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Cultural factors are associated with health behaviors among American Indians. Accordingly, the objective of our study was to investigate whether cultural identity, defined as the primary language spoken at home, is associated with: 1) higher total physical activity levels, and 2) levels of leisure-time physical activity recommended for health benef...
Contexts in source publication
Context 1
... activity data were available from 5,090 of the 5,207 adults exam- ined by the BHCIAH. Table 1 displays select demographic characteristics of the sample by region. Overall, the majority of the participants were female, had a mean age of 37 (range 18-82), and reported English as the primary lan- guage spoken at home. ...
Context 2
... theless, the instrument used in the EARTH cohort has been described and used in a number of studies, 5,13,17,34 and was found to have acceptable reliability and validity based on a small sub study of participants who wore pedometers. Finally, the esti- mates of leisure-time physical activity (Table 1) may be higher than expected because this calculation was not restrict- ed to moderate-intensity activities exclu- sively. Instead, a total leisure-time phys- ical activity level was calculated using the 25 individual activities within the leisure- time category of the instrument that also included five activities below the 4.0 MET threshold used to define moderate- intensity, such as stretching/hatha yoga (2.5 METs; 37% of subjects participated in this activity), and walking for exercise (3.5 METs; 44% of subjects participated in this activity). ...
Citations
... Traditional eating and cultural correlates among Alaska Native adults While causality cannot be determined from these cross-sectional data, it can be concluded that those who reported eating more traditional foods also reported greater connection and standing in their community-factors that promote health and well-being [12,[29][30][31][32][33][34]. ...
... Research on cultural and community connectedness and health behaviors in Indigenous adults has shown positive association for physical activity in multiple cross-sectional studies [31][32][33]. One study with African American adults found cultural identification associated with increased leisure-time physical activity, healthier diet, and less smoking [29]. ...
This cross-sectional study assessed how traditional eating relates to cultural and community factors. Alaska Native adults from the Norton Sound region were recruited and surveyed between 2015–2018 for a randomized clinical trial of multiple risk behavior change interventions for cardiovascular disease prevention. Participants (n = 291) were 49% female with a mean age of 47 years (SD = 14). A 34-item food frequency questionnaire assessed consumption of foods traditional and nontraditional to the regional Alaska Native diet. A novel measure, termed the “traditional foods index”, was computed as weekly servings of culturally traditional food consumption divided by total foods reported. Overall, the sample’s traditional foods index averaged 21%±16%, with higher values reported by participants assessed in summer (23%±17%) than winter (19%±15%, p<0.05); by women (22%±16%) than men (19%±16%, p < .05); and by residents of smaller communities (22%±17%) than the comparatively larger community of Nome (17%±14%, p<0.05). The traditional foods index was correlated with age (r = .26, p < .01), as well as the cultural variables of community connectedness (r = .19, p < .01), community standing (r = .15, p < .01), and traditional language comprehension (r = .19, p < .01). In a multivariate regression model, age, community connectedness, and community standing remained significantly associated with traditional diet. These findings may inform the design and evaluation of community-based, culturally-relevant dietary initiatives for heart health.
... For Native populations burdened by extreme health disparities, ethnic identity has been explored relative to general health and the related influence on preventive behaviors and behavioral compliance with medical recommendations [9,[12][13][14]. Some studies have shown that a strong sense of ethnic identification is associated with higher rates of optimal health beliefs and behaviors [15][16][17][18][19][20] and better health outcomes [9,[20][21][22][23][24]. In other studies, an inverse relationship between ethnic identity and health-promoting behaviors has been discerned. ...
... Findings provided evidence of a cross-sectional association of perceived importance of one's tribal identity with strong oral health knowledge and positive oral health-related beliefs. These results were consistent with studies in other health areas suggesting a positive association of ethnic identity with oral health-related attitudes [15][16][17][18][19][20][21][22]. However, results showed no relationship between perceived importance of tribal identity with oral health behavior, and a negative relationship between tribal identity with parental and pediatric oral health status. ...
... As such, the advantage of being bilingual may be additive rather than subtractive in health-promoting behavior [49,50]. In the Northern Plains, biculturalism was associated with positive health behaviors associated with physical activity [17]. The advantage of biculturalism over monoculturalism involving both minority and majority cultures and American Indian populations has been attributed to generating a higher sense of self-efficacy [17]. ...
