title: Providing culturally competent services for American Indian and Alaska Native veterans to reduce health care disparities.
abstract: OBJECTIVE
  We conducted an exploratory study to determine what organizational characteristics predict the provision of culturally competent services for American Indian and Alaska Native (AI/AN) veterans in Department of Veterans Affairs (VA) health facilities.
  
  
  METHODS
  In 2011 to 2012, we adapted the Organizational Readiness to Change Assessment (ORCA) for a survey of 27 VA facilities in the Western Region to assess organizational readiness and capacity to adopt and implement native-specific services and to profile the availability of AI/AN veteran programs and interest in and resources for such programs.
  
  
  RESULTS
  Several ORCA subscales (Program Needs, Leader's Practices, and Communication) statistically significantly predicted whether VA staff perceived that their facilities were meeting the needs of AI/AN veterans. However, none predicted greater implementation of native-specific services.
  
  
  CONCLUSIONS
  Our findings may aid in developing strategies for adopting and implementing promising native-specific programs and services for AI/AN veterans, and may be generalizable for other veteran groups.
authors.affiliation: The authors are with the Department of Veterans Affairs Office of Rural Health, Veterans Rural Health Resource Center-Western Region, Native Domain, and the Centers for American Indian and Alaska Native Health, School of Public Health, University of Colorado, Denver.
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Noe
authors.forename: Carol E
authors.initials: CE
authors.lastname: Kaufman
authors.forename: L Jeanne
authors.initials: LJ
authors.lastname: Kaufmann
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Brooks
authors.forename: Jay H
authors.initials: JH
authors.lastname: Shore
mesh_terms: D003142:Communication; D054521:Cultural Competency; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D007198:Indians, North American; D004930:Inuit; D007857:Leadership; D009936:Organizational Innovation; D015397:Program Evaluation; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*; D014728:Veterans; D058014:Veterans Health
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