Public insurance reforms of the past two decades have failed to substantively address the healthcare needs of American Indians in general, let alone the particular needs of American Indian elders, ages 55 years and older. It’s essentially on top of a hill. Health Promot Pract. It’s a layered answer that involves lack of education, poverty and a history of discrimination Native Americans face when seeking out health services. “We tried to be conscious of colors and other things that are of value to them,” VandenBussche adds. In: Mio JS, Iwamasa GY, editors. Aarons GA, Hurlburt M, Horwitz SM. The model responds to the National Action Plan to Improve Health Literacy and calls from the Agency for Healthcare Research and Quality for patient navigators to help surmount health literacy challenges in complex healthcare systems [87, 88]. 2014;15(3):448–54. After completion of the semi-structured interviews, we will use the same strategies to recruit 48 AIEs who can read in English to participate in the remaining CM exercises (described below). This will result in a two-dimensional visual representation of the location of each statement relative to other statements. The interview will measure perceived competence and confidence in sharing information regarding AI rights, coverage options, and health care with AIEs and their families, undertaking informational outreach with and providing resources to staff/providers, and creating social spaces within which community stakeholders can spearhead policy- and system-level discussions about AIE healthcare coverage and access. Kroskrity PV. 2003;9(7):502–9. “We thought about developing flexible spaces, so if services change over the years, it’s easy to adapt that space,” VandenBussche says. Health literacy is influenced by culturally-based beliefs and communication styles, English proficiency, and experiences of bias in healthcare settings [43]. Hyattsville: National Center for Health Statistics, Centers for Disease Control and Prevention; 2013. Trochim WM, Cabrera DA, Milstein B, Gallagher RS, Leischow SJ. Participants will first complete the “American Indian Elder Health Questionnaire” (AIEHQ), based on four surveys administered among AIEs across the country, thus providing a comparison between our NM sample and national multiethnic datasets [64]. 2002;92(4):598–610. In: Facilitating state health exchange communication through the use of health literate practices: workshop summary. Gone JP. With more than 1.2 million, or nearly a quarter, of AIs without healthcare coverage in 2011, lack of insurance is implicated in these disparities [14]. For example, the ACA included the reauthorization of the Indian Health Care Improvement Act (IHCIA) of 1976 along with specific language to “modernize” IHS and tribally-run 638 programs. Final concept maps and labels will be presented to the Advisory Board for approval, and then used to empirically assess (via t-tests) the extent to which demographic characteristics influence the rankings of each concept cluster (e.g., importance or feasibility of addressing specific issues). Concept mapping for planning and evaluation. The remaining CM exercises of pile-sorting and ranking will take place at a later date to reduce the possibility of participant fatigue, and last between 45 and 60 min [78,79,80]. Miranda J, Duan N, Sherbourne C, Schoenbaum M, Lagomasino I, Jackson-Triche M, et al. Geographic areas with high concentrations of AIs also have significant disparities in access to and use of health services, and particularly preventive care, such as cancer screening [20]. Trochim WM, Milstein B, Wood BJ, Jackson S, Pressler V. Setting objectives for community and systems change: an application of concept mapping for planning a statewide health improvement initiative. Use of the guide increases the comparability of responses and affords discretion to follow up on new or unexpected information. Data from this study will be used to develop standalone publications that will inform Tribes and states about the factors that possibly exacerbate or help ameliorate the disparities that persist among AIEs at multiple levels (per the SEM). After training, the AIE Navigators will implement the AIEONG in the context of their everyday outreach work with AIEs over two six-month intervention periods (P1 and P2). At the end of P2, we will use list sampling to recruit 48 AIEs and 48 healthcare staff/providers to participate in focus groups. ASPE issue brief - health insurance marketplace: summary enrollment report for the initial annual open enrollment period. Native American Heritage Month. Where possible, we will conduct descriptive comparisons that assess for differences between our study and AI and non-AI samples from other external studies that use the same questions. Landen M, Roeber J, Naimi T, Nielsen L, Sewell M. Alcohol-attributable mortality among American Indians and Alaska Natives in the United States, 1999-2009. Smedley BD, Stith AY, Nelson AR. The researcher and the AIE Consultant will compile comprehensive field notes in English during and immediately after such interviews. The self-described “health care cooperative” promised a shield against … Successful research with AIEs requires the full involvement and engagement of the focal community, which is a central tenet of our participatory research approach. The groups will comprise six to eight participants. This community-driven study features a mixed-method, participatory design to examine help-seeking behavior and healthcare experiences of American Indian elders in New Mexico, in order to develop and evaluate a tailored intervention to enhance knowledge of, access to, and use of insurance and available services to reduce healthcare disparities. New York, NY: Free Press; 2003). New Mexico Department of Health and Human Services. Handbook for team-based qualitative research. Based on implementation models such as CFIR and EPIS, the following characteristics are critical to intervention uptake: relative advantage over education/outreach activities as usual, compatibility with pre-existing navigation system, complexity or difficulty to learn, trialability or testability, organizational support, and observed effects (Rogers E: Diffusion of Innovations (5th ed.). Kane M, Trochim WMK. 1995;17(1):89–113. Blair T, Minkler M. Participatory action research with older adults: key principles in practice. After the participant has created piles by grouping the statements, the researcher will ask the participant to describe the reasons for these choices and label each pile with a theme (e.g., “Transportation”).
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