The Ahalaya case-management program for HIV-infected American Indians, Alaska Natives, and Native Hawaiians: quantitative and qualitative evaluation of impacts.
The Ahalaya case management model was designed to provide culturally sensitive services to HIV-positive American Indians (AI), Alaska Natives (AN), and Native Hawaiians (NH). This program started in 1991 and expanded across the country in 1994. The evaluation plan included a client satisfaction survey, along with focus groups and key informant interviews. Of the 389 active clients enrolled, 132 responded to the anonymous 35-item questionnaire. Responses were favorable regarding benefits of the programs. Self-reported quality of life changes after enrollment also were significantly improved (Wilcoxon Signed Rank Test: T=6.87, p=.000; n=131). Qualitative data highlighted other important issues. Social relationships-with staff, community, and family-were critical to client welfare, as a source of both strength and fear. While AI/AN/NH case management programs have been shown effective, services need to expand, and they have to facilitate resolutions to problems in clients  social relationships.
The National Native American AIDS Prevention Center, 436 14th Street, Suite 1020, Oakland, CA 94612, USA. Paulbouey@nnaapc.org
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D000328:Adult; D000413:Alaska / Q000453:epidemiology; D001294:Attitude to Health; D019090:Case Management / Q000458:organization & administration*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000208:ethnology* / Q000523:psychology / Q000628:therapy*; D006254:Hawaii / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data; D008297:Male; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service / Q000592:standards