Assessing Need across Provider and Community Member Dimensions in an Urban American Indian Center.

Abstract

A needs assessment of American Indian and Alaska Native (AI/AN) community members and providers of an American Indian Health and Family Services Center in Southeast Michigan was conducted to identify health needs with an emphasis on traditional Native healing. The first study in this three-paper project includes qualitative material from interviews of community members (N = 27; age 12-82) and service providers (N = 11; age 26-70). Three overarching themes resulted from both coding methods. Theme one indicated a need to include services that relate to the mind, body, and spirit. Respondents emphasized that the path to wellness includes physical, spiritual and mental health and that traditional healing can restore the imbalance that occurs from addiction, physical illness, and stress. Theme two emphasized traditional healing as a complement to Western medicine. Theme three highlighted the uses of traditional healing on a continuum in which health issues for which Western medicines are appropriate, health issues for which traditional medicines are better (e.g. treating addictions), and those situations for which a combination of both is ideal. In the second study talking circles (N = 9 groups; N = 73 participants; age 12-77), a traditional method of group communication in Native communities were conducted. Resulting themes were: 1) barriers to treatment: a) need for specialty services, b) lack of knowledge of services, and c) limited transportation; and 2) a request for culturally relevant youth services. The third study is a secondary analysis of data collected regionally from AIs/ANs (N =389; age 18-65+) by the Bemidji Area Office of Indian Health Service to identify health needs. Logistic regression indicated that participation in traditional services was associated significantly with ages 45-54; having received healthcare services in the past 12 months; wanting to see more traditional healing, health, and wellness; discrimination in healthcare settings; and knowing somebody with an addiction. This dissertation emphasizes the role that traditional healing occupies in the lives of AI/AN consumers and service providers of an urban Indian health center and serves to highlight the need to utilize both traditional Native healing and Western oriented treatment when providing services to urban AIs/ANs.