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Indigenous Native American Healing Traditions
... The concept of Indigenous mental health and well-being is receiving increased attention in the literature as scholars uncover the unique stressors that Indigenous Peoples face as well as the culturally distinct approaches that Indigenous nations and communities use to support resilience [19][20][21]. A key component of Indigenous mental health and well-being is the recognition of the impact of historical trauma. ...
... The living conditions for American Indian and Alaska Native populations vary greatly, with 78% living off reservations and 22% living on reservation lands [32]. Regardless of residence, the cultures of American Indian and Alaska Native populations generally emphasize connections to others, the past, the natural world, and traditional homelands [21,33]. This worldview is demonstrated by strong family bonds, respect for the wisdom of elders, and the maintenance of cultural traditions. ...
... This worldview is demonstrated by strong family bonds, respect for the wisdom of elders, and the maintenance of cultural traditions. These practices preserve, maintain, protect, and serve as solutions against threats to mental health and well-being in Indigenous communities [21,34]. ...
Background:
Despite experiencing many adversities, American Indians/Alaska Natives (AI/ANs) have demonstrated tremendous resilience during the COVID-19 pandemic, drawing upon Indigenous determinants of health (IDOH) and Indigenous Nation-Building.
Objective:
Our multidisciplinary team undertook this study to achieve two aims: 1) to determine the role of IDOH in tribal government policy and action that support Indigenous mental health and wellbeing, and in turn, resilience during the COVID-19 crisis; and 2) to document the impact of IDOH on Indigenous mental health, wellbeing, and resilience of four specific community groups, specifically first responders, educators, traditional knowledge holders and practitioners, and the substance use recovery community, living and/or working in or near three Native nations in Arizona.
Methods:
To guide this study, we developed a conceptual framework based upon IDOH, Indigenous Nation-Building, and concepts of Indigenous Mental Wellbeing and Resilience. The research process was guided by the CARE Principles for Indigenous Data Governance to honor tribal and data sovereignty. Data were collected through a multi-method research design - including interviews, talking circles, asset mapping, and coding of executive orders that documented the contextual factors that contribute to mental health and wellbeing among Native nations. Special attention was placed on the assets and culturally, socially, and geographically distinct features of each Native nation and the communities within them. Our study was unique in that our research team consisted of predominantly Indigenous scholars and community researchers representing at least eight tribes and nations in the United States. The members of the team, regardless of whether they identified as Indigenous or non-Indigenous, have many collective years of experience working with Indigenous peoples which ensured that the approach was culturally respectful and appropriate.
Results:
The number of participants enrolled in this study was 105 adults, with a total of 92 individuals interviewed and 13 individuals engaged in four talking circles. Due to time constraints, the team elected to host talking circles with only one nation, with participants ranging from 2-6 in each group. Currently, we are in the process of conducting a qualitative analysis of the transcribed narratives from the interviews, talking circles, and executive orders. These processes and outcomes will be described in future manuscripts.
Conclusions:
This community-engaged study lays the groundwork for future studies addressing Indigenous mental health, wellbeing, and resilience. Findings from this study will be shared through presentations and publications to larger Indigenous and non-Indigenous audiences; local recovery groups, treatment centers, and individuals in recovery; K-12 and higher education educators and administrators; directors of first responder agencies; traditional medicine practitioners; and elected community leaders. The findings will also be used to produce wellbeing and resilience education materials, such as print and digital toolkits, in-service training sessions, and future recommendations for stakeholder organizations.
International registered report:
DERR1-10.2196/44727.
... Indigenous healing systems comprise of beliefs and practices that originate within a culture and are designed specifically for the needs of its members. Kothian and Farrell (2010) emphasize that people of all cultures use symbolism found in their various religions and spiritual practices to cope with health problems. These symbols cue bio-psychosocial-spiritual healing responses by restoring the harmony necessary for health. ...
... These symbols cue bio-psychosocial-spiritual healing responses by restoring the harmony necessary for health. Incorporating symbolism into their treatment plan creates a powerful healing synergy (Kothian & Farrell, 2010). Native Hawaiians believe that true health requires harmony of the mind, body, and spirit. ...
... Indigenous healing systems comprise of beliefs and practices that originate within a culture and are designed specifically for the needs of its members. Kothian and Farrell (2010) emphasize that people of all cultures use symbolism found in their various religions and spiritual practices to cope with health problems. These symbols cue bio-psychosocial-spiritual healing responses by restoring the harmony necessary for health. ...
... These symbols cue bio-psychosocial-spiritual healing responses by restoring the harmony necessary for health. Incorporating symbolism into their treatment plan creates a powerful healing synergy (Kothian & Farrell, 2010). Native Hawaiians believe that true health requires harmony of the mind, body, and spirit. ...
... Cancer care creates scenarios where nurses act in a prominent capacity as supporters and advocates for patients (Hildebrandt, 2012;Potter et al., 2013). However, the establishment of caring relationships in the cancer care setting is particularly challenging for nurses who engage with racial-ethnic minority populations such as AIs as they contend with cultural and contextual influences different from those found in the majority population (Alpers & Hansson, 2014;Kelly & Minty, 2007;Koithan & Farrell, 2010;Murphy & Clark, 1993). Taking into account that over 80% of nurses in the United States self-identify as non-Hispanic White, the likelihood of patient-provider racial and cultural discordance occurring for minority patients such as AIs is significant and linked to poor communication and worse patient outcomes overall (Lamb et al., 2011;National Council of State Boards of Nursing, 2015;Stone & Moskowitz, 2011). ...
... For providers such as nurses, care of AIs presents language and other types of nonverbal communication challenges coupled with conflict surrounding treatment philosophies and discordant interpretations of wellness and disease (Guadagnolo et al., 2009;Koithan & Farrell, 2010;Lowe & Struthers, 2001). These contextual considerations undoubtedly impact the development of authentic, effective, and mutually beneficial patientnurse relationships during care. ...