Objectives:
To examine the relationship between ethnic identity and oral health knowledge, beliefs, behavior, and outcomes in American Indian families.
Methods:
Secondary data were analyzed for 579 parent-child dyads in a randomized controlled trial aimed at reducing early childhood caries in a Northern Plains tribal community. Data included demographic characteristics; parental ethnic identity; oral health knowledge, beliefs, and behavior; and parental/pediatric oral health outcomes. Ethnic identity was assessed using two measures: perceived importance of tribal identity and tribal language proficiency. We examined the association of baseline ethnic identity with baseline and longitudinal oral health measures.
Results:
At baseline, importance of tribal identity was significantly associated with several oral health beliefs, and one's locus of control measure (external-chance). Baseline scores on importance of tribal identity were also associated with one's oral heath belief (perceived severity), the same locus of control measure, and oral health knowledge and behavior over the three years of study follow up. Tribal language proficiency was not associated with any study measures at baseline, although it was associated with parental oral health status over the three years.
Conclusions:
Ethnic identity was associated with a range of oral health constructs expected to influence American Indian children's oral health.
... Cabe observar a diferença para os países desenvolvidos tais como Austrália e Canadá, com populações originárias, que geram dados relevantes e já superaram a citada "invisibilidade estatística" 34 (e, portanto, epidemiológica) que observamos no presente estudo. Em países desenvolvidos com populações originárias tais como Austrália, Canadá, Nova Zelândia e Estados Unidos, diversos estudos já tratam da temática da inatividade física nestas populações, incluindo as que residem em área urbana, sendo esta a realidade mais presente nestes países [35][36][37][38][39][40][41] . Muitas vezes estes países dispõem de sistemas de informação próprios onde se pode recuperar dados sobre diversas condições de saúde da população indígena (urbana e rural), incluindo aí a prevalência de inatividade física. ...
Embora a inatividade física esteja relacionada ao risco aumentado de doenças crônicas não-transmissíveis, existe pouca pesquisa publicada sobre a saúde de populações indígenas em área urbana nos países da América do Sul. O presente estudo conduziu revisão sistemática da literatura investigando a inatividade física em populações indígenas residindo em área urbana na América do Sul, identificando as prevalências encontradas, o instrumento utilizado para mensuração e o país de publicação. Realizou-se busca nas bases de dados Medline, Embase, ERIC, PsycInfo, Scopus, Web of Science, Scielo, teses e dissertações considerando descritores definidos. Considerou-se como critérios de inclusão: ser estudo com dados populacionais primários ou secundários, com populações indígenas residindo em área urbana em país da América do Sul, publicados entre os anos de 2008 a 2018. Ao final, 5 registros foram analisados na íntegra e tratavam de populações indígenas no Brasil, com prevalências de inatividade física variando de 28,8% a 64,5% da população, coletadas por meio de questionários variados. Em 3 estudos a inatividade física mensurada foi maior que a registrada para a população não-indígena urbana no Brasil no ano de 2013. Constituem limitações a pouca generalização dos dados dos estudos e a diversidade dos instrumentos utilizados. A temática da inatividade física em populações indígenas em área urbana é recente e necessária a um novo conceito de saúde indígena que considere esta parcela da população. Sugere-se que futuros estudos abranjam os países do Caribe e América Central, em especial. Palavras-chave: Exercício Físico. Povos indígenas. América do Sul.
... [21][22][23] In addition, cultural-specific forms of resilience, such as participation in regular cultural events like powwows, speaking Native language, and having strong community identity and social support, may ameliorate the relationship between psychological symptoms and health consequences in American Indians. [24][25][26][27][28] The association between depressive symptomology and cognitive function, and how it may differ for older American Indians compared with members of the majority population, is poorly understood. Very few studies are available on the clinical course and treatment of depressive symptoms in this vulnerable and understudied population. ...
BACKGROUND
American Indians have excess risk of depression, which can contribute to cerebrovascular and cognitive disability, with effects on memory, processing speed, executive function, and visuospatial ability. However, studies examining depression and cognition in American Indians are limited; this study aims to report associations of depression with general cognition, verbal fluency and memory, and processing speed.
