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At least 217 records · Page 12Linked to original sources
PubMed2003

Community based program to improve firearm storage practices in rural Alaska.

OBJECTIVE: To develop and evaluate a pilot program to reduce unauthorized access to firearms by youth by distributing gun safes and trigger locks to households. DESIGN: Pilot intervention with pre/post-evaluation design. SETTING: Two Alaska Native villages in the Bristol Bay Health Corporation region of southwest Alaska. SUBJECTS: Forty randomly selected households with two or more guns in the home. INTERVENTION: Initially, a focus group of community members who owned guns was convened to receive input regarding the acceptability of the distribution procedure for the gun storage devices. One gun safe and one trigger lock were distributed to each of the selected households during December 2000. Village public safety officers assisted with the distribution of the safes and provided gun storage education to participants. MAIN OUTCOME MEASURES: Baseline data were collected regarding household gun storage conditions at the time of device distribution. Three months after distribution, unannounced onsite home visits were conducted to identify if residents were using the gun safes and/or trigger locks. RESULTS: All selected households had at least two guns and 28 (70%) of the 40 households owned more than two guns. At baseline, 85% of homes were found to have unlocked guns in the home and were most often found in the breezeway, bedroom, storage room, or throughout the residence. During the follow up visits, 32 (86%) of the 37 gun safes were found locked with guns inside. In contrast, only 11 (30%) of the 37 trigger locks were found to be in use. CONCLUSIONS: This community based program demonstrated that Alaska Native gun owners accepted and used gun safes when they were installed in their homes, leading to substantial improvements in gun storage practices. Trigger locks were much less likely to be used.

Adolescent↗
PubMed2005

Development, adaptation, and implementation of a cardiovascular health program for Alaska native women.

Southcentral Foundation's Traditions of the Heart program is an innovative cardiovascular disease prevention program for women designed to build on the strengths of the Alaska Native culture as a way to support and encourage positive lifestyle behaviors that focus on healthy eating, active living, stress management, and tobacco cessation. After conducting assessments of existing intervention programs and formative data collection, we adapted two existing programs, Native Nutrition Circles and A New Leaf... Choices for Healthy Living, to develop the Traditions of the Heart program. We implemented and evaluated a pilot intervention study to determine the program's acceptance among Alaska Native women. We used the evaluation results to further refine our study protocol. This article describes the adaptation of these programs to the cultural needs and strengths of Alaska Native women and the results of the formative evaluation used to improve the program design. The complete pilot study outcomes will be published separately.

Alaska↗
PubMed2005

Communicating respectfully with American Indian and Alaska natives: lessons from the California Health Interview Survey.

Background. California is home to the largest number of American Indians in the United States, including large numbers of residents who are from tribes outside of the state, in addition to Alaska Natives. In 2000 to 2001, the California Health Interview Survey randomly surveyed, by telephone, approximately 54,122 households throughout the state, focusing on public health and access to health care. Methods. American Indian and Alaska Native cultural competency training materials were developed for the data collection interviewers. Unique cultural and linguistic issues identified were (1) reservation dialect English, (2) the long pause, (3) slow speaking, (4) "walking on words," and (5) a brief review of the importance of collecting tribal heritage information. Conclusions. Since the successful implementation of the competency training, several researchers, practitioners, state agencies, and others have requested and implemented the training materials in their work. In this article, we review the training materials. We hope that these few tips will help others have successful experiences communicating respectfully with American Indian and Alaska Natives.

Alaska↗
PubMed2006

The tools to understand: community as co-researcher on culture-specific protective factors for Alaska Natives.

A collaborative research process engaging Alaska Native communities in the study of protective factors in Alaska Native sobriety and the design of a preventative intervention using its findings is described. Study 1 was discovery oriented qualitative research whose objectives were identification of protective factors and development of a heuristic model. Study 2 involved quantitative survey methods to develop and test ameasure of protective factors identified by the qualitative study. Empirical data from these studies is presented, and the role of Alaska Native co-researchers who did not possess specialist research training is described in the design and implementation of the study, interpretation of findings, and design of the intervention model and tools. Benefits that emerged from co-researcher involvement in this process, to the community and to the co-researchers themselves, are described.