Introduction
The establishment of caring relationships with racial and ethnic minority populations is challenging for many cancer care nurses. Nurses serving American Indian (AI) patients frequently encounter population-specific issues, yet their experiences are largely unknown.
Objective
The purpose of this study was to describe the meaning of the AI patient–cancer care nurse relationship from nurses' perspectives. The study included three objectives: (a) to describe the immediate experiences of nurses that have engaged in cancer care relationships with AI patients, (b) to identify the underlying structures of the AI patient–cancer care nurse relationship as described by nurses, and (c) to interpret the meaning of the patient–nurse relationship within the context of AI cancer care experiences.
Methods
This was an interpretive phenomenological study using a hermeneutical process for data collection and analysis of multiple, exploratory interviews. Thematic reduction was completed to explicate the fundamental structures of this particular relationship. Reduction of individually situated themes resulted in seven shared meta-themes including from task to connection; unnerving messaging; we are one; the freedom of unconditional acceptance; attuning and opening; atoning for the past, one moment at a time; and humanizing the inhumane.
Results
Nine cancer care nurses participated. Reconstitution of data and reflective writing suggested that the essential meaning of the AI patient–cancer care nurse relationship was expressed in contradictory yet simultaneous patterns for nurses. Nurses sought synchronicity with their AI patients despite their contextual differences and similarities, yet most lacked adequate cultural safety training. Being in relationship provided nurses great purpose within the universal human context of caring.
Conclusions
Results contribute to the development of interventions designed to improve both the AI cancer care experience and the support and training of nurses. The mutually dependent nature of the patient–nurse relationship implies that strengthening and improving support for one entity may in turn positively impact the other.
... This diversity may appear to be an insurmountable challenge in developing culturally relevant cancer education and resources, but with the help of the Advisory Workgroup it was agreed that simply acknowledging the diversity in tribal communities was a critical first step. One attribute that is consistent across these varied communities is the deeply held belief that people are a balance of physical, mental, emotional, and spiritual aspects whose relatedness to others creates an interconnectedness that is celebrated [14,21]. The incorporation of this holistic view of self and the concept of interconnectedness throughout the process and the materials provided a sense of ownership to those engaged in the revision and field testing of the COL. ...
... Relationships are not solely defined by parental systems and birth order; the role of clans, extended families, and tribes also has a strong influence on relationships. Interactions are represented through stories of the individual that are almost equally important to the role of story in the community as a whole [21]. ...
... This diversity may appear to be an insurmountable challenge in developing culturally relevant cancer education and resources, but with the help of the Advisory Workgroup it was agreed that simply acknowledging the diversity in tribal communities was a critical first step. One attribute that is consistent across these varied communities is the deeply held belief that people are a balance of physical, mental, emotional, and spiritual aspects whose relatedness to others creates an interconnectedness that is celebrated [14,21]. The incorporation of this holistic view of self and the concept of interconnectedness throughout the process and the materials provided a sense of ownership to those engaged in the revision and field testing of the COL. ...
... Relationships are not solely defined by parental systems and birth order; the role of clans, extended families, and tribes also has a strong influence on relationships. Interactions are represented through stories of the individual that are almost equally important to the role of story in the community as a whole [21]. ...
The Circle Of Life (COL) was first developed in 1991 as a breast health program through a partnership between the American Cancer Society and a committee of lay and professional volunteers in Oklahoma, with representation from Oklahoma American Indian tribal communities. In 2008, The Society was awarded funding from the Centers for Disease Control and Prevention to expand and enhance COL. Since then, The Society has engaged a variety of tribal health and education leaders and Society staff to comprise a COL advisory workgroup. The workgroup's mission was to make recommendations and provide guidance in the revision of COL. Four cultural values emerged from the engagement of the workgroup: (1) the value of visual communication, (2) the value of interconnected generations, (3) the value of storytelling, and (4) the value of experiential learning. These four concepts greatly shaped the revision of the COL educational tools and resources.
... Alternative medications, such as enoxaparin, which is derived from nonporcine sources, may need to be considered in these cases. Sometimes, some Christians believe in the power of prayer and spiritual healing, and as such, they may refuse medical treatment, including device implantation [18]. In cases where device treatment is medically necessary, healthcare providers may need to work with the patient and their family to address their concerns and ensure that they receive appropriate care. ...
In cardiology, patients' cultural beliefs, linguistic differences, lack of knowledge, and socioeconomic status can create barriers to choosing device treatment. To address this issue, we conducted a thorough literature review using online databases such as PubMed, Google Scholar, and Texas Tech University Health Sciences Center's research portal. Our review found that cultural, religious, and linguistic barriers can contribute to patients' apprehension and reservations about device placement. These barriers can also impact patients' adherence to treatment and clinical outcomes. Patients from lower socioeconomic backgrounds may have difficulty accessing and affording device-based treatments. Additionally, fear and inadequate understanding of surgical procedures can deter patients from accepting device treatment in cardiology. To overcome these cultural barriers, healthcare providers must raise awareness about the benefits of device treatment and provide better training to overcome these challenges. It is crucial to address the unique needs of patients from different cultural backgrounds and socioeconomic statuses to ensure they receive the care they need.
... Specific to Māori holistic and whānau-centred (family-centred) approaches have been integral to Māori conceptualisations of health and wellbeing [32]. While each of the Indigenous population groups have their own autonomy and sovereignty over their own health and wellbeing aspirations, they share a collective perspective of health that is intrinsically linked to culture and the environment [33][34][35]. ...
Background
Research into the effectiveness of antenatal education classes is crucial for Indigenous Peoples from Aotearoa New Zealand, Australia, Canada and the United States who experience poorer maternal and infant health outcomes compared to non-Indigenous populations. Our systematic review questions were intended to determine the extent of Indigenous Peoples prioritisation and involvement in antenatal education classes, and to understand the experience of Indigenous Peoples from these countries in antenatal education classes.
