184012 Facing Cancer Care: Unique experiences of American Indian and Alaskan Natives

Monday, October 27, 2008

Brenda Seals, PhD, MPH , Native American Cancer Research Corporation, Lakewood, CO
Linda Burhansstipanov, DrPH , Native American Cancer Research Corporation, Pine, CO
Alice A. Bradley, MA , Bradley Consulting Group, Colorado Springs, CO
Linda U. Krebs, PhD, AOCN, FAAN , College of Nursing, University of Colorado Denver, Aurora, CO
Rosa Molina , Native American Cancer Research, Lakewood, CO
Rick Clark , Native American Cancer Research, Pine, CO
  
Purpose: In the United States, American Indians and Alaskan Natives (AIAN) face increasing rates of cancer, particularly in Alaska and the North and South Plains. Yet many AIAN face unique challenges resulting in health disparities such as struggles with long delays between screening and treatment, much of which may be due to displacement from usual care for those who move off of the reservations or those living within reservations where cancer care is not prioritized and resources are few. Under these circumstances, coping with cancer care is suboptimal. Study Design: Native American Cancer Research sponsors a website where in-depth interviews are publicly available online (http://natamcancer.org/vignettes/vignettes.html). Text from 52 of these case histories was analyzed to reveal coping strategies and mental health concerns. Cases were selected that mentioned chemotherapy or other therapy, challenges and coping solutions. Results: AIAN cancer survivors were both middle aged and older and had a wide range of diagnoses. Survivors discussed: reactions of others, preparations for dying, difficulty getting quality care and fears. Common coping strategies were spirituality, support, becoming an advocate and learning to stand up for oneself. Family and friends had unique relationships with survivors that influence coping and mental health. Conclusions: Mental Health professionals serving those with chronic disease may neglect profound cultural issues that AIAN cancer survivors face including unique circumstances (reservation life, non-English speaking, and health care access). AIAN “borders” within the US border are critical for professionals to understand if AIAN affected by cancer are to receive quality mental health services.

Learning Objectives:
Identify mental health needs of AIAN affected by cancer. Recognize unique circumstances, resources and stressors for AIAN that influence coping and care. Implement programs to enhance cultural sensitivity with mental health and other health care providers around AIAN spirituality, health care preferences and mental health needs. Discuss policy implications of AIAN health care needs given urban populations, under and uninsured, and Indian Health Services.

Keywords: Mental Health, American Indians

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: NRSA Post-Doctoral Fellow at CDC and Emory University PhD, Univ. of Iowa (Family Sociology and Statistics, focus Family Therapy) MPH, Emory University (Behavioral Epidemiology, focus HIV/AIDS coping) MA, University of Iowa (Sociology, focus adolescence substance use) 2006-2008 Publications Wiggins, C, Perdue, D, Henderson, J, Bruce, M, Lanier, A, Kelley, J, Seals, B, Espey, D. In Press. Gastric cancer among American Indians and Alaska Natives in the United States, 1999-2004. Cancer. Elliott, JO, Seals, BF, Jacobson, MP. 2008. Osteoprotective Knowledge in a Multiethnic Epilepsy Population. Journal of Neuroscience Nursing, 40(1): 14-39. Seals, G, Seals, B. 2008. Standards for Education Experimenting with Academic Freedom: Alternatively Certified Urban Teachers Discuss “Success for All.” Review Journal of Philosophy and Social Science, 33(1, 2): 69-92. Elliott, JO, Seals, BF, Jacobson, MP. 2007. Use of the Precaution Adoption Process Model to examine predictors of osteoprotective behavior in epilepsy. Seizure, 16(5): 424-437. Hausman, AJ, Hanlon, A, Seals, BF. 2007. Social Capital as a Mediating Factor in Emergency Preparedness and Concerns about Terrorism. Journal of Community Psychology, 35(8): 1073-1083. Elliott, JO, Jacobson, MP, Seals, BF. 2007. Self-Efficacy, Knowledge, Health Beliefs, Quality of Life and Stigma in Relation to Osteoprotective Behaviors in Epilepsy. Epilepsy and Behavior, 9(3). Seals, BF, Burhansstipanov, L Satter, DE, Chia, YJ, M Gatchell, M. 2006. California American Indian and Alaska Natives Tribal Groups, Care Access and Utilization of Care. Journal of Cancer Education, 21(1): S15-21. Su, X., Ma, G., Seals, B., Tan, Y., Hausman, A. 2006. Breast Cancer Early Detection among Chinese Women in the Philadelphia Area. Journal of Women’s Health,15(5):488-500. 2007-2008 Published Peer-Reviewed Presentations: Seals, B, Burhansstipanov, L, Dignan, M, Krebs, L., Bradley, A. Gamito, E. 2008. Reaching Native Americans through Web-Based Cancer Education. Intercultural Cancer Conference, Biennial Symposium on Minorities, the Medically Underserved & Cancer. Washington, DC. Seals, B, Burhansstipanov, L, Dignan, M, Krebs, L, Gamito, E. 2008. Adherence to breast cancer rescreening guidelines among underserved women. Intercultural Cancer Conference, Biennial Symposium on Minorities, the Medically Underserved & Cancer. Washington, DC. Seals, B., 2007. Emergency Room Medical Providers: Mental Health Needs. American Public Health Association, Washington, DC. Seals, B., 2007. Mental Health Concerns of Car Accident Survivors. American Public Health Association, Washington, DC. Seals, B., Knorr, D. 2007. Mental needs and use of services reported by disaster response volunteers. American Public Health Association, Washington, DC. Seals, B., Bass, SB., Knorr, DL, Thomas, C. 2007. Pandemic Flu and Community Emergency Readiness. American Public Health Association, Washington, DC. Knorr, D., Seals, B. 2007. Unchartered Waters of the American Red Cross: Experiences of Volunteers deployed to the Gult Coast in 2005. Kruus, LK, Karras, DJ, Seals, B, Thomas, CR, Wydro, GC. 2007. Healthcare Worker Response to Disaster Conditions. Society for Academic Emergency Medicine. Chicago, IL. 2007-8 Unpublished Keynotes, Workshops, Presentations: Seals, B. 2008. Mapping the Future: Shaping Practice and Policy. Cancer, Culture & Literacy Conference. Clearwater Beach, FL. Seals, B. 2008. Cancer and Native Americans: New Opportunities and Barriers for Diagnosis, Treatment and Care. Wyoming Chronic Disease Conference. Little America, WY. Seals, B. 2008. Cultural Competency: Native American Outreach and Social Marketing. Interactive Workshop. Wyoming Chronic Disease Conference. Little America, WY. Seals, B. 2008. Native American Survivors Network: Program Beginning, Maintenance and Expansion. South Eastern Spirit of Eagles Conference. Savannah, GA Seals, B, Burhansstipanov, L. 2008. Community Based Participatory Research in American Indian country. Community Based Cancer-Control: A Seminar for American Indian and Alaska Native Community Health Advocates. Seattle, WA. Seals, B, Burhansstipanov, L. 2008. Building Relationships with Native American Populations. Cultural Competency Training for the Centers for Disease Control and Prevention, Atlanta, GA. Will be disseminated through the grant to states throughout the US. Seals, B. 2008. Providing Cancer Recruitment, Screening and Navigation for American Indians. Women’s Wellness Connection, Regional Meeting, Denver, CO. Seals, B. 2007. Native Communities and Cancer: A New Age for Diagnosis, Treatment and Care. Native Am. Health Summit. Univ. of Texas, MD Anderson Cancer Ctr. Houston, TX.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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