Adult↗
PubMed1998

Sex partners of Alaskan drug users: HIV transmission between white men and Alaska Native women.

This study describes patterns of sexual behavior and condom use in a sample of 1125 Black, White, and Alaska Native drug users. Data are self-reports of recent sexual behavior, including descriptions of (up to) the five most recent sex partners. This provided information on 1116 sex partner pairs, of which at least one partner was a drug user. Sex partner pairs involving a White man and an Alaska Native woman were frequently reported. Level of condom use within these pairs was significantly lower than within all other pairs. The implications of a potential vector of HIV transmission from White, drug using men to Alaska Native women are discussed.

Adult↗
PubMed2001

Gender and reported health problems in treated alcohol dependent Alaska natives.

OBJECTIVE: An ongoing study of phenotypes of alcohol dependence among Alaska Natives provides the opportunity to investigate gender differences in reported health-related problems among alcohol dependent clients in three residential programs in Anchorage, Alaska. METHOD: Clinical assessment information was obtained on 469 (263 male) subjects from consecutive admissions to each of three treatment programs. The average (SD) age of the sample was 33.7 (8.4) years. Patterns of substance use, comorbid psychopathology, overall health status, alcohol and other drug withdrawal symptoms, and psychological and physical consequences of alcohol and other drug use were examined. RESULTS: Male and female subjects reported similar experiences with alcohol-related health problems, including symptoms of withdrawal and the psychological and physical consequences of chronic alcohol abuse. However, women were significantly more likely to have lifetime diagnoses of major depression and cocaine dependence, whereas men were more likely to have lifetime diagnoses of antisocial personality disorder and marijuana dependence. Women reported a lower overall health status, more medication use and pain complaints, and more negative consequences of cocaine abuse and withdrawal than did men. CONCLUSIONS: Both men and women within this sample of inpatient alcohol-dependent Alaska Natives were found to have a similar early onset and rapid progression to DSM-III-R alcohol dependence, and to report a similar prevalence of alcohol-related psychological and physical problems. Reports by women of more pain symptoms, more medication use and more negative health consequences related to their cocaine abuse, compared with men in this alcohol dependent sample, suggests additional considerations for treatment planning and intervention.

Adolescent↗
PubMed2004

Respiratory syncytial virus hospitalizations among American Indian and Alaska Native infants and the general United States infant population.

OBJECTIVE: To determine the burden of respiratory syncytial virus (RSV) disease among American Indian (AI) and Alaska Native (AN) infants, by examining RSV-associated hospitalizations. METHODS: Infant hospitalizations from 1997 through 2001 with RSV listed as a diagnosis were selected by using Indian Health Service/tribal hospital discharge data for AIs/ANs and National Hospital Discharge Survey data for the general US population. RESULTS: In 2000-2001, RSV disease was listed as a diagnosis for 14.4% of all AI/AN infant hospitalizations, with bronchiolitis attributable to RSV infection (12.2%) being among the top 5 listed diagnoses. The rate of RSV-specific hospitalizations was 34.4 hospitalizations per 1000 infants for AI/AN infants and 27.4 hospitalizations per 1000 births for the general US infant population. The hospitalization rates for AI/AN infants living in the Alaska and Southwest regions (70.9 and 48.2 hospitalizations per 1000 infants, respectively) were much higher than the overall rate for US infants. CONCLUSIONS: RSV infection is one of the leading causes of hospitalization among all infants in the United States, and AI/AN infants living in the Southwest and Alaska regions are at especially high risk for hospitalizations associated with RSV infection. Development of vaccines, antiviral agents, and other strategies to prevent RSV disease could yield substantial public health benefits.