Methods
Using a standardised protocol, we systematically searched five electronic databases for primary research papers on antenatal education classes within the four countries noted and identified 17 papers that met the criteria. We undertook a qualitative meta-synthesis using a socio-critical lens.
Results
Systematic review of the academic literature demonstrates that Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States are not prioritised in antenatal education classes with only two of 17 studies identifying Indigenous participants. Within these two studies, Indigenous Peoples were underrepresented. As a result of poor engagement and low participation numbers of Indigenous Peoples in these antenatal education classes, it was not possible to understand the experiences of Indigenous Peoples.
Conclusion
Given that Indigenous Peoples were absent from the majority of studies examined in this review, it is clear little consideration is afforded to the antenatal health needs and aspirations of Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States. To address the stark antenatal health inequities of Indigenous Peoples, targeted Indigenous interventions that consider culture, language, and wider aspects of holistic health must be privileged.
Trial registration
PROSPERO Registration ID: CRD4202017658
... However, Indigenous Peoples' wholistic worldview, on the other hand, focuses on the concept of "wellbeing," which contends that the social, emotional, cultural, and spiritual aspects of an individual's health must be addressed within the healthcare delivery system. 23,24 . ...
Objective:
To explore and catalog ways Indigenous Traditional Healing practices are supported within the mainstream healthcare system through policies and programs in Canada, Australia, and New Zealand.
Data sources:
A scoping review was conducted, guided by the PRISMA extension for Scoping Reviews. Databases for sources of information include CINAHL, Medline, Embase, Web of Science, Public Health ProQuest, Global Health EBSCO, iPortal, and grey literature.
Study selection:
2 reviewers screened the titles and abstracts of the studies for inclusion against the selection criteria independently. Studies that met the inclusion criteria were transferred to Covidence for further abstract and full-text review.
Data extraction:
Of a total of 2,017 articles identified, 22 met the inclusion criteria for data extraction for this scoping review. Data items extracted include study title, authors, year of publication, publication type, publication source, support policy or program, health system or service, Indigenous Traditional Healing practices, and significant findings.
Data synthesis:
2 categories emerged from the analysis of the source of evidence. That is, healthcare systems and services with programs and policies supporting Indigenous Traditional Healing practices, and ways Indigenous Traditional Healing was adopted and utilized within the identified support programs.
Conclusions:
This study demonstrated the various ways Indigenous Traditional Healing practices are supported within the mainstream healthcare systems in Canada, Australia, and New Zealand. Indigenous Traditional Healing practices can be utilized as either the primary choice of treatment, to support Western biomedical treatment or through the adoption of Indigenous Traditional knowledge within the mainstream healthcare system.
... 10,13 In American Indian and Alaska Native communities, treatment for alcohol use disorder differs from Western approaches (such as group and individual counseling) to include traditional healing strategies (such as sweat lodges and other ceremonies) or combinations of Western and traditional healing approaches. 14,15 Little empirical research has focused on the effectiveness of these interventions among American Indian and Alaska Native people. Published randomized clinical trials have observed intervention-associated reductions in alcohol use; however, most of these studies did not specifically focus on American Indian and Alaska Native people, had small samples, or were conducted in a single geographic location, limiting their generalizability to other American Indian and Alaska Native communities. ...
Importance:
Many American Indian and Alaska Native communities are disproportionately affected by problems with alcohol use and seek culturally appropriate and effective interventions for individuals with alcohol use disorders.
Objective:
To determine whether a culturally tailored contingency management intervention, in which incentives were offered for biologically verified alcohol abstinence, resulted in increased abstinence among American Indian and Alaska Native adults. This study hypothesized that adults assigned to receive a contingency management intervention would have higher levels of alcohol abstinence than those assigned to the control condition.
Design, setting, and participants:
This multisite randomized clinical trial, the Helping Our Native Ongoing Recovery (HONOR) study, included a 1-month observation period before randomization and a 3-month intervention period. The study was conducted at 3 American Indian and Alaska Native health care organizations located in Alaska, the Pacific Northwest, and the Northern Plains from October 10, 2014, to September 2, 2019. Recruitment occurred between October 10, 2014, and February 20, 2019. Eligible participants were American Indian or Alaska Native adults who had 1 or more days of high alcohol-use episodes within the last 30 days and a current diagnosis of alcohol dependence. Data were analyzed from February 1 to April 29, 2020.
Interventions:
Participants received treatment as usual and were randomized to either the contingency management group, in which individuals received 12 weeks of incentives for submitting a urine sample indicating alcohol abstinence, or the control group, in which individuals received 12 weeks of incentives for submitting a urine sample without the requirement of alcohol abstinence. Regression models fit with generalized estimating equations were used to assess differences in abstinence during the intervention period.
Main outcomes and measures:
Alcohol-negative ethyl glucuronide (EtG) urine test result (defined as EtG<150 ng/mL).
Results:
Among 1003 adults screened for eligibility, 400 individuals met the initial criteria. Of those, 158 individuals (39.5%; mean [SD] age, 42.1 [11.4] years; 83 men [52.5%]) met the criteria for randomization, which required submission of 4 or more urine samples and 1 alcohol-positive urine test result during the observation period before randomization. A total of 75 participants (47.5%) were randomized to the contingency management group, and 83 participants (52.5%) were randomized to the control group. At 16 weeks, the number who submitted an alcohol-negative urine sample was 19 (59.4%) in the intervention group vs 18 (38.3%) in the control group. Participants randomized to the contingency management group had a higher likelihood of submitting an alcohol-negative urine sample (averaged over time) compared with those randomized to the control group (odds ratio, 1.70; 95% CI, 1.05-2.76; P = .03).
