Purpose This article examines the concept and use of the term cultural safety in Canada and the United States. Design To examine the uptake of cultural awareness, cultural sensitivity, cultural competence, and cultural safety between health organizations in Canada and the United States, we reviewed position statements/policies of health care associations. Findings The majority of selected health associations in Canada include cultural safety within position statements or organizational policies; however, comparable U.S. organizations focused on cultural sensitivity and cultural competence. Discussion Through the work of the Center for American Indian Resilience, we demonstrate that U.S. researchers engage with the tenets of cultural safety—despite not using the language. Conclusions We recommend that health care providers and health researchers consider the tenets of cultural safety. Implications for Practice To address health disparities between American Indian populations and non–American Indians, we urge the adoption of the term and tenets of cultural safety in the United States.

This pilot study evaluated a culturally specific video designed to teach Navajo women about breast cancer treatment options. Fourteen Navajo women diagnosed with breast cancer and 26 healthcare providers participated in a mixed-method evaluation that documented their perceptions immediately and 6 months after viewing the video. After initial viewing, women reported reduced anxiety about treatment and interest in support groups. Six months later, women said the video prompted them to seek more information from printed sources and their provider. Younger Navajo women who were 44 to 51 years old were more likely to attend support groups than women who were 55-67 years. Providers corroborated the positive effects of the video. The providers believed the video encouraged patients to seek information about breast cancer and to ask questions about treatment plans and side effects. A culturally relevant video for Navajo women can be an effective teaching tool and can enhance patient-provider communication. KeywordsBreast cancer; Navajo; Culturally relevant video; American Indian In the 1990s, the incidence of breast cancer among American Indian women did not change and remained lower than that reported nationally for US women of all races [1]. However, during this same decade, American Indian women suffered the lowest 5-year breast cancer survival rate of all racial and ethnic groups in the United States [2]. Wilson et al. [3] reported that older American Indian women experience a delay from diagnosis of cancer to treatment that is two times greater than that reported for non-Hispanic White women. Delays contribute to poor outcomes and ultimately to greater mortality. Reasons for the delay have been attributedCorrespondence to: Priscilla R. Sanderson, priscilla.sanderson@nau.edu. pointed out that patient education and self-efficacy may be particularly important for breast cancer patients who feel socially and economically disempowered due to income and racial inequities and thus, are "less prepared to engage in a rational deliberative decision making process". These investigators suggest that patientprovider dynamics may favor physician control over decision making and support the idea that culturally and contextually relevant education and communication tools have the potential to teach underserved populations the importance of early breast cancer detection and treatment. NIH Public AccessThe purpose of this pilot study, conducted by investigators of the Native American Cancer Research Partnership, was to document the perceptions and impact generated by a 12-min culturally specific educational video entitled, "Breast Cancer: It Can Be Healed" on the target audience, Navajo women diagnosed with breast cancer, and providers serving Navajo patients. The video is narrated in the Navajo language with English subtitles, provides information on breast cancer treatment options, and was produced by a Navajo breast cancer survivor and her oncology nurse [11].One Navajo health educator who regularly translates for pati...

Attributes of AIAN resilience should be considered in the development of health interventions. Attention to collective resilience is recommended to leverage existing assets in AIAN communities.

American Indians are disproportionately affected by factors that lead to health disparities, however many Native people demonstrate resilience when faced with health risks. Study objectives were to use a resilience framework to identify wellness strategies among American Indian people and to assess health care provider perceptions of American Indian wellness. Participants included 39 American Indian adults who self-reported resilient change and 22 health care providers who served American Indian patients. Thematic categories across American Indian and health care provider data were identified: 1) relationships inform resilience; 2) prejudice stymies resilience; and 3) place shapes resilience. Results indicated the salience of relationships in demonstrating resilience. Identified challenges and supporters of resilience are discussed.

What is already known on this topic? Food and beverage taxation may be a cost-effective public health strategy, but no unhealthy food tax has been implemented in the United States or among a tribal nation at high risk for chronic conditions. What is added by this report? The Healthy Diné Nation Act, a 2% tax on unhealthy foods, generated over $13,000 annually per Navajo rural community for local wellness programming, of which 99.1% was disbursed. An average 3% revenue decrease was recorded each year with no retail-related sales tax decline. What are the implications for public health practice? Successful disbursements suggest feasibility of unhealthy foods policies in a sovereign tribal nation that serves an indigenous population at high risk for common chronic conditions.