The Native American Health Center provides substance use and mental health services for urban American Indians and Alaska Natives (AIs/ANs) utilizing a culturally based holistic system of care (HSOC). Substance use prevention, treatment, and recovery services emphasize traditional AI/AN healing practices alongside evidence-based practices. This article describes the HSOC approach and provides preliminary findings from an outcome evaluation. Participants in outpatient and residential treatment were interviewed at baseline and 6-month follow-up with a standardized assessment tool (n = 490). The sample we composed of 86% AI/AN, 70% females, 30% males, and was entirely urban. Decreases in substance use and its related consequences were evident in both modalities but were most pronounced in residential treatment. Study's limitations and implications are included.
In the context of cloud computing, risks associated with underlying technologies, risks involving service models and outsourcing, and enterprise readiness have been recognized as potential barriers for the adoption. To accelerate cloud adoption, the concrete barriers negatively influencing the adoption decision need to be identified. Our study aims at understanding the impact of technical and security-related barriers on the organizational decision to adopt the cloud. We analyzed data collected through a web survey of 352 individuals working for enterprises consisting of decision makers as well as employees from other levels within an organization. The comparison of adopter and non-adopter sample reveals three potential adoption inhibitor, security, data privacy, and portability. The result from our logistic regression analysis confirms the criticality of the security concern, which results in an up to 26-fold increase in the non-adoption likelihood. Our study underlines the importance of the technical and security perspectives for research investigating the adoption
Objectives: Residents in nursing homes are being isolated to prevent exposure to COVID-19. Many are prone to depression, anxiety and loneliness, and extra isolation leaves them vulnerable to compromised mental health. In this study, trained volunteers providing befriending for residents with symptoms of depression, anxiety and loneliness switched to remote befriending during COVID-19. The purpose of this study was to gauge volunteer perceptions of the switch. Methods: A qualitative phenomenological approach was used to understand how switching to remote befriending impacted on volunteers and residents. A convenience sample of 18 participants responded to questions either in individual or group interviews. Results: Volunteers adapted their befriending visits, switching from face to face visits to remote options. The format was decided collaboratively. Hearing impairments hindered phone calls. Residents sometimes felt uncomfortable with digital technology but on the whole, the change to remote "visiting" was accepted. Conclusions: Further research is being conducted to gauge mental health outcomes for residents. Most volunteers and residents accepted the switch to remote befriending as better than no contact. Clinical implications:Volunteers can provide valuable support for residents living with social isolation during COVID-19. The format for social support needs to be decided collaboratively between volunteer and resident.
Objective School mental health workers are ideally placed to respond to student trauma based on their mental health expertise and the impact of childhood trauma on learning, classroom behaviour, and school relationships. The current study aimed to explore the experiences, and support and training needs of school mental health workers regarding student trauma. Method Thirteen school mental health workers, including school counsellors and wellbeing staff, participated in semi‐structured interviews and their responses were analysed using thematic analysis. Results Although participants identified helpful factors, such as consistency in routines and procedural support from colleagues, the most prominent themes in participants’ narratives reflected the challenges of providing optimal training for staff, and support to students and staff regarding student traumatic exposure. Conclusions The findings suggest a need for further research regarding the development and ongoing implementation of multi‐tiered trauma‐informed support, training practices and protocols for school staff and school mental health workers.
Background: Among Indigenous people in Canada the incidence of HIV is 3.5 times higher than other ethnicities. In Manitoba First Nations, Metis and Inuit people are disproportionately represented (40%) among people who are new to HIV care. Northlands Denesuline First Nation (NDFN) identified the need to revisit their level of knowledge and preparedness for responding to the increasing rates of HIV. NDFN piloted a community readiness assessment (CRA) tool to assess its appropriateness for use in northern Manitoba. Methods: A First Nation and non-First Nation research team trained to administer the CRA tool at NDFN in Manitoba. Five informants were interviewed using the CRA tool and the responses were scored, analysed and reviewed at community workshops and with stakeholders to develop a 1year action plan. Results: CRA training was best conducted in the community. Using the readiness score of 2.4 along with feedback from two workshops, community members, the research team and stakeholders, we identified priorities for adult education and youth involvement in programmes and planning. Conclusions: In response to the increasing incidence of HIV, a northern First Nation community successfully modified and implemented a CRA tool to develop an action plan for culturally appropriate interventions and programmes.
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