Conclusions and relevance:
The study's findings indicate that contingency management may be an effective strategy for increasing alcohol abstinence and a tool that can be used by American Indian and Alaska Native communities for the treatment of individuals with alcohol use disorders.
Trial registration:
ClinicalTrials.gov Identifier: NCT02174315.
... Nature and healing are connected in many ways. They are connected through cultural practices, spiritual teachings, and ceremonies that in combination with other factors can prevent and treat disease (Koithan and Farrell 2010). For many Latinx, healing practices in nature are grounded in the knowledge of Indigenous ancestors who viewed nature as a sacred space for connection. ...
... Moreover, nutraceuticals, commonly deemed as "Westernized" products, have shown benefits in maintaining health and reducing the risk of chronic disease [56]. Many of the benefits derived from these supplements mimic the medicinal properties of Indigenous plants that are used by traditional healers [57]. In this way, encouraging nutrition education programs that not only aim to promote a healthy diet but take advantage of Native traditions can prove to have peripheral benefits. ...
As health disparities among Native Americans persist, promoting better health outcomes is of paramount concern among Indigenous populations. A variety of programs exist that try to alleviate problems resulting in higher rates of diet-related chronic diseases and premature death. For this study, we collaborated with an Indigenous-led nonprofit that implemented a series of nutrition education courses designed to empower community members to make healthier food choices. The theoretically based curriculum, which provided learners with information in the form of sensory-based modules, e.g., food preparation, food handling, cultural awareness, and practical cooking skills, was introduced in various communities in the Great Plains and Southwest. The nutrition education programs were modeled after a canonical educational learning model, Bloom’s Taxonomy, designed to provide participants with information and resources necessary to make healthier food choices across three cognitive domains (i.e., tiers). We used a mixed-methods approach, coupling Principal Components Analysis with a qualitative SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis, to assess each program’s capacity to enhance learning retention, i.e., to assess the salience of information provided and the extent to which each program was more or less successful in participants’ learning. We found that course content and instruction are strongly correlated with program satisfaction. In addition, from the qualitative analysis, we found that as each successive module of the program challenged higher cognitive domains, participants were more likely to indicate satisfaction in the course material as well as state a desired change in their behavior, which we attribute to participants’ ability to synthesize and evaluate information. Aspects of this programming framework have the potential to be adapted to and integrated into other Native communities striving for the successful adoption of healthier diets.
... In the review of this category, it became clearly evident that the terms or conceptualizations applied to traditional medicine or its variants (i.e., traditional healing, Native American healing, etc.) were very generalized. Specifically, the general research topics ranged from trying to answer the question of what is traditional medicine [13,[39][40][41], to asking questions on the efficacy and acceptance of traditional medicine [42][43][44], to the applicability of traditional medicine with specific disease states [45][46][47], in addition to stories of healing by recipients of traditional medicine practice or approaches [48,49]. ...
Background
Despite the documented continued use of traditional healing methods, modalities and its associated practitioners by Indigenous groups across North America, it is presumed that widespread knowledge is elusive amongst most Western trained health professionals and systems. This despite that the approximately 7.5 million Indigenous peoples who currently reside in Canada and the United States (US) are most often served by Western systems of medicine. A state of the literature is currently needed in this area to provide an accessible resource tool for medical practitioners, scholars, and communities to better understand Indigenous traditional medicine in the context of current clinical care delivery and future policy making.
Methods
A systematic search of multiple databases was performed utilizing an established scoping review framework. A consequent title and abstract review of articles published on traditional Indigenous medicine in the North American context was completed.
Findings
Of the 4,277 published studies identified, 249 met the inclusion criteria divided into the following five categorical themes: General traditional medicine, integration of traditional and Western medicine systems, ceremonial practice for healing, usage of traditional medicine, and traditional healer perspectives.
Conclusions
This scoping review was an attempt to catalogue the wide array of published research in the peer-reviewed and online grey literature on traditional Indigenous medicine in North America in order to provide an accessible database for medical practitioners, scholars, and communities to better inform practice, policymaking, and research in Indigenous communities
... There is no approved treatment for COVID-19 but innovative use of traditional indigenous systems of care that nourish physical and spiritual well-being may be helpful. 26 Increasing telehealth diffusion in rural American Indian communities of the Southwest may further help protect these susceptible minority groups. 27 ...
... There are a wide variety of healing practices that North American Indigenous people use to promote health, including ceremonies, the use of native plants, connections with nature, and spiritual practices (Koithan & Farrell, 2010;Rybak & Decker-Fitts, 2009). To outsiders, the most apparent way that centering culture can benefit physical health is by reinvigorating traditional food and movement practices. ...
Recent perspectives on Indigenous health have recognized language, culture, and values as central to well-being and recovery from historical trauma. Health coalitions, which identify community health concerns and mobilize members to implement strategies for change, have begun to shift their focus from programs to policy, systems, and environmental change but have been slower to recognize the possibilities of centering Indigenous ways of being in their work. This article details a case study of the Menominee Wellness Initiative, an Indigenous health coalition that has increasingly made language, culture, and collective values the focus of their health promotion work, and often due to the participation and influence of community organizers in the coalition. The study is presented as a collaborative writing effort between coalition members and academic partners. Qualitative data were gathered through observations of coalition meetings; in-depth, semistructured interviews with coalition members; and interactive data analysis discussions within the collaborative writing team. In the results, we describe how the shift in the coalition’s framework came to be and the influence this shift has had on the coalition, its activities, and its community impacts. These findings illustrate and extend understanding of several principles of Collaborating for Equity and Justice and supports literature and practice related to health promotion through the centering of Indigenous ways.
