Online Program

Developing cultural enhancements for a home visiting program based in an urban Indian community

Tuesday, November 5, 2013 : 3:30 p.m. - 3:50 p.m.

Katherine Hess, MPH, Ina Maka Family Program, United Indians of All Tribes Foundation, Seattle, WA
Myra Parker, J.D, PhD, Center for the Study of Health and Risk Behavior, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
Background: King County, WA is home to over 39,000 American Indian / Alaska Natives (AIAN). Urban Indian families prioritized the following issues in a community needs assessment: employment, anti-poverty efforts, and culturally-appropriate services. Countywide data supports these priorities: AIAN children under 5 live in poverty at a rate 3.5 times the rate for all races in King County and the AIAN unemployment rate is almost 2 times the rate of all races. Infant mortality and the teen birth rate are about 3 times higher among AIAN women than for all races. Qualitative focus group data demonstrated the need and importance of incorporating AIAN cultures into home visitation services for AIAN families. Families provided a variety of culturally appropriate services that could be included. Methods: Eighty community members participated in twelve Talking Circles (focus groups) and provided feedback on potential cultural enhancements: assessment tools, Elder participation, culturally-relevant materials and incentives, culturally meaningful activities, and historical trauma. Results: Identified specific, culturally acceptable methods of integrating key cultural constructs into program elements, including building relationships with elders and maintaining connections to cultural activities. Confirmed the interest and need to address historical trauma. Established regular and sustainable method of collecting community input on key cultural programmatic issues. Conclusions: Developed replicable framework for cultural enhancement development in an evidence-based social service program and established qualitative methodology to identify culturally-relevant commonalities among diverse Urban Indian populations. We anticipate improving program retention among a hard-to-reach population based on a culturally tailored program.

Learning Areas:

Diversity and culture
Implementation of health education strategies, interventions and programs
Program planning

Learning Objectives:
Describe the cultural issues relevant to urban AIAN specific cultural enhancements. Formulate an approach for identification of culturally appropriate enhancements to evidence based interventions. Discuss programmatic benefits to developing cultural enhancements through CBPR.

Keyword(s): Cultural Competency, American Indians

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the program manager and community researcher for an Urban Indian organization. Among my responsiblities is evidence-based, culturally-enhanced program development.
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.