Data Capture Perspectives On Multi-dimensional Health Locus of Control (and other standardized instruments) and American Indian Health Outcomes

Introduction: There are many social and cultural covariates that influence health outcomes. The Multi-dimensional Health Locus of Control binary of internality and externality correspond to better and worse outcomes, respectively. In American Indian and Alaska Native communities the potential resistance to research participation often has to do with research results translating visible community improvement. Measurement and analysis of such social determinants of health may represent minimally invasive research questions that can result in community wide interventions, so it is imperative to capture them with as much accuracy and richness as possible.

Discussion: The Multi-dimensional Locus of Control and other psycho-social instruments demonstrate interesting variation in participants of the Strong Heart Study. There are some indications from participant responses that the questions in the instrument weren’t sufficient to capture some unique perspectives and realities in this population. A few are a) lack of non-native community comparison, self-reliance in rural setting, lack of access to health care not due to SES but to rural distances, and cultural resilience amongst many social and medical ailments. The literature so far does not demonstrate a validation of such instruments in this population. One criticism of helicopter research is that hypotheses are built on previous hypotheses, which in certain populations may become “stereotypes” without solutions. We argue that American Indian research may have a need for a cultural translation of such instruments with validation to move past health disparities.