... The Native American Indian TM system, well known in the western world, is one that has been studied and written about by many researchers. Like Ayurveda and TCM, Native American TM is engaged for healings, ceremonies and most daily practices (Koithan & Farrell, 2010). It is therefore not farfetched to say that American Indian TM is a way of life for its users. ...
Background Hypertension continues to be an international public health concern. This chronic disease is highly prevalent in Caribbean countries. Jamaican migrants to the Greater Hartford, Connecticut area share in this high prevalence. The purpose of this study was to investigate the concomitant use of herbal and conventional medicines for treating hypertension among these migrant Jamaicans. Methods Qualitative and quantitative mixed methods were used to carry out this study. Focus groups and in-depth interviews collected qualitative data and a survey questionnaire collected quantitative data allowing for representation and hypothesis testing. Analysis of qualitative data used a thematic approach while SPSS was used for univariate and bivariate analyses. Results Two focus group meetings initially led to selection of a sample for in-depth interviews with fifteen participants. Later, a questionnaire showed 92.9% of migrant Jamaicans continued to use herbal medicines for treating high blood pressure. The majority of respondents, 95.2% engaged in concomitant therapy, that is, use of both herbal and conventional medicines. Belief in the limited side effects of herbs was a primary reason given for continued use of herbal medicines. Strong correlations were seen for herbal and OTC use (p < .001), as well as herbal and prescription use (p = .004). Conclusion A high percentage of migrant Jamaicans in the Hartford area used herbal along with biomedicines to treat their hypertension suggesting that primary care providers need to know what their Jamaican hypertensive patients are taking beyond the medicines they prescribe.
... It also identifies the role of land as medicine to heal and support mino-pimatisiwin, the good life. Koithan and Farrell (2010) explain the role of medicine within Indigenous societies: ...
In response to the Truth and Reconciliation Commission’s Calls to Action, universities across Canada are currently exploring ways to decolonize and indigenize their institutions and curriculum. The profession of social work has had an historical and ongoing role in the oppression of Indigenous Peoples, and now has the responsibility to advance and integrate Indigenous worldviews for reconciliation and healing. Storytelling has been described as an embodiment of Indigenous knowledges and validates the experiences of Indigenous Peoples. Although traditional stories have been most often shared orally, visual methods of storytelling have gained popularity among oppressed communities as a way to share their realities. This photo essay project was developed as a tool to guide social work educators and students to decolonize their reflexive practice by reflecting on their personal and professional identities in relationship to place.The photo essay presents a series of images evoking stories of original peoples and settlers on this land and fuels important questions about identity and belongingness. Keywords: Decolonization, reflexive practice, photography, storytelling
... It also identifies the role of land as medicine to heal and support mino-pimatisiwin, the good life. Koithan and Farrell (2010) explain the role of medicine within Indigenous societies: ...
In response to the Truth and Reconciliation Commission’s Calls to Action, universities across Canada are currently exploring ways to decolonize and indigenize their institutions and curriculum. The profession of social work has had an historical and ongoing role in the oppression of Indigenous Peoples, and now has the responsibility to advance and integrate Indigenous worldviews for reconciliation and healing. Storytelling has been described as an embodiment of Indigenous knowledges and validates the experiences of Indigenous Peoples. Although traditional stories have been most often shared orally, visual methods of storytelling have gained popularity among oppressed communities as a way to share their realities. This photo essay project was developed as a tool to guide social work educators and students to decolonize their reflexive practice by reflecting on their personal and professional identities in relationship to place.The photo essay presents a series of images evoking stories of original peoples and settlers on this land and fuels important questions about identity and belongingness. Keywords: Decolonization, reflexive practice, photography, storytelling
... Given that 32 Asian languages are spoken within the United States and over 20 languages are spoken among American Indians and Alaska Natives, trials recognized the need to address linguistic barriers [25][26][27]. Additionally, many Asian cultures historically practice Eastern medicine and American Indians and Alaska Natives might also rely on traditional healing practices [28]. Trials may have implemented sociocultural tailoring strategies to incorporate these cultural medical beliefs and practices into interventions. ...
In 2010, Patient-Centered Outcomes Research Institute (PCORI) was authorized by Congress to improve the quality and relevance of evidence available to help patients, caregivers, employers, insurers, and policy makers make better-informed health decisions. We conducted a qualitative analysis of behavioral health trials in the PCORI Addressing Disparities portfolio to examine cultural tailoring strategies across the following priority populations: racial and ethnic minorities, rural populations, people with low-income or low socioeconomic status, individuals with disabilities, people with low health literacy, and lesbian, gay, bisexual, and transgender (LGBT) communities. The Common Strategies for Enhancing Cultural Appropriateness model was used to examine cultural tailoring strategies within trials. We hypothesized increased intersectionality within a patient population at risk for disparities would correlate with the dosage and type of cultural tailoring strategies applied. Thirty-three behavioral health trials applied cultural tailoring strategies and a majority of trials (n = 30) used three or more strategies. Trends in cultural tailoring were associated with certain racial and ethnic groups; however, increased use of tailoring was not associated with the number of priority populations included in a trial. The PCORI Addressing Disparities portfolio demonstrates how a range of cultural tailoring strategies are used, within comparative clinical effectiveness research trials, to address the needs and intersectionality of patients to reduce health and healthcare disparities.
... 24 A holistic approach to diabetes prevention and education blends well with traditional AI life paths, and a home-based intervention addresses transportation and privacy barriers known to influence care seeking in AI communities. 25,26 ...
Purpose:
The purpose of this study was to examine the impact of a home-based diabetes prevention and management program on high-risk American Indian youth.
Methods:
Together on Diabetes (TOD) was designed via a participatory approach with 4 tribal communities in the southwestern United States. A multisite pre- and postevaluation design was used to evaluate the efficacy of the TOD intervention on improving youth's psychosocial, knowledge, behavioral, and physiological outcomes at 4 time points from baseline to 12 months postenrollment.
