Using the American Indian and Alaska Native oral tradition to record family health history

Background

American Indians and Alaska Natives (AI/AN) have used storytelling for generations to convey history and culture. Stories about family members, events, and lessons learned are key components of knowledge transfer. Health care providers have also used a form of storytelling; the family medical history. Unfortunately, these important and similar purposed storytelling processes are not inclusive of each other. Stigma exists in revealing personal health information in communities and families, and fears of discrimination make it difficult to discuss health issues. Individuals are unaware of the value of this information in preventing health problems and helping health professionals provide better care.

Objective

Evaluate the use of a Family Health History Awareness Tool by urban AI/AN, so that the tool is understandable by community members and useful to providers, as measured by successful dissemination and community acceptance.

Methods

A Community Advisory Board (CAB) was developed to guide the project and ensure all research procedures are respectful of privacy and community norms and values. Five diseases that disproportionally affect AI/AN families were included in the tool: heart disease, cancer, diabetes, cirrhosis, and depression. Using Social Learning Theory, urban AI/AN shared family health history stories and assessed whether the tool effectively captured meaningful risk information.

Findings

We discuss methods for using the tool in urban AI/AN communities and provide ideas on how AI/AN communities can help families record and recount their family health histories using this Native-specific tool. Storytelling is an important step in addressing health disparities.