title: Staying connected: a feasibility study linking American Indian and Alaska Native trauma survivors to their tribal communities.
abstract: The objective of this investigation was to assess the feasibility of a culturally tailored care management intervention for physically injured American Indian/Alaska Native (AI/AN) patients. The intervention was initiated at a Level I trauma center and aimed to link AI/AN patients to their distant tribal communities. Thirty AI/AN patients were randomized to the intervention or to usual care. Assessments at baseline, 3 months, and 6 months included self-reported lifetime cumulative trauma burden, Native healing requests, and symptoms of posttraumatic stress, depression, and alcohol use. Generalized estimating equations ascertained differences between groups over time. Ninety-four percent of eligible patients participated; follow-up at 3 and 6 months was 83%. Participants had high numbers of lifetime traumas (mean = 5.1, standard deviation = 2.6). No differences between the intervention and control groups were observed in posttraumatic stress symptoms, depression symptoms, or alcohol use at baseline or follow-up time points. Among intervention patients, 60% either requested or participated in traditional Native healing practices and 75% reported that the intervention was helpful. This effectiveness trial demonstrated the feasibility of recruiting and randomizing injured AI/AN patients. Future efforts could integrate evidence-based interventions and traditional Native healing into stepped collaborative care treatment programs.
authors.affiliation: Partnerships for Native Health, Department of Medicine, University of Washington School of Medicine, Seattle, USA. utsosie@uw.edu
authors.forename: Ursula
authors.initials: U
authors.lastname: Tsosie
authors.forename: Sweetwater
authors.initials: S
authors.lastname: Nannauck
authors.forename: Dedra
authors.initials: D
authors.lastname: Buchwald
authors.forename: Joan
authors.initials: J
authors.lastname: Russo
authors.forename: Sarah Geiss
authors.initials: SG
authors.lastname: Trusz
authors.forename: Hugh
authors.initials: H
authors.lastname: Foy
authors.forename: Douglas
authors.initials: D
authors.lastname: Zatzick
mesh_terms: D000328:Adult; D000413:Alaska; D000428:Alcohol Drinking; D003863:Depression; D029221:Faith Healing; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management; D012111:Residence Characteristics; D013313:Stress Disorders, Post-Traumatic; D017741:Survivors; D014947:Wounds and Injuries / Q000523:psychology*