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Objectives American Indian girls have higher teen pregnancy rates than the national rate. Intervention studies that utilize the Theory of Reasoned Action have found that changing attitudes and subjective norms often leads to subsequent change in a variety of health behaviors in young adults. The current study goal is to better understand sexual decision-making among American Indian youth using the Theory of Reasoned Action model and to introduce ways to utilize attitudes and subjective norms to modify risky behaviors. Methods The project collected qualitative data at a reservation site and an urban site through 16 focus groups with American Indian young people aged 16-24. Results Attitudes towards, perceived impact of, and perception of how others felt about teen pregnancy vary between American Indian parents and non-parents. Particularly, young American Indian parents felt more negatively about teen pregnancy. Participants also perceived a larger impact on female than male teen parents. Conclusions There are differences between American Indian parents and non-parents regarding attitudes towards, the perceived impact of, and how they perceived others felt about teen pregnancy. Teen pregnancy prevention programs for American Indian youth should include youth parents in curriculum creation and curriculum that addresses normative beliefs about teen pregnancy and provides education on the ramifications of teen pregnancy to change attitudes., Author(s): Elizabeth A. Dippel [sup.1] , Jessica D. Hanson [sup.1] , Tracey R. McMahon [sup.1] , Emily R. Griese [sup.1] , DenYelle B. Kenyon [sup.1] Author Affiliations: (1) Center for [...]

Byline: Kathleen R. Moum (1), Gregory S. Holzman (2), Todd S. Harwell (3), Sherri L. Parsons (1), Sandra D. Adams (1), Carrie S. Oser (3), Michael R. Spence (3), Steven D. Helgerson (2,3), Dorothy Gohdes (3) Keywords: diabetes mellitus; gestational diabetes mellitus; longitudinal studies; North American/Indian Abstract: Objectives: The purpose of this study was to assess trends in diabetes in pregnancy in American Indian and whites mothers in Montana and North Dakota. Methods: Montana and North Dakota birth records were utilized to assess trends in any diabetes in pregnancy in American Indians and whites from 1989 to 2000. Results: From 1989 through 2000, there were 133,991 and 102,232 births in Montana and North Dakota, respectively. The majority of mothers were American Indian (11%) or white (87%). The rate of any diabetes in pregnancy increased significantly in Montana Indian (3.1--4.1%, p = 0.04) and white mothers (1.8--2.6%, p &lt 0.001) from 1989--1991 to 1998--2000. The rate also increased significantly in white North Dakota mothers (1.6--3.2%, p &lt 0.001), but the increase in rate for Indian mothers in North Dakota did not reach statistical significance (3.8--4.8%, p=0.06) during this time period. In each time period, Montana and North Dakota Indian mothers were more likely than white mothers to have any diabetes in pregnancy. Conclusions: The rate of diabetes in pregnancy has increased in American Indian and white mothers. Thus public health programs are now facing an increasing number of women with a history of GDM at future risk of type 2 diabetes and an increasing number of offspring of diabetic pregnancies at risk for becoming overweight and developing type 2 diabetes at a young age. Author Affiliation: (1) North Dakota Diabetes Prevention and Control Program, North Dakota Department of Health, Bismarck, North Dakota (2) Department of Community Medicine, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota (3) Montana Diabetes Project, Montana Department of Public Health and Human Services, Helena, Montana Article History: Registration Date: 18/10/2004

Focus group interviews were conducted to explore sociocultural, environmental, and policy-related determinants of physical activity among sedentary American Indian women. Thirty women aged 20 to 50 years (mean = 37.4 [+ or -] 10.6 years) participated. Three sessions were conducted with women aged 20 to 34 years and three with women aged 35 to 50 to evaluate response differences by age. Because no obvious age differences were observed, data were pooled. Barriers to physical activity included inadequate support for household and child care responsibilities and difficulties balancing home-related and societal expectations with physical activity. In addition, women reported little support from their communities and work sites to be physically active. Environmental barriers included lack of safe outdoor areas and accessible walking trails. Weather and stray dogs were also commonly mentioned. Sociocultural barriers included giving family obligations priority above all other things, being expected to eat large portions of high-fat foods, and failing to follow a traditionally active lifestyle. Enablers of physical activity included support from family and coworkers and participation in traditional community events. Suggested intervention approaches included accessible and affordable programs and facilities, community emphasis on physical activity, and programs that incorporated the needs of larger women and of families. Participants emphasized a preference for programs that were compatible with the role expectations of their families and communities, and they expressed the desire for acceptance and encouragement to be physically active from the family, the community, the worksite, and their tribal leaders. KEYWORDS. American Indian, exercise, barriers, environment

This commentary presents an 'indigenist' model of Native women's health, a stress-coping paradigm that situates Native women's health within the larger context of their status as a colonized people. The model is grounded in empirical evidence that traumas such as the 'soul wound' of historical and contemporary discrimination among Native women influence health and mental health outcomes. The preliminary model also incorporates cultural resilience, including as moderators identity, enculturation, spiritual coping, and traditional healing practices. Current epidemiological data on Native women's general health and mental health are reconsidered within the framework of this model.

The health status of female Alaskan natives is examined. The author maintains native Alaskan women have high incidences of smoking and drinking, consume high fat diets and are more likely to be obese than other women in the United States, and have high rates of diabetes, and argues that more research should be conducted in order to establish effective intervention programs.