Results:
A total of 256 youth and 225 support persons were enrolled in the TOD program. At 12 months postenrollment, improvements were observed in youth's quality of life (P < .001), depressive symptoms (P < .001), knowledge related to TOD content (P < .001), standardized body mass index scores (P = .004), and hypertension (P = .026). Improvements in mean A1C were observed among diabetic youth with baseline A1C >6.5% (P = .036).
Conclusions:
The TOD program was feasible, acceptable, and effective in lowering diabetes risk among reservation-based American Indian youth. It is the first efficacious youth-focused diabetes prevention and management program developed and implemented in partnership with tribal communities.
... Yet many AIANs share cultural health beliefs that embrace a biopsychosocial-spiritual approach based on the mind, body and spirit; which could provide a guiding framework for culturally-tailored health interventions. 30,31 In fact, some evidence suggests that social networks can provide important mechanisms to increase CRC knowledge and promote CRC screenings among AIANs. 23,32 Overall, this study had several limitations because of the nature of the aggregated, large national sample used. ...
BACKGROUND
The objectives of this study were to describe, examine, and compare prevalence estimates of colorectal cancer (CRC) screening practices and to determine whether disparities exist for American Indians/Alaska Natives (AIANs) and blacks compared with whites.METHODS
Behavioral Risk Factor Surveillance System (2001-2010) data from respondents aged ≥50 years (n = 356,073) were used. The primary outcome was self-reported CRC screening according to US Preventive Services Task Force guidelines for endoscopy (colonoscopy or sigmoidoscopy), fecal occult blood test (FOBT), or mixed screening (endoscopy or FOBT).RESULTSFrom 2001 to 2010, endoscopy screening increased in the AIAN population by 44.8% (P < .001) compared with black respondents (51.7%) and white respondents (26.5%). AIANs were less likely to report endoscopy screening (45%) compared with both blacks (56%) and whites (55%). For mixed CRC screenings, AIAN rates increased by 34.5%, compared with 29.7% for blacks and 15% for whites. In 2010, AIANs (51%) had the lowest prevalence of mixed CRC screening compared with blacks (61%) and whites (60%; P < .001). Factors that enabled health care attenuated the lowered likelihood of CRC screenings, but disparities remained for AIAN CRC screening. In contrast, once enabling factors were controlled, the odds ratios of CRC screening among blacks were higher compared with whites.CONCLUSIONS
Between 2001 and 2010, AIANs had the lowest CRC screening rates in the United States compared with blacks and whites, presenting a CRC disparity, as rigorously defined. The current findings indicate that, although considerable progress has been made to increase CRC screening for blacks and whites, progress for AIANs continues to lag behind in the first decade of 21st century. Cancer 2014 © 2014 American Cancer Society.
... Unlike Western medicine, which relies on a rational and scientific model, traditional medicine is based on ritual and myth (Struthers & Eschiti, 2005). Storytelling is a teaching method in traditional Native Medicine Stories (Mulcahy, 2005). Koithan and Farrell (2010) explain that in the Native American tradition " Stories and legends are used to teach positive behaviors as well as the consequences of failing to observe the laws of nature " (p. 477). Finally, Morris (1996) expressed that story and ceremony are the main and most persuasive methods to restore the disruptions of normal life and loss of ...
This paper explores the role of story for healing. Specifically, this paper describes story and healing in cultural or whole medical systems, including Latino/Hispanic traditions, Native American/Indigenous traditions, and Homeopathy. In addition, the authors provide a brief overview of story and healing in the nursing and medical literature, and evaluate the value of story in our current practice as holistic nurses. It is important for the holistic nurse to be aware of the role of stories for healing in diverse systems of healthcare. This awareness can help bridge the knowledge gap between cultural or whole medical systems and Western Medicine, thus optimizing the healing environment for the patient, nurse, and other providers of care.
This chapter will describe, albeit briefly and incompletely, five paradigms of medicine or healing: traditional Chinese medicine, traditional North American indigenous medicine, traditional African medicine, American faith healing, and homeopathy. After describing the theoretical foundations of each and their relationships to their cultures, there will be a brief description of their practices. I will assert that the major theses of this book of argumentation and persuasion, which was analyzed in relation to conventional, Western allopathic medicine, are applicable to these medical paradigms. The difference has to do with the cultural influences on the creation of the theory and what is accepted as evidence. This will be placed into the context of the evolution of the human mind, human universals, the need for group cohesion and the social and cultural umwelt of members of these communities. I will assert that these are essential features in how these practitioners persuade their patients.KeywordsTraditional Chinese medicineTraditional North American indigenous medicineTraditional African medicineAmerican faith healingHomeopathyMedical theoryMedical practice
Indigenous peoples in the United States experience many health disparities and barriers to accessing health care services. In addition, Indigenous communities experience poor social drivers of health, including disproportionately high rates of food insecurity, violence, and poverty, among others. These challenges are unsurprising, given historical societal discrimination toward Indigenous peoples and government policies of violence, forced relocation with loss of ancestral home, and erasure of cultures and traditions. Indigenous peoples have displayed resilience that has sustained their communities through these hardships. Through treaties between the federal government and Indigenous nations, the federal government has assumed a trust responsibility to provide for the health and well-being of Indigenous populations through the direct provision of health care services and financial support of tribally operated health systems. However, despite serving a population that has endured substantial historical trauma and subsequent health issues, federal programs serving Indigenous peoples receive inadequate federal funding and substantially fewer resources compared with other federal health care programs. Access to care is further challenged by geographic isolation and health care workforce vacancies. Given the history of Indigenous peoples in the United States and their treatment by the federal government and society, the American College of Physicians (ACP) asserts the federal government must faithfully execute its trust responsibility through increased funding and resources directed toward Indigenous communities and the undertaking of concerted policy efforts to support the health and well-being of Indigenous people. ACP believes that these efforts must be community-driven, Indigenous-led, and culturally appropriate and accepted, and center values of respect and self-determination.