Alaska↗
PubMed2005

Eimeria species (Apicomplexa: Eimeriidae) from arctic ground squirrels (Spermophilus parryii) and red squirrels (Tamiasciurus hudsonicus) in Alaska and in Siberia, Russia.

Fecal samples from arctic ground squirrels (Spermophilus parryii) collected in Alaska (n = 90) and Russia (n = 46) and from red squirrels (Tamiasciurus hudsonicus) in Alaska (n = 35) were examined for the presence of Eimeria spp. (Apicomplexa: Eimeriidae). Four species were recovered from arctic ground squirrels, including Eimeria callospermophili (prevalence = 18%), Eimeria cynomysis (23.5%), Eimeria lateralis (19%), and Eimeria morainensis (77%). A single species, Eimeria tamiasciuri (91%), was recovered from red squirrels. Eimerians recovered from arctic ground squirrels represent new host records, and the single species from red squirrels is a new geographic record. Alaskan arctic ground squirrel prevalence was higher for E. callospermophili (Alaska = 22% vs. Russia = 9%), E. cynomysis (34% vs. 2%), and E. lateralis (27% vs. 4%), but not E. morainensis (78% vs. 76%).

Alaska↗
PubMed2004

Concentrations of metals and trace elements in blood of spectacled and king eiders in northern Alaska, USA.

In 1996, we measured concentrations of arsenic, barium, cadmium, lead, mercury, and selenium in blood of adult king (Somateria spectabilis) and spectacled (Somateria fischeri) eiders and duckling spectacled eiders from northern Alaska, USA. Concentrations of selenium exceeded background levels in all adults sampled and 9 of 12 ducklings. Mercury was detected in all adult spectacled eiders and 5 of 12 ducklings. Lead concentrations were above the clinical toxicity threshold in one duckling (0.64 ppm) and two adult female spectacled eiders (0.54 and 4.30 ppm). Concentrations of cadmium and mercury varied between species; barium, cadmium, mercury, and selenium varied between sexes. In female spectacled eiders, mercury concentrations increased during the breeding season and barium and selenium levels decreased through the breeding season. Selenium declined at 2.3 +/- 0.9% per day and levels were lower in spectacled eiders arriving to the breeding grounds in northern Alaska than in western Alaska. The variation in selenium levels between breeding areas may be explained by differences in timing and routes of spring migration. Most trace elements for which we tested were not at levels currently considered toxic to marine birds. However, the presence of mercury and elevated lead in ducklings and adult female spectacled eiders suggests these metals are available on the breeding grounds.

Alaska↗
PubMed1993

Diabetes prevalence, incidence, and complications among Alaska Natives, 1987.

OBJECTIVE: To provide descriptive epidemiological data on diabetes mellitus among Alaska Natives, including incidence, updated prevalence, and incidence rates of ESRD, LEA, MI, and stroke in the diabetic population. RESEARCH DESIGN AND METHODS: In IHS and tribal contract hospitals and clinics throughout Alaska, Alaskan Indians, Eskimos, and Aleuts living in Alaska with documented diabetes mellitus were studied from 1986 to 1987. RESULTS: The number of diabetic patients increased from 610 to 708, and the prevalence changed from 15.7 to 17.4/1000 (not a statistically significant increase). Incidence rates per 10,000 diabetic person-yr for complications were 38 for ESRD, 69 for LEA, 92 for MI, and 92 for stroke. CONCLUSIONS: The prevalence of diabetes mellitus increased during the period of observation, but not to a statistically significant degree. Incidence rates for diabetes are lower than for the U.S. general population, but complications rates are as high as those in other diabetic populations.

Alaska↗
PubMed1993

Prevalence of diagnosed diabetes among American Indians and Alaska Natives, 1987. Estimates from a national outpatient data base.

