Cancer screening and risk factor rates among American Indians.

MHS, 6116 Executive Blvd, Suite 504, Bethesda, MD 20892-8315. .
American Journal of Public Health (Impact Factor: 4.23). 03/2006; 96(2):340-50. DOI: 10.2105/AJPH.2004.053231
Source: PubMed

ABSTRACT We examined cancer screening and risk factor patterns in California using 4 different statistical tabulations of American Indian and Alaska Native (AIAN) populations.
We used the 2001 California Health Interview Survey to compare cancer screening and risk factor data across 4 different tabulation approaches. We calculated weighted prevalence estimates by gender and race/ethnicity for cancer screening and risk factors, sociodemographic characteristics, and access to care variables. We compared AIAN men and women with members of other racial groups and examined outcomes among AIAN men and women using the 4 tabulation methods.
Although some differences were small, in general, screening and risk factor rates among American Indians/Alaska Natives were most similar to rates among Whites when the most inclusive multiracial tabulation approach was used and least similar when the more exclusive US census "single-race" approach was used.
Racial misclassification and undercounting are among the most difficult obstacles to obtaining accurate and informative data on the AIAN population. Our analysis suggests some guidelines for overcoming these obstacles.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The United States is home to more than 4 million Native Americans, the majority of whom live in urban areas. Urban Native Americans often experience significant social, health, and economic problems while having access to substantially fewer Native-specific resources than their reservation-based counterparts. They also face challenges with access to tribal services and political processes, as well as identity-sustaining cultural resources. This article describes the urban nature of many contemporary Native American communities. Examples from various urban Native American communities highlight the challenges faced by urban Native people, as well as creative initiatives developed to serve this population. This paper draws on and synthesizes the literature on contemporary urban Native communities, thus providing needed information for service providers and researchers working in these communities.
    Journal of Community Practice 10/2012; 20(4):470-488. DOI:10.1080/10705422.2012.732001
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To quantify the loss to follow-up rate after abnormal Pap test results at the Phoenix Indian Medical Center, an Indian Health Service regional facility, and identify barriers to follow-up from the patients' point of view. Materials and Methods: Patient records were used to identify women who had abnormal Pap tests in 2002 and to document the status of their follow-up care. Women who had no clinical record of follow-up were contacted by telephone to arrange a follow-up appointment and to request participation in a structured qualitative interview to identify barriers to follow-up at the individual, family, community, and health care system levels. Structured qualitative interviews were conducted with 15 women. Results: Of the 930 women with abnormal Pap test results in 2002, 11.1% received follow-up care at PIMC in accordance with the recommended timeframe stipulated in clinical protocols; 74.6% received follow-up care at PIMC, but not in accordance with protocols; 2.6% were followed-up at another facility, 1% had moved out of the area, 3.5% were never treated, and we were unable to contact 6.6%. Most of the barriers to follow-up were related to communicating the need for follow-up and providing access to care within a timeframe appropriate for clinical care. Conclusion: While these findings place an important additional responsibility and burden on the health care system serving American Indian women, our research outreach efforts suggest that given the availability of appropriate resources, these barriers can be overcome.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Tribal sovereignty exempts tribal casinos from statewide smoking bans. Purpose: To conduct a tribally-led assessment to identify the characteristics of casino patrons at Lake of the Torches Resort Casino in Lac du Flambeau WI and their preferences for a smoke-free casino. Methods: A survey was administered from April to August 2011 to a stratified random sample of 957 members of the casino players club to assess their preferences for a smoke-free casino. These members were categorized into three groups: those who reported being likely to (1) visit more; (2) visit less; or (3) visit the same if the casino prohibited smoking. They were characterized by age, education, sex, race/ethnicity, annual income, players club level, and reasons for visiting the casino. Statistical analyses were conducted on weighted data in October to December 2011. Weighted logistic regression was calculated to control for potential confounding of patron characteristics. Results: Of the 957 surveyed patrons, 520 (54%) patrons were likely to visit more; 173 (18%) patrons to visit less; and 264 (28%) patrons were indifferent to the smoke-free status. Patrons more likely to prefer a smoke-free casino tended to be white, elderly, middle class and above, and visit the casino restaurants. Patrons within the lower tiers of the players club, almost half of the players club members, also showed a higher preference for a smoke-free casino. Conclusions: This tribal casino would likely realize increased patronage associated with smoke-free status while also contributing to improved health for casino workers and patrons. (C) 2014 American Journal of Preventive Medicine
    American Journal of Preventive Medicine 06/2014; 47(3). DOI:10.1016/j.amepre.2014.04.006 · 4.28 Impact Factor