Scholarly Work - Indigenous Research Initiative
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/15852
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Item Community-based prevention education on abusive head trauma in a Montana Native American community(Montana State University - Bozeman, College of Nursing, 2019) Schmitt, Emily Marie; Chairperson, Graduate Committee: Sandra KuntzThis scholarly project cultivated a partnership with a Montana Native American community to develop an implementation method of an evidence-based, abusive-head-trauma-prevention education program. The partnering community felt that more could be done to prevent abusive head trauma. Utilizing the framework of Community-Based Participatory Research and the Rural Nursing Theory, this project identified the best available evidence and then developed multiple methods to implement this prevention material. Multiple lessons were learned and important reflections developed from the project process. These lessons can be utilized to guide future projects. A model for program implementation was developed for future use and implementation of the evidence-based, abusive-head-trauma-prevention program.Item Interprofessional oral health initiative in a nondental, American Indian setting(2017-09) Murphy, Kate L.; Larsson, Laura S.Background and Purpose Tooth decay is the most common chronic childhood disease and American Indian (AI) children are at increased risk. Pediatric primary care providers are in an opportune position to reduce tooth decay. The purpose of this study was to integrate and evaluate a pediatric oral health project in an AI, pediatric primary care setting. Methods The intervention set included caregiver education, caries risk assessment, and a same-day dental home referral. All caregiver/child dyads age birth to 5 years presenting to the pediatric clinic were eligible (n = 47). Conclusions Most children (n = 35, 91.1%) were scored as high risk for caries development. Of those with first tooth eruption (n = 36), ten had healthy teeth (27.8%) and seven had seen a dentist in the past 3 months (19.4%). All others were referred to a dentist (n = 29) and 21 families (72.4%) completed the referral. Implications for Practice In fewer than 5 min per appointment (x = 4.73 min), the primary care provider integrated oral health screening, education, and referral into the well-child visit. Oral health is part of total health, and thus should be incorporated into routine well-child visits.Item Native American Death Taboo: Implications for Health Care Providers(2017-07) Colclough, Yoshiko YamashitaThis study was conducted to highlight Native American (NA) perspectives on death taboo in order to examine the cultural appropriateness of hospice services for NA patients, if any. Searching literature that addressed taboo and death from historical, psychological, sociological, and anthropological aspects, a comparison of death perspectives was made between NAs and European Americans. A culturally sensitive transition from palliative care to hospice care was suggested for NA patients and their family.Item Community assessment of cancer screening services for women in Cascade County and perceptions of American Indian women regarding those services(Montana State University - Bozeman, College of Nursing, 2001) Rowell, Nancy Jo; Chairperson, Graduate Committee: Therese SullivanItem Implementing an oral health tool and motivation interviewing tool to improve oral health care among type II diabetics on a northern plains reservation(Montana State University - Bozeman, College of Nursing, 2016) Show, Jennifer Aurice; Chairperson, Graduate Committee: Elizabeth S. KinionType II diabetes and periodontal disease are two common chronic diseases that have been shown to have a physiologically bi-directional relationship. In recent years, type II diabetes and periodontal disease have reached epidemic proportions throughout the United States; disproportionately affecting racial and ethnic minorities such as American Indians. American Indians often have diabetes rates that are two times the general U.S. population and periodontal disease rates that are equally as high. Adding to the oral health disparity in American Indian populations, accessing dental care is often limited making oral health preventive behaviors especially important. This project chose to examine oral health in a group of American Indian adults with type II diabetes focusing on 1) the identification of oral health status using the Oral Health Assessment Tool 2) the facilitation of oral health care to the local Indian Health Service agency and 3) supporting and improving preventive oral health behaviors through motivational interviewing. Participants took part in bi-weekly face-to-face motivational interviewing sessions with their oral health status being evaluated using the Oral Health Assessment Tool concurrently. Participants were referred to the local Indian Health Service agency for dental care based on Oral Health Assessment scores. Scores could range from 0 (good oral health) to 16 (poor oral health). The overall analysis of data found a slight improvement in average Oral Health Assessment Tool scores from 2.75 at baseline to 2.25 at three months. Content analysis of the motivational interviewing sessions found an increased interest among participants to improve oral health behaviors such as brushing for longer periods of time or a desire to quit smoking. The findings of this study are encouraging. While the Oral Health Assessment Tool scores did not improve by leaps and bounds, it does show promise for the use of motivational interviewing to improve preventive oral health behaviors in the American Indian population while also showing the ease of integrating the Oral Health Assessment Tool into general diabetes care.Item Oral health outreach and education in a non-dental, American Indian setting(Montana State University - Bozeman, College of Nursing, 2016) Taubert, Kate Lisco; Chairperson, Graduate Committee: Laura LarssonTooth decay is the single most common chronic childhood disease (Centers for Disease Control and Prevention, 2014) and children with minority and low socioeconomic status are at an increased risk for early childhood caries (ECC) development. The number of children who routinely visit primary care providers is much higher than those who have seen a dental provider (American Academy of Pediatrics, 2008). Thus, pediatric primary care providers are in an opportune position to provide oral health screenings, interventions, and referrals. The purpose of this quality improvement project was to identify, implement, and evaluate a Doctor of Nursing Practice (DNP) pediatric oral health outreach and education quality improvement project in an American Indian, pediatric primary care setting. The intervention contained three parts including a caries risk assessment, caregiver education, and a same-day dental home referral. All caregiver/child dyads age birth - 5 years