OBJECTIVE: To estimate the prevalence of diagnosed diabetes among American Indians and Alaska Natives served by the IHS. RESEARCH DESIGN AND METHODS: This was a cross-sectional study of the 1987 IHS national outpatient data base. RESULTS: Prevalence rates of diagnosed diabetes determined from the IHS outpatient data base were consistent with recent studies of diabetes in different IHS areas. IHS-wide, age-adjusted prevalence was 69/100,000, or 2.8 times the U.S. rate. There was considerable variation in prevalence rates of diabetes throughout the country, with rates ranging from 15.3/100,000 in Alaska to 119.2/100,000 in southern Arizona. CONCLUSIONS: This study documented the high prevalence of diabetes among American Indians and Alaska Natives and the wide variation in rates between different tribal groups. This study also demonstrated the feasibility of using an outpatient data base to estimate rates of disease that have uniform methods of diagnosis and result in frequent clinic visits.

Age Factors↗
PubMed1983

Alcohol and alcoholism in Alaska: research in a multicultural and transitional society.

Working and living in Alaska, where social and cultural transitions are taking place, allows one the opportunity to reflect on the methods and procedures involved in one's discipline and/or research orientation. This article thus provides a review of what is happening in Alaska with respect to alcohol use by Alaska Natives and reflects on the issues involved when traditional cross-cultural research procedures are followed. Questions are also raised concerning what the focus of research might be, and suggestions for more culturally relevant research are advanced.

Adult↗
PubMed2003

Employment retention of health care providers in frontier areas of Alaska.

OBJECTIVES: The objectives of this study were to: describe the length of employment of health care providers in rural Alaska; assess whether there are differences in length of employment among community health aides, medical doctors, and nurses; and determine whether provider length of employment is significantly increased following implementation of telemedicine. STUDY DESIGN: We conducted a prospective cohort study of length of employment among health professionals in rural Alaska, and identified the cohort based on current employment status of community health aides, medical doctors, and nurses. METHODS: Employment data were collected from four Alaska Native regional health corporations. Kaplan-Meier product-limit survival analysis was used to assess employment length. The Mantel-Haenszel log-rank test was used to test the difference between retention (survival) curves among doctors, nurses, and community health aides for all four regional health corporations combined. Data included provider hire date, termination date, and position title. Fifty seven percent of the data points were right-hand censored. RESULTS: The community health aides (median (Mdn) = 1186 days) were retained significantly longer than either the doctors (Mdn = 596 days), or the nurses (Mdn = 408 days), who were not significantly different from each other (log-rank chi2 (2, N = 996) = 68.30, p = 0.0001). CONCLUSIONS: Our findings document that community health aides in the region retain their jobs significantly longer than doctors and nurses. Findings highlight the problem of providing an adequate health work force in rural areas.

Alaska↗
PubMed2005

Building a community-based participatory research center to investigate obesity and diabetes in Alaska Natives.

The Center for Alaska Native Health Research (CANHR) is a community-based participatory research project aimed at understanding current risk factors for obesity, diabetes, and cardiovascular disease in Alaska Natives living in Southwest Alaska. We utilize a multidisciplinary approach that includes assessment of genetic, nutritional and behavioral risk factors and their interrelationships with one another in the overall development of disease. The design of the CANHR project involved community participation in the development, implementation and interpretation of research results. We have developed a participatory research program that is designed to be culturally appropriate, relevant to community needs and interests, and respectful to our participants. This manuscript describes the organizational development of our CANHR study and the procedures employed in its progression to date.

Alaska↗
PubMed2006

Breast cancer among Alaska Native women potentially exposed to environmental organochlorine chemicals.