This article discusses Native American women and their intentions to get Pap tests. The author maintains intentions to get pap tests depended on factors such as educational level, marital status, income, and beliefs regarding cancer.

This article discusses the social and economic aspects influencing Native American women's vulnerability to HIV infection and AIDS. Topics include the relationships between poverty, powerlessness, sex role, social role, and disease.

Objectives. This study examined the implications of annual screening mammography for cost and mortality in American Indian populations with differing baseline breast cancer rates. Methods. A decision tree compared annual screening mammography and screening clinical breast examination with referral for diagnostic mammography when appropriate. The decision tree was constructed to examine the effect of different baseline cancer rates, stage at diagnosis, and stage-specific survival. Outcomes included 5-year relative survival, deaths prevented at 5 years, cost per death prevented, and total costs. Results. The findings suggest that the total cost of breast cancer is 3.6 times higher with the screening mammography program but results in a 27.9% reduction in breast cancer deaths over the first 5 years of the program. Both costs and deaths prevented are sensitive to the incidence of breast cancer in the population and are less favorable in the range of incidence seen in American Indians. Conclusions. The cost and impact of a given strategy for cancer screening vary among communities with different disease incidence, stage at diagnosis, and stage-specific survival, as seen in American Indian populations. (Am J Public Health. 1994;84:1631-1636), The cost and mortality rates affected by breast cancer screening programs may differ according to a population's disease characteristics. A decision tree analysis of the impact of annual screening mammography in the American Indian population revealed that the total cost of breast cancer may be 3.6 times higher with the screening program. It may result in a 28% decrease in breast cancer deaths in the first five years of the program. American Indian women experience breast cancer at 20% to 70% of the general US rate. They may be diagnosed at more advanced stages of cancer and their stage-specific survival rate is lower than that of non-Indian women. The cost of the screening program would exceed the cost of cancer care by $124,857 over 15 years. The mortality reduction would be small, since only 1.22 women over age 50 out of 13,620 women would be expected to die of breast cancer in a five-year period. Some deaths might be prevented through combinations of screening and medical management of patients.

DESPITE A PRECIPITOUS FALL during the past three decades, infant mortality for American Indians and Alaska Natives (AI) continues to exceed that for the general population (1, 2). Although in […]

CANCER IS THE THIRD LEADING cause of death among American Indians, with a 1987 mortality rate of 83 per 100,000 population [1]. Compared with rates for whites, the American Indian […]

Although the benefits of mammography are well established, many remain skeptical of the value of mammography for American Indian women. This skepticism stems in part from a belief that breast cancer is too rare an event among American Indians to warrant widespread screening. The validity of this assumption for Northern Plains Indians is challenged by a discussion of the limitations of available data on breast cancer in American Indian populations (including lack of generalizability, underestimation, and an overreliance on relative rather than absolute measures of cancer incidence) and by findings from the Minnesota Breast and Cervical Cancer Control Program, a federally funded program providing free breast and cervical cancer screening to American Indian and other women in Minnesota. In light of this information, the authors recommend that the low priority of mammography for American Indian women be reconsidered. (Am J Public Health. 1997;87:1100-1102)

The risk factors for overweight among Amerindian children and their mothers are analyzed using the data collected in 15 Amerindian riverside communities from the Beni River (Bolivia). It is found that body mass index is moderately related to anthropometric indices of body composition in children but highly correlated with fatness in mothers and the risk of overweight is not associated with environmental factors in children.

A young Indian woman entered Dr. Connie Pinkerton-Uri's Los Angeles office on a November day in 1972. The twenty-six-year-old woman asked Dr. Pinkerton-Uri for a "womb transplant" because she and […]

KARI E. NORTH [1,2] JEAN W. MACCLUER [1] LINDA D. COWAN [3] BARBARA V. HOWARD [4] Abstract The fertility of a large sample of American Indian women participating in the [...]

Illuminating the diversity and sociocultural specificity of women's experiences may be important if healthy lifestyles and quality of life are to be achieved. The incidence of cardiovascular disease linked to physical inactivity is high among African American and American Indian women. If more is understood about the experience of physical activity involvement, healthier living might be encouraged. Therefore, the purpose of this study was to explore the sociocultural meanings of physical activity for older (over the age of 40 years) African American and American Indian women who participated in the Cross Cultural Activity Participation Study (CAPS). Through qualitative in-depth interviews, we explored how sociocultural perspectives are related to perceptions about physical activity. Gender and other sociocultural factors influenced physical involvement on a continuum from negligible to significant. Both groups interviewed showed evidence that opportunities for physical activity in their free time did not always exist for them. For African American women, history and daily living issues were important factors limiting their involvement. Marginality limited American Indian women, but their cultural pride was often a source of physical activity. The juxtaposition of cultural and personal values emerged as a determinant of physical activity involvement among the women in this study. A further expansion of cultural and personal life situation perspectives is recommended to help understand the complex dimensions of physical activity as it relates to healthy living. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Website: ] KEYWORDS. African American, American Indian, physical activity, constraints, leisure, culture, race

Using 1990 National MCH Objectives To Assess Health Status and Risk in an American Indian Community Synopsis The authors used data from birth records to assess changes in health risks […]

Background: The etiology of pre-eclampsia (PE) is unknown; but endothelial dysfunction has been hypothesized to play a role since at least the early 1990's. (1) A hallmark of endothelial function [...]