign yet domestically dependent nations, they are often forgotten. The plight of these Native American women can teach us about the health and social effects of external pressures on women of once independent cultures. In other words, Native American women have experienced war, death, acculturation, racism, loss of land, sustenance shortage, and the “give and take” of sovereignty.
Overall, these obstacles have forced many Native Americans away from their traditional beliefs/practices and into a cycle of health and social inequalities. However, there is hope for the health of Native American women. A recent study of health-risk behavior in the Cheyenne River Sioux tribe by Han 1994 “found that women who were more traditionally engaged in terms of lifestyle and language fluency were healthier than less traditional women” [1]. Thus, the healing journey for many Native American women entails reclaiming native heritage, identity, and spirituality while also addressing historical trauma (i.e. harmful psycho-social legacy of boarding schools) [3].
“As individuals become meaningful, well-functioning participants in a given cultural system, they gradually develop a particular set of psychological processes that are attuned to and therefore support and reproduce the prevalent patterns of this cultural system . . . psychological processes and a cultural system are mutually constitutive.” -Kitayama, Markus, Matsumoto, & Norasakkunkit, [5]
Citations:
[1] Joe, Jennie Rose., and Francine C. Gachupin. Health and Social Issues of Native American Women. Santa Barbara: Praeger, 2012. Print.
[2] Hobfoll, Stevan E., Anita Jackson, Ivonne Hobfoll, Charles A. Pierce, and Sara Young. “The Impact of Communal-Mastery Versus Self-Mastery on Emotional Outcomes During Stressful Conditions: A Prospective Study of Native American Women.” American Journal of Community Psychology 30.6 (2002): 853-71. Springer.com. Web. 27 Feb. 2014.
[3] Gone, Joseph P. “A Community-based Treatment for Native American Historical Trauma: Prospects for Evidence-based Practice.” Spirituality in Clinical Practice 1.S (2013): 78-94. 2013. Web.
[4] Thompson, J. “Personal, Social, and Environmental Correlates of Physical Activity in Native American Women.” American Journal of Preventive Medicine 25.3 (2003): 53-60.Elsevier Inc. 2003. Web.
[5] Kitayama, S., Markus, H. R., Matsumoto, H., & Norasakkunkit, V. (1997). Individual and collective processes in the construction of the self: Self-enhancement in the United States and self-criticism in Japan. Journal of Personality and Social Psychology, 72, 1245–1267.
[6] Chilton, Janice A., Cheryl Downing, Melissa Lofton, Mike Hernandez, Beth W. Allen, Richard A. Hajek, and Beverly Gor. “Circle of Sisters: Raising Awareness of Native American Women to Breast Cancer.” Journal of Health Care for the Poor and Underserved 24.3 (2013): 1167-179. 3 Aug. 2013. Web.
[7] Montag, Annika, John D. Clapp, Dan Calac, Jessica Gorman, and Christina Chambers. “A Review of Evidence-Based Approaches for Reduction of Alcohol Consumption in Native Women Who Are Pregnant or of Reproductive Age.” The American Journal of Drug and Alcohol Abuse 38.5 (2012): 436-43. 2012. Web.
[8] Ndikum-Moffor, Florence M., Stacy Braiuca, Christine Makosky Daley, Byron J. Gajewski, and Kimberly K. Engelman. “Assessment of Mammography Experiences and Satisfaction Among American Indian/Alaska Native Women.” Women’s Health Issues 23.6 (2013): E395-402. 2013. Web.
[9] Rutman, Shira, Maile Taualii, Dena Ned, and Crystal Tetrick. “Reproductive Health and Sexual Violence Among Urban American Indian and Alaska Native Young Women: Select Findings from the National Survey of Family Growth (2002).” Maternal and Child Health Journal 16.S2 (2012): 347-52. Springer Science+Business Media. 19 Aug. 2012. Web.
[10] Smith, M. U., Rushing, S. C., & Native STAND Curriculum Development Group. (2011). Native STAND (students together against negative decisions): Evaluating a school-based sexual risk reduction intervention in Indian boarding schools. The Health Education Monograph, 28(2), 67–74. Available from: http://www.indiana.edu/*aids/
[11] Crossland, C., J. Palmer, and A. Brooks. “NIJ’s Program of Research on Violence Against American Indian and Alaska Native Women.” Violence Against Women 19.6 (2013): 771-90. 2013. Web.
[12] Holkup, Patricia A., PhD, RN, Toni Tripp-Reimer, PhD, RN, RAAN, Emily Matt Salois, MSW, ACSW, and Clarann Weinert, SC, PhD, RN, FAAN. “Community-based Participatory Research: An Approach to Intervention Research With a Native American Community.” Advances in Nursing Science 27.3 (2004): 162-75. NCBI. Web.
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