OBJECTIVES: To determine if an increased rate of breast cancer in Alaska Native women is related to their consumption of a subsistence diet that may contain p,p'-dichlorodiphenylethylene (DDE) and polychlorinated biphenyls (PCBs). STUDY DESIGN: A retrospective case control design. METHODS: We analyzed banked serum collected between 1981 and 1987 from 126 Alaska Native women, including 63 case women who subsequently developed breast cancer and 63 age-matched control women who remained cancer-free. Serum was analyzed for DDT, DDE, 13 other chlorinated pesticides, and 28 PCB congeners. RESULTS: The geometric mean for p,p'-DDE levels among case women was 8.67 ppb (95% Confidence Interval 7.48, 10.04); among control women, the geometric mean was 7.36 ppb (6.53, 8.30). The geometric mean for total PCB levels among case women was 4.55 ppb (3.61, 5.74) and for control women, the geometric mean was 6.10 ppb (4.73, 7.86). Cancer status and total PCB levels varied across ethnicity (i.e., Eskimo, Aleut, and Indian) but DDE levels were uniform among these ethnic groups. Using conditional logistic regression analysis to adjust for potential confounders (e.g., ethnicity, family history of breast cancer, parity), we found an odds ratio of 1.43 (0.46, 4.47) for the highest tertile of DDE exposure and 0.42 (0.07, 2.38) for the highest tertile of total PCB exposure. CONCLUSIONS: Although the results are limited by small sample size and restricted risk factor information, our findings of higher DDE levels, but lower PCB levels among women with breast cancer are consistent with previous research. Our results confirm exposure to organochlorines among Alaska Native women but do not identify these exposures as a significant risk factor for breast cancer.

Alaska↗
PubMed2006

Fetal and neonatal deaths and congenital anomalies associated with open dumpsites in Alaska Native villages.

OBJECTIVE: To determine if women living in Alaska Native villages with open dumpsites ranked as higher hazard have higher rates of adverse pregnancy outcomes than women living in villages with sites that have lower hazard rankings. Adverse pregnancy outcomes examined included fetal and neonatal death and congenital anomalies. STUDY DESIGN: A population-based retrospective cohort study. METHODS: Birth records from 1997-2001 were used to identify the 10,360 eligible infants born to mothers who resided in 197 Alaska Native villages with dumpsite rankings. Exposure variables were derived from hazard rankings of dumpsites. Covariates were obtained from both birth certificate information and village-specific characteristics. RESULTS: Neither crude, nor adjusted estimates detected a statistically significant difference in rates between exposure levels, although adjusted estimates were positive in all congenital anomaly categories, except gastrointestinal defects. Infants born to mothers residing in villages with high hazard dumpsite contents were more likely (RR=4.27; 95% CI: 1.76, 10.36) to have anomalies classified as other defects. Other hazard factors were not significant predictors for any of the adverse outcomes examined. CONCLUSIONS: This is the first study to evaluate fetal and neonatal deaths and congenital anomalies associated with open dumpsites in Alaska Native villages. Problems with the study include a population-based exposure measurement, small sample size, and biases related to birth record information. Future studies should include more comprehensive registries of congenital anomalies.

Alaska↗
PubMedDate not supplied

Iqmik: a form of smokeless tobacco used among Alaska natives.

OBJECTIVES: To describe a homemade form of smokeless tobacco known as Iqmik used among Alaska Natives residing in western Alaska. METHODS: Individual and small-group interviews were conducted with 23 adult Alaska Natives. The major themes from the interview data were summarized. A chemical analysis was conducted of the alkalinity of a sample of fungus ash used to prepare Iqmik. RESULTS: Few adverse health effects of using Iqmik were reported. The alkalinity of the sample of fungus ash was high (pH=10.9). CONCLUSION: The high alkalinity of Iqmik may contribute to the higher rates of tobacco use in this population.

Adolescent↗
PubMed1993

Alcohol and suicide in Alaska Natives.

A retrospective review of hospital records from the Alaska Native Medical Center, controlled for age, sex, and race, is presented for 33 Alaska Native suicide completers who died between 1980 and 1984. Suicide rates for Alaska Natives were twice the national average during the study period. The only significant differences between the suicide and control groups was the history of a prior suicide attempt (p 0.003). Alcohol abuse was diagnosed more often than any other psychiatric disorder in the suicide group and appears to be the most important antecedent of suicide in this study.

Alaska↗