Spiritual Care within Oncology Care: Development of a Spiritual Care Program at an Indian Health Service Hospital

Spiritual care is essential in providing quality health care for patients and their families and is supported in the mission of the Indian Health Service (IHS). Their mission is to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level. This paper will describe the spiritual care programs at the Phoenix Indian Medical Center, an IHS hospital located in Phoenix, Arizona. Two hospital committees, the Volunteer Chaplains’ Association and the Traditional Cultural Advocacy Committee, provide spiritual care for the medical center and work to sustain a presence of spiritual and cultural awareness and well being. In this paper, particular attention is focused on the ways in which these committees have worked collaboratively with community agencies, tribes in Arizona, and academic institutions, through National Cancer Institute funded grants to raise awareness of how spiritual and cultural understandings of American Indians play an essential role in cancer care

Talking Glossary of Genomics Terminology: A Genomics Education Module for American Indian Communities

This paper describes the development of an audio visual genomics glossary that was designed as an education tool for American Indian communities. This “Talking Glossary of Genomics Terminology” is a multimedia DVD that was modeled on the “Talking Glossary of Genetics,” which was developed by the National Human Genome Research Institute (NHGRI). The NHGRI Glossary was modified and expanded with content designed to increase awareness among American Indians about cancer, genomics, and personalized medicine. Partners on the project include the Inter Tribal Council of Arizona, Inc., Phoenix Indian Medical Center, Arizona Cancer Center at the University of Arizona, the Translational Genomics Research Institute, as well as Arizona State University and University of Arizona graduate students

Cultural Relevance of the Transtheoretical Model in Physical Activity Promotion: Mexican-American Women’s use of the Processes of Change

Hispanic women in the U.S. have disproportionately high rates of obesity and health disparities related to insufficient physical activity (PA). While the Transtheoretical Model (TTM) is one of the most commonly used behavioral theories in interventions promoting PA, there is a lack of evidence to support the cultural relevance of theoretical constructs for increasing PA in Hispanic women. To learn about Hispanic women’s use and interpretation of the construct Processes of Change (POC) for increasing PA, we conducted focus groups with overweight/obese Mexican/Mexican-American females (N=13) ages 27-40 years. Major themes centered on the importance of children and family caretaking, social support, and PA to promote weight loss. Participants identified strategies they use to enact the POC for increasing PA such as retos (challenges), exercise as an alternative to eating, and clothing as a reward/reminder for PA. This study examined culture-specific factors used by Mexican-American women for becoming more physically active as they correspond to the theoretical constructs of the TTM. We showed that the POC examined in our study are culturally relevant and enacted by Mexican-American women for increasing PA, and are poised to be deployed in culturally appropriate PA promotion and weight loss interventions

“Visiting” Close Kin Abroad: Migration Strategies of the Serbian Roma

The Roma/Gypsies are the largest, poorest and youngest ethnic group in Europe. During the past decade, the Roma from Central and Eastern Europe were of considerable public concern due to a large inflow of Roma emigrants into Western European countries. Applications for international protection submitted by the Roma from the Western Balkans became a substantial part of the asylum case-load at the EU level. More recently, however, a new wave of migrants, mostly from Syria, Iraq and Afghanistan, has found its way to Europe. As Serbia is classified as a safe country, Serbian nationals have limited chances of being awarded refugee status. Nevertheless undeterred, the Serbian Roma/Gypsies continue to travel to and apply for asylum in Western European countries. Using data from original fieldwork conducted among Serbian Roma women, we argue that their desire to travel and possibly reside in one of the more affluent Western European countries is connected to the fact that they have extensive kinship ties in those counties. Kinship ties, in brief, explain much of current Roma migration practices

Сви срећни бракови личе један другом: брак и самопроцена здравља међу Ромима у Србији

We describe how self-rated health varies with gender, type of marriage (marriage of choice vs arranged marriage), and cultural traits among Serbian Roma. Data on 91 men and 113 women (self-reported health, demographics and family dynamics) were collected in 2016 in Roma communities in Belgrade, Serbia. Roma in arranged marriage differ on a number of variables in regard to Roma in marriage of choice but not in regard to self-rated health. Gender specific analyses revealed that arranged marriages appear adaptive for both males and females, but they seem to benefit the males and not females in terms of health. For Roma women, a non-subordinate status was the strongest predictor of relatively “good” subjective health. All healthy (happily married) Roma men are alike in that they think they have subordinate wives and all healthy (happily married) Roma women are alike in that they think they are non-subordinate to their husbands.У овом раду испитујемо како самопроцена здравља варира у односу на пол, тип брака (брак по избору у односу на уговорени брак), и културу у популацији српских Рома. Подаци су прикупљени 2016. у ромским насељима у околини Београда (испитани 91 мушкарац и 113 жена), и обухватају самопроцену здравља, демографију и породичне односе. Самопроцена здравља се не разликује по типу брака, али постоје значајне разлике између Рома који живе у уговореном браку и Рома који су сами бирали брачне партнере. Уговорени бракови су адаптивни за оба пола, и доприносе бољем здравственом статусу мушкараца, али не и жена. За ромске жене, неподређени статус у браку је најважнији предиктор доброг здравља. Сви здрави (срећно ожењени) ромски мушкарци су слични по томе што мисле да имају подређене жене, а све здраве (срећно удате) Ромкиње су сличне по томе што сматрају да нису подређене својим мужевима.Тема броја: Род и ред. Родни режими у култури – кроз историју и данас (ур. Лада Стевановић) / Topic of Issue: Gender and Order. Gender Regimes in Culture - Today and through History (ed. Lada Stevanović