DESIGN
Cohort study.
SETTING
The Cerebrovascular Disease and its Consequences in American Indians study was an ancillary examination of Strong Heart Study participants from 3 U.S. regions.
PARTICIPANTS
All eligible were included in this analysis (N=818).
MEASUREMENTS
Participants completed evaluations for depressive symptomology, cognition, and physical function—including Center for Epidemiologic Studies Depression (CESD), Modified Mini‐Mental State Examination (3MSE), Wechsler Adult Intelligence Scale‐Fourth Edition coding (WAIS), Controlled Oral Word Association (COWA), California Verbal and Learning Test, Halstead finger tapping, grip strength, and Short Physical Performance Battery (SPPB) tests. Linear mixed models were adjusted for site, age, sex, education, income, marital status, alcohol, smoking, diabetes, hypertension, obesity, cholesterol, stroke, infarct, and hemorrhage.
RESULTS
Symptoms of depression were common, with 20% (N=138) endorsing CES‐D scores of 16+. More depressive symptoms were associated with older age, female sex, lower education, lower income, non‐married status, not using alcohol, not smoking, hypertension, diabetes, and stroke. In adjusted analyses, processing speed (WAIS: β −0.13, 95%CI −0.25, −0.03), general cognition (3MSE: β −0.10, 95%CI −0.17, −0.03), verbal fluency (COWA: β −0.10, 95%CI −0.19, −0.01), and motor function (SPPB: β −0.05, 95%CI −0.07, −0.03) were significantly associated with more symptoms of depression.
CONCLUSION
These findings maybe informative for health disparities populations, especially those with depressive risk. Clinicians may require particular training in cultural humility. Future studies should validate use of the CES‐D scale in this population; longitudinal studies may focus on causal mechanisms and potential secondary prevention, such as social support.
... Understood to be the subjective identification with and sense of belonging to one's ethnic group 6 -in this case, one's tribe-ethnic identity is commonly measured by indicators such as participation in cultural activities, use of the language of one's ethnic group, pride in one's cultural heritage, and perceived importance of ethnic group membership to one's self-concept. 7 Among AI/ ANs, strong ethnic identification is linked to higher levels of positive health attitudes, 8,9 higher rates of positive health behaviors, 10,11 lower rates of negative health behaviors, 9,12,13 and better health outcomes. 7,[13][14][15][16][17] Despite these results, it appears that ethnic identity is not always associated with positive outcomes for Native people. ...
American Indians and Alaska Natives (AI/ANs) experience poor oral health. Children and adults living on the Navajo Nation have a particularly high rate of dental decay. The literature suggests that health outcomes are often associated with the strength of one's ethnic identity. We investigated the association of ethnic identity among Native parents with oral health knowledge, attitudes, behavior, and outcomes. Analyses used baseline data from a randomized controlled trial designed to reduce dental decay among AI/AN preschoolers enrolled in the Navajo Nation Head Start Program. Greater perceived importance of ethnic identity was associated with better oral health knowledge and attitudes but was unassociated with oral health behavior and was linked to worse oral health status. Parents who were better able to speak their tribal language had greater confidence in their ability to manage their children's oral health, engaged in better oral health behavior, and reported better parental oral health status.
... Epidemiologists have frequently observed trends in minority population health that seem to reflect changes in "cultural orientations," or the degree to which individuals espouse the culture (values; identity; preferences; behaviors; traditions) of their heritage (ethnic; racial; religious; national) group. Consequently, a large number of studies have investigated the relationship between various aspects of acculturation and health, particularly in Hispanic Americans (reviews: (Abraído-Lanza et al., 2016;Lara et al., 2005;Thomson and Hoffman-Goetz, 2009)), Asian Americans (reviews: (Salant and Lauderdale, 2003;Suinn, 2010)), ethnic minority immigrants to Canada (reviews: (Sanou et al., 2013;Urquia et al., 2012)), and Native Americans (Duncan et al., 2014;Garrett et al., 2012). Notable inconsistencies have emerged in the relationship between acculturation and health (Castro, 2007). ...
