Navajo Use of Native Healers

Kim, Catherine; Kwok, Yeong S.

doi:10.1001/archinte.158.20.2245

Cited by 86 publications

(53 citation statements)

References 6 publications

(2 reference statements)

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“…[12][13][14][15][16][17][18][19] We carried out a multistage qualitative study using focus groups, in-depth interviews, and a video vignette to investigate processes of communication about TM/CAM. The 5 stages of the design were (1) focus groups composed of clinic staff and community key informants; (2) interviews of patients being seen in clinic; (3) interviews of clinicians in the same clinics; (4) an analytic focus group of clinicians from other clinics; and (5) refl ective interviews of community members and patients being seen in the clinics using a video vignette ( Figure 1 displays an overview of the study design).…”

Section: Designmentioning

confidence: 99%

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Shelley¹,

Sussman²,

Williams³

et al. 2009

The Annals of Family Medicine

205

156

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PURPOSE Although high rates of traditional medicine and complementary and alternative medicine (TM/CAM) use have been well documented, there has been less attention to the factors infl uencing communication between patients and their primary care clinicians about TM/CAM. Such communication can be important in anticipating possible drug-herb interactions and in assuring agreement about therapeutic plans. METHODSWe used sequential, multistage, qualitative methods, including focus groups, in-depth interviews, and a video vignette, to explore communication about TM/CAM between patients and their primary care clinicians. The study was conducted in RIOS Net (Research Involved in Outpatient Settings Network), a Southwestern US practice-based research network, situated largely in Hispanic and American Indian communities where TM/CAM is an important part of self-care. RESULTSOne hundred fourteen patients, 41 clinic staff members, and 19 primary care clinicians in 8 clinic sites participated. The degree and nature of TM/ CAM communication is based on certain conditions in the clinical encounter. We categorized these fi ndings into 3 themes: acceptance/nonjudgment, initiation of communication, and safety/effi cacy. Perceived clinician receptivity to and initiation of discussion about TM/CAM strongly infl uenced patients' decisions to communicate; perceived clinician expertise in TM/CAM was less important. Clinicians' comfort with patients' self-care approaches and their level of concern about lack of scientifi c evidence of effectiveness and safety of TM/CAM infl uenced their communication about TM/CAM with patients. CONCLUSIONS Specifi c communication barriers limit patient-clinician communication about TM/CAM. Clinicians who wish to communicate more effectively with their patients about these topics and better integrate the types of care their patients use can change the communication dynamic with simple strategies designed to overcome these barriers. INTRODUCTIONT he use of traditional, complementary, and alternative medicine is widespread, 1-4 although most users of traditional medicine and complementary and alternative medicine (TM/CAM) 2 also use allopathic care. 3 There are numerous studies, however, documenting a lack of communication in the conventional care setting between patients and their primary care clinicians about patients' use of TM/CAM. [5][6][7] Patient-centered communication is an evolving construct unifi ed by a set of core values defi ned by Epstein et al as a set of strategies (or a "way of being") designed to enhance a sense of partnership in the patient-clinician 8 Applied to TM/CAM use, patient-centered communication can be important because it may (1) result in closer agreement between the clinician and patient about treatment plans, (2) reduce misunderstandings between patients and clinicians, (3) uncover potential herb-drug interactions, (4) strengthen the quality of the patient-clinician relationship, and (5) provide an opportunity to discuss specifi c TM/CAM modalities with high-qu...

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Section: Designmentioning

confidence: 99%

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Shelley¹,

Sussman²,

Williams³

et al. 2009

The Annals of Family Medicine

205

156

View full text Add to dashboard Cite

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“…[26][27][28] The role that cultural practices may play in influencing AI/AN receipt of preventive cancer screening and other prevention efforts is important, given the frequent parallel use of traditional and allopathic health and healing practices among AI/ANs. [29][30][31] Although no consistent association between use of traditional health practices or cultural characteristics and mammography or cervical cancer screening has been shown, overall, these results are important to discourage the notion that the use of such practices and allopathic medicine, and breast and cervical cancer screening in particular, are incompatible. In this regard, previous research has argued that Native healers do not necessarily compete with allopathic medical services.…”

Section: Cultural Considerations In Cancer Prevention and Control Effmentioning

confidence: 92%

Strengthening breast and cervical cancer control through partnerships: American Indian and Alaska Native Women and the National Breast and Cervical Cancer Early Detection Program

