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.
Bouey
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The National Native American AIDS Prevention Center, 436 14th Street, Suite 1020, Oakland, CA 94612, USA. Paulbouey@nnaapc.org
Druan
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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