Узори у детињству и здравље ромских жена у Србији

We examine role model choice among Serbian Roma women and describe the relationships found among preferred role model type and socio-economic and health variables. Data were collected in 2015-2016 from 274 Roma women, averaging 55 years of age. Most often, Roma women chose female family members as role models, but some women also chose role models outside their ethic group. We discuss how the values of the two disparate role model choices, i.e., kin and non-kin, each with associated differences in underlying behavior, may be a critical component of influence on the Roma girls’ outcomes. Role models can have an effect on health, and in the case of Roma women, this effect is found in differential level of stress.У овом раду испитујемо узоре у детињству и током одрастања у популацији ромских жена и њихов утицај на каснији здравствени статус и социоекономске прилике. Током 2015. и 2016. године прикупљени су подаци од 274 жене, са просеком година 55. Као узор најчешће се бирају женски чланови уже и шире породице, али и жене ван сопствене етничке групе. У раду се разматра како вредности повезане са два различита избора узора, сродничког и несродничког, могу бити битна компонента која утиче на животне исходе ромских девојака. Узори су важни за развој личности и могу имати утицаја на здравље, а у случају ромских жена, могу утицати и на ниво стреса.Тема броја – Интердисциплинарне перспективе етнологије и антропологије (ур. Весна Трифуновић) / Topic of the Issue – Interdisciplinary Perspectives of Ethnology and Anthropology (ed. Vesna Trifunović

Pap Test Follow-up Pattern Among American Indian Women in Arizona

Objective: To quantify the loss to follow-up rate after abnormal Pap test results at the Phoenix Indian Medical Center, an Indian Health Service regional facility, and identify barriers to follow-up from the patients’ point of view. Materials and Methods: Patient records were used to identify women who had abnormal Pap tests in 2002 and to document the status of their follow-up care. Women who had no clinical record of follow-up were contacted by telephone to arrange a follow-up appointment and to request participation in a structured qualitative interview to identify barriers to follow-up at the individual, family, community, and health care system levels. Structured qualitative interviews were conducted with 15 women. Results: Of the 930 women with abnormal Pap test results in 2002, 11.1% received follow-up care at PIMC in accordance with the recommended time frame stipulated inclinical protocols; 74.6% received follow-up care at PIMC, but not in accordance with protocols; 2.6% were followed-up at another facility, 1% had moved out of the area, 3.5% were never treated, and we were unable to contact 6.6%. Most of the barriers to follow-up were related to communicating the need for follow-up and providing access to care within a time frame appropriate for clinical care. Conclusion: While these findings place an important additional responsibility and burden on the health care system serving American Indian women, our research outreach efforts suggest that given the availability of appropriate resources, these barriers can be overcome

The Words of Our Ancestors: Kinship, Tradition, and Moral Codes

In this paper we use the cross-cultural record to identify the behavioral rules of conduct, and the system supporting those rules, that are found in traditional societies, such as tribal societies. We then draw on the historical record to identify the behavioral rules of conduct, and the system supporting those rules that were found in the early state. The proposal tested here is that in traditional societies the behavioral rules of conduct and the systems that support them (e.g., processes for identifying guilt, punishing offenders, enacting legislation, preventing conflict) are aimed at promoting enduring, cooperative relationships among individuals who are identified as kin through common ancestry. The assumption underlying this proposal is that once human females increased their investment in offspring, cultural strategies to protect those offspring became more important. A moral system, which is the term we use to refer to the early system of behavioral codes, protected offspring by turning conspecific threats into the protectors, providers, and educators of children. It did this by creating a strong kinship system, the members of which were bound by common ancestry (actual or metaphorical), thus tying individuals into enduring, cooperative relationships by using culture to encourage them to honor ongoing duties to one another. This kinship-based moral system is significantly different from that found in societies in which the majority of interactions are with non-kin, interactions often center on the exchange of good and services, and traditions have largely been broken down. We refer to this second system as a system of law and argue that this distinction between moral and legal systems has implications for attempts to explain the evolutionary basis of human cooperation