presenting to the pediatric clinic for a well-child visit were eligible and consented to the intervention (n = 47). The results determined that 86.84% of the sample population was at high risk for caries development and that 52.78% of children with first tooth eruption had previously seen a dentist. Of those children, 78.95% had caries. For children with first tooth eruption that had not seen a dental provider in the past three months, a successful completed referral rate of 72.41% was obtained. The average intervention duration was 4.73 minutes. The intervention was successful in integrating well-child and well-dental visiting into a combined visit that was feasible to sustain. All caregiver/child dyads consented to the intervention and received age appropriate oral health education. This interprofessional collaboration and was effective in addressing three aspects of oral health prevention and outreach. Oral health is part of total health, and thus should be incorporated into routine well-child visits.Item Perspectives of registered nurse cultural competence in a rural state: Part I(2007) Seright, Teresa J.Inferences have been made from recent research that there is a correlation between lack of cultural competence and the incidence of health disparity. As our society becomes more global and more diverse, it is apparent that culture can no longer be considered as solely associated with ethnic/racial/cultural groups. Nurses permeate all areas of health care and are therefore in a position to have positive impact on cultural competency. This paper describes the 5 constructs of cultural competence as described by Dr. Josepha Campinha-Bacote: cultural awareness, cultural knowledge, cultural skill, cultural encounters, and cultural desire. She emphasizes, as do others in the literature, that cultural desire and awareness are antecedents to knowledge acquisition and skill. Is mere cultural awareness enough? How do healthcare providers in homogenous rural states attain cultural competence when cultural encounters and cultural knowledge may not be readily accessible? This is the first in a series of two articles which explores Cultural Competence of health care providers in a rural state. The first article in the series provides literature review and definitions related to cultural competence as well as the impact of cultural competence. The second article reveal results of a cultural competence self-assessment survey of registered nurses in North Dakota, a sprawling rural state described as 9th in the union for percentage of caucasions and 5th in rank for the most American Indians.Item Social Marketing Risk-Framing Approaches for Dental Sealants in Rural American Indian Children(2015-06) Larrson, Laura S.; Champine, Dorothy; Hoyt, Dee; Lin, Lillian; Salois, Emily; Silvas, Sharon; Weasel Tail, Terri; Williams, MatthewObjective: To compare three variants of a culturally relevant and theoretically based message to determine the most influential risk-framing approach for improving intention to place dental sealants for preschool children. Design and Sample: A convenience sample of adult, American Indian participants (n = 89) attending a community health fair were assigned to view a gain-framed, loss-framed, or mix-framed dental sealant message. Measures: We compared participants\' scores on a 46-item survey to determine the relative effect of the frame assignment on seven indices of behavior change. Results: The mean difference in participants\' stage-of-change scores (x = 1.17, n = 89, SD = 1.90) demonstrated a significant improvement for all groups after watching the dental sealant message t88 = 5.81, p < .0001, 95% CI [0.77–1.57]. Self-efficacy was the only construct for which we detected a statistically significant difference as a function of frame assignment. Overall, the mix-framed message resulted in the highest scores. The gain-framed message was the least influential on four constructs. This finding is in contrast to findings that gain-framed oral health messages are most influential (Gallagher & Updegraff, 2012; O'Keefe & Jensen, 2007). Conclusions: Community advisory board members determined to use the mix-framed approach in an oral health social marketing campaign with a rural, American Indian audience.Item Rural generalist : community based nursing(Montana State University - Bozeman, College of Nursing, 2000) Troyer, Linda ElisabethItem Methylmercury risk, awareness, and exposure in recreational anglers(Montana State University - Bozeman, College of Nursing, 2013) Angert, Stephanie Diane; Chairperson, Graduate Committee: Sandra KuntzWhile fish and seafood are a beneficial food source for all ages, some populations are at risk for exposure to environmental pollutants found in fish. Methylmercury is one such toxin found in nearly all fish species. Regular consumption of fish, especially those high in methylmercury, is associated with neurotoxicities in developing fetuses and children and increased risk for cardiovascular disease in adults. National and state fish advisories are established to guide the general population in safe fish-eating practices. Although not commonly studied, research suggests anglers likely have higher exposures to methylmercury due to greater consumption of locally-caught fish. The purpose of this study was to examine fish consumption patterns, fish advisory awareness, risk communication preferences, and actual methylmercury exposure among recreational anglers. Further evaluation was necessary to determine the type, size, amount, and frequency of fish consumed by the anglers, assess awareness of fish consumption advisories, and measure actual methylmercury exposure relative to dietary intake of fish, in order to ascertain whether this population is at risk and in need of a risk communication intervention. A convenience sample was performed with participating recreational anglers (N = 31). A survey completed by the participants examined fish consumption patterns, fish advisory awareness, and risk communication preferences. Biomarker assessment included hair mercury analysis to measure actual methylmercury exposure in the participating angler population (N = 25). Results revealed elevated hair mercury levels in 32% of participants (n = 8). After adjusting for all other variables, anglers who eat northern pike and walleye had significantly higher hair mercury levels (p = 0.009 and p = 0.016 respectively) than those who do not. Additionally, anglers who fish in lakes have higher hair mercury levels than those who do not (p = 0.005). Advisory awareness was not a significant factor after adjusting for all other variables. Additional research is needed to (a) improve the identification of specific routes of exposure (fish species, size, and waterbody) in recreational anglers, (b) identify the health impacts of mercury in the exposed population, and (c) establish effective risk reduction interventions specific for the angler population.
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