This article provides an overview of the clinical evaluation and clinical treatment on multiple levels of American Indian, Alaskan Native, Native Hawaiian, and Pacific Islander youth, and their families. Included are basic cultural beliefs and practices shared among multiple tribes and nations within this diaspora, where the most important concept is balance and harmony in healing. Readers are provided with current practice approaches to core issues of substance abuse, anxiety, depression, and suicidal ideation including case examples, psychopharmacology, and therapy.
Ethnomedicine literally means the therapies used by the group of people. It is being practiced in every part of the world since the inception of man on earth which later became a part of their tradition and culture. The ethnomedicine include all therapies which are animal, plant and mineral based medicine, spiritual therapies, manual techniques, exercises etc. are also included which have been used alone or in combination to diagnose, prevent, treat or cure physical and mental illness and to maintain well being. Ethnomedicine is based on theories, beliefs, experiences, practices, skills and knowledge. The ethnomedicines of the different countries like
Alzheimer’s disease (AD) is an age-related, progressive neurodegenerative disorder characterized by impaired cognition, memory loss, and altered personality. Many of the available pharmaceutical treatments do not alter the onset of disease progression. Recently, alternatives to developed drug candidates have been explored including medicinal plants and herbal treatments for the treatment of AD. This article examines the role of herbal plant extracts and the neuroprotective effects as alternative modes of intervention for AD progression. These extracts contain key metabolites that culminate alterations in AD progression. The traditional plant extracts explored in this article induce a variety of beneficial properties, including antioxidants, anti-inflammatory, and enhanced cognition, while also inducing activity on AD drug targets such as Aβ degradation. While these neuroprotective aspects for AD are relatively recent, there is great potential in the drug discovery aspect of these plant extracts for future use in AD treatment.
Taking a new and innovative angle on social work, this book seeks to remedy the exclusion of holistic perspectives and rejection of the diversity of human socio-cultural understandings and experiences of healing currently seen in western social work practice.
This book examines six areas of healing through an integrative holistic approach that is grounded in a decolonizing perspective. Situating integrative healing within social work education and theory, the book takes an interdisciplinary approach, drawing from social memory and historical trauma, contemplative traditions, storytelling, healing literatures, integrative health, and the traditional environmental knowledge of Indigenous peoples.
Exploring issues of movement, play, creativity, animals and the natural world in relation to social work it will appeal to all scholars, practitioners, and community members interested in decolonisation and Indigenous studies.
For most families, the preferred location of death for their child is home, yet most children still die in the hospital. Many children with life-threatening and life-limiting illness are medically dependent on technology, and palliative transport can serve as a bridge from the intensive care unit to the family's home to achieve family-centered goals of care. Palliative transport may also present an opportunity to prioritize cultural care and rituals at end of life which cannot be provided in the hospital. We describe a case series of pediatric patients from communities espousing markedly diverse cross-cultural values and limited financial resources. Specific cultural considerations at end of life for these children included optimizing the presence of the shared community or tribe, the centrality of healing rituals, and varied attitudes toward withdrawal of life-sustaining medical treatment. By addressing each of these components, we were able to coordinate palliative transport to enhance cross-cultural care and meaning at end of life for children with life-limiting illness.
This chapter uses the voices of Indigenous Australians to outline cultural significance of Country, including their relationship with Country, and the cultural and environmental wisdom in the care of Country. It highlights the values embedded in the care of Country, including the connection between human and non-human wellbeing. In addition, a `Wise Practices’ model of social work is shown as an effective way of working and collaborating with Aboriginal people. Indeed, Wise Practices centres Indigenous culture and heritage while recognising that social work must be inclusive of the strengths and the spirituality of the people. Moreover, Wise Practices prioritises the use of local culture, knowledge and leadership, while using only that which is appropriate from western academia. In this way, the Wise Practices approach to community work harnesses local solutions to address local issues.
This chapter can be undertaken in a single session or spread across various
sessions. As the content is based on philosophical aspects of practice, it may
be better suited for students who have established some understanding
about the knowledge base of practice. The chapter will commence with a
summary of key attributes relating to ecosocial work, highlighting that
ecosocial work is distinct from conventional methods of practice. The need
for transformative change involving a shift in the profession’s philosophical
base is presented as a way forward to challenge inherent modernist
assumptions that impede effective ecosocial work practice. A model of
ecosocial work will be constructed according to the philosophical
dimensions of ontology (being); epistemology (knowing); and methodology
(doing). Exercises relating to each of these dimensions will be provided, as
well as an exercise exploring the influence of dominant modernist
discourses on student worldviews. Finally, Indigenous content will be
embedded throughout the lesson in an attempt to pursue ongoing
decolonisation and indigenisation processes within the profession, and to
inform ecosocial work.
Culture is generally defined as a set of attitudes, values, behaviors, and symbols shared by a large group of people and usually communicated from one generation to the next (Hays, 2001). People are multicultural, often identifying with various cultural categories (e.g., sex, age, disability, religion, national origin, race) that are layered and intersect in every possible way. It is insufficient to understand a person’s worldview without appreciating the social positions of their cultural memberships (Crenshaw, 1989; Hays, 2001). An individual’s social position can be best understood by examining how their cultural identities influence their role in Hofstede’s power distance relationship paradigm (Hofstede & Bond, 2016). Belonging to various cultural groups that have historically faced oppression, discrimination, stigmatization, or exclusion may exacerbate barriers in biological, psychological, and social areas of the human experience. Belonging to lower-power groups does not determine poor life experiences, and belonging to a higher-power group does not guarantee positive life experiences (see Table 40.1). The factors that contribute to life inequities are multifactorial, interrelated, and complex. This holds true for health inequities, which are rooted in an amalgamation of individual, provider, health system, societal, and environmental factors. Health inequities have been noted across a number of lower-power cultural groups including disability, minority race/ethnicity, homo- or bi-sexual orientation, female or transgender, and lower socioeconomic status (Farber, Ali, Van Sickle, & Kaslow, 2017).
