People's Clinic: A health education partnership with North Carolina American Indian communities

Background. North Carolina (NC) is home to nearly 100,000 American Indians, and the state recognizes eight tribes (two of which also receive federal recognition). American Indians in NC are more likely than whites to die from cardiovascular disease, diabetes, renal disease, HIV/AIDS, motor vehicle injuries, and homicide. Non-conventional health education is essential in reducing these disparities. Objectives. The People's Clinic is a health education collaborative that provides scientifically sound, relevant, and understandable health information to minority communities across NC. Methods. Researchers met with the NC Commission of Indian Affairs to obtain approval and support for the project and forged partnerships with six NC tribes. Focus groups with tribal gatekeepers determined how best to meet the health education needs of these communities. The study team composes articles for local news magazines, tribal newsletters, and church bulletins, and pamphlets and public service announcements are created and distributed. Results. Focus groups determined that partnering with local churches is the best way to reach Indian communities. Themes from the groups included limited access to care, health insurance, and resources; lack of trust of outsiders and of the health field in general; health issues among children; and concerns about discrimination. Process evaluation revealed that the communities like the messages and find them useful. Conclusion. The People's Clinic has partnered with American Indian communities across NC to provide culturally appropriate health information. The communities served have widely accepted the materials produced through these partnerships. This collaborative model of health education is replicable in other minority communities.