Browsing by Author "Shure, Mark B."

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Daasachchuchik:A Trauma-Informed Approach to Developing a Chronic Illness Self-Management Program for the Apsáalooke People
(2020-05) Shure, Mark B.; Allen, Sarah; Trottier, Coleen; McCormick, Alma; Other Medicine, Lucille; Castille, Dorothy; Held, Suzanne
In Montana, American Indians with chronic illnesses (CIs) die 20 years earlier than their White counterparts highlighting an urgent need to develop culturally consonant CI self-management programs. Historical and current trauma places Indigenous peoples at increased health risk relative to others, and negatively influences CI self-management. The Apsáalooke Nation and Montana State University worked together to develop and implement a trauma-informed CI self-management program to improve the Apsáalooke community's health. This paper describes the origins and development of the trauma-informed components of the program. Using community stories and a literature review of trauma-informed interventions, partners co-developed culturally consonant trauma materials and activities grounded in community values and spirituality. Trauma-informed content was woven throughout three intervention gatherings and was the central focus of the gathering, Daasachchuchik ('Strong Heart'). Apsáalooke ancestors survived because of their cultural strengths and resilience; these cultural roots continue to be essential to healing from historical and current trauma.
Dietary Beliefs and Management of Older American Indians With Type 2 Diabetes
(2019-07) Shure, Mark B.; Turner Goins, Ruth; Jones, Jacqueline; Winchester, Blythe; Bradley, Vickie
Objectives This qualitative study examined dietary-related beliefs and self-management among older American Indians with type 2 diabetes mellitus (T2DM). Design Semistructured in-person interviews were conducted and digitally recorded. Setting Southeastern American Indian tribal community. Participants A total of 28 noninstitutionalized older tribal members aged >60 years. Phenomenon of Interest Study participants’ beliefs and experiences with dietary practices and management related to T2DM. Analysis Transcribed qualitative interviews were coded using an inductive content analysis approach. Results Four themes regarding T2DM dietary beliefs and T2DM dietary management emerged from the analyses: diet changes, portion control, health care professional and family influence, and barriers to healthy eating. Study participants described how their beliefs, practices, and experiences in these 4 areas related to T2DM. Conclusions and Implications American Indian older adults face a variety of challenges to dietary management of T2DM. Future research efforts can focus on assessing how social support can be leveraged to facilitate healthy diets for American Indians with T2DM. Clinicians and diabetes educators and Native communities have an instrumental role in identifying culturally appropriate messages and programs to help persons effectively manage T2DM.
Farmer and Rancher Perceptions of Climate Change and Their Relationships with Mental Health
(2020-04) Howard, Meredith; Ahmed, Selena; Lachapelle, Paul; Shure, Mark B.
The impacts of climate change are having negative consequences on agricultural communities in the United States and other regions of the world. More specifically, these impacts are expected to increase in both scale and complexity and will continue to pose challenges both in terms of agricultural production and capacity. The purpose of this study was to understand ranchers’ and farmers’ perceptions of climate change’s impact on their businesses and their mental well-being in a rural U.S. western state. Surveys were administered online and in-person to farmers and ranchers in fall of 2017. Descriptive statistics and correlational tests were conducted to evaluate if climate risk perception was related to levels of mental distress. Open-ended survey questions explored specifically how climate change is impacting mental well-being. The majority of respondents agree that climate change is having an impact on agricultural business, and nearly three quarters of respondents are experiencing moderate to high levels of anxiety when thinking about climate change and its effects on agricultural business. A moderate correlation was observed between climate risk perception and climate-related anxiety. Qualitative data showed the impact of climate change on profitability was perceived as the main cause of distress. This study demonstrates that climate change is generating anxiety and distress for farmers and ranchers. To maximize public health preparedness efforts, interventions are warranted to provide climate adaptation education and therapeutic outreach specific to agricultural workers experiencing economic struggle in the context of climate change.