Binge drinking among American Indians and Alaskan Natives is an acute health issue in the United States. The Radcliffe Institute for Advanced Study at Harvard University convened a one-day meeting with North American experts to identify key elements for developing research methodologies to measure treatment outcomes founded in Indigenous cultural ways of knowing. Three were identified: recognize culture as treatment, overcome Western interpretations of research, and apply culturally appropriate research methodologies. Common across the elements is respectful relationship development, which mirrors the efforts of the Canadian Truth and Reconciliation Commission that was established to address the destructive legacy of residential schools among First Nations. Reconciling America’s research response to binge drinking among American Indians and Alaskan Natives requires a similar commitment.
Health disparities exact a devastating toll upon Indigenous people in the USA. However, there has been scant research investment to develop strategies to address these inequities in Indigenous health. We present a case for increased health promotion, prevention, and treatment research with Indigenous populations, providing context to the recent NIH investment in the Intervention Research to Improve Native American Health (IRINAH) network. We discuss the disproportionate costs and consequences of disparities borne by Indigenous groups, the limited evidence base on effective intervention for this population, how population uniqueness often makes transfer of existing intervention models difficult, and additional challenges in creating interventions for Indigenous settings. Given the history of colonial disruption that has included genocide, forced removal from lands, damaging federal, state and local policies and practices, environmental contamination, and most recently, climate change, we conclude research that moves beyond minor transformations of existing majority population focused interventions, but instead truly respects Indigenous wisdom, knowledge, traditions, and aspirations is needed, and that investment in intervention science to address Indigenous health disparities represent a moral imperative.
Elder American Indians account for 9% of all American Indians and 1% of all US elders (65 years and older). American Indian elders suffer poorer health, greater functional disability, and a shorter life-span compared to the general US population. Poor health in the form of multiple chronic conditions accounts for unique medication use issues. However, little research exists on medication use and prescribing practices for American Indian elders. Currently available medication use data addresses polypharmacy, potentially inappropriate medication (PIM) use, and management of select conditions common to American Indians. Many of these studies are limited by lack of a comparator group, small sample sizes, specific health care settings, and amount of time that has transpired since data collection (1993 to 2009). However, this literature indicates American Indian elders frequently receive polypharmacy (fouror more medications), have twice the odds of receiving a PIM, and often receive suboptimal therapy for diabetes, lipid management, and asthma. Health disparities which have been clearly identified for various minority groups help to explain the differences in medication use practices for American Indian elders. Yet limited research exists on health disparities for American Indian elders. For this chapter, 25 prescription medication use issues that may potentially result in health disparities are organized into six categories: access, social support, patient characteristics, health beliefs/behaviors, health status, and prescribing behaviors. Published data related to these factors among American Indian elders provides some insight into the cause of disparities. However, further research is needed to understand the impact of these issues. While limited information is available on medication use patterns in the American Indian elder population, it appears that disparities exist. Focused efforts are necessary to optimize the management of disease in this population. However, well designed research is required to create approaches that best meet the needs of this population.
An ever increasing body of work is emerging within the pedagogical arena that explores the realm of spirituality and its implications
within a classroom (Tisdell and Tolliver, 2006; Groen, 2008), in curriculum (Fraser, 2004), for student development (Love,
2001; Kessler, 1999; Hindman, 2002), or within the academy as a whole (Shahjahan, 2006; Rendon, 2000). The emergence of this
body of work stems from what is perceived as an ever widening chasm that separates Western education from the “whole person”,
suppressing and silencing aspects of student life that are important in the quest for a holistic education experience. This
chapter examines the definitions of spirituality that are emerging out of this Western educational discourse and contends
that the current definitions undermine the collective power of spirituality by centering the individual as the sole locus
of spiritual determination in a sort of spiritual solipsism. The current discourse of spirituality has been born out of resistance
to organized religion and its coercive, imperialistic endeavors but, in rejecting the organized structures of religion, spirituality
has engaged in the other extreme, namely Western liberalism and its dogmatic emphasis on individual rights – throwing any
notion of collective spirituality out with the proverbial bath water.
How is it possible that I have an undergraduate degree in Child Development and am completing my final course for a Masters
in Education in Developmental Psychology and I have only just been introduced to the validity of the concept of ‘other ways
of knowing’? ‘Other ways of knowing’ explore alternative, nonscientific ways of interpreting and understanding reality. Western
scientific models of knowledge production rely almost exclusively on linear theories and empirical evidence that place logical
reasoning as the definitive source of knowing. Spiritual ways of knowing rely on intuition and wonder, aspects that Western
scientific models discount as taboo. My interest in writing about children’s spirituality has arisen from the startling realization
that my current knowledge of child development is dangerously limited. Until now I have been led down a singular path in my
education. Without an appreciation for other ways of knowing, my understanding of spirituality has been restricted. I believe
that spirituality lies at the core of our humanity and is a gateway to knowledge, not the obstruction that I’ve been taught.
In this article I propose that symbolic healing has a universal structure in which the healer helps the patient particularize a general cultural mythic world and manipulate healing symbols in it. Problems currently existing in the explanation of symbolic healing are examined. The relationship between Western psychotherapy and magical healing is explained, the Junction qfshamanic ecstasy is discussed, and symbolic healing is explained in terms of a theory of living systems.
Honoring the Medicine: An Essential Guide to Native American Healing
- K Cohen
Cohen K. Honoring the Medicine: An Essential Guide to Native American Healing. New York, NY: Ballantine Books; 2006.