Browsing by Subject "American Indian"

Now showing 1 - 3 of 3
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    Metabolic Syndrome Among American Indian and Alaska Native Populations: Implications for Cardiovascular Health
    (Springer, 2022) Godfrey, Timian M.; Cordova-Marks, Felina M.; Jones, Desiree; Melton, Forest; Breathett, Khadijah; Medicine, School of Medicine
    Purpose of review: The latest national data reports a 55% prevalence of metabolic syndrome in American Indian adults compared to 34.7% of the general US adult population. Metabolic syndrome is a strong predictor for diabetes, which is the leading cause of heart disease in American Indian and Alaska Native populations. Metabolic syndrome and associated risk factors disproportionately impacts this population. We describe the presentation, etiology, and roles of structural racism and social determinants of health on metabolic syndrome. Findings: Much of what is known about metabolic syndrome in American Indian and Alaska Native populations comes from the Strong Heart Study as there is scant literature. American Indian and Alaska Native adults have an increased propensity towards metabolic syndrome as they are 1.1 times more likely to have high blood pressure, approximately three times more likely to have diabetes, and have higher rates of obesity compared with their non-Hispanic White counterparts. Culturally informed lifestyle and behavior interventions are promising approaches to address structural racism and social determinants of health that highly influence factors contributing to these rates. Summary: Among American Indian and Alaska Native populations, there is scarce updated literature evaluating the underlying causes of major risk factors for metabolic syndrome, and progression to cardiometabolic disease. As a result, the actual state of metabolic syndrome in this population is not well understood. Systemic and structural changes must occur to address the root causes of these disparities.
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    The Paradox of Respect and Risk: Six Lakota Adolescents Speak
    (2009-06-23T21:40:14Z) Isaacson, Mary J; Swenson, Melinda M.; Russell, Kathleen M.; Stiffler, Deborah; Zimmerman, Larry J.
    Adolescence is a time of turbulence as young people stretch parental boundaries, seeking where they fit in society. For many American Indian adolescents this time involves the initiation of dangerous high-risk behaviors. Potential causes posed for this are: loss of identity, loss of cultural values and traditions, lack of positive role modeling and feelings of hopelessness. Survey research has been the predominant method of data collection. Very few studies of Native American youth use storytelling, even though stories are a part of many Indian cultures. The primary purpose of this study was to describe the phenomena of respect and risk from the viewpoint of the Lakota adolescent. I employed hermeneutic phenomenology with photography to help the adolescents illuminate these somewhat abstract concepts. I recruited participants from a single reservation on the Northern Plains. I collected data through non-structured interviews and participant observation. I analyzed the data using hermeneutic phenomenology based on Gadamer. Ecological systems theory provided a framework to assist me in understanding the multiple dimensions present in the adolescent’s stories. The phenomena of respect and risk from the perspective of these Lakota adolescents revealed a paradox. Each can be either positive or negative, depending upon the circumstances or the context of the situation. This paradox became the pattern among the participants. The pattern is the rock (inyan) and the wind (tate). The rock and the wind are deeply interconnected, and the influence of one may impact the other. Three themes emerged from this pattern: role modeling (positive or negative), identity, and feeling valued. These themes are consistent with current research regarding adolescent high-risk behaviors. These stories are significant in that they are personal accounts by these adolescents. This study has implications in nursing education, nursing practice, and health policy. Nursing education must attend to teaching students to listen and to become comfortable working with other cultures. As nurses advocate for future programming, it is essential that the research that guides the policies and programming be community-based action research. As society becomes more diverse, nursing must embrace many perspectives, helping all to achieve the highest quality of health and well-being.
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    Surviving the Perfect Storm of Diabetes in the World of the Schitsu'umsh
    (2010-10-21) Tiedt, Jane A.; Sloan, Rebecca S.; Frey, Rodney, 1950-; Mays, Rose M.; Pesut, Daniel J.
    Diabetes is a significant health problem in the United States which disproportionately affects Native Americans. Despite many new prevention and intervention programs, there has been a prolific increase in the incidence of diabetes among Native Americans. The purpose of this qualitative study was to explore the experience of Coeur d’Alene tribal members living with type 2 diabetes using a Heideggerian hermeneutic framework. Participants were recruited through the local diabetes educator at the tribal clinic using purposive and snowball sampling. Individual interviews were conducted with ten Coeur d’Alene tribal members whom had type 2 diabetes and were willing to share their stories of about living with diabetes. Participants ranged in age from 26-86. Interviews lasted from 25-90 minutes and focused on gathering stories about their daily life with their diabetes, and barriers and supports to their diabetes self-management. These became the data for hermeneutic interpretations. Individual transcripts were read and reread for initial themes. Next, comparisons between and across transcripts were done through interpretive emersion into the texts. Emerging themes and patterns were brought before a group of qualitative nurse researchers and doctoral students as a means of cross-checking and validating interpretations. Perseverance was the overarching pattern in the stories of living with diabetes in the world of Schitsu’umsh. The four themes that emerged under the umbrella of perseverance were valuing tribal traditions, being inattentively caring, struggling with disease burdens, and experiencing tensions in patient-provider relations. Living with diabetes in the world of the Schitsu’umsh was always a tenuous balancing act. There was an ever present dialectic tension between strengths and barriers underlying their daily struggles for balance. By increasing our understanding of Native American experiences of living with diabetes, collaborative partnerships can be developed with the tribes to address these barriers to diabetes self-management and to develop culturally relevant diabetes education programs. There is also a need to address cultural competence by the health care community and to work at eliminating biases and prejudice in our healthcare system. This work brings new cultural understandings of what it means to live with diabetes in one Native American group.