The purpose of this study was to determine levels of food security among American Indians (AI) living in the Midwest and possible correlations between food security levels and various health outcomes, diet, and demographic variables. This study used a cross-sectional design to determine health behaviors among AI. Participants (n = 362) were recruited by AI staff through various cultural community events in the Midwest, such as powwows and health fairs. Inclusion criteria included the following: age 18 years or older, self-identify as an AI, and willing to participate in the survey. Of all participants, 210 (58%) had either low or very low food security, with 96 in the very low category (26.5%). Participants with very low food security tended to have significantly more chronic conditions. Additional significant differences for very low food security existed by demographic variables, including having no insurance (p < 0.0001) or having a regular primary care provider (p = 0.0354). There was also a significant difference between food security levels and the consumption of fast food within the past week (p value = 0.0420), though no differences were found in fruit and vegetable consumption. AI in our sample had higher levels of food insecurity than those reported in the literature for other racial/ethnic groups. AI and non-Native health professionals should be aware of the gravity of food insecurity and the impact it has on overall health. Additional research is needed to determine specific aspects of food insecurity affecting different Native communities to develop appropriate interventions.
The purpose of this study was to understand if American Indian adults with diabetes in the Midwest are similar to American Indian adults nationally in their self-management behaviors. This cross-sectional survey was conducted from May 2009 to April 2010 at powwows, health fairs, and other community events. The convenience sample self-selected into the study and answered questions via touch screen computer about diabetes self-management. Participants were significantly below the national average for American Indians in their adherence to self-management recommendations in daily foot checks (p=0.0035) and having had a dilated eye exam in the previous year (p=0.0002), despite being significantly more likely to have taken a diabetes self-management class (p<0.0001). They were similar to the national average for daily glucose checks and having had one or more hemoglobin A1C tests in the previous year. Participants were less likely to eat 5 or more servings of fruits or vegetables per day (p=0.0001), but more likely to achieve 150 minutes or more of physical activity per week (p=0.0001). Programs addressing self-care issues should be developed to help improve the self-management habits of American Indian adults with diabetes, with particular attention to activities outside of monitoring blood glucose and hemoglobin A1C levels.
Breast cancer mortality disproportionately affects American Indians, with one-half of the newly diagnosed cases at regional or distant metastasis. Low screening rates are a primary reason for the disproportionate number of late-stage diagnoses in this under-served community. American Indians are also under-represented in clinical trials and other research, as well as in the health and research professions. The lack of American Indian researchers has a direct impact on the number of studies conducted with American Indians and the poor rates of mammography and other breast cancer screenings. The AIHREA/ Susan G. Komen Scholars in American Indian Breast Cancer Disparities seek to increase the number of American Indian researchers trained in breast cancer research to reduce disparities in their communities. Breast cancer is the second leading cause of cancer mortality among American Indian (AI) and Alaska Native (AN) women, who have the lowest 5-year survival rates of all racial/ethnic groups. AI/AN women are twice as likely to die from breast cancer than non-Hispanic white women. Incidence rates have risen steadily over the last 50 years. Although incidence rates among AI/AN women are lower than for other racial/ethnic groups (67.2/100,000 women versus 125.3/100,000 women for all ethnic groups),10 more AI/AN women are diagnosed with late-stage breast cancers than other racial/ethnic groups, with 44% of newly diagnosed cases staged at regional or distant metastasis, compared to 33% among non-Hispanic whites. Breast cancer incidence rates among AI/AN women differ by geographic region, with rates as high as 139.5/100,000 women in Alaska and as low as 50.4/100,000 women in the Southwest. Recent data show that breast cancer incidence may be significantly under-reported among AI/AN women due, in large part, to racial misclassification. To help reduced the disparities in breast cancer screening we created five culturally tailored brochures. Focus groups with American Indian community members were used to determine topics for the brochures titled BRCA Facts, BRCA Screening, BRCA Positive Screen, BRCA Someone You Love, and BRCA Men. After drafting the brochures they were edited focusing on access for scientific accuracy by using a panel of experts, then checking the readability level by using Suitability Assessment of Materials, followed by checking the cultural appropriateness by receiving feedback from community members at events such as powwows. Culturally appropriate imagery was added and adjustments were made according to the feedback we received. The finalized brochures are now available to the American Indian tribes, organizations and individuals. Citation Format: Jordyn Gunville, Charley Lewis, Kelly Berryhill, Crissandra Wilkie, Joseph Pacheco, Christine Daley. Series of breast cancer brochures for American Indian addressing breast cancer disparities. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C25.
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