Acculturation represents an important construct in the context of health disparities. Although several studies have reported relationships between various aspects of acculturation and health in minority populations, crucial inconsistencies remain. One likely reason for these inconsistencies may relate to limitations in the conceptualization and operationalization of acculturation, particularly in the context of health research. The acculturation construct underwent major conceptual and operational change when it was adapted from anthropology to psychology, and we argue another major shift is now required for use of this construct in health research. Issues include determining whether acculturation measures should focus on an individual's internal attitudes or overt behaviors; whether they should characterize cultural orientation status at a given point in time or change over time; whether measures should be culture-specific or more global in nature; how the issue of multiculturalism should be addressed; how measures can optimally incorporate multiple dimensions of acculturation; and whether proxy measures should be used. These issues are important in the context of health research because of their implications for determining the direct and indirect effects of cultural change on health-related biological and behavioral processes. We elaborate on and address each of these issues from a perspective that spans multiple disciplines across the biological and social sciences, and offer concrete recommendations with the ultimate goal of achieving a better understanding of the role of acculturation in minority health and health disparities.
... Harnack et al. reported that lack of child care, lack of time, and safety concerns (such as snakes and stray dogs) were the most frequently-mentioned barriers to physical activity among Northern Plains women [18]. Social support and cultural identity have also been identified with physical activity level, with the highest levels of activity found among adults who speak both English and traditional language compared to either alone [28,29]. Similar to this study, barriers presented by the physical environment have been identified in qualitative studies of women [18,30] but a review of the correlates of physical activity in Native Americans concluded that while age, gender, and social support are important factors to consider, there is no empirical evidence to suggest that the physical environment is a barrier [29]. ...
The objective of the present study was to identify barriers to and facilitators of physical activity among American Indian adults living on a rural, U.S. Northern Plains reservation using the nominal group technique (NGT). NGT is a method of data generation and interpretation that combines aspects of qualitative (free generation of responses) and quantitative (systematic ranking of responses) methodologies. Adults participated in one of two NGT sessions asking about either barriers to (n = 6), or facilitators of (n = 5), being physically active. Participants nominated and ranked 21 barriers and 18 facilitators. Barriers indicated lack of knowledge of how to fit physical activity into a daily schedule, work, caring for family members, and prioritizing sedentary pursuits. Other responses included environmental barriers such as lack of access and transportation to a gym, unsafe walking conditions, and inclement weather. Facilitators to following recommendations included knowledge of health benefits of physical activity and the perception of physical activity as enjoyable, including feeling good when working out. Environmental facilitators included being outdoors walking and biking as well as parks and exercise facilities. Responses provided direction for locally designed community-based programs to promote facilitators and decrease barriers to individual's engagement in physical activity.
Purpose
This study aimed to describe physical activity (PA) via the frequency, intensity, time, type, volume, and progression (FITT-VP) principles of Native Americans (NA), it is necessary to understand their current PA. The purpose was to 1) evaluate PA levels utilizing FITT-VP principles and 2) compare the patterns of PA in NA men and women.
Methods
Recruitment and evaluation ( n = 586) took place as part of the OPREVENT2 study baseline evaluation. The International Physical Activity Questionnaire–Short Form assessed frequency (days per week), intensity (walking, moderate, vigorous), and time (minutes per day). The total MET-minutes for the previous 7 d provided the volume of activity.
Results
The NA sample was 45.8 ± 15.1 yr of age, with a body mass index of 31.5 ± 6.4 kg·m ⁻² . The FIT-V corresponded to 4.7 ± 2.3 d·wk ⁻¹ , walking (3.3 METs intensity), 52 ± 47 min·d ⁻¹ , and 2536 ± 2203 MET·min ⁻¹ . The men ( n = 162) reported a greater frequency of 3.2 ± 2.5 d·wk ⁻¹ ( P = 0.007) of vigorous activity lasting 55 ± 50 min·d ⁻¹ compared with the women ( n = 433) with 2.6 ± 2.5 d·wk ⁻¹ of vigorous activity lasting 34 ± 38 min·d ⁻¹ . The men reported higher MET-minutes than did the women ( P = 0.0001). Overall, 71% of men and 77% of women met the recommended PA guidelines.
Conclusions
Given that the majority of NA report adequate walking time and frequency, interventions are needed to improve moderate- and vigorous-intensity aerobic fitness, as well as muscular strength and endurance, neuromotor, and flexibility activities.
