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 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 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 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.Item Practice implications for addressing Native American youth suicide : an integrative review(Montana State University - Bozeman, College of Nursing, 2013) Erickson, Janet Leigh; Chairperson, Graduate Committee: Patricia A. HolkupAmerican Indian/Alaska Natives experience the highest rate of suicide compared to all ethnic groups in the United States, and the youth of this minority population account for 40 percent these suicides. The aim of this integrative literature review was to provide information and direction to health care professionals, including nurses, who deliver care to the AI/AN youth across Indian Country. An integrative review, including a comprehensive computer-assisted search of three separate databases, and a subsequent review of the reference lists of selected articles was completed. Forty-one articles met the inclusion/ exclusion criteria. The findings, recommendations and practice implications were documented in a chart (Appendix C) and then organized according to the biological systems theory model (Appendix D), which allowed for illustration of the multi-layered risk unique to Native youth, the importance of considering the social context in which Native youth suicide occurs, and assisted in identifying practice implications specific to Native American youth. The risk factors ranged from individual and family "day-to-day realities," to factors that were a part of the adolescent's environment but not necessarily a direct influence, to cultural, economic and political issues, and historical events that remain active as factors affecting the lives of Native youth. The results of this integrative literature review provided the evidence for the need to develop a collaborative approach that is culturally anchored in the world of the Native youth. The need for increased research related to addressing the Native American youth suicide crisis is described as imperative with suggestions to focus on studying current culturally appropriate, holistic care in attempts to determine its effectiveness.Item Preferences and perceptions following sexual assault : a study exploring the awareness and use of support services, and estimated extent of sexual assault among American Indian women at one northwestern university(Montana State University - Bozeman, College of Nursing, 2012) Van Houweling, Audry Beth; Chairperson, Graduate Committee: Patricia A. HolkupSexual assault is a national and global epidemic. This study focuses on American Indian women, who experience sexual assault at greater rates compared to all other racial groups and college students, who experience a high prevalence of sexual assault. This exploratory, mixed methods study considers the perceptions and preferences relative to sexual assault among American Indian college women. Specifically, this study explored the perceived barriers to reporting sexual assault, the perceived awareness of campus and community sexual assault services, preferred reporting patterns, and the perceived magnitude of sexual assault among American Indian college women while enrolled in a northwestern university and prior to enrollment. An anonymous online survey was distributed to American Indian students with the permission of an on-campus American Indian organization. A total of 31 responses were collected over a one-month time period from American Indian college women. The results suggested the need for improved sexual assault awareness and prevention strategies. Further research is needed to fully understand the implications of culture and the perceptions and preferences among American Indian college women. PLEASE NOTE: For purposes of confidentiality, the name of the northwestern university and information identifying the university's location were withheld throughout the body, references, and appendices of this document. The original survey sent to participants did identify the university and its location for reference purposes, but subsequently was removed and masked.Item Cultural considerations at the end of life : communication of helathcare providers with Native American patients(Montana State University - Bozeman, College of Nursing, 2012) Hunsucker, Heidi Lynn; Chairperson, Graduate Committee: Yoshiko Yamashita ColcloughThe purpose of this project was to provide information to non-Native-American healthcare providers to help enhance their communication with Native-American patients at the end of life. The end of life can be a distressing time for patients, families, and healthcare providers alike. Cultural differences which may exist among these groups can make the transition even more difficult. Communication may be hindered due to misunderstandings or unclear expectations. This project was an extension of a study focusing on an Indian reservation in north central Montana which identified several areas to focus on for improving end-of-life care including educating the patients and families about palliative care options, helping healthcare providers become more culturally sensitive, and creating a culturally appropriate and sensitive end-of-life program. A pamphlet was developed based on the findings of a literature review and information from a cultural expert to help healthcare providers identify and address communication issues at the end of life. The pamphlet addressed communication issues between non-Native-American healthcare providers and Native-American patients. Madeleine Leininger's Theory of Culture Care Diversity and Universality was used to guide the project, and a modified Delphi method was used to help create a culturally appropriate pamphlet for non-Native-American healthcare providers. By understanding their own cultural influences and taking the time to understand and respect the cultural influences of their patients, healthcare providers can provide quality end-of-life care. Communication at the end of life can be enhanced by recognizing that culture may confound understandings and expectations, and addressing that factor can help remove barriers from quality care. This pamphlet will serve as a device to help prepare APNs for the barriers they may encounter when working with patients from not only the individual tribe in north central Montana, but also to make them aware of the fact that cultural barriers exist among different cultures. Perhaps making APNs aware of the cultural differences will open the way for increasing research about different cultures in the future. APNs should enter into every patient encounter with the knowledge that there are things they can learn from their patient to better provide effective care.