Assessing Need across Provider and Community Member Dimensions in an Urban American Indian Center.

A needs assessment of American Indian and Alaska Native (AI/AN) community members and providers of an American Indian Health and Family Services Center in Southeast Michigan was conducted to identify health needs with an emphasis on traditional Native healing. The first study in this three-paper project includes qualitative material from interviews of community members (N = 27; age 12-82) and service providers (N = 11; age 26-70). Three overarching themes resulted from both coding methods. Theme one indicated a need to include services that relate to the mind, body, and spirit. Respondents emphasized that the path to wellness includes physical, spiritual and mental health and that traditional healing can restore the imbalance that occurs from addiction, physical illness, and stress. Theme two emphasized traditional healing as a complement to Western medicine. Theme three highlighted the uses of traditional healing on a continuum in which health issues for which Western medicines are appropriate, health issues for which traditional medicines are better (e.g. treating addictions), and those situations for which a combination of both is ideal. In the second study talking circles (N = 9 groups; N = 73 participants; age 12-77), a traditional method of group communication in Native communities were conducted. Resulting themes were: 1) barriers to treatment: a) need for specialty services, b) lack of knowledge of services, and c) limited transportation; and 2) a request for culturally relevant youth services. The third study is a secondary analysis of data collected regionally from AIs/ANs (N =389; age 18-65+) by the Bemidji Area Office of Indian Health Service to identify health needs. Logistic regression indicated that participation in traditional services was associated significantly with ages 45-54; having received healthcare services in the past 12 months; wanting to see more traditional healing, health, and wellness; discrimination in healthcare settings; and knowing somebody with an addiction. This dissertation emphasizes the role that traditional healing occupies in the lives of AI/AN consumers and service providers of an urban Indian health center and serves to highlight the need to utilize both traditional Native healing and Western oriented treatment when providing services to urban AIs/ANs.PHDPsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/93949/1/jfarrahm_1.pd

Correlates of Motivational Interviewing Use Among Substance Use Treatment Programs Serving American Indians/Alaska Natives

Motivational interviewing (MI) offers a treatment modality that can help meet the treatment needs of American Indians/Alaska Natives (AI/ANs) with substance use disorders. This report presents results from a national survey of 192 AI/AN substance abuse treatment programs with regard to their use of MI and factors related to its implementation, including program characteristics, workforce issues, clinician perceptions of MI, and how clinicians learned about MI. Sixty-six percent of programs reported having implemented the use of MI in their programs. In the final logistic regression model, the odds of implementing MI were significantly higher when programs were tribally owned (OR = 2.946; CI95 1.014, 8.564), where more than 50% of staff were Certified Alcohol and Drug Counselors (CADCs) (OR = 5.469; CI951.330, 22.487), and in programs in which the survey respondent perceived that MI fit well with their staff\u27s expertise and training (OR = 3.321; CI95 1.287, 8.569)