Espey

Castro

Flagg

et al. 2014

Cancer

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The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) has played a critical role in providing cancer screening services to American Indian and Alaska Native (AI/ANs) women and strengthening tribal screening capacity. Since 1991, the NBCCEDP has funded states, tribal nations, and tribal organizations to develop and implement organized screening programs. The ultimate goal is to deliver breast and cervical cancer screening to women who do not have health insurance and cannot afford to pay for these services. The delivery of clinical services is supported through complementary program efforts such as professional development, public education and outreach, and patient navigation. This article seeks to describe the growth of NBCCEDP's tribal commitment and the unique history and aspects of serving the AI/AN population. The article describes: 1) how this program has demonstrated success in improving screening of AI/AN women; 2) innovative partnerships with the Indian Health Service, state programs, and other organizations that have improved tribal public health infrastructure; and 3) the evolution of Centers for Disease Control and Prevention work with tribal communities. Cancer 2014;120(16 suppl):2557-65. V C 2014 American Cancer Society.KEYWORDS: American Indians, Alaska Natives, early detection of cancer, breast cancer, cervical cancer, partnerships. INTRODUCTIONProviding health services to American Indians and Alaska Natives (AI/ANs) poses unique challenges related to geographic isolation, cultural attitudes, poverty, and language. Nonetheless, the Indian Health Service (IHS), working with its tribal, state, and federal partners, offers unique opportunities to deliver health care for members of federally recognized tribes. IHS-initiated cervical cancer screening in the 1960s and 1970s contributed to declining incidence of cervical cancer and mortality rates in the 1980s and 1990s. However, screening mammography provided to women served by the IHS before the establishment of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) of the Centers for Disease Control and Prevention (CDC) was very limited. 1,2 We describe the important contributions of NBCCEDP, in partnership with the IHS tribal programs and state programs. We review how these efforts improved access of breast and cervical cancer screening to AI/AN women and strengthened the tribal screening infrastructure. We begin with a brief history of the role of IHS and NBCCEDP in addressing the burden of breast and cervical cancer and include the impact of the program using multiple data sources. We discuss considerations important in working with tribal communities and provide examples of partnerships created between state and tribal grantees and between federal agencies.

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“…Recent surveys show that 30-42% of obese patients with hypertension and type 2 diabetes use natural products/complementary and alternative medicine (CAM) to manage their conditions [6]. In certain ethnic populations (Navajo, Vietnamese, Hispanic), the percentages are even higher (40-66%) [7,8].…”

Section: Recent Statisticsmentioning

confidence: 99%

Theoretical Studies on the Effects of Palmitic Acid Adulteration to the Hydroperoxyl Methyl Linoleate-Tbhq System

Ali¹,

Ariffin²,

Bulat³

2013

TOPROCJ

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Abstract:Obesity is a complex multifactorial disease. Adipocytes arise from pluripotent mesenchymal stem cells (MSC), which are also capable of differentiation into bone, muscle, or cartilage. Adipogenesis involves lineage commitment, mitotic clonal expansion, and terminal differentiation. Understanding these mechanisms, as well as when and how to turn them on or off, may allow development of new therapeutic approaches to obesity, diabetes, and cardiovascular disease. The most abundant non-lipid component of olive plant is the polyphenol oleuropein (Ole). We found that Ole modulates adipocyte differentiation, fat accumulation and adipogenic gene expression in human MSCs (hMSC). Ole blocks adipogenesis in a dose-dependent manner. Using RT-PCR to monitor gene expression, we found that Ole down-regulates the expression of adipogenic genes PPARγ2, LPL (lipoprotein lipase), and aP2 (lipid binding protein), while it upregulates PPARδ expression. In addition, in the presence of Ole, we were able to achieve transdifferentiation and dedifferentiation, allowing fat cells to assume other fates. These results demonstrate the potential utility of Ole for the treatment of obesity, diabetes, and related disorders, which are associated with increased fat mass. Because it modulates adipocyte differentaion, Ole may also be useful for the treatment of cachexia and lipodystrophy.

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Navajo Use of Native Healers

Cited by 86 publications

References 6 publications

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Strengthening breast and cervical cancer control through partnerships: American Indian and Alaska Native Women and the National Breast and Cervical Cancer Early Detection Program

Theoretical Studies on the Effects of Palmitic Acid Adulteration to the Hydroperoxyl Methyl Linoleate-Tbhq System

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